Study of perception and behaviour in patients with coronary heart disease about risk factors and life style modification in tertiary care hospital, Bhavnagar

Pooja A. Chauhan, Atul Trivedi


Background: Non-communicable diseases are now the major cause of death in India, with cardiovascular diseases being the dominant cause. Very few studies had been done regarding patients perception of risk factors, behaviour change and counselling. So this study is based on patient perspective and role of health education for patients. The objective of the study was to identify the risk factors of CHD, to assess behaviour changes whether lifestyle and habits modified by patients of CHD, to assess perception, to assess effectiveness of counselling.

Methods: A cross-sectional study was conducted in 174 patients attending follow up Out Patient Department in Tertiary Care Hospital, Bhavnagar using questionnaire which includes personal data, BMI, history of risk factors, behaviour change and medical counselling. Data was analyzed by epi info and appropriate statistical tests were applied.

Results: Total 73 patients were addicted to tobacco; smoking or alcohol. Mean duration of addiction was 22.43 years. Counselling was given by doctors at the time of illness to 94% patients. Counselling regarding disease, risk factors, lifestyle modification has got positive effect in 96% patients and only 4% patients were in need of further future counselling.

Conclusions: More and more emphasis should be given to preventive aspect and population should be given counselling before actual illness.


Coronary heart disease, Counselling, Life style modification, Risk factors

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World Health Organization. Non communicable diseases country profile; 2014.

WHO. The World Health Report 1999. Making a difference. Geneva: World Health Organization; 1999

Mohan V, Deepa R, Rani SS, Premalatha G; Chennai Urban Population Study (CUPS No.5). Prevalence of coronary artery disease and its relationship to lipids in a selected population in South India. J Am Coll Cardiol. 2001;38:682-7.

Gupta R, Gupta VP, Sarna M, Bhatnagar S, Thanvi J, Sharma V, et al. Prevalence of coronary heart disease and risk factors in an urban Indian population: Jaipur Heart Watch-2. Indian Heart J. 2002;54:59-66.

Kamili MA, Dar IH, Ali G, Wazir H, Hussain S. Prevalence of coronary heart disease in Kashmiris. Indian Heart J. 2007;61:44-9.

Gupta AK, Bharadwaj A, Ashotra S, Gupta BP. Feasibility and training of multipurpose workers in detection, prevention and control of coronary artery disease in apple-belt of Shimla hills. South Asian J Prev Cardiol. 2002;6:17-22.

Kumar R, Singh MC, Ahlawat SK, Thakur JS, Srivastava A, Sharma MK, et al. Urbanization and coronary heart disease: a study of urbanerural differences in northern India. Indian Heart J. 2006;58:126-30.

Krishnan MN. Coronary heart disease and risk factors in India e On the brink of an epidemic? Indian Heart J. 2012;64:364-7.

Global Atlas on Cardiovascular Disease Prevention and Control. Mendis S, Puska P, Norrving B, eds. WHO, 2011.

Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2095–128.

Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2224–60.

Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Di Angelantonio E, et al. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens. 2014;32:1170–7.

Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res. 2007;125:217–30.

Gupta R, Guptha S, Agrawal A, Kaul V, Gaur K, Gupta VP. Secular trends in cholesterol lipoproteins and triglycerides and prevalence of dyslipidemias in an urban Indian population. Lipids Health Dis. 2008;7:40.

Ajithakumari PP, Roy A, Anand K, Ritvik A, Lakshmy R, Ruby G, et al. Rising prevalence of Coronary Heart Disease (CHD) in urban Delhi, India – results from a repeat cross-sectional study. Eur Heart J. 2013;34(suppl 1):P2506.

Wilson PW. Assessing Coronary Heart Disease Risk with Traditional and Novel Risk Factors. Clin Cardiol. 2004;27(6 Suppl 3):III7-11.

D’Agostino RB Sr, Grundy S, Sullivan LM, Wilson P. Validation of the Framingham coronary heart disease prediction scores: Results of a multiple ethnic groups investigation. J Am Med Assoc. 2001;286:180–7.

Greenland P, Knoll MD, Stamler J, Neaton JD, Dyer AR, Garside DB, et al. Major risk factors as antecedents of fatal and nonfatal coronary heart disease events. J Am Med Assoc. 2003;290:891–7.

Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. J Am Med Assoc. 2002;288:2709–16.

Khot UN, Khot MB, Bajzer CT, Sapp SK, Ohman EM, Brener SJ, et al. Prevalence of conventional risk factors in patients with coronary heart disease. J Am Med Assoc. 2003;290:898–904.

van Berkel TFM, Boersma H, De Baquer D, Deckers JW, Wood D. Registration and management of smoking behavior in patients with coronary heart disease. European Heart J. 1999;20:1630–7.

Ngiap-Chuan T, Wei SHC, Seng-Lian NMC. Lifestyle modifications of patients with coronary heart disease on follow up in public primary care centres in Singapore: assessment of perception and behaviour. The Singapore Family Physician. 2011;37(1):67-72.

Ornish D, Brown SE, Scherwiz LW, Billings JH, Armstrong WT, Ports TA, et al. Can lifestyle changes reverse coronary heart disease? Lancet. 1990;336:129-33.

James C. Risk Factors for Coronary Artery Diseases: A Study Among Patients With Ischemic Heart Disease in Kerala. Heart India, 2013;1:1.

Sekhri T, Kanwar RS, Wilfred R, Chugh P, Chhillar M, Aggarwal R, at el. Prevalence of risk factors for coronary artery disease in an urban Indian population. BMJ Open. 2014;4.

Dabbak H, Arafa MA. Risk Assessment and Risk Perception of Coronary Heart Disease in Gaza Strip, Palastine. Health. 2014;6:2883-93.

Crouch R. Perception, knowledge & awareness of coronary heart disease among rural Australian women 25-65 years of age: A descriptive study. 2008.