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Objective: We prospectively determined incident cardiovascular events and their association with risk factors in rural India. Methods: We followed up with 7935 adults from the Rishi Valley Prospective Cohort Study to identify incident cardiovascular events. Using Cox proportional hazards regression, we estimated hazard ratios (HRs) with 95% confidence intervals (95% CI) for associations between potential risk factors and cardiovascular events. Population attributable fractions (PAFs) for risk factors were estimated using R ('averisk' package). Results: Of the 4809 participants without prior cardiovascular disease, 57.7% were women and baseline mean age was 45.3 years. At follow‐up (median of 4.9 years, 23,180 person‐years [PYs]), 202 participants developed cardiovascular events, equating to an incidence of 8.7 cardiovascular events/1000 PYs. Incidence was greater in those with hypertension (hazard ratio [HR] [95% CI] 1.73 [1.21–2.49], adjusted PAF 18%), diabetes (1.96 [1.15–3.36], 4%) or central obesity (1.77 [1.23, 2.54], 9%) which together accounted for 31% of the PAF. Non‐traditional risk factors such as night sleeping hours and number of children accounted for 16% of the PAF. Conclusions: Both traditional and non‐traditional cardiovascular risk factors are important contributors to incident cardiovascular events in rural India. Interventions targeted to these factors could assist in reducing the incidence of cardiovascular events. [ABSTRACT FROM AUTHOR]

Introduction: Non Communicable Diseases (NCDs) cause significant premature mortality. Prevention of major cardiovascular disease risk factors, like diabetes and hypertension, is a priority for public health. Aim: To estimate the risk assessment of NCD using the Community-Based Assessment Checklist (CBAC) scoring system developed by the Government of India among adults in rural areas. Materials and Methods: This community-based cross-sectional study was conducted among 400 adults attending the hospital at the rural health training centre of Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, Odisha, India, from March 2023 to August 2023 using consecutive sampling. Face-toface interviews using a structured CBAC questionnaire and socio-demographic variables were used to gather data on age, tobacco consumption, alcohol intake, waist measurement, physical inactivity, and family history. Data were analysed using IBM Statistical Package for Social Sciences (SPSS) version 21.0 and interpreted in frequencies, percentages, and the Chi-square test. A p-value <0.05 was considered statistically significant. Results: The overall risk of NCD was estimated to be 57.25%. The risk of NCD was significantly associated with age (p-value <0.00001), tobacco consumption (p-value <0.0001), alcohol consumption (p-value <0.0001), waist circumference (p-value <0.0001), physical activity (p-value=0.000018), family history of diabetes mellitus, hypertension, and cardiovascular illness (p-value <0.00001), education (p-value=0.0079), and socioeconomic status (p-value=0.0415). Conclusion: The overall risk of NCD was estimated to be 57.25%. Most of the CBAC variables were found to have a significant association with NCD risk. However, no significant association was found between CBAC variables and gender. CBAC is a simple and economical screening tool employed at the community level so that early intervention strategies can be planned for those at risk of NCDs. [ABSTRACT FROM AUTHOR]

The D allele has been identified as being linked to cardiovascular disease since the discovery of an insertion/deletion (I/D) polymorphism in the ACE gene, this polymorphism has been found to have significant associations with a variety of cardiovascular risk factors. Recent findings indicate a rising prevalence of metabolic disorders among rural populations in developing nations. Research on health matters has been predominantly focused on urban populations, with relatively less attention given to their rural counterparts Hence, the present study attempts to estimate the prevalence of ACE gene I/D polymorphism and explore its association with various cardiovascular risk factors among Rural Yadav population from India. In the present study, 207 (Male 47, Female 160) members of the Yadav community participated in the cross-sectional study. All the socio-demographic factors, somatometric (anthropometric) variables, and the intravenous blood was collected and Physiological (blood pressure), and biochemical (fasting glucose and lipid profile) parameters were measured as recommended by the American Heart Association, allele-specific PCR of the ACE gene I/D polymorphism was carried out, the PCR products were genotyped on 2% agarose gel Electrophoresis and ACE gene polymorphism was analysed for its association with various cardiovascular risk factors. Among the analysed individuals, 34 (16.4%) were found to have the II genotype, 58 (28.0%) had the ID genotype, and 115 (55.6%) had the DD genotype. The allele frequency of the I allele was found to be 0.31, and the frequency of the D allele was 0.69. The frequency of the DD genotype was found to be significantly higher among individuals with high TC, high TG, and low non-HDL levels (p value < 0.05). When considered collectively, the findings of this study are consistent with the hypothesis that the DD genotype of ACE polymorphism represents a correlation with cardiovascular disease risk factors in this population. [ABSTRACT FROM AUTHOR]

Background: World has seen a tremendous epidemiological transition in disease patterns from communicable to non-communicable diseases (NCDs). Currently cardiovascular diseases are a major cause of disability and premature deaths globally. Objective: (1) To know prevalence of various risk factors of cardiovascular diseases in the rural area of Meerut. (2) To find out the association of sociodemographic factors with hypertension. Settings and design: A cross-sectional study was conducted in Machchra village. Methods: The study was conducted among 315 study participants over time period of one year in which all the adults aged >30 years above residing in the ward of study area were included. Sampling technique used was systematic random sampling. Results: The prevalence of hypertension, diabetes and hypercholesterolemia was found to be 30.2%, 22.2% and 15.2% respectively. The prevalence of pre-obese and obese were 14.3% and 7.0% respectively. The maximum prevalence of hypertension was seen in the age group of 70 years (66.7%), in females (30.6%), SES as class IV (36.5%), secondary school completed population (42.9%) and among homemakers (40.9%). The prevalence of hypertension was found to be statistically significant in relation to age, educational status and occupation. Conclusion: In our study the prevalence of hypertension was found to be 30.2% (in males 29.6% while in females 30.6%). [ABSTRACT FROM AUTHOR]

Background: Low- and middle-income countries face the dual problem of infectious and non-infectious diseases. Persons living with HIV/AIDS (PLHIV) are also at risk of cardiovascular diseases. Hence, we did this study to determine the prevalence of cardiovascular risk factors (CVRF) among PLHIV and to find the factors associated with it. Methods: We carried out a cross-sectional analytical study among all adults aged ≥18 years registered at a facility-integrated anti-retroviral therapy center in Puducherry, India, from September 2016 to February 2018. After obtaining informed consent, we interviewed the participants to assess physical activity, alcohol, and tobacco use. We measured weight, height, abdominal circumference, and blood pressure, with biochemical investigations such as blood glucose and lipid profile. Results: Of the total 316 adults PLHIV studied, the most common cardiovascular risk factor found was dyslipidemia (82.7%), followed by inadequate physical activity (74.4%). Other behavioral risk factors studied, such as current tobacco use and current alcohol use, showed a prevalence of 12.8% and 5.4%, respectively, among male participants. The prevalence of hypertension among adult PLHIV studied was 15.8%, and diabetes was 12.3%. In the multivariate analysis, diabetes, and hypertension were significantly associated with age and literacy. Obesity was found to be associated with diabetes and abdominal obesity with dyslipidemia. Conclusion: Dyslipidemia was the most common cardiovascular risk factor, followed by inadequate physical inactivity among PLHIV. Regular screening with blood glucose, blood pressure, and lipid profile, and timely cross-referrals can help in the early detection of CVRF among PLHIV and hence improve their quality of life through appropriate treatment. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases (CVDs) account for over three-quarters of all deaths taking place in developing nations. Objective: The present study aims to stratify noncommunicable disease (NCD) patients using the Globorisk chart for predicting their 10-year risk of a major (fatal or nonfatal) CVD event and to estimate the level of agreement between this country-specific chart and the existing World Health Organization (WHO)/International Society of Hypertension (ISH) risk strata. Methods: A record-based cross-sectional analytical study was conducted in 2018 among adults attending the NCD clinic of one rural and one urban primary health center in Puducherry. Laboratory and office risk calculators of the Globorisk chart were used to calculate the risk. Results: The median age (interquartile range (IQR)) of the 760 study participants was 58 (50--65) years. When calculated using the Globorisk prediction chart, 22.1% (n = 168) of the participants had a <10% risk for any CVD event in the next 10 years, whereas the same risk was found in 71.1% (n = 540) by using the WHO/ISH risk chart. There was no agreement found between the two risk charts (k = 0.0174; P-value = 0.26). Conclusion: The Globorisk chart was found to identify more patients as belonging to the higher risk category as compared to WHO/ISH charts. [ABSTRACT FROM AUTHOR]

