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R B Singh

Publications and source records attributed to R B Singh.

At least 73 records · Page 4Linked to original sources

Serum cholesterol and coronary artery disease in populations with low cholesterol levels: the Indian paradox.

OBJECTIVE: To examine the relation between serum cholesterol and coronary artery disease prevalence below the range of cholesterol values generally observed in developed countries. DESIGN AND SETTING: Cross-sectional survey of two randomly selected villages from Moradabad district and 20 randomly selected streets in the city of Moradabad. SUBJECTS AND METHODS: 3575 Indians, aged 25-64 years including 1769 rural (894 men, 875 women) and 1806 urban (904 men, 902 women) subjects. The survey methods were questionnaires, physical examination and electrocardiography. RESULTS: The overall prevalences of coronary artery disease were 9.0% in urban and 3.3% in rural subjects and the prevalences were significantly (P<0.001) higher in men compared to women in both urban (11.0 vs. 6.9%) and rural subjects (3.9 vs. 2.6%). The average serum cholesterol concentrations were 4.91 mmol/l in urban and 4.22 mmol/l in rural subjects without any sex differences. The prevalences of coronary artery disease were significantly higher among subjects with low and high serum cholesterol concentration compared to subjects with very low cholesterol and showed a positive relation with serum cholesterol within the range of serum cholesterol level studied in both rural and urban in both sexes. Among subjects with low serum cholesterol, there was a higher prevalence of coronary risk factors, hypertension, diabetes, obesity and sedentary lifestyle. Serum cholesterol level showed a significant positive relation with low density lipoprotein cholesterol and triglycerides in all the four subgroups. Logistic regression analysis after pooling of data from both rural and urban, with adjustment of age showed that low serum cholesterol level (odds ratio: men 0.96, women 0.91) had a positive strong relation with coronary artery disease and there was no evidence of any threshold. Diabetes mellitus (men 0.73, women 0.74) and sedentary lifestyle (men 0.86, women 0.74) were significant risk factors of coronary disease in both sexes. Hypertension (men 0.82, women 0.64) and smoking (men 0.81, women 0.52) were weakly associated with coronary disease in men but not in women. CONCLUSION: Serum cholesterol level was directly related to prevalence of coronary artery disease even in those with low cholesterol concentration (<5.18 mmol/l). It is possible that some Indian populations may benefit by increased physical activity and decline in serum cholesterol below the range of desired serum cholesterol in developed countries.

Adult↗

Social class and coronary artery disease in a urban population of North India in the Indian Lifestyle and Heart Study.

OBJECTIVE: To determine the association of social class with prevalence of coronary risk factors and coronary artery disease (CAD). DESIGN AND SETTING: Total community cross sectional survey of 20 randomly selected streets in the city of Moradabad. SUBJECTS AND METHODS: 1806 urban (904 men and 902 women) randomly selected subjects aged 25-64 years. The survey methods were physician and dietitian administered questionnaire, physical examination and electrocardiography. All subjects were divided into social classes 1-5 based on attributes of education, occupation, per capita income, housing condition and consumer durables and other family assets. RESULTS: Social classes 1, 2 and 3 were mainly high and middle socioeconomic groups and 3 and 4 low income groups. The prevalence of CAD and coronary risk factors hypercholesterolemia, hypertension, diabetes mellitus and sedentary lifestyle were significantly higher among social classes 1, 2 and 3 in both sexes compared to lower social classes. Mean serum cholesterol, triglycerides, low density lipoprotein cholesterol and blood pressure were significantly associated with higher and middle social classes. Smoking was significantly associated with lower social classes. Multivariate logistic regression analysis after adjustment of age revealed that social class was positively associated with CAD (odds ratio: men 0.84, women 0.86), hypercholesterolemia (men 0.87, women 0.85), hypertension (men 0.91, women 0.89), diabetes mellitus (men 0.71, women 0.68) and sedentary lifestyle (men 0.68, women 0.66). Smoking was significantly associated with CAD in men. CONCLUSION: Social class 1, 2 and 3 in an urban population of India have a higher prevalence of CAD and coronary risk factors hypercholesterolemia, hypertension, diabetes mellitus and sedentary lifestyle in both sexes.

