Abstract
The prevalence of cardiovascular disease and associated risk factors are increasing globally, particularly in the developing world. Those in the South Asian region are especially at risk of cardiovascular disease due to an increasing prevalence of its risk factors. This study was undertaken to investigate the association of social class with location of residence in the distribution of cardiovascular risk factors (mainly hypertension and diabetes mellitus) in Pakistan. A cross-sectional study of 2495 subjects aged between 30-75 years was conducted in Punjab Province, which includes urban and rural areas. Subjects completed a detailed questionnaire, and anthropometric measurements and blood samples were taken after a written informed consent. Participants were categorized as urban or rural and assigned a social class according to their occupation. A logistic regression model was used to explore the association between social class and location of residence. The overall prevalence of hypertension and diabetes was 24.2% and 16.6%, respectively. Of the total number of participants, 56.8% (n=1417) were rural residents and 43.2% (n=1078) were urban. Urban individuals were significantly more likely (p<0.001) to be hypertensive (OR=3.03, 95% CI 2.14-4.30) and more likely (p<0.001) to be diabetic (OR=1.77, 95% CI 1.29-2.42) than rural dwellers, after multivariate adjustments for age, sex, BMI and social class. Social class was not significantly associated with the prevalence of either hypertension or diabetes. In the Pakistani population, rural or urban location of residence is a more powerful determinant of cardiovascular risk factors than social class.
Highlights
The prevalence of cardiovascular disease and associated risk factors are increasing globally, in the developing world
This study investigated the distribution of hypertension and diabetes mellitus in relation to social class and location of residence in a Pakistani population, with the aim of exploring major determinants in urban and rural populations
Information was collected from 2700 individuals; due to missing information (BP, n=75; self-reported diabetes mellitus, and blood glucose level, n=47; height and weight, n=24; and social class, n=59), 2495 individuals were included in the final analysis
Summary
The prevalence of cardiovascular disease and associated risk factors are increasing globally, in the developing world. The prevalence of cardiovascular disease and its adverse health effects are increasing more rapidly in the South Asian region than in any other world region[2], and at a relatively younger age compared with other populations[3,4,5,6]. This is mainly attributed to an increased prevalence of known risk factors, such as hypertension, diabetes mellitus and obesity. In a nationally representative sample, the prevalence of diabetes in urban versus rural areas was 6.0% in men and 3.5% in women as opposed to 6.9% in men and 2.5% in women, respectively[12]
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