Introduction: Present era is an era of lifestyle diseases. This includes diseases like diabetes mellitus, hypertension, obesity and heart diseases. All these have one most common findings that today's modern sedentary and stressful lifestyle contributes to various type of heart diseases. Aim and Objectives: To evaluate various risk factors in patients diagnosed with different type of heart diseases. Material and Methods: The present prospective and observational study was conducted in Bharat Nursing Home, Sonipat Road, Rohtak, Haryana (India). Patients who visited to outpatient department of General Medicine with known or suspected criteria of various type of heart diseases. The total study population consists 50 coronary artery disease patients aged between 18-70 years at that time of their enrollment. Results: Mean age of the patients was 55.15±16.01 years. A total of 42(84%) were male and 8(16%) were female and majority of them belonged to urban areas i.e. 76%. A total of 44% patients were illiterate and 56% were literate. Forty four (88%) patients were found to be alcoholic, 38(76%) were smoker and 37(74%) were using tobacco. Mean systolic blood pressure was 128±21.85, diastolic blood pressure 96.19±14.12. mean body mass index observed was 28.14±6.45. Maximum number of patients were suffering from diabetes mellitus type I i.e. 45(90%) and 5(10%) had type II diabetes mellitus. In 38(76%) patients we observed positive family history of heart diseases. Mean haemoglobin was 11.18±2.12, mean TLC was 7771.83±1879.19, APC was 2.9±0.84, fasting blood sugar was 169.18±26.12, postprandial blood sugar was 292.19±52.11, blood urea 97.11±22.10, serum creatinine 9.12±1.87 and serum uric acid 6.12±1.87. Mean AST was 36.10±21.72 and ALT was 32.17±16.98. Mean triglycerides was 153±48.23, cholesterol was 158.39±45.16, high density lipoprotein was 37.2±29.14, low density lipoprotein was 105.21±39.19 and VLDL was 42.13±26.28. Conclusion: This study showed that various risk factors related to cardiovascular diseases is the major cause of death. Present study recommends improvement in life style in patients who already diagnosed with various type of heart diseases. [ABSTRACT FROM AUTHOR]

Context: Police personnel constitute a special occupational group with exposure to stressful work environment indirectly resulting in a high prevalence of cardiovascular risk factors, including metabolic syndrome (MS), hypertension, hyperlipidemia, cigarette smoking, and a sedentary lifestyle is reported among policemen. Surveillance activities are limited in the present scenario. Aims: The present study was designed to measure the prevalence of metabolic syndrome and other cardiovascular risk factors among police officers in Kozhikode district and observe the trend over the last 10 years. Settings and Design: The design was cross-sectional and spanned 630 policemen of Kozhikode Corporation in Kerala Methods and Material: Data collection was done using a pre-tested questionnaire. Anthropometric and biochemical measurements were carried out using standard techniques. MS was diagnosed using the National Cholesterol Education Program--Adult Treatment Panel III criteria. Statistical Analysis Used: Statistical analysis was performed using the SPSS 20.0 software. Prevalence of MS and cardiovascular risk factors were expressed as percentages (95% CI). Associated factors with MS were identified using Chi square test. Results: MS was observed in 45.1% of the study population. Obesity and lack of physical activity were the commonest abnormalities. Cardiovascular risk factors identified were high body mass index (67.3%), lack of physical activity (47.1%), hypertension (16.7%), alcohol use (24.2%), smoking (17.3%) and diabetes (8.8%). Conclusions: There is a rising prevalence (16.8% in 2012 to 45.1% in 2021) of Metabolic Syndrome among policemen in Calicut Corporation. All the cardio vascular risk factors are also highly prevalent among the policemen. Policy makers might seriously take up the issue and introduce effective policies that might help reduce the incidence of MS and other cardio vascular risk factors in the newly recruited young policemen. [ABSTRACT FROM AUTHOR]

Background: Many studies have associated male androgenetic alopecia with the risk of cardiovascular disorders but very few studies have addressed this association in women with FPHL. Materials and Methods: This was a cross-sectional hospital-based study in which a total of 50 women (18-45 years) were recruited. The objective was to measure carotid intima-media thickness (CIMT) by doppler ultrasound, Body mass index (BMI), waist circumference, lipid profile, fasting blood sugar (FBS), insulin, testosterone, Sex hormone binding globulin (SHBG), hs-CRP, ESR and fibrinogen, in pre-menopausal women having FPHL and to correlate these parameters with severity of FPHL. The prevalence of Metabolic syndrome (MetS) and Insulin resistance were evaluated. Results: Metabolic syndrome and insulin resistance were found in 12 (24%) and 17 (34%) cases respectively. Hypercholesterolemia, elevated LDL levels and hypertriglyceridemia, low HDL levels and hyperinsulinemia were found in 11 (22%), 31 (62%), 9 (18%), 17 (34%) and 7 (14%) cases respectively. 8 (16%) cases were diabetics. Elevated ESR, increased fibrinogen levels and elevated hs-CRP were found in 43 (86%), 10 (20%) and 21 (42%) cases respectively. CIMT was found to be within its normal range. Correlation of CIMT, anthropometric indices (BMI and WC), biochemical markers (serum cholesterol, triglycerides, FBS, and fibrinogen), and presence of metabolic syndrome with severity of FPHL in terms of Ludwig grade was found to be statistically significant. Conclusions: The determination of metabolic syndrome, insulin resistance and acute phase reactants such as hs-CRP and fibrinogen may be useful screening methods to detect increased cardiovascular risk in women with FPHL. [ABSTRACT FROM AUTHOR]

