Abstract
The World Health Organization and the Government of India have set targets to reduce burden of noncommunicable diseases. Information on population level trend of risk factors would provide insights regarding the possibility of achieving them. This study aimed to determine the population trends of cardiovascular disease risk factors in the National Capital Region of Delhi over 2 decades. Two representative cross-sectional surveys were conducted among men and women ages 35 to 64 years, residing in the urban and rural areas (survey 1 [1991 to 1994] and survey 2 [2010 to 2012]) using similar methodology. The urban sample was collected from the Municipal Corporation of Delhi, and the rural sample was from the Ballabgarh block of the adjoining state of Haryana. A total of 3,048 and 2,052 subjects of urban areas and 2,487 and 1,917 subjects of rural areas were surveyed in surveys 1 and 2, respectively. Behavioral (smoking and alcohol use), physical (overweight, abdominal obesity, and raised blood pressure), and biochemical risk factors (raised fasting blood glucose and raised total cholesterol) were measured using standard tools. Urban and rural prevalence of overweight, alcohol use, raised blood pressure, and blood glucose increased with increases in age-standardized mean body mass index (urban: 24.4 to 26.0 kg/m2; rural: 20.2 to 23.0 kg/m2), systolic blood pressure (urban: 121.2 to 129.8 mm Hg; rural: 114.9 to 123.1 mm Hg), diastolic blood pressure (urban: 74.3 to 83.9 mm Hg; rural: 73.1 to 82.3 mm Hg), and fasting glucose (urban: 101.2 to 115.3 mg/dl; rural: 83.9 to 103.2 mg/dl). The smoking prevalence increased in the rural male population. Raised total cholesterol declined in urban and increased significantly in rural populations. The study indicates an overall worsening of population levels of all cardiovascular disease risk factors in National Capital Region over past 20 years, though some signs of stabilization and reversal are seen in urban Delhi.
Highlights
The World Health Organization and the Government of India have set targets to reduce burden of noncommunicable diseases
The study indicates an overall worsening of population levels of all cardiovascular disease risk factors in National Capital Region over past 20 years, though some signs of stabilization and reversal are seen in urban Delhi
General Assembly on noncommunicable diseases (NCD) [1] and the subsequent goals and targets set by the World Health Organization (WHO) has opened an enormous window of opportunity to reduce the burden of chronic diseases worldwide
Summary
Two representative cross-sectional surveys were conducted among men and women ages 35 to 64 years, residing in the urban and rural areas (survey 1 [1991 to 1994] and survey 2 [2010 to 2012]) using similar methodology. The cross-sectional surveys were carried out in adults ages 35 to 64 years using a multistage cluster random sampling method in the urban area and a simple random sampling method in the rural area. Both the surveys received ethical clearance by the Ethics Committee of All India Institute of Medical Sciences, New Delhi, and were funded by Indian Council of Medical Research. The final sample was sufficient to detect an estimated absolute increase in coronary artery disease prevalence between the surveys (1.5% to 2.0% in rural area and 3.0% to 3.5% urban area) with a power of 80%. As the first survey was restricted to the 35 to 64 year age group, we have only reported for that age group in this paper
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