Abstract
International Journal of Medicine and Public Health,2017,7,1,01-17.DOI:10.5530/ijmedph.2017.1.1Published:March 2017Type:Systematic ReviewSocioeconomic Patterning of Cardiovascular Disease and its Risk Factors among Indians: A Systematic Review of LiteratureArti Singh, and Shikha Dixit Arti Singh1* and Shikha Dixit2 1Department of Humanities and Social Sciences, Indian Institute of Technology Kanpur, Kanpur 208016, INDIA. 2Department of Humanities and Social Sciences, Indian Institute of Technology Kanpur, Kanpur 208016, INDIA.Abstract:Objective: To investigate the socioeconomic patterning of cardiovascular disease (CVD), its mortality and associated risk factors in the Indian population. Methods: Studies conducted on Indian population between January 1992 and the second week of April 2015 satisfying predefined inclusion and exclusion criteria were selected. PubMed, Ebscohost, Google scholar and Google were searched for CVD prevalence, CVD mortality and its six risk factors (alcohol, tobacco, hypertension, diabetes, obesity and sedentary lifestyle w.r.t. socioeconomic status (SES)). Result: 3, 550, 404 participants and 1, 71, 657 households were studied though 72 selected studies. Of these 13, 31, 23, 20, 21 and 16 articles investigated alcohol, tobacco, hypertension, diabetes, obesity and sedentary lifestyle, respectively, and 11 studies investigated the trend of CVD and its mortality w.r.t. to SES. Higher SES is found to be positively associated with hypertension, diabetes, obesity and sedentary lifestyle, whereas lower SES is found to be positively associated with alcohol and tobacco consumption only. No consensus has been found among studies over socioeconomic patterning of CVD, but the burden of its mortality has been found to be positively associated with lower SES. Conclusion: Even after 25 years of liberalisation of the Indian economy, the association between the CVD and SES is still positive. Rich people are getting more affected by CVD risk factors, but the burden of CVD mortality lies with poor people who cannot afford expensive drugs and interventional treatment. Poor healthcare facilities, high out-of-pocket expenditure and not-so-favourable policies are adversely affecting the CVD health of the weaker sections of India. Keywords:Cardiovascular (CVD) diseases, CVD risk factors, India, Socioeconomic disparity/inequalityView:PDF (712.13 KB) Full Text
Highlights
CorrespondenceCardiovascular disease (CVD) is responsible for causing the highest number of deaths worldwide in the age group of 15–59 years, which is the most productive age-group population for any country.[1]
Eleven additional studies were included after scanning the reference lists and citation lists of all articles. Out of these 72 studies, 15 investigated tobacco, 5 diabetes, 7 obesity, 3 sedentary lifestyle, 9 alcohol, 5 hypertension, 5 cardiovascular disease (CVD) prevalence and 1 CVD mortality only, while the remaining 22 studies investigated a combination of these six risk factors and/or CVD prevalence and mortality w.r.t
We can conclude that only two risk factors out of six that were studied are linked to lower SES, but the mortality rate due to CVD is higher among lower SES groups
Summary
CorrespondenceCardiovascular disease (CVD) is responsible for causing the highest number of deaths worldwide in the age group of 15–59 years, which is the most productive age-group population for any country.[1]. SES.[7] a positive association between the SES and CVD has been reported by other researchers too.[8,9,10,11,12] On the other hand, some studies have reported a negative association and have concluded that the CVD mortality rate is higher in lower SES groups.[6,13,14,15,16] Subramanian et al have reported a higher prevalence of CVD risk factors in high SES groups, but a higher death rate among lower SES groups.[17] They suggested that many studies have wrongly concluded that the pattern of CVD in India is similar to that in developed countries. Though their review has sparked a fresh debate over the role of SES in the development of CVD in India, they included studies prior to the economic liberalisation
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