Introduction: Child marriage, defined as marriage before the age of 18 years, is a precocious transition from adolescence to adulthood, which may take a long-term toll on health. Aim: This study aims to assess whether child marriage was associated with added risk of adverse cardiovascular outcomes in a nationally representative sample of Indian adults. Methods: Applying the non-laboratory-based Framingham algorithm to data on 336,953 women aged 30–49 years and 49,617 men aged 30–54 years, we estimated individual's predicted heart age (PHA). Comparing the PHA with chronological age (CA), we categorized individuals in four groups: (i) low PHA: PHA < CA, (ii) equal PHA: PHA = CA (reference category), (iii) high PHA: PHA > CA by at most 4 years, and (iv) very high PHA: PHA > CA by 5 + years. We estimated multivariable multinomial logistic regressions to obtain relative risks of respective categories for the child marriage indicator. Results: We found that women who were married in childhood had 1.06 (95% CI 1.01–1.10) and 1.22 (95% CI 1.16–1.27) times higher adjusted risks of having high and very high PHA, respectively, compared to women who were married as adults. For men, no differential risks were found between those who were married as children and as adults. These results were generally robust across various socioeconomic sub-groups. Conclusions: These findings add to the relatively new and evolving strand of literature that examines the role of child marriage on later life chronic health outcomes and provide important insights for public health policies aimed at improving women's health and wellbeing. [ABSTRACT FROM AUTHOR]

Background: Dyslipidemia is a crucial risk factor for atherosclerotic cardiovascular disease. However, there is limited data available on the differences in the prevalence of dyslipidemia between rural and urban populations in India. The aim of the present investigation is to describe the prevalence of dyslipidemia and the risk factors associated with adverse lipid profiles among adults residing in rural, sub-urban, and urban areas of India, and to assess its association with diabetes and hypertension. Methods: We enrolled adults over the age of 20 who lived in three distinct demographic areas in South India: rural, sub-urban, and urban. Data on demographics, lifestyle, disease history, family history, body weight, height, waist circumference, blood pressure, and clinical characteristics were collected for this study. We used chi-square tests and multivariable logistic regression to analyze demographic prevalence and risk factors related to lipid abnormalities among study participants. Results: This study enrolled 2976 randomly selected participants from rural, sub-urban, and urban communities in Tamil Nadu, India. Of these, 865 (29.1%) were rural residents, 1030 (34.6%) were sub-urban residents, and 1081 (36.3%) were urban residents. About 80% of women who lived in the suburban area had higher rates of low-HDL cholesterol. Compared to sub-urban (29.9%, 49%, and 21.1%) and rural (33.4%, 43.4%, and 24.1%) populations, urban populations had higher prevalence rates of hypercholesterolemia, hypertriglyceridemia, and elevated LDL-C (37.3%, 52.5%, and 38.6%), respectively. Men were more likely than women to develop dyslipidemia before the age of 40, but after that age, men showed a reduced risk of dyslipidemia than women, except for low HDL cholesterol. Age group, gender, current drinker, overweight, obesity, diabetes, and hypertension showed a significant association (p < 0.05) with dyslipidemia. Conclusions: The study found that more than 85% of the sub-urban and urban population had dyslipidemia (at least one lipid abnormality) compared to rural residents (78.5%). The prevalence rates were higher among those with diabetes and hypertension in urban residents. [ABSTRACT FROM AUTHOR]

Preliminary studies have shown that yoga as well as fenugreek are beneficial in patients with type 2 diabetes mellitus (T2DM). This clinical trial is the first of its kind to prospectively evaluate in a multicentric, randomized, and controlled design if yoga and fenugreek can prevent the composite outcome of T2DM in prediabetic individuals. It aims to investigate whether there is an effective and safe treatment modality for the prevention of T2DMwhich is also-cost effective and can be implemented easily on a large scale so as to reduce the burden of T2DM. One thousand five hundred obese prediabetic individual aged 30–70 years were proposed to be identified on the basis of a 75-g oral glucose tolerance test (OGTT) and randomized to one of the three intervention arms viz standard life style measures + placebo (n = 500), standard life style measures + placebo + yoga (n = 500), and Standard life style measures + fenugreek (n = 500). Yoga consisted of a 40-min session each day which included yoga asanas and pranayamas. Fenugreek was given as fenugreek powder. All subjects were followed on an outpatient basis for 3 years, and annual OGTTs were done to pick up incident cases of diabetes mellitus. Incident rates, time to event analysis, and hazard ratios were compared between the groups. Secondary outcomes studied were change in glycemia, quality of life, cardiovascular disease and cardiovascular risk factors, beta cell function (HOMA-B), insulin resistance (HOMA-IR), and adverse events. Trial registration: Clinical trial registration number: CTRI/2013/01/003316. [ABSTRACT FROM AUTHOR]

INTRODUCTION People with severe mental illness (SMI) tend to die early due to cardiovascular and respiratory diseases, which may be linked to tobacco use. There is limited information on tobacco use in people with SMI in low- and middle-income countries where most tobacco users reside. We present novel data on tobacco use in people with SMI and their access to tobacco cessation advice in South Asia. METHODS We conducted a multi-country survey of adults with SMI attending mental health facilities in Bangladesh, India, and Pakistan. Using data collected with a standardized WHO STEPS survey tool, we estimated the prevalence and distribution of tobacco use and assessed receipt of tobacco cessation advice. RESULTS We recruited 3874 participants with SMI; 46.8% and 15.0% of men and women consumed tobacco, respectively. Smoking prevalence in men varied by country (Bangladesh 42.8%, India 20.1% and Pakistan 31.7%); <4% of women reported smoking in each country. Smokeless tobacco use in men also varied by country (Bangladesh 16.2%, India 18.2% and Pakistan 40.8%); for women, it was higher in Bangladesh (19.1%), but similar in India (9.9%) and Pakistan (9.1%). Just over a third of tobacco users (38.4%) had received advice to quit tobacco. Among smokers, 29.1% (n=244) made at least one quit attempt in the past year. There was strong evidence for the association between tobacco use and the severity of depression (OR=1.29; 95% CI: 1.12-1.48) and anxiety (OR=1.29; 95% CI: 1.12-1.49). CONCLUSIONS As observed in high-income countries, we found higher tobacco use in people with SMI, particularly in men compared with rates reported for the general population in South Asia. Tobacco cessation support within mental health services offers an opportunity to close the gap in life expectancy between SMI and the general population. [ABSTRACT FROM AUTHOR]

