Ponraj David Gregg Smith, Gopikrishnan Sri Keerthana, Newtonraj Ariarathinam, Arokiaraj Mark Christopher, Purty Anil Jacob, Nanda Sunil Kumar, Manikandan Mani, Vincent Antony
Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India.
Department of Cardiology, Pondicherry Institute of Medical Sciences, Puducherry, India.
J Family Med Prim Care. 2020 Aug 25;9(8):4145-4150. doi: 10.4103/jfmpc.jfmpc_538_20. eCollection 2020 Aug.
Cardiovascular diseases (CVDs) are major problems in India and many other developing and developed countries. As India is committed to provide universal health care for the population, there is a need to find out the prevalence and determinants of CVD risk among high-risk individuals (Diabetes and Hypertensive patients) in the remote rural area of India to deliver appropriate services, as they are considered as neglected population.
We screened high-risk individuals (Hypertension and Diabetes patients) for CVD risk using WHO/ISH chart, in a remote rural area of south India, covering ten villages surrounding the Rural Health Training Centre (RHTC), in August-September 2017. After line-listing the participants from the electronic database of RHTC, screening with questionnaire and biochemical tests was done at village level as the first step. Thereafter, the participants were invited to the hospital on a particular day where electrocardiography (ECG) and echocardiography (ECHO) were done with special consultation.
Among the total of 303 individuals screened at the village level, 64 [21%(CI 17-25)] had a higher risk for CVD. 235 people attended the special consultation; among them, 212 underwent ECG and 88 underwent ECHO. Among those screened with ECHO, 18 had some cardiac pathologies. The relationship between CVD risk and other factors is shown in. After final adjustment, illiteracy [adjusted prevalence ratio (aPR) 1.8 (0.1-3.1)], anemia [aPR 1.8 (1-3.6)], and chronic renal diseases [aPR 1.8 (1.0-3.4)] were found to be associated with high risk for CVD among hypertension and diabetes groups.
Cardiovascular disease risk assessment using WHO/ISH chart showed an association with poor education, anemia, and chronic kidney disease.
心血管疾病（CVDs）是印度以及许多其他发展中国家和发达国家面临的主要问题。由于印度致力于为民众提供全民医疗保健，因此有必要查明印度偏远农村地区高危个体（糖尿病和高血压患者）中CVD风险的患病率和决定因素，以便提供适当的服务，因为这些人群被视为被忽视的群体。
2017年8月至9月，我们在印度南部一个偏远农村地区，使用世界卫生组织/国际高血压学会（WHO/ISH）图表对高危个体（高血压和糖尿病患者）进行CVD风险筛查，该地区涵盖农村卫生培训中心（RHTC）周边的10个村庄。从RHTC的电子数据库中列出参与者名单后，第一步是在村庄层面通过问卷调查和生化检测进行筛查。此后，邀请参与者在特定日期到医院，进行心电图（ECG）和超声心动图（ECHO）检查，并接受专科会诊。
在村庄层面筛查的303名个体中，64名[21%（CI 17 - 25）]有较高的CVD风险。235人参加了专科会诊；其中，212人进行了心电图检查，88人进行了超声心动图检查。在接受超声心动图检查的人群中，18人有一些心脏病变。CVD风险与其他因素之间的关系见……。最终调整后发现，在高血压和糖尿病组中，文盲[调整患病率比（aPR）1.8（0.1 - 3.1）]、贫血[aPR 1.8（1 - 3.6）]和慢性肾病[aPR 1.8（1.0 - 3.4）]与CVD高风险相关。
使用WHO/ISH图表进行心血管疾病风险评估显示，其与教育程度低、贫血和慢性肾病有关。