Adult↗

Prevalence and risk factors of hypertension and age-specific blood pressures in five cities: a study of Indian women. NKP Salve Institute of Medical Sciences, Nagpur, India. Five City Study Group.

OBJECTIVE: To measure the prevalence of hypertension and age-specific blood pressure in urban populations from five Indian cities. Cross-sectional surveys were conducted in six-twenty urban streets in different cities from five different corners of India, using similar methods of sample selection and criteria. There were 3212 randomly selected women from Moradabad (n=902), Trivandrum (n=760), Calcutta (n=365), Nagpur (n=405) and Bombay (n=780), aged 25-64 years, inclusive. Evaluation was by a physician and a dietitian, an administered questionnaire, a physical examination and using a sphygmomanometer. The diagnosis of hypertension was based on old World Health Organisation criteria and new World Health Organisation/International Society of Hypertension criteria. The prevalence of hypertension (>140/90 mm Hg) was significantly (P<0.01) high in Trivandrum, South India (30.7%), and Bombay, West India (28.0%), compared to Moradabad, which is in northern India (22.6%), Nagpur, in central India (24.2%), and Calcutta, in east India (19.1%). Mean systolic and diastolic blood pressures were significantly higher in Trivandrum and Bombay compared to the other three cities. The overall prevalence of hypertension was 25.6% (n=823) and isolated diastolic hypertension was the most common form of hypertension (50.5%, n=1506) in the five Indian cities. According to old criteria, the overall prevalence of hypertension (>160/95 mm Hg) was 14.8% (n=481). Multivariate logistic regression analysis on pooled data from the five cities, after adjustment for age, showed that age (odds ratio 1.16), body mass index (1.68) and obesity were strongly associated with hypertension. A sedentary lifestyle and salt intake were weakly associated and alcohol intake was not a factor with these women.

Adult↗

Intestinal obstruction caused by caecal volvulus.

The case of a 6-month-pregnant woman who had an uneventful postoperative recovery and normal vaginal delivery following a right hemi-colectomy for volvulus of the caecum with gangrene is reported.

Adult↗

Randomized, double-blind placebo-controlled trial of coenzyme Q10 in patients with acute myocardial infarction.

The effects of oral treatment with coenzyme Q10 (120 mg/d) were compared for 28 days in 73 (intervention group A) and 71 (placebo group B) patients with acute myocardial infarction (AMI). After treatment, angina pectoris (9.5 vs. 28.1), total arrhythmias (9.5% vs. 25.3%), and poor left ventricular function (8.2% vs. 22.5%) were significantly (P < 0.05) reduced in the coenzyme Q group than placebo group. Total cardiac events, including cardiac deaths and nonfatal infarction, were also significantly reduced in the coenzyme Q10 group compared with the placebo group (15.0% vs. 30.9%, P < 0.02). The extent of cardiac disease, elevation in cardiac enzymes, and oxidative stress at entry to the study were comparable between the two groups. Lipid peroxides, diene conjugates, and malondialdehyde, which are indicators of oxidative stress, showed a greater reduction in the treatment group than in the placebo group. The antioxidants vitamin A, E, and C and beta-carotene, which were lower initially after AMI, increased more in the coenzyme Q10 group than in the placebo group. These findings suggest that coenzyme Q10 can provide rapid protective effects in patients with AMI if administered within 3 days of the onset of symptoms. More studies in a larger number of patients and long-term follow-up are needed to confirm our results.

Angina Pectoris↗

Low fat intake and coronary artery disease in a population with higher prevalence of coronary artery disease: the Indian paradox.