Background and objective: According to recent research, decreased renal function and cardiovascular disease are significantly linked to elevated serum levels of uric acid and hs-CRP. In order to identify early renal function deterioration before the start of proteinuria and cardiovascular risk in type 1 diabetic patients, this study will examine the roles of uric acid and hs-CRP. Method: In the cross-sectional study, a total of 140 type 1 diabetic individuals (70 normoalbuminuric and 70 microalbumin uric) were enrolled. Enzymatic colorimetric method and ELISA method were each used to quantify uric acid and hs-CRP, respectively. Blood pressure, body mass index, HbA1c, fasting plasma glucose, plasma lipid profile, serum creatinine, and urine albumin creatinine ratio were also evaluated as metabolic markers. The CKD-EPI equation was used to compute the estimated glomerular filtration rate. Result: Mean uric acid levels were 3.92+/-1.59 and 4.99+/-2.48mg/dL, respectively, for normoalbuminuria and microalbuminuria (p-0.004). Mean hs-CRP levels were 1.93+/-2.14mg/L in normoalbuminuria and 4.47+/- 3.05mg/L in microalbuminuria, respectively (p <0.001). Urinary albumin to creatinine ratios were 15.74+/- 8.88 in normoalbuminuria and 129.98+/-85.25 in microalbuminuria (both p<0.001). The mean GFR in individuals with normoalbuminuria was 112.45+/-20.30ml/min, whereas it was 100.25+/-27.12ml/min in individuals with microalbuminuria (p-0.02). A greater than 90 ml/min eGFR was present in 55.6% of normoalbuminurics and 47.5% of microalbuminurics. The eGFR was less than 90 ml/min in 36.8% of normal albuminurics and 67.6% of microalbuminurics. Lower GFR was strongly and independently linked with both elevated blood uric acid and elevated urine albumin creatinine ratio. Uric acid and hs-CRP correlated positively (p-0.04 and p0.001, respectively), whereas uric acid and eGFR correlated negatively. Conclusion: When blood uric acid levels were in the upper normal range and hs-CRP levels were elevated, renal function was decreased in patients with type 1 diabetes. As a result, in the clinical setting in India, where the detection rate is lower and the repercussions are more frequent, it can be used as markers for identifying cardiovascular risk and early renal function deterioration in patients with type 1 diabetes. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular Diseases (CVDs) are a group of disorders affecting the heart and blood vessels, including Coronary Heart Disease (CHD), cerebrovascular disease, rheumatic heart disease, peripheral artery disease, congenital heart disease, and pulmonary embolism. CVDs contribute to approximately 17.9 million deaths worldwide each year. Risk factors for CVDs can be classified as non modifiable (such as age, gender, ethnicity, and family history) and modifiable (such as obesity, dyslipidaemia, diabetes, hypertension, stress, poor diet, and physical inactivity). Men are more susceptible to CVDs than women. The QRISK3 risk score is an algorithm used to predict an individual's 10 year risk of developing CVDs. Aim: To assess the distribution of CVD risk among men and women aged 30-70 years using the QRISK3 risk score and its correlation with dietary intake, physical activity, and perceived stress. Materials and Methods: A cross-sectional study was conducted at the Department of Physiology at RUHS-CMS and Associated Hospitals in Jaipur, Rajasthan, India. The study duration was six months, from July 2022 to December 2022. A total of 220 subjects, aged 30-70 years, of both sexes were recruited from the Outpatient Department (OPD) of Medicine, based on inclusion and exclusion criteria. The QRISK3 web calculator was used to calculate the CVD risk, which was then correlated with the Food Frequency Questionnaire (FFQ), Perceived Stress Scale (PSS), and Global Physical Activity Questionnaire (GPAQ). Statistical analysis was performed using the Chi-square test for qualitative analysis, and Pearson's correlation analysis was used to assess correlations. Results: The mean age of the study participants (males) was 42.75±10.86 years and (females) was 42.82±10.85 years. A total of 220 participants (123 males and 97 females) aged between 30-70 years were included in the study. Among the males, 90 (73.17%) had low CVD risk, 15 (12.19%) had moderate risk, and 18 (14.63%) had high risk. Among the females, 83 (85.57%) had low risk, 9 (9.28%) had moderate risk, and 5 (5.15%) had high risk. There was a significant association between the QRISK3 risk score and gender (X2=6.14, df=218, p=0.04). Males showed a stronger association with the QRISK3 risk score compared to females within different age groups. Significant positive correlations were observed between the QRISK3 score and FFQ (r=0.28) and PSS (0.42). Additionally, a significant negative correlation was found between the QRISK3 score and GPAQ (-0.24). Conclusion: The QRISK3 score calculator was found to be useful in assessing the 10-year risk of developing CVDs in males and females across different age groups. The association between CVD risk and various scores suggests that perceived stress is strongly correlated with CVD risk. [ABSTRACT FROM AUTHOR]

Background: There is a correlation between obesity and a rise in cardiovascular disease risk factors. Several investigations have demonstrated their continued presence into adulthood from early childhood and adolescence. Materials and Methods: A case-control or cross-sectional survey was done at Department of Paediatric, Dhanalakshmi Srinivasan Medical College, Siruvachur, Perambalur, Tamil Nadu, India, between November, 2021 to October, 2022. We did a random sampling and selected a sample size of 500 to ensure a 95% confidence interval and 20% precision at a prevalence rate of 10%. Results: There were a total of 500 cases recorded among kids aged 12-16. 15-year-olds made up the bulk of the population that was analysed. And the 12 year-olds make up the youngest age group. Overall, 500 children of both sexes had their mean systolic and diastolic blood pressure values analysed and compared to age. It was discovered that BP levels rise steadily with ageing. Conclusion: In both sexes, the overall prevalence of "at risk for overweight" and "overweight" was 10.47%. Independent risk factors for childhood obesity were identified to include higher socioeconomic status, parental obesity and parental hypertension and diabetes. [ABSTRACT FROM AUTHOR]

Background: The prevalence of overweight and obesity is rising worldwide, but it is more common among women in India. To put a stop to this epidemic, we need to pinpoint the causes of obesity in young women. Methods: A case-control study of this magnitude has been conducted at Tertiary Care Centre, from period of October 2021 to September 2022. Cases and controls were selected at random from the pool of people who participated in a cross-sectional study on cardiovascular disease risk factors. Results: There were 110 cases and 50 controls in the research. Women from the elite and upper middle classes had an odds ratio of 2.74 times greater of being obese or overweight than women from other lower socioeconomic classes, when comparing the two groups on an unadjusted basis. Several risk factors for being overweight were identified after controlling for age and socioeconomic status: having a history of hyperlipidemia; having a parity of =2 and consuming more protein than is recommended. Conclusions: Obesity is a public health crisis that can lead to a variety of avoidable metabolic complications, as highlighted by this study. Housewives are a vital part of many families and communities; as such, they need to be included in efforts to detect, educate about and treat obesity. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease is the leading cause of mortality in all over the world, prediction of future risk of cardiovascular disease (CVD) is a crucial tool for primary prevention of CVD. Objectives: To determine the risk of cardiovascular disease by implementation of QRISK3 prediction algorithms in individual patients. This study is performed to assess the cardiovascular risk for the next 10 years in an individual patient without known cardiac disease. Methods: A prospective study is conducted in department of medicine, tertiary care hospital. This study uses the updated QRISK3-risk score method to analyze the person's risk of getting cardiovascular risk. Results: A total of 175 patients with age groups 25-84 years were enrolled in the study. Majority of the patients was 41-50 years age group with male predominance. Body mass index (BMI) was high (25 or >) found in 73.7% patients, 51.4% were non-smokers, 36% diabetics, 41.2% hypertensive, 18.3% rheumatoid arthritis and 11.4% were suffering for chronic kidney disease. Conclusion: Cardiovascular risk increases with increasing age and association of other co morbidities mainly obesity, diabetes and hypertension. [ABSTRACT FROM AUTHOR]

