RESUMO
BACKGROUND: Familial hypercholesterolemia (FH) is an under-diagnosed autosomal co-dominant genetic disorder characterized by very high plasma levels of low-density lipoprotein cholesterol (LDL-C), premature coronary artery disease (CAD) with arcus cornealis, and xanthomas. Among patients with CAD, the frequency of FH is significantly higher than that of the general population, but little data are available in India in this regard. This study aimed to assess the prevalence of FH in patients with premature coronary artery disease for the first time in the Jharkhand population. RESULTS: The study was conducted on 200 premature CAD patients at RIMS hospital, Ranchi, from January 2020 to June 2021 with CAG-confirmed acute coronary syndrome. The study, without taking the aid of genetic profiling of the patients and using the Dutch Lipid Clinic Network Criteria, revealed quite a high (23.5%) prevalence of potential FH in patients with premature CAD apart from the conventional risk factors. Mean LDL-C levels among patients with definite, probable, possible, and no FH were recorded as 250.39, 184.32, 136.11, and 108.09 mg/dl, respectively. Arcus cornealis was seen in 55.31% of patients with potential FH, 90% in definite FH, and 44.40% with probable FH. Patients with potential FH were more likely to be younger (age < 40 years) males, having a history of CAD and a family history of premature CAD as compared to patients without FH. CONCLUSIONS: There was no previous report of large studies on FH or its epidemiology and its natural history from India. The present study is the first one to show a high prevalence of potential FH in premature CAD (about 23.5%). This preliminary study revealed that the prevalence of FH in patients with premature CAD who came to the tertiary care hospital of Ranchi, Jharkhand, was high, apart from the conventional risk factors.
RESUMO
BACKGROUND: World especially India had been witnessing a sharp increase of death and disability due to cardiovascular disease (CVD). Prevention, cure and management of cardiovascular diseases (CVD) necessitate true picture of the spread of CVD risk factors throughout the country. Among few surveys in India, very little reports were from state Jharkhand. This study aimed to report the status of CVD risk factors among tribal and nontribal population of Jharkhand. METHODS: Comparative study was conducted on rural tribals and urban nontribals with no apparent CVD related symptoms. Informed consents, filled up CVD risk questionnaire were collected. Anthropometric and behavioral data with measured Blood pressure (BP), blood sugar and body mass index (BMI) were analyzed by multivariate logistic regression to find out the association of inappropriate features related to CVD, if any with age, gender and ethnicity. RESULTS: Almost 2 fold more susceptibility to develop hypertension, pre-hypertension and obesity was found in nontribals over 8.0%, 15.6% and 22.1% of respective affected tribals. This trend increased up to 3 fold in > 40 years age group. This >40 when compared with < 40 years age group nearly 16 fold and 11 fold significantly increased hypertension risk was reported in nontribals and tribals respectively We report 14.8% diabetic in tribals, highest so far in India. CONCLUSION: With age above 40 years, susceptibility to different CVD risk factors like hypertension, pre-hypertension, obesity, high MAP reported to increase severely in urban nontribals than rural tribals.