OBJECTIVE: To determine the association between saturated fat intake and prevalence of coronary artery disease (CAD) and coronary risk factors. DESIGN AND SETTING: Total community cross sectional survey of 20 urban streets out of 196 streets, in the city of Moradabad in north India. SUBJECTS AND METHODS: Adult population between 25 to 64 years inclusive comprised of 1806 subjects (904 men, 902 women) were divided into three groups according to level of saturated fat intake as assessed by 7-day dietary intake records (very low < 7%, low 7 to 10%, high > 10% energy (en) per day). RESULTS: We examined the relationship between CAD risk and levels of % en from fat intake. Low (7 to 10% en/day) and high (> 10% en/day) saturated fat were positively and significantly associated with higher prevalence of CAD. The prevalence of coronary risk factors (hypertension, hypercholesterolemia, obesity and sedentary lifestyle) were significantly higher among subjects with low and high saturated fat intake compared to subjects with very low (< 7%) saturated fat intake. Logistic regression analysis with adjustment for age showed that hypercholesterolemia (OR: men 0.89, women 0.68), hypertension (men 0.92, women 0.56), physical activity (men 0.80, women 0.36), obesity (men 0.82, women 0.88) and smoking (0.70 men) were significant risk factors of CAD. Low and high saturated fat intake were associated with more prestigious occupations, higher and middle income status and better educational levels compared to very low saturated fat intake. CONCLUSIONS: The prevalence of CAD and coronary risk factors was higher in urban Indians with low and high saturated fat intake than those with lower saturated fat intake. These findings suggest that the saturated fat intake should be < 7% en/day for prevention of CAD in Indians.

Adult↗

Current zinc intake and risk of diabetes and coronary artery disease and factors associated with insulin resistance in rural and urban populations of North India.

OBJECTIVE: To determine the association between current zinc intake and prevalence of coronary artery disease (CAD) and diabetes as well as factors associated with insulin resistance. DESIGN, SUBJECTS AND METHODS: In this cross sectional survey, 3575 subjects, aged 25 to 64 years, including 1769 rural (894 men. 875 women) and 1806 urban (904 men, 902 women) subjects were studied. The survey methods included questionnaires for 7-day food intake record, physical examination, and electrocardiography using World Health Organization criteria. RESULTS: The prevalence of CAD, diabetes and glucose intolerance was significantly higher among subjects consuming lower intakes of dietary zinc. There was a higher prevalence of hypertension, hypertriglyceridemia and low high-density lipoprotein cholesterol levels which showed significant upward trend with lower zinc intakes. Serum lipoprotein (a) and 2-hour plasma insulin levels also were associated with low zinc intake. Multivariate logistic regression analysis after adjustment for age showed that zinc intake and CAD were inversely associated. Serum zinc (odds ratio:men 0.77, women 0.57), serum triglycerides (men 0.86, women 0.81), blood pressure (0.83 men, women 0.76), diabetes mellitus (men 0.90, women 0.85), central obesity (men 0.88, women 0.87), glucose intolerance (men 0.66, women 0.57) and low high-density lipoprotein cholesterol (men 0.72, women 0.70) were significant risk factors for CAD (explained by tertiles of zinc status) in urban subjects. These associations were not observed in rural subjects. CONCLUSION: Lower consumption of dietary zinc and low serum zinc levels were associated with an increased prevalence of CAD and diabetes and several of their associated risk factors including hypertension, hypertriglyceridemia and other factors suggestive of mild insulin resistance in urban subjects.

Adult↗

Association of central obesity and insulin resistance with high prevalence of diabetes and cardiovascular disease in an elderly population with low fat intake and lower than normal prevalence of obesity: the Indian paradox.

