Gupta Rajeev, Gupta V P, Sarna Mukesh, Bhatnagar Smita, Thanvi Jyoti, Sharma Vibha, Singh A K, Gupta J B, Kaul Vijay
Department of Medicine, Monilek Hospital and Research Centre, Jaipur.
Indian Heart J. 2002 Jan-Feb;54(1):59-66.
The prevalence of risk factors for coronary heart disease has been inadequately studied in India. A repeat cross-sectional survey was carried out to evaluate the changes in the major coronary risk factors in the urban population of Jaipur previously studied in the early 1990s.
Randomly selected adults > or =20 years of age were studied using stratified sampling. The target study sample was 1800 with a population proportionate gender distribution (males 960, females 840). Coronary risk factors, anthropometric variables, blood pressure, ECG, fasting blood glucose and lipids were evaluated. A total of 1123 subjects (62.4%) (males 550, females 573) were examined. Fasting blood samples were available in 523 males and 559 females. Overall coronary heart diesase prevalence, diagnosed by history or ECG changes, was found in 34 males (6.18%) and 58 females (10.12%). Risk factor prevalence showed that smoking/tobacco use was present in 201 males (36.5%) and 67 females (11.7%). Physical inactivity, either work-related or leisure time, was seen in 157 males (28.5%) and 130 females (22.7%). Hypertension (> or =140 and/or 90 mmHg) was present in 200 males (36.4%) and 215 females (37.5%). Diabetes diagnosed by history or fasting glucose > or =126 mg/dl was found in 72 males (13.1%) and 65 females (11.3%). Obesity, body mass index > or =27 kg/m2 was present in 135 males (24.5%) and 173 females (30.2%), while truncal obesity (waist:hip >0.9 males, >0.8 females) was found in 316 males (57.4%) and 392 females (68.4%). The most common dyslipidemia in both males and females was low HDL-cholesterol (<40 mg/dl: males 54.9%, females 54.2%). High total cholesterol levels of > or =200 mg/dl (males 37.4%, females 4.1%), high LDL-cholesterol levels of > or =130 mg/dl (males 37.0%, females 45.8%) and high levels of triglycerides > or = 150 mg/dl (males 32.3%, females 28.6%) were also seen in a significant number. Hypertension, obesity, truncal obesity, diabetes and dyslipidemias increased significantly with age in both males and females (Mantel-Haenzel chi2 for trend, p<0.05).
There is a high prevalence of standard coronary risk factors--smoking, physical inactivity, hypertension, hypercholesterolemia, diabetes and obesity--as well as factors peculiar to south Asians--truncal obesity, low HDL-cholesterol and high triglycerides--in this urban Indian population. As compared to a previous study in the early 1900s in a similar population, there is a significant increase in the number of people with obesity, diabetes and dyslipidemias.
在印度，冠心病风险因素的患病率尚未得到充分研究。我们开展了一项重复横断面调查，以评估斋浦尔城市人口中主要冠心病风险因素的变化，此前曾在20世纪90年代初对该人群进行过研究。
采用分层抽样法对随机选取的年龄≥20岁的成年人进行研究。目标研究样本为1800人，男女比例按人口比例分布（男性960人，女性840人）。对冠心病风险因素、人体测量变量、血压、心电图、空腹血糖和血脂进行了评估。共检查了1123名受试者（62.4%）（男性550人，女性573人）。523名男性和559名女性提供了空腹血样。通过病史或心电图变化诊断出的冠心病总体患病率为：男性34人（6.18%），女性58人（10.12%）。风险因素患病率显示，吸烟/使用烟草的男性有201人（36.5%），女性有67人（11.7%）。与工作相关或休闲时间的身体活动不足在男性中有157人（28.5%），女性中有130人（22.7%）。高血压（≥140和/或90 mmHg）在男性中有200人（36.4%），女性中有215人（37.5%）。通过病史或空腹血糖≥126 mg/dl诊断出的糖尿病在男性中有72人（13.1%），女性中有65人（11.3%）。肥胖，即体重指数≥27 kg/m²，在男性中有135人（24.5%），女性中有173人（30.2%），而腹型肥胖（男性腰臀比>0.9，女性>0.8）在男性中有316人（57.4%），女性中有392人（68.4%）。男性和女性中最常见的血脂异常是低高密度脂蛋白胆固醇（<40 mg/dl：男性54.9%，女性54.2%）。总胆固醇水平≥200 mg/dl（男性37.4%，女性4.1%）、低密度脂蛋白胆固醇水平≥130 mg/dl（男性37.0%，女性45.8%）以及甘油三酯水平≥150 mg/dl（男性32.3%，女性28.6%）的人数也相当可观。高血压、肥胖、腹型肥胖、糖尿病和血脂异常在男性和女性中均随年龄显著增加（趋势的Mantel-Haenzel卡方检验，p<0.05）。
在这个印度城市人群中，标准的冠心病风险因素——吸烟、身体活动不足、高血压、高胆固醇血症、糖尿病和肥胖——以及南亚人特有的因素——腹型肥胖、低高密度脂蛋白胆固醇和高甘油三酯——的患病率都很高。与20世纪90年代初对类似人群的一项研究相比，肥胖、糖尿病和血脂异常患者的数量有显著增加。
