Skip to main content
Bulletin of the World Health Organization logoLink to Bulletin of the World Health Organization
. 1997;75(1):31–38.

Urban-rural differences in the prevalence of coronary heart disease and its risk factors in Delhi.

S L Chadha 1, N Gopinath 1, S Shekhawat 1
PMCID: PMC2486981  PMID: 9141748

Abstract

A community-based epidemiological survey of coronary heart disease and its risk factors was carried out over the period 1984-87 on a random sample of adults aged 25-64 years: 13,723 adults living in Delhi and 3375 in adjoining rural areas. ECG examination and analysis of fasting blood samples for lipids were performed on subjects with the disease and asymptomatic adults free of clinical manifestations. The overall prevalence of coronary heart disease among adults based on clinical and ECG criteria was estimated at 96.7 per 1000 and 27.1 per 1000 in the urban and rural populations, respectively. Prevalences of a family history of coronary heart disease, hypertension, obesity and diabetes mellitus were significantly higher in the urban than in the rural population, and smoking was commoner among rural men and women. Mean levels of total serum cholesterol and low density lipoprotein cholesterol were higher among urban subjects; the mean level of triglycerides was higher in rural subjects. The proportions with total cholesterol levels > 190 mg/dl were 44.1% and 23.0% in urban and rural men, respectively, and 50.1% and 23.9% among urban and rural women, respectively. High density lipoprotein cholesterol levels < 35 mg/dl were found in 2.2% of urban men and 8.0% of rural men compared with 1.6% and 3.5% among urban and rural women, respectively. An abnormal ECG pattern (Q wave or ST-T changes) in asymptomatic individuals is also considered to be a risk factor for coronary heart disease. In asymptomatic adults, 1.7% of urban men and 1.2% of urban women showed abnormal Q waves compared with 0.3% of rural men and 0.4% of rural women. A higher proportion of asymptomatic women showed ST-T changes in both populations. Rural men and women had higher total calorie and saturated fat intakes than urban subjects. Differences in dietary cholesterol intake were marginal. Sodium intake was greater in urban adults. Average daily consumption of alcohol by urban men was 12.7 ml ethanol compared with 2.4 ml in rural men.

Full text

PDF
37

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Campos H., Mata L., Siles X., Vives M., Ordovas J. M., Schaefer E. J. Prevalence of cardiovascular risk factors in rural and urban Costa Rica. Circulation. 1992 Feb;85(2):648–658. doi: 10.1161/01.cir.85.2.648. [DOI] [PubMed] [Google Scholar]
  2. Campos H., Willett W. C., Peterson R. M., Siles X., Bailey S. M., Wilson P. W., Posner B. M., Ordovas J. M., Schaefer E. J. Nutrient intake comparisons between Framingham and rural and Urban Puriscal, Costa Rica. Associations with lipoproteins, apolipoproteins, and low density lipoprotein particle size. Arterioscler Thromb. 1991 Jul-Aug;11(4):1089–1099. doi: 10.1161/01.atv.11.4.1089. [DOI] [PubMed] [Google Scholar]
  3. Chadha S. L., Radhakrishnan S., Ramachandran K., Kaul U., Gopinath N. Epidemiological study of coronary heart disease in urban population of Delhi. Indian J Med Res. 1990 Dec;92:424–430. [PubMed] [Google Scholar]
  4. Chadha S. L., Ramachandran K., Shekhawat S., Tandon R., Gopinath N. A 3-year follow-up study of coronary heart disease in Delhi. Bull World Health Organ. 1993;71(1):67–72. [PMC free article] [PubMed] [Google Scholar]
  5. Connor W. E., Cerqueira M. T., Connor R. W., Wallace R. B., Malinow M. R., Casdorph H. R. The plasma lipids, lipoproteins, and diet of the Tarahumara indians of Mexico. Am J Clin Nutr. 1978 Jul;31(7):1131–1142. doi: 10.1093/ajcn/31.7.1131. [DOI] [PubMed] [Google Scholar]
  6. Evans J. R., Hall K. L., Warford J. Shattuck Lecture--health care in the developing world: problems of scarcity and choice. N Engl J Med. 1981 Nov 5;305(19):1117–1127. doi: 10.1056/NEJM198111053051904. [DOI] [PubMed] [Google Scholar]
  7. Garcia-Palmieri M. R., Sorlie P., Tillotson J., Costas R., Jr, Cordero E., Rodriguez M. Relationship of dietary intake to subsequent coronary heart disease incidence: The Puerto Rico Heart Health Program. Am J Clin Nutr. 1980 Aug;33(8):1818–1827. doi: 10.1093/ajcn/33.8.1818. [DOI] [PubMed] [Google Scholar]
  8. Gupta S. P., Malhotra K. C. Urban--rural trends in the epidemiology of coronary heart disease. J Assoc Physicians India. 1975 Dec;23(12):885–892. [PubMed] [Google Scholar]
  9. Howard B. V., Davis M. P., Pettitt D. J., Knowler W. C., Bennett P. H. Plasma and lipoprotein cholesterol and triglyceride concentrations in the Pima Indians: distributions differing from those of Caucasians. Circulation. 1983 Oct;68(4):714–724. doi: 10.1161/01.cir.68.4.714. [DOI] [PubMed] [Google Scholar]
  10. Kannel W. B., Gordon T., Castelli W. P., Margolis J. R. Electrocardiographic left ventricular hypertrophy and risk of coronary heart disease. The Framingham study. Ann Intern Med. 1970 Jun;72(6):813–822. doi: 10.7326/0003-4819-72-6-813. [DOI] [PubMed] [Google Scholar]
  11. Knuiman J. T., West C. E., Katan M. B., Hautvast J. G. Total cholesterol and high density lipoprotein cholesterol levels in populations differing in fat and carbohydrate intake. Arteriosclerosis. 1987 Nov-Dec;7(6):612–619. doi: 10.1161/01.atv.7.6.612. [DOI] [PubMed] [Google Scholar]
  12. Lessa I., Almeida F. A., Almeida Alves J. F., Souza M. E., Silva Jesus M. de F., Caricchio R. Prevalence of chronic diseases in a district of Salvador, Bahia, Brazil. Bull Pan Am Health Organ. 1982;16(2):138–150. [PubMed] [Google Scholar]
  13. Reardon M. F., Nestel P. J., Craig I. H., Harper R. W. Lipoprotein predictors of the severity of coronary artery disease in men and women. Circulation. 1985 May;71(5):881–888. doi: 10.1161/01.cir.71.5.881. [DOI] [PubMed] [Google Scholar]

Articles from Bulletin of the World Health Organization are provided here courtesy of World Health Organization

RESOURCES