Prevalence of coronary artery disease and coronary risk factors in an urban population of Tirupati.

ABSTRACT

AIMS AND OBJECTIVES: To determine the prevalence of coronary heart disease and its risk factors in the urban population of Tirupati. METHODS: The urban population of Tirupati is spread into 20 wards. Thirteen wards were selected randomly and systematic random sampling was done to identify the sampling unit household. A total of 1519 subjects (539 males and 980 females) 20 years of age formed the sample of the study. Demographic (age, sex, occupation, education and income), behavioral (smoking), anthropometric (height, weight, waist and hip circumferences) and physiological (blood pressure) parameters were noted and recorded and biochemical parameters (serum glucose, total cholesterol, triglycerides, HDL cholesterol levels) were assayed. Coronary artery disease was diagnosed based on history and ECG changes suggestive of ST-segment depression (Minnesota 4-1 to 4-2) or Q wave changes (Minnesota codes 1-1-1 to 1-1-7) or T wave changes (Minnesota codes 5-1 to 5-3). RESULTS: The overall prevalence in the study population was 12.63 (192 cases). In males it was 6.86 (37 cases) and in females 15.81 (155 cases). The major risk factors in this population were central obesity 1003 (66%) [male 320 (59.4%) and females 683 (41.12%)], low HDL cholesterol 709 (46.67%) [male 284 (52.69%) and females 425 (43.36%)], obesity 588 (38.07%) [males 187 (34.32%) and females 403 (41.12%)], high triglyceride levels (>or= 150 mg/dl) 444 (29.22%)[(males 173 (32.09%) and females 272 (27.75%)], high cholesterol levels (>or= 200mg/dl) [(males 127 (23.56%) and females 278 (28.36%)] and hypertension 396 (26.06) [(males 149 (27.64%) and females 247 (25.20%)]. Around a fraction of subjects had metabolic syndrome 371 (24.42%) [(males 90 (16.69%) and females 281 (28.64%)]. In multivariate regression analysis, age (OR 1.05 95% CI 1.01-1.09 p<0.01) and high serum LDL cholesterol level (OR 4.62 95% CI 2.29-9.32 p<0.001) in males and serum triglycerides (OR 1.003 95% CI 1.000-1.005) in females were associated with CAD. CONCLUSIONS: Association of age, high LDL cholesterol in males and triglycerides in females with CAD shows the importance of these risk factors in this population. This was only a cross-sectional study done at one point of time. Clinical importance of these risk factors needs to be tested in the longitudinal study.