OBJECTIVE: To test the hypothesis that high prevalences of cardiovascular disease and diabetes in urban population of India are manifestations of insulin-resistance syndrome. DESIGN AND SETTING: Cross-sectional surveys were conducted in 20 streets in the city of Moradabad and in two villages. SUBJECTS AND METHODS: There were 566 subjects (255 rural and 311 urban) aged 60-84 years. All subjects were divided on the basis of their insensitivity to insulin into groups with mild, moderate and high insensitivity to insulin and data from both sexes were pooled for analysis. RESULTS: Overall increases in the prevalences of coronary disease, diabetes, hypertension, central obesity and associated disturbances were observed with increasing insensitivity to insulin and the trend was more significant among urban than it was among rural subjects. Multivariate logistic regression analysis revealed a significant positive association of level of insulin insensitivity with the age-adjusted prevalences of coronary disease, hypertension, diabetes, hypertriglyceridaemia, intolerance of glucose and central obesity among urban subjects. We observed a significant inverse association between insensitivity to insulin and physical activity both for rural and for urban subjects and between insensitivity to insulin and high-density lipoprotein cholesterol level for urban subjects. For rural subjects, we found significant associations of sensitivity to insulin with coronary artery disease and intolerance of glucose without significant associations with other risk factors. CONCLUSION: Insensitivity to insulin was significantly associated with risks of cardiovascular disease and diabetes, despite there being a low prevalence of obesity (9.0%) among urban subjects. Hypertension, diabetes, hypertriglyceridaemia, intolerance of glucose and central obesity were significantly associated with insensitivity to insulin and coronary disease for urban but not for rural people.

Aged↗

L-carnitine administration in coronary artery disease and cardiomyopathy.

Myocardial ischaemia may be defined as a deficiency in cardiac energy supply relative to energy demand. In coronary artery disease (CAD), oxygen supply is limited due to coronary obstruction so energy production is not enough to meet the energy demands for work. Several reports involving about 2500 patients of CAD where carnitine was administered for upto 1 year indicate some beneficial effects. There is reduction in ischaemia showing reduced ST-segment depression and angina, greater effort tolerance and decreased need of cardiac drugs. Carnitine can cause overall improvement in cardiac performance in patients with CAD as well as in cardiomyopathy. More studies are necessary to demonstrate where carnitine can scavenge free radicals apart from its beneficial effect on fatty acid metabolism. Side effects of carnitine are mild nausea and vomiting and dose upto 2 g/day in 3 divided doses may not have any side effects. Intravenous L-carnitine acts rapidly and has no side effects.

Carnitine↗

Coenzyme Q in cardiovascular disease.

Coenzyme Q10 or ubiquinone normally present in many plant and animal cells is an antioxidant. Coenzyme Q10 deficiency has been observed in patients with congestive heart failure, angina pectoris, coronary artery disease, cardiomyopathy, hypertension, mitral valve prolapse and after coronary revascularization. Coenzyme Q10 is involved in the synthesis of ATP and hence is useful in preventing cellular damage during ischaemia-reperfusion injury. The clinical benefits are mainly due to its ability to improve energy production, antioxidant activity, and membrane stabilizing properties. Several studies showed that coenzyme Q could be useful in patients with congestive heart failure, angina pectoris, cardiomyopathy, coronary artery disease and in the preservation of myocardium. Coenzyme Q10 is normally present in the low density lipoprotein cholesterol fraction and inhibits its oxidation. It can also regenerate vitamin E. Coenzyme Q10 is known for producing minor gastrointestinal discomfort and elevation in SGOT and LDH when used.

Animals↗

Validation of tobacco and alcohol intake questionnaire in relation to food intakes for the Five City Study and a proposed classification for Indians.

