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. 1994 Nov 19;309(6965):1332–1336. doi: 10.1136/bmj.309.6965.1332

Educational status, coronary heart disease, and coronary risk factor prevalence in a rural population of India.

R Gupta 1, V P Gupta 1, N S Ahluwalia 1
PMCID: PMC2541843  PMID: 7866081

Abstract

OBJECTIVE--To define the association between educational level and prevalence of coronary heart disease and coronary risk factors in India. DESIGN--Total community cross sectional survey with a doctor administered questionnaire, physical examination, and electrocardiography. SETTING--A cluster of three villages in rural Rajasthan, western India. SUBJECTS--3148 residents aged over 20 (1982 men, 1166 women) divided into various groups according to years of formal schooling. RESULTS--Illiteracy and low educational levels were associated with less prestigious occupations (agricultural and farm labouring) and inferior housing. There was an inverse correlation of educational level with age (rank correlation: mean -0.45, women -0.49). The prevalence of coronary heart disease (diagnosed by electrocardiography) was significantly higher among uneducated and less educated people and showed an inverse relation with education in both sexes. Among uneducated and less educated people there was a higher prevalence of the coronary risk factors smoking and hypertension. Educational level showed a significant inverse correlation with systolic and diastolic blood pressure. Logistic regression analysis with adjustment for age showed that educational level had an inverse relation with prevalence of electrocardiographically diagnosed coronary heart disease (odds ratio: men 0.82, women 0.53), hypertension (men 0.88, women 0.56), and smoking (men 0.73, women 0.65) but not with hypercholesterolaemia and obesity. The inverse relation of coronary heart disease with educational level abated after adjustment for smoking, physical activity, body mass index, and blood pressure (odds ratio: men 0.98, women 0.78). CONCLUSION--Uneducated and less educated people in rural India have a higher prevalence of coronary heart disease and of the coronary risk factors smoking and hypertension.

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Selected References

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  1. Angell M. Privilege and health--what is the connection? N Engl J Med. 1993 Jul 8;329(2):126–127. doi: 10.1056/NEJM199307083290210. [DOI] [PubMed] [Google Scholar]
  2. 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]
  3. Dewan B. D., Malhotra K. C., Gupta S. P. Epidemiological study of coronary heart disease in rural community in Haryana. Indian Heart J. 1974 Apr;26(2):68–78. [PubMed] [Google Scholar]
  4. Gupta R., Gupta H. P., Keswani P., Sharma S., Gupta V. P., Gupta K. D. Coronary heart disease and coronary risk factor prevalence in rural Rajasthan. J Assoc Physicians India. 1994 Jan;42(1):24–26. [PubMed] [Google Scholar]
  5. 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]
  6. Jacobsen B. K., Thelle D. S. Risk factors for coronary heart disease and level of education. The Tromsø Heart Study. Am J Epidemiol. 1988 May;127(5):923–932. doi: 10.1093/oxfordjournals.aje.a114895. [DOI] [PubMed] [Google Scholar]
  7. Jajoo U. N., Kalantri S. P., Gupta O. P., Jain A. P., Gupta K. The prevalence of coronary heart disease in rural population from central India. J Assoc Physicians India. 1988 Dec;36(12):689–693. [PubMed] [Google Scholar]
  8. Joshi P. P., Kate S. K., Shegokar V. Blood pressure trends and life style risk factors in rural India. J Assoc Physicians India. 1993 Sep;41(9):579–581. [PubMed] [Google Scholar]
  9. Kaplan G. A., Keil J. E. Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation. 1993 Oct;88(4 Pt 1):1973–1998. doi: 10.1161/01.cir.88.4.1973. [DOI] [PubMed] [Google Scholar]
  10. Marmot M. G., Kogevinas M., Elston M. A. Social/economic status and disease. Annu Rev Public Health. 1987;8:111–135. doi: 10.1146/annurev.pu.08.050187.000551. [DOI] [PubMed] [Google Scholar]
  11. McKeigue P. M., Ferrie J. E., Pierpoint T., Marmot M. G. Association of early-onset coronary heart disease in South Asian men with glucose intolerance and hyperinsulinemia. Circulation. 1993 Jan;87(1):152–161. doi: 10.1161/01.cir.87.1.152. [DOI] [PubMed] [Google Scholar]
  12. Packer M., Gheorghiade M., Young J. B., Costantini P. J., Adams K. F., Cody R. J., Smith L. K., Van Voorhees L., Gourley L. A., Jolly M. K. Withdrawal of digoxin from patients with chronic heart failure treated with angiotensin-converting-enzyme inhibitors. RADIANCE Study. N Engl J Med. 1993 Jul 1;329(1):1–7. doi: 10.1056/NEJM199307013290101. [DOI] [PubMed] [Google Scholar]
  13. Paffenbarger R. S., Jr, Hyde R. T., Wing A. L., Lee I. M., Jung D. L., Kampert J. B. The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. N Engl J Med. 1993 Feb 25;328(8):538–545. doi: 10.1056/NEJM199302253280804. [DOI] [PubMed] [Google Scholar]
  14. Pappas G., Queen S., Hadden W., Fisher G. The increasing disparity in mortality between socioeconomic groups in the United States, 1960 and 1986. N Engl J Med. 1993 Jul 8;329(2):103–109. doi: 10.1056/NEJM199307083290207. [DOI] [PubMed] [Google Scholar]
  15. Rose G., Marmot M. G. Social class and coronary heart disease. Br Heart J. 1981 Jan;45(1):13–19. doi: 10.1136/hrt.45.1.13. [DOI] [PMC free article] [PubMed] [Google Scholar]

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