Ischemic heart disease (IHD) is the leading cause of both mortality and forgone healthy years of life among working -age adults (15-69 years) in South Asia. It is the leading cause of death in India and worldwide. For noncommunicable diseases (NCDs), common, modifiable and easily measurable risk factors could be reliably used to predict the future burden of the diseases and to measure the effectiveness of public health interventions. A casecontrol study was undertaken to examine the socio-demographic profile of IHD patients and to identify the risk factors in already diagnosed cases of IHD admitted in three tertiary care hospitals of Ahmedabad, India. We have included 100 cases and 100 controls who were group matched with the cases. The association of various risk factors with IHD was assessed. On univariate analysis it was found that 7 out of 8 risk factors were significantly associated with IHD. They are alcohol consumption (OR; 14.6, 95% CI; 6.4-33.3), smoking (OR; 13.6, 95% CI; 6.6-27.8), tobacco consumption in non-smoking form (OR;2.3, 95% CI; 0.78-7.02), hypertension (OR; 6.5, 95% CI; 3.4-12.3), Type 2 diabetes (OR; 4.5, 95% CI; 2.4-8.7), obesity (OR; 9.7, 95% CI; 4.9-19.1), sedentary lifestyle (OR; 3.8, CI; 1.8-8.4 ) and family history (OR; 5.3, 95% CI; 2.8-9.9). This study identified the significance of alcohol, smoking, obesity, Type 2 diabetes, hypertension, sedentary lifestyle and family history in the outcome of IHD. This suggests that the increased cardiovascular risk among the urban population of Ahmedabad city may be preventable through lifestyle interventions along with the judicious use of medicines to attain optimal levels of blood pressure, lipids and glucose among the high risk population. A total of 57 million deaths occurred in the world during 2008; 36 million (63%) were due to non-communicable diseases (NCDs), principally cardiovascular diseases (CVD), diabetes, cancer and chronic respiratory diseases. 1NCDs are the most frequent causes of death in most countries in the Americas, the Eastern Mediterranean, Europe, South-East Asia and the Western Pacific.2 The leading causes of NCD deaths in 2008 were CVD (17 million deaths, or 48% of NCD deaths) -over 80% of cardiovascular and diabetes deaths occurred in low-and middleincome countries.3 NCD deaths are projected to increase by 15% globally between 2010 and 2020 (to 44 million deaths). The greatest increases will be in the WHO regions of Africa, South-East Asia and the Eastern Mediterranean, where they will increase by over 20%. The regions that are projected to have the greatest total number of NCD deaths in 2020 are South-East Asia (10.4 million deaths) and the Western Pacific (12.3 million deaths). 4 Most NCDs are strongly associated and causally linked with four particular behaviors: tobacco use, physical inactivity, unhealthy diet and the harmful use of alcohol. 5These behaviors lead to four key metabolic/physiological changes: raised blood pressure, overweight/obesity, hyperglycemia and hyperlipidemia. In terms of attributable

Objectives: The relationship between sleep disturbances and cardiovascular disease (CVD) is not well established. This study assesses the association between sleep disturbances and CVD, and the effect of sleep duration on the relationship between sleep disturbances and CVD among adults in the United States (US). Design: Cross-sectional analysis. Setting: NHANES (National Health and Nutrition Examination Survey). Participants: A total of 5660 adults were included from the 2015-2016 cycle of the NHANES survey. Measurements: The main outcome was the presence of any CVD and included self-reported angina, congestive heart failure, coronary heart disease, hypertension and myocardial infarction. Associations between sleep disturbances and sleep duration with CVD were analyzed using logistic regression. Stratified models by sleep duration were used to assess effect modification. Results: We included 5660 participants (52.2% males), 32.7% of the participants reported having a disturbed sleep and 38% reported a CVD. Compared to those who did not report any sleep disturbances, those with sleep disturbance had 85% higher odds of CVD (OR 1.85, 95% CI 1.43-2.39). Similarly, there were 40% higher odds of CVD (OR 1.40, 95% CI 1.01-1.95) among those with shorter sleep duration compared with those that slept for 6 to 9hours. However, there was no evidence of effect modification by sleep duration. Conclusions: Our findings show that sleep disturbance is associated with higher odds of CVD. Clinicians and other healthcare providers need to consider the consequence of sleep disturbances and implement strategies in the treatment of patients with or at high risk of CVD.