Urban-Rural Differences in the Prevalence of Coronary Heart Disease and Its Risk Factors in Delhi

By Chadha, S. L.; Gopinath, N. et al. | Bulletin of the World Health Organization, January-February 1997 | Go to article overview

Urban-Rural Differences in the Prevalence of Coronary Heart Disease and Its Risk Factors in Delhi


Chadha, S. L., Gopinath, N., Shekhawat, S., Bulletin of the World Health Organization


Introduction

Public health planning in most developing countries has focused mainly on problems related to communicable diseases, which have been responsible for high morbidity and mortality (1). The situation is different in developed countries, such as the USA, where coronary heart disease is the leading cause of death (2). However, with changing lifestyles in developing countries such as India? chronic and degenerative diseases, including coronary heart disease, are making an increasingly important contribution to mortality statistics, particularly in urban areas.

Over the last three decades, great progress has been made in identifying the risk factors for coronary heart disease. Some of the preventive measures, such as cessation of smoking? management of hypertension both by pharmacological and nonpharmacological means, control of diabetes, reduction in intake of dietary saturated fats, and early diagnosis and management of hypercholesterolaemia, have resulted in a significant decline in mortality from the condition in the industrialized world. Nevertheless, the disease continues to be the leading cause of death in many countries.

Coronary heart disease is considered to be an important public health problem not only in developed countries but increasingly in developing countries such as India. In 1959, the WHO Expert Committee on Cardiovascular Diseases and Hypertension (3) recommended that epidemiological surveys be conducted in as many countries as possible, in order to analyse the risk factors and to determine the prevalence of the disease in different countries. Over the past three decades a few such studies have been conducted in India, but the majority have been confined to hospital populations or used a sample size that was too small and/or nonrandomized, making it difficult to draw any valid conclusions.

Materials and methods

A community-based epidemiological study was conducted over the period 1984-87 on 13723 adults in the age group 25-64 years living in Delhi and 3375 living in rural areas about 50km away from the city, to determine the prevalence of coronary heart disease and its risk factors. The cluster sampling methodology, using a randomized house-to-house survey, and the criteria for diagnosis have been published elsewhere (4, 5). The study was supported by ECG examination and analysis of fasting blood samples for lipids in subjects with clinically detected coronary heart disease and asymptomatic adults free of clinically manifest disease in every second and fifth household, respectively.

In the present study, the prevalence of coronary heart disease and its risk factors were compared in the two populations. The following risk factors were studied: family history of coronary heart disease, obesity, smoking, physical inactivity, hypertension, diabetes mellitus, and hyperlipidaemia. In addition, dietary intake of the following was also assessed: total and saturated fat, cholesterol, sodium, and alcohol.

The U.S. National Cholesterol Education Program Expert Panel on detection, evaluation and treatment of high blood cholesterol has defined desirable, borderline, and high levels of blood lipids as below the 50th percentile, between the 50th and 75th percentile, and above the 75th percentile values, respectively (6). For the present study, the cut-off levels of serum lipids were based on 50th percentile values obtained from the study population (Table 1).

Table 1: Cut-off levels of serum lipids used in the study

                                    Cut-off (mg/dl) in:

Blood lipid (mg/dl)              Urban sample   Rural sample

Total cholesterol                190            170
Low density lipoprotein (LDL)    110             90
   cholesterol
High density lipoprotein (HDL)    53             52
   cholesterol
Triglycerides                    120            138

Hypertension was defined as a systolic blood pressure of [is greater than] 160 mm Hg and/or a diastolic blood pressure of [is greater than] 90 mm Hg or currently taking anti-hypertensive drugs. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Urban-Rural Differences in the Prevalence of Coronary Heart Disease and Its Risk Factors in Delhi
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.