Cross-sectional survey was conducted among 1806 subjects (904 men and 902 women) between 25-64 years of age. The survey instruments were questionnaires according to guidelines of WHO and other Indian studies and based on scores of various attributes of tobacco and alcohol consumption. All subjects with tobacco and alcohol consumption were classified separately into mild, moderate and heavy consumption and previous consumptions were also recorded. The overall prevalence of tobacco consumption was significantly higher in men compared to women (27.5 vs 11.6%), while mild tobacco intakes were comparable (2.0 vs 1.6%), moderate (22.2 vs 7.7%) and heavy (3.3 vs 2.2%) tobacco consumptions were significantly higher in men compared to women. The overall prevalence of alcohol consumption was 10.4% in men without any subject among women. The prevalence of moderate (6.6%) alcohol intakes was significantly higher compared to mild (1.2%) and heavy (2.5%) alcohol consumption. Whisky and country liquor were most commonly consumed alcoholic beverages. Smoking (20.7 vs 1.6%) and tobacco chewing (13.3 vs 10.7%) in men and women respectively were common modes of tobacco consumption. Tobacco consumption was significantly associated with lower consumption of vitamin C and beta-carotene and lower body mass index. These findings suggest that tobacco and alcohol consumption assessed by scores constructed on the basis of various attributes appear to be accurate and the questionnaires may be used with precision for classification and assessment in other population groups.

Adult↗

Association of low plasma concentrations of antioxidant vitamins, magnesium and zinc with high body fat per cent measured by bioelectrical impedance analysis in Indian men.

This cross-sectional study was conducted to determine the association of high body fat per cent measured by bioelectric impedance analysis with known risk factors of obesity as well as with serum levels of vitamins, trace elements and magnesium and oxidative stress in an urban population in India. There were 850 men aged 25-64 years, randomly selected from the city of Moradabad. Subjects were divided into high body fat per cent (n = 357), over fat per cent (n = 230), desirable fat (n = 200) and low fat (n = 63) based on criteria of body fat per cent analysis. The prevalence of central obesity, sedentary lifestyle, family history and higher visible fat intake showed significant association with higher over fat per cent. Postprandial plasma insulin and glucose and serum iron and oxidative stress were significantly higher and plasma levels of vitamin C and E and serum zinc/insulin ratio as well as serum magnesium/insulin ratio showed inverse association with high body fat per cent. Multivariate logistic regression analysis after adjustment of age showed a significant positive association of body mass index (odds ratio 0.97), sedentary lifestyle (odds ratio 1.12) and serum iron (OR 1.00) with higher body fat per cent. Zinc (OR 1.03), magnesium (OR 1.02), vitamins C (OR 1.08 and E (OR 1.09) deficiency were risk factors of higher body per cent and central obesity. It is possible that some Indian men can benefit by increased intake of zinc, magnesium, vitamin C and vitamin E in conjunction with lifestyle changes.

Adult↗

Prevalence and determinants of central obesity and age-specific waist:hip ratio of people in five cities: the Indian Women's Health Study.

OBJECTIVE: To study the prevalence of central obesity and age-specific waist:hip ratio of urban women from five Indian cities. DESIGN AND SETTING: Cross-sectional surveys were conducted in 6-12 urban streets in different parts of India using similar methods of sample selection and criteria of diagnosis. SUBJECTS AND METHODS: We randomly selected 3212 women, aged 25-64 years, from Moradabad (n = 902), Trivandrum (n = 760), Calcutta (n = 365), Nagpur (n = 405), and Bombay (n = 780). Evaluation was by a questionnaire administered by a physician and a dietician, a physical examination, and anthropometric measurements. RESULTS: The overall prevalence of central obesity among the total number of women was 55.0%, with the highest prevalence in Calcutta (62.2%) and the lowest in Bombay (47.4%). Waist:hip ratio was 0.85 +/- 0.13 (mean +/- SD) with the highest ratio for women in Calcutta (0.87 +/- 0.12) and the lowest for women in Moradabad (0.84 +/- 0.16). After pooling of data from all five cities, multivariate logistic regression analysis showed that, regardless of age, body mass index (> 23 kg/m2; odds ratio 1.12), sedentary lifestyle (odds ratio 2.51), and family history of obesity (odds ratio 2.15) were strongly associated with central obesity. Excess intake of fat was weakly associated with central obesity but age was not a risk factor for central obesity, although the prevalence was highest among those aged over 55 years in Moradabad, Calcutta, and Nagpur. CONCLUSIONS: The overall prevalence of central obesity among the urban women of India has increased, more so in Calcutta and Trivandrum. Body mass index, sedentary lifestyle, and family history of excess intake of fat were significant risk factors for central obesity.

