Prevalence of Cardiovascular Disease Risk Factors among Adults of Mulbagal in Rural South India: A Cross-sectional Study Using the WHO STEPS Approach

BACKGROUND: Cardiovascular diseases (CVDs) are the leading global cause of mortality, disproportionately affecting low- and middle-income countries. Rural India is experiencing rising CVD risk factors, but high-quality community data are limited. This study assessed the prevalence, clustering, and predictors of CVD risk factors in rural South India using the WHO STEPS approach. METHODS: A community-based, cross-sectional survey was conducted among 979 adults aged 25-64 years from 20 randomly selected villages in Kolar district, Karnataka (2012). Standardized questionnaires, anthropometry, blood pressure, and biochemical measures (fasting glucose and cholesterol in a subsample, n = 260) were obtained. Prevalence estimates were reported as n (%). Logistic regression identified predictors of hypertension. RESULTS: Tobacco use was reported by 450 (46.0%) participants, alcohol use by 85 (8.7%) participants, low fruit/vegetable intake by 967 (98.8%) participants, and physical inactivity by 451 (46.1%) participants. Hypertension was present in 214 (21.9%) participants, overweight/obesity in 317 (32.4%) participants, and known diabetes in 30 (3.1%) participants. In the subsample, 25 (9.6%) participants had fasting glucose ≥126 mg/dL, and 9 (3.5%) participants had hypercholesterolemia. Clustering was marked: 802 (82%) participants had ≥1 risk factor, 490 (50%) participants had ≥2, and 245 (25%) participants had ≥3, with clustering more common among men. On multivariate regression, tobacco use (odds ratio [OR]: 1.55; 95% confidence interval: 1.12-2.14; P = 0.01) was independently associated with hypertension, whereas obesity showed a positive nonsignificant trend (OR: 1.30; P = 0.11). CONCLUSION: Adults in rural South India exhibit a high burden and clustering of modifiable CVD risk factors, with tobacco use and obesity contributing significantly to hypertension. These findings highlight the urgent need for integrated community-based prevention strategies targeting multiple risk factors simultaneously.