Indian Council of Medical Research (ICMR), New Delhi, IN.
Centre for Chronic Disease Control (CCDC), New Delhi, IN.
Glob Heart. 2022 Aug 2;17(1):52. doi: 10.5334/gh.1137. eCollection 2022.
Markers of ideal cardiovascular health (CVH) predict cardiovascular events. We estimated the prevalence of ideal CVH markers in two levels of cities and villages in India.
We did pooled analysis of individual-level data from three cross sectional surveys of adults ≥ 30 years over 2010-14 (CARRS: Centre for cArdiometabolic Risk Reduction in South Asia; UDAY and Solan Surveillance Study) representing metropolitan cities; smaller cities and rural areas in diverse locations of India. We defined ideal CVH using modified American Heart Association recommendations: not smoking, ≥ 5 servings of fruits and vegetables (F&V), high physical activity (PA), body mass index (BMI) <25 Kg/m, blood pressure (BP) <120/80 mm Hg, fasting plasma glucose (FPG) <100 mg/dl, and total cholesterol (TC) <200 mg/dL. We estimated (1) age-and sex-standardized prevalence of ideal CVH and (2) prevalence of good (≥6 markers), moderate (4-5), and poor CVH (≤3) adjusted for age, sex, education, and stratified by setting and asset tertiles.
Of the total 22,144 participants, the prevalence of ideal CVH markers were: not smoking (76.7% [95% CI 76.1, 77.2]), consumed ≥5 F&V (4.2% [3.9, 4.5]), high PA (67.5% [66.8, 68.2]), optimum BMI (59.6% [58.9, 60.3]), ideal BP (34.5% [33.9, 35.2]), FPG (65.8% [65.1, 66.5]) and TC (65.4% [64.7, 66.1]). The mean number of ideal CVH metrics was 3.7(95% CI: 3.7, 3.8). Adjusted prevalence of good, moderate, and poor CVH, varied across settings: metropolitan (3.9%, 41.0%, and 55.1%), smaller cities (7.8%, 49.2%, and 43%), and rural (10.4%, 60.9%, and 28.7%) and across asset tertiles: Low (11.0%, 55.9%, 33.1%), Middle (6.3%, 52.2%, 41.5%), and High (5.0%, 46.4%, 48.7%), respectively.
Achievement of ideal CVH varied, with higher prevalence in rural and lower asset tertiles. Multi-sectoral and targeted policy and program actions are needed to improve CVH in diverse contexts in India.
心血管健康理想标志物可预测心血管事件。我们评估了印度城乡两种水平的心血管健康理想标志物的流行率。
我们对 2010-14 年期间进行的三项成年人（年龄≥30 岁）横断面调查的个体水平数据进行了汇总分析，这些调查代表了大都市、小城市和印度不同地区的农村地区。我们使用改良的美国心脏协会建议来定义心血管健康理想状态：不吸烟、≥5 份水果和蔬菜（F&V）、高身体活动（PA）、体重指数（BMI）<25 Kg/m、血压（BP）<120/80 mmHg、空腹血糖（FPG）<100 mg/dl 和总胆固醇（TC）<200 mg/dL。我们估计了（1）理想心血管健康标志物的年龄和性别标准化流行率，以及（2）在年龄、性别、教育水平的调整下，根据设置和资产三分位数分层，良好（≥6 个标志物）、中等（4-5 个）和较差（≤3 个）心血管健康的流行率。
在总共 22144 名参与者中，理想心血管健康标志物的流行率为：不吸烟（76.7%[95%CI 76.1, 77.2%]）、食用≥5 份 F&V（4.2%[3.9, 4.5%]）、高 PA（67.5%[66.8, 68.2%]）、最佳 BMI（59.6%[58.9, 60.3%]）、理想 BP（34.5%[33.9, 35.2%]）、FPG（65.8%[65.1, 66.5%]）和 TC（65.4%[64.7, 66.1%]）。理想心血管健康指标的平均数量为 3.7（95%CI：3.7, 3.8）。不同设置（大都市[3.9%、41.0%和 55.1%]、小城市[7.8%、49.2%和 43%]）和资产三分位数（低[11.0%、55.9%和 33.1%]、中[6.3%、52.2%和 41.5%]和高[5.0%、46.4%和 48.7%]）的良好、中等和较差心血管健康的调整后流行率存在差异。
理想心血管健康的实现程度存在差异，农村地区和低资产三分位数的流行率较高。印度需要采取多部门和有针对性的政策和方案行动来改善不同背景下的心血管健康。