Background: Coronary artery disease(CAD) is a leading cause of morbidity and mortality in India. We have done this work to study prevalence of symptomatic and asymptomatic PVD in CAD patients undergoing CABG and to study whether low ankle brachial pressure index (ABPI) can be used as predictor of morbidity and mortality in CABG. Methods: Descriptive study was done enrolling continuous 80 patients who were referred for coronary artery bypass grafting. On bases of ABPI they were divided into 2 groups, group I included patients of CAD with PAD and group II included patients of CAD without PVD. Syntax score was calculated. Cardiovascular risk factors, intraoperative mortality and myocardial infarction, postoperative complications were studied. Study was performed from March 2013 up to December 2014. Results: 88.75% of patients were males and 11.25% patients were females. Mean age was 55.94±8.42. Smoking and hypertension encountered in 85% and 45.6% of all patients respectively. BMI of >30 was present in 8.75% patients. 36% patients of group I and 35 % patients of group were diabetic. Left anterior descending artery was most commonly involved vessel in 97%. Deranged RFT's were found in 29% and 8% patients in group I and II respectively. Conclusion: ABPI can be useful in assessing both the atherosclerotic risk factors and the degree of coronary involvement. ABPI is a simple and easy tool to diagnose symptomatic and asymptomatic PVD. [ABSTRACT FROM AUTHOR]

Background: India has 66 million people with diabetes, of which a large proportion do not receive adequate care. The primary health centres can serve as platforms for early detection of diabetes and continuum of care. Objectives: This project evaluates a community-level technology-enabled system-level intervention based around the community health workers and primary-care physicians. We hypothesize that incorporation of a mobile clinical decision support system, with other process-level changes will improve identification and management of individuals with diabetes in primary care settings. Methods: A cluster-randomized trial in sixteen villages/peri-urban areas in Andhra Pradesh and Haryana will test the feasibility and preliminary effectiveness of this intervention. The effectiveness of the extended care intervention will be evaluated by the difference in HbA1c (glycosylated hemoglobin) measured at baseline and end-line between the two study arms. Qualitative interviews of physicians, ASHA, and community members will ascertain the intervention acceptability and feasibility. Results: A total of 1785 adults (females: 53.2%; median age: 50 years) were screened. ASHAs achieved 100% completeness of data for anthropometric, blood-pressure, and blood-glucose measures. At baseline, 63% of the participants were overweight/obese, 27.8% had elevated blood pressure, 20.3% were at high-risk for cardiovascular disease (CVD), and 21.3% had elevated blood glucose. Half of the individuals with diabetes were newly diagnosed. Conclusion: Technology enabled transfer of simple clinical procedures from physicians to nonphysician health workers can support the provision of healthcare in under-served communities. Community health workers can successfully screen and refer patients with diabetes and/or CVD to physicians in primary healthcare system. [ABSTRACT FROM AUTHOR]

Objectives: Cardiovascular risk factors (e.g., diabetes and hypertension) are comorbidities associated with cognitive impairment. The present study was planned to study the relationship between cardiovascular risk factors and cognitive impairment using General Practitioner assessment of Cognition (GPCOG) scale, which is easy to use scale in the primary care. Materials and Methods: A total of 350 older adults (mean age=66.71 ± 6.53 years; M:F = 220:130) among 3000 who reported to the primary care center in West India were screened. Cardiovascular risk factors were assessed based on written medical records. GPCOG was used for cognitive screening of those over the age of 60 with subjective memory complaints. Results: Frequency of cardiovascular (CV) risk factors in those with cognitive impairment was 46.2% (n = 162/350) and 29% (101/350) in those without cognitive impairment. A Chi-square test of proportion showed values to be statistically significantly different (Chi-square value = 22.04; P =< 0.001; 95% confidence interval [CI] = 10.0463-24.1076%). Odds ratio was found to be 1.6 (95% CI =2-2.1; P =< 0.05). Conclusion: A higher CV risk factors were observed among those with cognitive impairment compared to those cognitively normal older adults in the primary care. [ABSTRACT FROM AUTHOR]

Background: Coronary heart disease, peripheral arterial disease, cerebrovascular disease, congenital and rheumatic heart illnesses are among the heart and blood vessel disorders classified as cardiovascular diseases (CVDs). Sudden premature cardiovascular deaths among apparently healthy population can be well prevented by the early recognition of cardiovascular risk factors using validated cardiovascular risk prediction tools. Aims and Objectives: The World Health Organization/international society of hypertension (WHO/ISH) Risk Prediction Charts was utilized to estimate the upcoming 10-year risk of CVD events, and the study's objectives were to identify the risk factors for high CVD risk among urban residents aged =40-79 years in Tamil Nadu State, South India. Materials and Methods: A total of 350 participants were selected for a community-based cross-sectional study using a two-stage selection technique. A pretested questionnaire, anthropometry and laboratory research were used to acquire the required data. Finding the relationship between the risk factors and high CVD risk among the subjects was done using both univariate and multivariate regression analysis. Results: Mean age of subjects was 55.6 years. Hypertensives and diabetics were 35.4% and 27.4%, respectively. An alarming 75.1% subjects were either overweight or obese. The WHO/ISH chart categorized 20.9% subjects with >10% risk of impending CVDs. Risk factors which independently influenced high cardiovascular risk were "being unmarried" (adjusted odds ratio [aOR] 31.76; 95% CI; P=0.009), "positive family history" (aOR 4.13; P=0.017), "Sedentary Occupation" (aOR 3.18; P=0.036), and "alcohol usage" (aOR 3.03; 95% CI [1.06-10.27]; P=0.039). Conclusion: The study has identified that more than one-fifth of the subjects were under the >10% CVD risk category thereby underscoring the immediate need for inclusion of CVD risk scoring tools in routine screening programs in all levels of health care settings as an effective health promotion strategy in curtailing the escalating incidence of CVDs events worldwide. [ABSTRACT FROM AUTHOR]

Background : We present a large Indian series of Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19) infection. The aim of the study is to present the incidence and pattern of cardiac involvement in children with MIS-C and their short-term follow-up. Methods and Results : Consecutive 144 children younger than 18 years of age diagnosed with MIS-C referred for cardiac evaluation between June 1 and November 30, 2021, were included and were followed up till February 2022. In addition to the demographics, details of COVID-19 infection, and biomarkers, their cardiovascular assessment (echocardiogram and electrocardiogram) was documented at baseline and on follow-up. The median age of children with MIS-C was 60 (24-104) months. Abnormal cardiac imaging was noted in 59% of children. Ventricular dysfunction was noted in 13.9% and coronary abnormalities were noted in 25.7% of children. The median duration when the first cardiac abnormality was reported was 7 (5-10) days. The distribution of age categories between children with and without cardiac abnormality was comparable. Children with cardiac abnormalities were followed up for a median duration of 47 (30-58) days. Complete resolution was documented in 92% of children after a median duration of 20 (9-38) days. There were no readmissions or deaths during follow-up. Conclusion : Cardiac involvement in children with MIS-C is frequent with coronary abnormalities and ventricular dysfunction being the most common manifestations. Most children exhibit complete clinical and myocardial recovery with appropriate anti-inflammatory therapy. Studies on long-term outcome of these children are needed. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is one of the leading causes of death in women. On an average, coronary artery disease develops 10 years later in women than men, but they represent the majority of patients when age above 75 years is considered. Men and women share most of the classic cardiovascular risk factors, but the relative importance of each risk factor may be gender specific. This review explores the recommendations for the management of cardiovascular risk and CVD prevention in women in the Indian clinical setting based on multiple advisory board meetings conducted with cardiology experts across India. The experts concurred that women have distinct patterns of ischemic heart disease (IHD) and that the presence of traditional risk factors, female-specific risk factors, and nontraditional risk variables may add to the increasing risk of IHD. Transition to postmenopausal status is associated with a worsening coronary heart disease risk profile in women. Evidence suggests that both traditional and novel cardiovascular risk factors are often under recognized and undertreated in women. Several female-specific risk factors such as preterm delivery, preeclampsia, gestational diabetes, and polycystic ovary syndrome are not included in primary prevention nor are they routinely considered in a cardiovascular assessment at the clinical level. Understanding and good diagnostic tools are necessary to evaluate the different pathophysiological aspects and early detection of CVD in women. [ABSTRACT FROM AUTHOR]

