Abstract
BackgroundCardiovascular disease (CVD) is the leading cause of mortality in India. Social and behavioural factors are strongly interrelated in the prevention and control of CVD. The ability to make lifestyle changes to control hypertension and diabetes (major risk factors for CVD) is determined by factors such as education, gender, caste, poverty, and urbanicity. This study aimed to improve our understanding of the inter-relationship of social and behavioural factors in the management of elevated serum glucose and high blood pressure and co-morbid mental health conditions.MethodsA population-based catchment area cross sectional survey was conducted in Kerala, India. Data were collected from residents aged over 30 years (n = 997) using standardized tools and clinical measures. We performed latent class analysis incrementally to extract homogeneous latent classes of individuals based on their responses to social and behavioural risk factors in the survey. Using structural equation models, we assessed the mediating effect of depression and anxiety, and social or behavioural risk factors, on management of high blood pressure and raised serum glucose levels.ResultsThe prevalence of high blood pressure and blood glucose in the sample was 33 and 26% respectively. Latent class analysis found three clusters of risk factors. One had a predominance of behavioural characteristics, another of social risk factors and the third was a low risk group. Age, female sex, and marital status had an effect on high blood pressure and high glucose, though were mediated by mental health, social and behavioural risk factors.ConclusionsInterventions to improve the management of risk factors for CVD need to address social risk factors and be sensitive to the needs of population sub-groups that may require additional support to access health services. An integration of social and health services may be required to achieve this.
Highlights
Cardiovascular disease (CVD) is the leading cause of mortality in India
This review found that factors such as demographics, poverty, social networks, life events, health barriers and health risk behaviours were associated with poor management of diabetes and hypertension, as well as the co-morbidities of depression and anxiety in India [15]
We aimed to explore in this cross-sectional study in a South-Indian community the relationship between social and behavioural risk factors and the management of Non-communicable disease (NCD), in particular their effect on poor management of elevated serum glucose and hypertension as well as their relationship to the co-morbid mental health conditions depression and anxiety
Summary
Cardiovascular disease (CVD) is the leading cause of mortality in India. In India, cardiovascular disease (CVD) is currently the leading cause of mortality and is responsible for 28% of all deaths [2]. The most important behavioural risk factors related to CVD prevalent in India are lack of physical activity, tobacco use, and excess use of alcohol [4]. These negative behaviours are frequently present in people with hypertension, glucose intolerance and obesity. Socioeconomic status, both affluence and poverty, have recognized association with NCDs
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