A case-control study of risk factors for ischemic heart disease in patients attending tertiary care hospitals in India

Abstract

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

Cardiovascular Diseases and the Common Risk Factors Presented by Patients at Kitwe Teaching Hospital

“…Similar results have been produced by Smith, were a total of 43.7% of patients included in their study (72.3% of cases and 32.8% of controls) were hypertensive [6]. Reference [11] also found that hypertension was present in 62% of cases and 20% in the controls. However, the odds ratios of a hypertensive patient developing CVD that were reported in these studies were lower than those found in this study.…”

“…Likewise, diabetes was prevalent among 29% of the patients (42% within cases and 16% within controls). This is slightly lower than what kapoor et al [11] found (50%). The odds of a diabetic patient developing CVD was 3.725 times (OR 3.725, 95% CI 1.722 -8.057; AOR 6.033, 95% CI 1.630 -22.332) more than a non -diabetic patient.…”

“…This study showed that the following factors were independently associated with cardiovascular disease: age, family history of CVDs, smoking, alcohol consumption, hypertension, high blood cholesterol, diabetes mellitus, lack of physical exercise, lack of balanced diet and inability to control weight. These factors have also been identified in several studies that have been conducted across the world [4,[9][10][11][12].…”

Effect Modification of Modifiable Cardiovascular Risk Factors : A Hospital-Based Matched Case Control Study

“…Kapoor menemukan responden hi pertensi berisiko 6,5 kali untuk menderita pe nyakit jantung koroner. Nababan menyatakan orang yang hipertensi berisiko 2,25 kali untuk menderita penyakit jantung koroner (14) yang tidak memiliki riwayat hipertensi, serta penelitian yang dilakukan oleh Siregar melalui anali sis regresi logistik juga didapatkan hubungan antara penderita hi- pertensi dengan penyakit jantung koroner dengan tingkat kemaknaan p= 0,0005. (15) Pada variabel diabetes melitus ditemukan tidak terlihat adanya hubungan signifikan antara riwayat diabetes melitus terhadap pe nyakt jantung koroner (p-value 0,134).…”

Effect Modification of Modifiable Cardiovascular Risk Factors : A Hospital-Based Matched Case Control Study

“…Kapoor menemukan responden hi pertensi berisiko 6,5 kali untuk menderita pe nyakit jantung koroner. Nababan menyatakan orang yang hipertensi berisiko 2,25 kali untuk menderita penyakit jantung koroner (14) yang tidak memiliki riwayat hipertensi, serta penelitian yang dilakukan oleh Siregar melalui anali sis regresi logistik juga didapatkan hubungan antara penderita hi- …”