Background and Aim: Smoking is an important cardiovascular disease risk factor, but the mechanisms linking smoking to blood pressure are poorly understood. Present study was done to compare and assess resting heart rate in smoker and nonsmoker healthy males. Our objective was to study the effect of smoking on resting heart rate. Material and Methods: A total 100 healthy male subjects in the age group 20- 70 years comprising 50 smokers as case group and 50 nonsmokers as control group were considered for present study at tertiary care institute of India. Subjects having history of diabetes mellitus, hypertension, coronary artery disease and neurological disorders and any other systemic illnesses in past and present in both case and control study group. Results: Smokers have significantly higher resting heart rate than nonsmokers. Resting heart rate is important parameter to measure the effect of smoking on cardiovascular system. Smoking related products are dangerous to health and cause many health related disease. Conclusion: Smoking is by far the hardest on the heart, increasing persons resting heart rate. Resting heart rate is easy measurable parameter with prognostic implications. Sympathetic overactivity which lead to cardiovascular disease development in smokers. [ABSTRACT FROM AUTHOR]

Introduction: Raising trend of cardiovascular diseases (CVD) in developing countries created a platform for exploring the sociodemographic nexus in search of underlying cause. Aim and Objectives: The precise aim of the study is to detect any possible association of social determinants and metabolic derangement with CVDs risk, particularly focusing on comparative analysis of the data to decipher the most significant factor(s), if any among the studied parameters contributing toward prediction of such cardiometabolic risk in linked with insulin resistance. Results: In the present study, it was found that 2% of the studied population had high risk, and 13.3% had intermediate risk of developing cardiovascular events in next 10 years. Results also showed that estimated CVD risk was significantly higher in males with central obesity and age more >60 years as key determinants showing more insulin resistance at lower cut-off. Conclusion: This study also strongly suggests need to revise the cut-off values for HOMA index in defining insulin resistance to rural population with active the life style and need of redefining new targeted preventive health care planning. [ABSTRACT FROM AUTHOR]

Hypertension and diabetes mellitus (DM) are two of the leading lifestyle diseases in the Indian and South Asian populations that often co-exist due to overlapping pathophysiological factors. Obesity, insulin resistance, inflammation, and oxidative stress are thought to be some common pathways. Up to 50% of hypertensive cases in India are diagnosed with type 2 diabetes mellitus (T2DM), which defines the need for a comprehensive guideline for managing hypertension in diabetic patients. These RSSDI guidelines have been formulated based on consultation with expert endocrinologists in India and Southeast Asia, acknowledging the needs of the Indian population. Ambulatory blood pressure monitoring and office and home-based blood pressure (BP) monitoring are recommended for the early analysis of risks. Cardiovascular risks, end-organ damage, and renal disorders are the primary complications associated with diabetic hypertension that needs to be managed with the help of non-pharmacological and pharmacological interventions. The non-pharmacological interventions include the nutrition education of the patient to reduce the intake of salt, sodium, and trans fats and increase the consumption of nuts, fresh fruits, vegetables, and potassium-rich foods. It is also recommended to initiate 50 to 60 min of exercise three to four times a week since physical activity has shown to be more beneficial for hypertension control in Indian patients than dietary modulation. For the pharmacological management of hypertension in patients with T2DM, angiotensin II receptor blockers (ARBs) are recommended as the first line of therapy, demonstrating their superiority over other antihypertensive agents such as ACEi. However, most of the global hypertension guidelines recommend initiation with combination therapy to achieve better BP control in most patients and to reduce the risk of adverse events. For combination therapy, calcium channel blockers (CCBs) are recommended to be administered along with ARBs instead of beta-blockers or diuretics to avoid the risk of cardiovascular events and hyperglycaemia. Among the CCBs, novel molecules (e.g. cilnidipine) are recommended in combination with ARBs for better cardiovascular and reno-protection in diabetic hypertensive patients. [ABSTRACT FROM AUTHOR]

. Indian subcontinent exhibits considerable degree of ethnic heterogeneity in cardiovascular disease (CVD) risks. Given the importance of ethnicity, the present multi-ethnic study was conducted to find out the differences in body composition patterning and its influence on CVD risk variables.. Owing to considerable ethnic heterogeneity among Asian Indians the study was performed to determine the association of variability between body composition and CVD risk factors at the micro-level among different tribes by sex, province, and generation Nine tribes from three different states (provinces) were considered. Anthropometric measurements, body composition, adiposity, blood pressure, and fasting blood glucose was measured using standard technique. Body composition was measured using BIA method by means of body fat monitor. Mean differences of the body composition measures were analysed by ANOVA. Stepwise multiple regressions were done with CVD risk variables as dependent and body composition profiles as independent variables to find out the significant predictors. Those were then loaded for principal component factor analyses (PCFA).. Tribal subjects of both sexes and from both younger and older generations in Gujarat had significantly higher percentage body fat, subcutaneous fat-whole body, and subcutaneous fat-trunk as compared to tribal subjects of Odisha, and West Bengal, as well as significantly lower skeletal mass-whole body and skeletal mass-trunk. PCFA showed two components: (i) percentage body fat with muscle mass; and (ii) visceral fat with resting metabolism. These two components cumulatively explained 80–90% of the total variance associated with CVD risk variables, across the nine tribes.. Tribal subjects of Gujarat had higher CVD risks with significantly higher fat mass and lower muscle mass followed by the tribal subjects of Odisha, and West Bengal respectively. The younger generation are equally at risk as their older counterparts. The CVD risks are developing at a much faster rate resulting in a serious public health threat, even in traditional societies. Body composition measures could be considered as a better non-invasive technique for early intervention and proper risk management among the Asian Indians in general and tribal populations in particular. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a major modifiable risk factor for cardiovascular and cerebrovascular diseases. The association between different risk factors including smoking and hypertension is studied extensively; however, there is a paucity of literature with respect to association between smokeless tobacco use and hypertension in India. In the current study, the relationship between smokeless forms of tobacco use and hypertension is being investigated. Methodology: This study analyzed the data from fourth round of National Family Health Survey conducted during 2015–2016. Socio-demographic variables such as age, sex, education, wealth index, body mass index, smoked forms of tobacco use, and smokeless forms of tobacco like paan, gutkha, Khaini, etc., presence of co-morbidities were the independent variables. Hypertension was the dependent variable. Results: It was observed from the present analysis that, smokeless tobacco use is a risk factor for hypertension both in the case of females OR-1.1**(1.08-1.13) as well as males OR-1.07**(1.03-1.1). The other predictors observed were overweight, consumption of alcohol, and diabetes. Conclusion: It was concluded from the present study, that consumption of smokeless tobacco use acts as an independent risk factor for hypertension. [ABSTRACT FROM AUTHOR]