Adult↗

Association of higher saturated fat intake with higher risk of hypertension in an urban population of Trivandrum in south India.

Saturated fat intake appears to be a risk factor of insulin resistance which is important in the pathogenesis of diabetes and cardiovascular disease. This study aims to demonstrate whether saturated fat intake may be a risk factor of hypertension. Cross-sectional survey in six randomly selected streets in Trivandrum city in south India was conducted to study 1497 randomly selected subjects (737 males and 760 females) of 25-64 years of age. The prevalence of hypertension by Joint National Committee V criteria (> 140/90 were 34.6% (n = 255) in males and 30.7% (n = 234) in females. The consumption of food groups showed that they were within desirable limits. However, the intake of fruit, vegetable, legume and coconuts was lower and saturated fat intake higher (> 10% kcal/day), although total fat intake was within desirable limits. Total and saturated fat intake, and the consumption of coconut oil and butter, flesh foods, milk and yogurt as well as sugar and jaggery were significantly associated with hypertension. Total visible fat (> 20 g/day) intake was positively associated whereas fruit, vegetable, legume and coconut intake (< 400 g/day) was inversely associated with hypertension. Salt intake (> 8 g/day), smoking and illiteracy were not associated with hypertension. Multivariate logistic regression analysis showed that saturated fat intake, age and body mass index were independently and strongly associated with hypertension whereas fruits, vegetable, legume and coconuts, coconut oil and butter and alcohol (males) intakes were weakly associated with hypertension. The odds ratio indicate higher risk of hypertension due to higher intake of saturated fat in both sexes (mean: odds ratio, 1.07, 95% confidence interval 1.05-1.09; women, 1.08, 1.06-1.12, P < 0.01). Significant determinants of hypertension were higher saturated fat, particularly coconut oil, and lower fruit, vegetable, legume and coconuts, particularly legumes and coconuts in the diet, apart from conventional risk factors.

Adult↗

Randomized, double-blind, placebo-controlled trial of fish oil and mustard oil in patients with suspected acute myocardial infarction: the Indian experiment of infarct survival--4.

In a randomized, placebo-controlled trial, the effects of treatment with fish oil (eicosapentaenoic acid, 1.08 g/day) and mustard oil (alpha-linolenic acid, 2.9 g/day) were compared for 1 year in the management of 122 patients (fish oil, group A), 120 patients (mustard oil, group B), and 118 patients (placebo, group C) with suspected acute myocardial infarction (AMI). Treatments were administered about (mean) 18 hours after the symptoms of AMI in all three groups. The extent of cardiac disease, rise in cardiac enzymes, and lipid peroxides were comparable among the groups at entry into the study. After 1 year total cardiac events were significantly less in the fish oil and mustard oil groups compared with the placebo group (24.5% and 28% vs. 34.7%, p < 0.01). Nonfatal infarctions were also significantly less in the fish oil and mustard oil groups compared with the placebo group (13.0% and 15.0% vs. 25.4%, p < 0.05). Total cardiac deaths showed no significant reduction in the mustard oil group; however, the fish oil group had significantly less cardiac deaths compared with the placebo group (11.4% vs. 22.0%, p < 0.05). Apart from the decrease in the cardiac event rate, the fish oil and mustard oil groups also showed a significant reduction in total cardiac arrhythmias, left ventricular enlargement, and angina pectoris compared with the placebo group. Reductions in blood lipoproteins in the two intervention groups were modest and do not appear to be the cause of the benefit in the two groups. Diene conjugates showed a significant reduction in the fish oil and mustard oil groups, indicating that a part of the benefit may be caused by the reduction in oxidative stress. The findings of this study suggest that fish oil and mustard oil, possibly due to the presence of n-3 fatty acids, may provide rapid protective effects in patients with AMI. However, a large study is necessary to confirm this suggestion.

