Key result
Rural South Indian screening finds ~15% of adults face high 10-year risk of MI or stroke.
Why the study?
Cardiovascular diseases are the leading cause of death in low- and middle-income countries including India, yet there were no published data on multivariable cardiovascular risk prediction from rural India.
Cross-Sectional (n=3,780)
Yes
First study in rural India applying the WHO/ISH multivariable risk prediction algorithm, demonstrating an alarmingly high burden of modifiable CVD risk factors (98.5%) and high 10-year predicted CVD event risk (>=30% in 15.2% of adults aged 40-80).
Answers are grounded in this paper and cite their sources.
Alerts clinicians to high modifiable CVD risk in rural India; leaves open whether WHO/ISH stratification improves outcomes.
Background: Cardiovascular diseases (CVD) account for almost half of all non-communicable disease related deaths and are now the leading cause of death in low- and middle-income countries including India. There is no published data on multivariable risk prediction for cardiovascular disease from rural India. Aims & Objective: Determine the cardiovascular risk profile and the 10 year risk of fatal and non-fatal cardiovascular event in a rural population. Materials and Methods: A community based cross sectional study was done in 47 villages of Karnataka over a period of 3 years. A total of 3780 adults were screened for CVD risk factors. Various risk stratification criteria including the WHO 10 year risk of fatal/ non-fatal CVD event were used to study the magnitude of individual and aggregated risk factors for CVD. Results: The study reveals a high prevalence of CVD risk factors despite using three different risk stratification methods. The prevalence of at least one modifiable CVD risk factor in the population was 98.5%. An alarming 15.2% of the population had a high risk (>30%) of getting fatal or non-fatal MI or stroke in 10 years. Older age, lack of education, physical inactivity and family history of MI/ stroke were associated with high risk for CVD. Conclusion: The prevalence of CVD risk factors as well as the probability of a fatal or non-fatal cardiovascular event is very high in this rural population. This warrants strategies that would improve awareness and promote healthy life-styles to reduce the risk of cardiovascular disease in this population.
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Norman et al. (2014) conducted a cross-sectional in Cardiovascular disease risk factors (n=3,780). Cardiovascular risk factor screening and WHO/ISH multivariable risk prediction algorithm was evaluated on High 10-year risk (>=30%) of fatal or non-fatal myocardial infarction or stroke using WHO/ISH risk prediction chart (among n=763 assessed aged 40-80 years). Cardiovascular risk screening in rural South India revealed that 98.5% of adults had at least one modifiable risk factor and 15.2% had a >30% 10-year risk of fatal or non-fatal MI or stroke.
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