Background: Hypertension, is a crucial risk factor for the development of cardiovascular disease (CVD). Studies assessing the risk of developing CVD among high-risk groups like hypertensives is limited. Aim: The purpose of this study was to find the distribution of CVD risk with respect to hypertension status among Indian adults. Material and Methods: This was a secondary data analysis of NFHS-4 survey data. The distribution of CVD risk among hypertensive participants using 2019 WHO CVD risk prediction charts was compared with normotensive participants among women aged 40–49 years and men in the age group of 40–54 years. Results: The proportion of hypertension was higher among women who consumed alcohol (31.5%) than those who did not (24.3%). The proportion of hypertensives increased with increasing BMI, with maximum proportion among obese women (37.3%). Among women, majority (95.7%) had low CVD risk (<5%) while 4.2% had 5% to <10% CVD risk, and only 0.1% had >10% risk. Among men, those with low CVD risk (<5%) was 65%, those with 5% to <10% CVD risk was 32.3%, 10% to <20% was 2.7%, and a meagre 0.03% had 20 to <30% risk. Conclusion: In the current study, prevalence of hypertension was seen to be increasing with age and was higher in urban residents than rural among both men and women. Both high blood pressure reading during the survey and self-reported hypertension was found to be higher among richest wealth index category. Although risk was higher among hypertensives, self-reported hypertensives who had their blood pressure controlled, had risk similar to normotensives indicating the importance of management of hypertension. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular Autonomic Neuropathy (CAN) may be seen in patients of Type 2 Diabetes Mellitus (T2DM). In many previous studies it was seen that there is reduced heart rate variability in DM patients. Reduced heart rate variability is earliest indicator for the CAN. In different earlier studies, it was found that results of Short-term Heart Rate Variability (HRV) analysis of five minutes is comparable to standard 24 hours HRV analysis. In DM patients CAN is mostly found to be associated with a longer duration of disease, but according to some studies CAN may be present in newly diagnosed diabetes patients also, but the percentage is lower. Aim: To assess the short-term HRV profile as cardiovascular risks among newly diagnosed T2DM patients and to find the correlation of HRV parameters with duration of disease and biochemical parameters; Fasting Plasma Glucose (FPG) and Postprandial Plasma Glucose (PPPG) for early detection and management of CAN. Materials and Methods: The present study was a cross-sectional study conducted in the Department of Physiology in collaboration with the Department of Endocrinology at R.G. Kar Medical College and Hospital, Kolkata, West Bengal, India, from September 2020 to August 2021 on 56 newly diagnosed T2DM (age group 30 to 64 years). Study subjects were grouped according to the Standard deviation of NN intervals (SDNN) (millisecond) value as cardiovascular risk factor. Group 1 was the low risk group, group 2 was the moderate risk group, group 3 was the high-risk group. HRV testing was done with Physiograph Polyrite-D instrument with bio-amplifiers, 4 channels and accessories (RMS latest software-Version 3.0.16) in Autonomic Function Research Laboratory to measure HRV parameters. After collecting data, analysis was done using Statistical Package for Social Sciences (IBM, SPSS) version 23.0 Unpaired student's t-test, Chi-square test, Analysis of Variance (ANOVA) test, Pearson correlation test were performed and statistical significance of different parameters were evaluated. It was considered statistically significant when p-value <0.05. Results: By assessing HRV parameters as cardiovascular risk factors among newly diagnosed T2DM patients the present study showed there was significantly (p-value=0.0065) high LF/HF ratio in males (1.70±1.19) than in females (0.99±0.69). The SDNN value was significantly highest in low cardiovascular risk group (137.29±25.49 ms) and lowest in high cardiovascular risk group (26.07±12.03 ms) (p-value=0.00001). Low Frequency and High Frequency Ratio (LF:HF ratio) was significantly more in age group of 51-60 years. Among all the patients, 34 (61%) patients had increased parasympathetic activity and 22 (39%) subjects had increased sympathetic activity. Female patients showed significantly more increased parasympathetic 24 (75%) activity than males 10 (41.7%). There was a significant association between SDNN values with the duration of disease (p-value=0.004). Conclusion: The present study showed that cardiac autonomic neuropathy is present even at the time of diagnosis of newly diagnosed T2DM as there was sympathovagal imbalance. Female patients have more parasympathetic drive than males which indicates that females are more cardioprotective. [ABSTRACT FROM AUTHOR]

Background: The problems of cardiovascular diseases are on the rise and the tribal population are also not an exception to it. The present study aims to estimate the prevalence of risk factors of cardiovascular diseases and to find association of hypertension and diabetes with various risk factors among the Tharu tribe of Bihar, India. Methodology: The present study was an observational, cross-sectional study conducted on 252 individuals of 20–60 years age group. Risk factors related to cardiovascular diseases were assessed. Results: Among 252 participants, the prevalence of hypertension and diabetes was 32.5% and 4.8%, respectively. Around 30% of study participants were smokers, 39% were habitual of chewing tobacco, and about half of the population were not involved in active physical activities (49.2%). Raised blood glucose level was significantly associated with gender, age, smoking status, and tobacco chewing while hypertension was significantly associated with age, smoking status, and body mass index. Conclusions: Increased number of various risk factors among the tribal population makes them vulnerable to cardiovascular diseases and other complications. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular Disease (CVD) is the leading cause of mortality globally. Over 75% of CVD deaths occur in low- and middle-income countries. Objectives: To assess the 10-year CVD risk among adults aged 30 years and above attending the outpatient department at a Taluk Hospital, Bangalore Urban District, Karnataka. Methods: A cross-sectional study was conducted among 217 subjects above 30 years of age attending the hospital. They were selected by consecutive sampling and administered a face-validated interview schedule. WHO/ISH CVD risk assessment tool was used to categorize them into four categories of CVD risk. Additional risk factors like alcohol use and smoking were also assessed. Results: The mean age of the subjects was 55.7 ± 12.3 years. About 65% of the study population had low risk (<10%), 21.2% had mild risk (10%–20%), 9.7% had moderate risk (20%–30%) and 4.1% had high risk (>30%) according to the World Health Organization/International Society of Hypertension (WHO/ISH) CVD risk assessment tool. In the study population, 4.6% were abusing alcohol as per the CAGE questionnaire. Conclusion: The burden of CVD risk among the adults interviewed was high. The WHO/ISH chart is an inexpensive tool that can be used for screening in a regular OPD. [ABSTRACT FROM AUTHOR]

Context: Hypertension is an emerging public health problem due to its high prevalence and association with cardiovascular and overall morbidity and mortality. Police personnel constitute a special occupational group with exposure to violence and stress at work, which affects their health directly and indirectly. Methodology: A cross-sectional study was conducted to find out the prevalence of hypertension and its relation with respect to police duty profile along with other risk factors among the police personnel of the Gwalior district stationed at various police stations. Results: In total, 402 police personnel were included in the study. Forty (14.7%) participants reported that they had h/o hypertension, while 26 (9.5%) reported that they were diagnosed as hypertensive in recent 1–2 months. As per the findings of our study, 273 (67.91%) participants come out to be hypertensive; among them, 207 (75.8%) were diagnosed in the current study. With increase in hierarchy, more police personnel suffered with hypertension. Conclusions: Long duty hours, higher rank, prolonged service duration, and inappropriate eating habits are the significant factors for the high prevalence of hypertension in police personnel. [ABSTRACT FROM AUTHOR]