Adult↗

Antioxidant effects of lovastatin and vitamin E on experimental atherosclerosis in rabbits.

The effects of the administration of vitamin E (10 mg/day) plus lovastatin (2 mg/day; group A, n = 10), lovastatin alone (2 mg/day; group B, n = 10), and placebo (group C, n = 10) were compared over 24 weeks in a randomized, single-blind controlled trial. All groups of rabbits received a trans fatty acid (TFA)-rich diet (5-10 g/day) for 36 weeks. Treatment with vitamin E plus lovastatin (group A) and lovastatin (group B) started after 12 weeks of administration of TFA-rich diet was associated with a significant but similar decline in serum cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides in both groups at 36 weeks. Lipid peroxides and diene conjugates showed a significant decline in association with a significant increase in the plasma level of vitamin E in group A rabbits at 36 weeks. However, the lovastatin group B showed a lesser but significant decrease in lipid peroxides and diene conjugates at 36 weeks, indicating that lovastatin may have antioxidant activity. In control group C, the increase in blood lipids and oxidative stress at 36 weeks was much greater than the decrease in groups A and B. After experimental lipid peroxidation at 24 weeks in all of the rabbits, 2 of 10 group B and 3 of 10 group C rabbits died due to coronary thrombosis; there were no deaths in group A. Thus antioxidant therapy with vitamin E can provide protection against death due to free radical stress. Aortic lipids and sudanophilia indicating athorosclorosis were significantly lower in groups A and B than in group C. The atherosclerotic coronary plaque sizes were significantly smaller in group A (18.5 +/- 3.6 microns) than in groups B (41.6 +/- 4.2 microns) and C (85 +/- 6.7 microns). Aortic plaque sizes were also smaller in group A than in group B and C. It is possible that antioxidant therapy with vitamin E, as an adjunct to lipid lowering with lovastatin, can provide additional benefit in the inhibition of oxidative stress and atherosclerosis. The antioxidant activity of lovastatin has not been reported, to our knowledge.

Animals↗

Prevalence and determinants of hypertension in the Indian social class and heart survey.

To determine the association of socio-economic status (SES) and prevalence of hypertension and its risk factors in a rural population, a cross sectional survey was conducted in two randomly selected villages in the Moradabad district in North India. There were 1935 residents aged over 25 (984 men and 951 women) who were randomly selected and categorised into social classes 1-4 depending upon SES based on occupation, housing conditions, land holding, total per capita income, ownership of consumer durables and education. The prevalence of hypertension diagnosed by JNC V criteria (>140/90 mm Hg) was significantly higher among social class 1 and 2 and showed positive relation with SES in both sexes. Among social class 1 and 2 subjects, there was a higher prevalence of overweight and obesity and sedentary lifestyle. Logistic regression analysis with adjustment of age showed that SES had a positive relation with hypertension (odds ratio: men 1.09, 95% CI 1.05-1.14; women 1.08, 95% CI 1.05-1.13), body mass index (odds ratio: men 1.12, 1.08-1.18; women 1.11, 1.06-1.16) and sedentary lifestyle (odds ratio: men 1.45, 1.32-1.58; women 1.38, 1.26-1.49). Only weak but significant associations were observed with smoking, alcohol and salt intake. The association of hypertension with social class was reduced after adjustment of body mass index, sedentary lifestyle, smoking and salt intake (odds ratio: men 0.96, 0.81-1.14; women 0.73, 0.54-1.04). There was an increase in the prevalence of hypertension and age-specific blood pressure (BP) with increasing age in both sexes. The overall prevalence of hypertension by WHO criteria (>160/95) was 4.6% and by JNC V criteria 20.8%, and the rates were comparable in both sexes. Social class 1 and 2 subjects in rural North India have a higher prevalence of hypertension and its risk factors of overweight and sedentary lifestyle.

Adult↗