Prevention of cardiovascular disease in a rural region of India and strategies to address the unmet need

Wood, A., Pell, J. , Patel, A., Neal, B., Raju, P.K. and Chow, C.K. (2011) Prevention of cardiovascular disease in a rural region of India and strategies to address the unmet need. Heart, 97(17), pp. 1373-1378. (doi: 10.1136/hrt.2011.225987)

Abstract

Objectives To determine levels of cardiovascular disease (CVD) prevention and to model the potential impact of improved prevention strategies for a large rural Indian region.Design A cross-sectional study with modelling of coronary heart disease (CHD) events over 10GÇàyears.Setting Rural Andhra Pradesh, India.Participants A stratified random sample of 1079 adults 30GÇàyears and older.Main outcome measures Proportion on medical and behavioural treatments for prevention of CVD; estimated number of CHD events using a locally recalibrated Framingham risk equation.Results Among the 3.5% (95% CI 2.1% to 4.9%) with existing CVD, 49.3% (95% CI 28.8% to 69.8%) were on blood pressure (BP)-lowering medication, 4.7% (95% CI 0 to 10.4%) were on cholesterol-lowering medication, 24.6% (95% CI 9% to 40.3%) had increased exercise and 26.9% (95% CI 2.6% to 51.1%) attempted to quit smoking. Among the 7.6% (95% CI 6.2% to 8.9%) with a high global CHD risk (>20% over 10GÇàyears), 29.5% (95% CI 19.5 to 39.5%) were on BP-lowering medication, 2.8% (95% CI 0 to 6.7%) were on cholesterol-lowering medication, 19.4% (95% CI 10.9% to 28%) had increased exercise and 24.8% (95% CI 15.8% to 33.8%) attempted to quit smoking. If confirmed drug therapies were provided to all individuals at high risk there would be a 28% reduction in cardiovascular events over 10GÇàyears at an approximate annual treatment cost of US$533 per event avoided.Conclusions There are serious deficiencies in CVD prevention in rural areas of India. Addressing these with simple confirmed drug treatments could produce a large reduction in the future cardiovascular burden in India

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Pell, Professor Jill
• Authors: Wood, A., Pell, J., Patel, A., Neal, B., Raju, P.K., and Chow, C.K.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: Heart
• ISSN: 1355-6037
• ISSN (Online): 1468-201X