Risk factors of cardiovascular diseases in young and middle aged Indian males: a case control study
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20234140Keywords:
Cardiovascular diseases, Cholesterol, Diabetes mellitus, High triglycerideAbstract
Background: Cardiovascular diseases (CVDs) are common in India, yet there is a lack of comprehensive studies on the specific risk factors for the Indian population. Our research aimed to identify CVD risk factors in individuals under 50 and compare them with healthy controls, offering insights into preventing CVDs in this younger demographic.
Methods: This study focused on newly diagnosed cases of CVDs in males under 50 and matched controls with same demographic parameters. Data on personal, medical, lifestyle and biochemical parameters was compared to identify and understand the key risk factors associated with CVDs in this specific population group.
Results: Elevated body mass index (BMI) and waist-hip ratio were linked to CVD, with BMI showing a significant association. High triglyceride (TGL) levels (>150 mg/dl) and LDL cholesterol levels (>130 mg/dl) were significantly associated with CVD. The total cholesterol to HDL cholesterol ratio (>4.5) and low HDL cholesterol (<40 mg/dl) were also linked to CVD risk. Diabetes mellitus was strongly associated with CVD (OR-14.04). Stress, as assessed by a stress score >12, was associated with CVD, although the association was not very strong (OR 1.39). Physical exercise was associated with a protective effect against CVD (OR-0.28). These findings emphasize the critical role of lifestyle factors, such as diet, exercise and stress management in CVD prevention and highlight the importance of managing conditions like obesity and diabetes.
Conclusions: This study not only deepens our comprehension of CVD prevention but also provides actionable guidance for fostering heart health, both within the studied population and in broader contexts.
References
Mackay J, Mensah G. The atlas of heart diseases and stroke: In Risk factor. 1st ed. World Health Organization: Myriad ed Ltd; 2004;24-25.
World Health Organization. Global atlas on cardiovascular diseases prevention and control, 2011. Available at: https://www.who.int/ publications-detail-redirect/9789241564373. Accessed 25 February 2023.
Rosengren A, Hawken S, Ôunpuu S, Sliwa K, Zubaid M, Almahmeed WA, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11 119 cases and 13 648 controls from 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):953-62.
Berenson GS, Srinivasan SR, Bao W, Newman WP, Tracy RE, Wattigney WA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. N Engl J Med. 1998;338(23):1650-6.
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Heal Soc Behav. 1983;24(4):385-96.
Venkatramana P, Reddy PC. Association of overall and abdominal obesity with coronary heart disease risk factors: comparison between urban and rural Indian men. Asia Pacific J Clin Nutr. 2002;11(1):66–71.
Pischon T, Boeing H, Hoffmann K, Bergmann M, Schulze MB, Overvad K, et al. General and abdominal adiposity and risk of death in Europe. N Engl J Medi. 2008;359(20):2105-20.
Chen L, Chester M, Kaski JC. Clinical Factors and angiographic Features associated with premature coronary artery disease. Chest. 1995;108(2):364-9.
Pekkanen J, Linn S, Heiss G, Suchindran CM, Leon A, Rifkind BM, et al. Ten-year mortality from cardiovascular disease in relation to cholesterol level among men with and without preexisting cardiovascular disease. N Engl J Medi. 1990;322(24):1700-7.
National Cholesterol Education Program (US). Expert Panel on Detection, Treatment of High Blood Cholesterol in Adults. Third report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). The Program; 2002.
Stamler J, Wentworth D, Neaton JD, for the MRFIT Research Group. Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT). JAMA. 1986;256(20):2823-8.
Lipid Research Clinics Program. The Lipid Research Clinics Coronary Primary Prevention Trial results. I: Reduction in the incidence of coronary heart disease. JAMA. 1984;251:351-64.
Lipid Research Clinics Coronary Primary Prevention Trial results. The relationship of reduction in incidence of coronary heart disease to cholesterol lowering. Jama. 1984;251(3):365-74.
Gordon DJ, Probstfield JL, Garrison RJ, Neaton JD, Castelli WP, Knoke JD, et al. High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies. Circulation. 1989;79(1):8-15.
Libby P, Nathan DM, Abraham K, Brunzell JD, Fradkin JE, Haffner SM, et al. Report of the national heart, lung, and blood institute-national institute of diabetes and digestive and kidney diseases working group on cardiovascular complications of type 1 diabetes mellitus. Circulation. 2005;111(25):3489-93.
Stamler J, Vaccaro O, Neaton JD, Wenworth D. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care. 1993;16(2):434-44.
Gabbay FH, Krantz DS, Kop WJ, Hedges SM, Klein J, Gottdiener JS, et al. Triggers of myocardial ischemia during daily life in patients with coronary artery disease: physical and mental activities, anger and smoking. J Am Coll Cardiol. 1996;27(3):585-92.
Gullette EC, Blumenthal JA, Babyak M, Jiang W, Waugh RA, Frid DJ, et al. Effects of mental stress on myocardial ischemia during daily life. JAMA. 1997;277(19):1521-6.
Strike PC, Steptoe A. Behavioral and emotional triggers of acute syndromes: a systematic review and critique. Psychom Med. 2005;67(2):179-86.
Sheps DS, McMahon RP, Becker L, Carney RM, Freedland KE, Cohen JD, et al. Mental stress–induced ischemia and all-cause mortality in patients with coronary artery disease: results from the Psychophysiological Investigations of Myocardial Ischemia study. Circulation. 2002;105(15):1780-4.
Rosengren A, Hawken S, Ôunpuu S, Sliwa K, Zubaid M, Almahmeed WA, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11 119 cases and 13 648 controls from 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):953-62.
Theorell T, Karasek RA. Current issues relating to psychosocial job strain and cardiovascular disease research. J Occup Health Psychol. 1996;1(1):9-26.
Peter R, Siegrist J. Psychosocial work environment and the risk of coronary heart disease. Int Arch Occup Environ Helath. 2000;73:S41-45.
Slack J. Risks of Ischaemic heart-disease in familial hyperlipoproteinaemic states. Lancet. 1969;2(7635):1380-2.
Phillips RL, Lilienfeld AM, Diamond EL, Kagan A. Frequency of coronary heart disease and cerebrovascular accidents in parents and sons of coronary heart disease index cases and controls. Am J Epidemiol. 1974;100(2):87-100.
Rissanen AM. Familial aggregation of coronary heart disease in a high incidence area (North Karelia, Finland). Br Heart J. 1979;42(3):294-303.
Whelton SP, Chin A, Xin X. Effect of aerobic exercise on blood pressure: A meta-analysis of randomized controlled trials. Ann Inter Medi. 2002;136(7):493-503.
Khan NA, Hemmelgarn B, Herman RJ, Bell CM, Mahon JL, Leiter LA, et al. The 2009 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 2–therapy. Cana J Cardiol. 2009;25(5):287-98.
Redon J, Cifkova R, Laurent S, Nilsson P, Narkiewicz K, Erdine S, et al. The metabolic syndrome in hypertension: European society of hypertension position statement. J Hypert. 2008;26(10):1891-900.
Blumenthal JA, Babyak MA, Hinderliter A, Watkins LL, Craighead L, Lin PH, et al. Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study. Arch Int Med. 2010;170(2):126-35.
Goodpaster BH, DeLany JP, Otto AD, Kuller L, Vockley J, South-Paul JE, et al. Effects of diet and physical activity interventions on weight loss and cardiometabolic risk factors in severely obese adults: a randomized trial. Jama. 2010;304(16):1795-802.
Ma H, Shieh KJ. Cholesterol and human health. J Am Sci. 2006;2(1):46-50.
