TY - JOUR
T1 - Socioeconomic status and cardiovascular risk in urban South Asia
T2 - The CARRS Study
AU - Ali, Mohammed K.
AU - Bhaskarapillai, Binukumar
AU - Shivashankar, Roopa
AU - Mohan, Deepa
AU - Fatmi, Zafar A.
AU - Pradeepa, Rajendra
AU - Masood Kadir, M.
AU - Mohan, Viswanathan
AU - Tandon, Nikhil
AU - Venkat Narayan, K. M.
AU - Prabhakaran, Dorairaj
N1 - Funding Information:
The authors would like to thank and recognize Dr Bob Gerzoff and Dr Kai M Bullard (US Centers for Disease Control and Prevention) for their help with statistical analyses, data management and multiple imputation. The CARRS Study and authors MKA, MMK, VM, NT, KMVN and DP were funded in whole or in part by the National Heart, Lung, and Blood Institute of the National Institutes of Health, Department of Health and Human Services (contract no. HHSN268200900026C) and the United Health Group (Minneapolis, MN, USA). Authors BB and RS were supported by grant number 1 D43 HD065249 from the Fogarty International Centre and the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health.
Publisher Copyright:
© European Society of Cardiology 2015.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Background Although South Asians experience cardiovascular disease (CVD) and risk factors at an early age, the distribution of CVD risks across the socioeconomic spectrum remains unclear. Methods We analysed the 2011 Centre for Cardiometabolic Risk Reduction in South Asia survey data including 16,288 non-pregnant adults (≥20 years) that are representative of Chennai and Delhi, India, and Karachi, Pakistan. Socioeconomic status (SES) was defined by highest education (primary schooling, high/secondary schooling, college graduate or greater); wealth tertiles (low, middle, high household assets) and occupation (not working outside home, semi/unskilled, skilled, white-collar work). We estimated age and sex-standardized prevalence of behavioural (daily fruit/vegetables; tobacco use), weight (body mass index; waist-to-height ratio) and metabolic risk factors (diabetes, hypertension, hypercholesterolaemia; hypo-HDL; and hypertriglyceridaemia) by each SES category. Results Across cities, 61.2% and 16.1% completed secondary and college educations, respectively; 52.8% reported not working, 22.9% were unskilled; 21.3% were skilled and 3.1% were white-collar workers. For behavioural risk factors, low fruit/vegetable intake, smoked and smokeless tobacco use were more prevalent in lowest education, wealthy and occupation (for men only) groups compared to higher SES counterparts, while weight-related risks (body mass index 25.0-29.9 and ≥30 kg/m2; waist-to-height ratio ≥0.5) were more common in higher educated and wealthy groups, and technical/professional men. For metabolic risks, a higher prevalence of diabetes, hypertension and dyslipidaemias was observed in more educated and affluent groups, with unclear patterns across occupation groups. Conclusions SES-CVD patterns are heterogeneous, suggesting customized interventions for different SES groups may be warranted. Different behavioural, weight, and metabolic risk factor prevalence patterns across SES indicators may signal on-going epidemiological transition in South Asia.
AB - Background Although South Asians experience cardiovascular disease (CVD) and risk factors at an early age, the distribution of CVD risks across the socioeconomic spectrum remains unclear. Methods We analysed the 2011 Centre for Cardiometabolic Risk Reduction in South Asia survey data including 16,288 non-pregnant adults (≥20 years) that are representative of Chennai and Delhi, India, and Karachi, Pakistan. Socioeconomic status (SES) was defined by highest education (primary schooling, high/secondary schooling, college graduate or greater); wealth tertiles (low, middle, high household assets) and occupation (not working outside home, semi/unskilled, skilled, white-collar work). We estimated age and sex-standardized prevalence of behavioural (daily fruit/vegetables; tobacco use), weight (body mass index; waist-to-height ratio) and metabolic risk factors (diabetes, hypertension, hypercholesterolaemia; hypo-HDL; and hypertriglyceridaemia) by each SES category. Results Across cities, 61.2% and 16.1% completed secondary and college educations, respectively; 52.8% reported not working, 22.9% were unskilled; 21.3% were skilled and 3.1% were white-collar workers. For behavioural risk factors, low fruit/vegetable intake, smoked and smokeless tobacco use were more prevalent in lowest education, wealthy and occupation (for men only) groups compared to higher SES counterparts, while weight-related risks (body mass index 25.0-29.9 and ≥30 kg/m2; waist-to-height ratio ≥0.5) were more common in higher educated and wealthy groups, and technical/professional men. For metabolic risks, a higher prevalence of diabetes, hypertension and dyslipidaemias was observed in more educated and affluent groups, with unclear patterns across occupation groups. Conclusions SES-CVD patterns are heterogeneous, suggesting customized interventions for different SES groups may be warranted. Different behavioural, weight, and metabolic risk factor prevalence patterns across SES indicators may signal on-going epidemiological transition in South Asia.
KW - Cardiovascular risk factors
KW - South Asians
KW - global cardiovascular health
KW - socioeconomic status
UR - http://www.scopus.com/inward/record.url?scp=84957551742&partnerID=8YFLogxK
U2 - 10.1177/2047487315580891
DO - 10.1177/2047487315580891
M3 - Article
C2 - 25917221
AN - SCOPUS:84957551742
SN - 2047-4873
VL - 23
SP - 408
EP - 419
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
IS - 4
ER -
