Descriptive profile of risk factors for cardiovascular diseases using WHO STEP wise approach in Madhya Pradesh

Abstract

Background Periodic information on risk factor distribution is critical for public health response for reduction in non-communicable disease (NCDs). For this purpose, the WHO has developed STEPs wise approach. State representative population-based STEPS survey was last conducted in 2007–08 in seven states of In India. Since then no such work has been reported from low ETL states. This survey was carried out to assess the prevalence of risk factors associated with NCDs and the prevalence of NCDs in the low ETL state of Madhya Pradesh using the WHO STEPs approach. Methods A total of 5680 persons aged 18–69 years were selected from the state of Madhya Pradesh using multi-stage cluster random sampling. Using the WHO STEPs approach, details were collected on demographics, STEP 1 variables (tobacco consumption, alcohol consumption, physical activity, diet), STEP 2 variables (weight, height, waist circumference, blood pressure) and STEP 3 variables (fasting blood glucose, blood cholesterol). Results We found that 9.4% individuals smoked tobacco, 15.3% were overweight/obese, 22.3% had hypertension, and 6.8% have diabetes mellitus. As compared to women, men were less likely to be overweight or obese, but more likely to smoke tobacco, and have diabetes mellitus. Hypertension was also more common in men. Overall, about a fourth of all adults had three or more risk factors for cardiovascular disease. Conclusion The survey shows that a large section of the population from Madhya Pradesh is either suffering from NCDs or have risk factors which predispose them to acquire NCDs. This state representative survey provides benchmarking information for behavioural and biological risk factor distribution for recently scaled up National Programme for the Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS).

Determinants of behavioural and biological risk factors for cardiovascular diseases from state level STEPS survey (2017–19) in Madhya Pradesh

“…A total of 18.7% (95% CI [15.4–22.5]) were either overweight or obese, 22.3% (95% CI [20.5–24.1]) had raised blood pressure, 6.8% (95% CI [5.6–8.3]) had raised blood glucose, and 4.3% (95% CI [3.4–5.3]) had raised cholesterol levels. The detailed overall results are described in a previous publication ( Kokane et al, 2020 ).…”

“…All the data was collected digitally using mobile phone-based applications, and securely stored prior to analysis. The methods of primary data collection, and overall results are described in detail elsewhere ( Kokane et al, 2020 ). Briefly, field investigators calculated the sampling interval for household selection in a cluster by dividing the total number of households in that cluster by 58.…”

“…Madhya Pradesh has lower proportion of individuals who consume tobacco, and who are overweight or obese as compared to high epidemiological transition states. The prevalence of hypertension and diabetes is also low in MP as compared to other states ( Kokane et al, 2020 ).…”

Incident hypertension in urban slums of central India: a prospective cohort study

“…We found that prevalence to be 25.7% in urban and 20.8% in rural areas. 2 These numbers translate into more than 200 million individuals with hypertension in India. 3 Given this huge burden, National Program for Cancer, Diabetes, Cardiovascular diseases and Stroke (NPCDCS) launched by the government of India envisages annual screening for hypertension in all adults above 30 years of age.…”

Status of hypertension control in urban slums of Central India : A Community health worker based two-year follow up

“…We found that 22.3% of all individuals had hypertension, but only 11.8% were on some medication. 2,3 The proportion of those controlled is likely to be only about half of those on medication. In order to improve control, availability and access to quality health-care is imperative, in order to reduce cardiovascular mortality and morbidity.…”