Introduction  Timely detecting dementia is an important goal of clinicians and public health professionals alike for better management and prevention of complications. Community screening of dementia could be a powerful strategy. Facilities for dementia screening at primary care level are virtually nonexistent and are a prominent implementation gap. Hence, a study was done to assess the feasibility of dementia screening at primary care using General Practitioner Assessment of Cognition (GPCoG) scale among older adults with subjective memory complaints. It was further aimed to assess the frequency of cardiovascular risk factors in those who met screening criteria for cognitive impairment. Materials and Methods  Older adults coming to three urban primary care centers in western India for screening of noncommunicable diseases such as diabetes and hypertension (opportunistic screening) with subjective memory complaints were enrolled and screened for dementia using GPCoG. A Mini-Mental State Examination (MMSE) was done in patients who came alone for referral purpose in case the score levels in GPCoG examination met cutoff limits for informant interview. Written medical records were examined to assess status of comorbid vascular risk factors such as diabetes, hypertension, coronary artery disease, and cerebrovascular accidents. Results  A total of 350 older adults (M:F = 276: 74; mean age ± 68 ± 6.7 years) were screened out of 3,000 older adults who reported during the study period. There were 161 older adults with GPCoG score less than or equal to 5 (56.14%) and 149 subjects with MMSE less than or equal to 24 indicating significant cognitive impairment (42.5%). There were very few (n  = 11, 3.14%) out of 350 people who came with caregivers; hence, MMSE was done along with for referral to healthcare providers. A total of 142 had comorbid diabetes/and or hypertension (40.5%). A total of 86 had diabetes alone (24.5%) and a total of 128 had hypertension (36.5%). Conclusion  Current study results indicate that using a simple screening tool such as GPCoG, community screening of probable dementia, is feasible in primary care settings, as is indicated by significant yield of probable dementia cases (42.5%). These cases can be referred to appropriate centers for further workup, confirmation of diagnosis, and treatment. Also, detection of comorbid cardiovascular conditions, for example, diabetes and hypertension, that can be managed along with cognitive impairment/dementia for potential prevention/further deterioration, which can strengthen noncommunicable disease screening. [ABSTRACT FROM AUTHOR]

Background and Aims: The American Diabetes Association recommends statin therapy for young type 2 diabetes mellitus (T2DM) adults only if one additional cardiovascular (CV) risk factor coexists. The data regarding CV risk factors in young Indian T2DM adults is limited. Hence, we assessed the prevalence of CV risk factors in young adults with T2DM from eastern India. Methods: In this cross-sectional study, diabetic medical health check records of eastern-Indian T2DM patients performed between March 2018 and March 2019 were retrospectively reviewed and the relevant data of T2DM patients (n = 3564) including CV risk factors [serum LDL-cholesterol of =100 mg/dL, hypertension (>140/90 mmHg), smoking, chronic kidney disease (eGFR of <60 ml/min), microalbumin to creatinine ratio of =30 µg/mg, and obesity/overweight (body mass index =23 kg/m2)] were analysed. Results: There were 3280 T2DM patients from eastern India and 679 (20.7%) were =40 years of age. Overweight/obesity (74.3%) and serum LDL-cholesterol of =100 mg/dL (69.2%) were the two most common additional CV risk factors. At least one additional CV risk factor was present in 576 (95.36%) patients, whereas at least two additional CV risk factors were present in 409 (67.7%) patients. At least one non-obesity/overweight CV risk factor was present in 472 (78.1%) patients. Conclusions: The study demonstrates a high prevalence of additional CV risk factors in young eastern-Indian adults with T2DM. Hence, there is a need for an intensive approach to managing the CV risk factors in young Indian adults with T2DM. [ABSTRACT FROM AUTHOR]

Oxidative stress, due to reactive oxygen species (ROS) or free radicals, can increase cardiovascular risk factors (CRFs). Lifestyle, environment, and genetics are the primary reasons for ROS generation. The role of genetics in the causation of CRFs mediated by ROS is still elusive. The present study aimed to determine the prevalence of null genotypes of oxidative stress genes (GSTM1 and GSTT1) and cardiovascular risk factors (CRFs) in an urban population. The association of GSTM1 & GSTT1 null genotypes with CRFs was also assessed in this study. A total of 40 participants (permanent residents of Chandigarh, India) were recruited. Anthropometric and physiological data were collected along with blood samples. Biochemical and molecular analysis were performed on all the collected blood samples. More than 90% of the participants had high blood pressure (HBP), 70% had obesity (OBS), and 40% had postprandial hyperglycemia (PPH). The null-genotype of GSTM1 and GSTT1 exhibited 47.50% and 7.50% of participants, respectively. GSTM1 and GSTT1 null genotypes were higher in males than females (50% vs 42.9% and 7.7% vs 7.1%). Agewise distribution showed that the absence of GSTM1 genotype was more in older participants (56.5% vs 35.3%) while GSTT1 genotype was more absent in younger participants (11.8 % vs 4.3%). Participants with null genotypes had trends of high CRFs, but only diastolic blood pressure (DBP) was significantly high. Although, mean arterial pressure (MAP) was also on the verge of significance. Odd ratio analysis showed a 2.383-fold risk of hyperglycemia in participants with either null genotypes. The present study concluded that studied participants are at greater risk of cardiovascular diseases due to high trends of CRFs. High CRFs may be related to the null genotype of GSTM1 and GSTT1 in the urban environment. Further studies with a bigger sample size are warranted to establish the results of the present study. [ABSTRACT FROM AUTHOR]

The present study is an attempt to envisage the various cardiovascular diseases risk factors among the rural and urban population of West Bengal. A total number of 224 participants (rural - 93; urban -131) aged 20 to 70 years were apparently selected to participate in the study. Significant difference (p < 0.05) was observed in physical activity, consumption of oil, consumption of fruits and overall and central adiposity variables between the rural and urban participants of both sexes. A significant association of behavioural risk factors with CVDs was observed. The age-specific mean difference was statistically significant (p < 0.001) among the participants. Significant difference was observed between the menopausal and the non-menopausal women. CVDs, a major public health challenge, require identification and implementation of proper health programmes at the grass root. [ABSTRACT FROM AUTHOR]

Objective: Leptin has drawn the attention of experts for its role in a myriad of conditions including stroke. However, in the absence of credible evidence linking leptin to stroke, its role as a risk factor is still debatable. We aimed to determine the leptin levels and its relationship with other cardiometabolic risk factors in patients with ischemic stroke in our region. Materials and Methods: It was a hospital based case-control observational study involving 100 patients and 100 age- and sex- matched healthy controls. Leptin levels were measured in both patients and controls in addition to estimation of lipid profile, insulin level and fasting blood glucose. Insulin resistance was calculated using the homeostasis model assessment for insulin resistance model. Carotid intima-media thickness (CIMT) was determined by high-resolution echocolour Doppler system (GE LOGIQ S8). Neuroimaging was also performed. Student's t-test for continuous variables, chi-square test for categorical variables and Pearson correlation coefficient to determine the correlation of leptin levels with various parameters were used. Results: The mean leptin levels were significantly higher in patients compared to control group (15.36±5.76 vs. 5.72±1.19 ng/ml; p<0.001). Leptin was found to have positive correlations with atherogenic lipid profile, inflammatory markers i.e, white blood cells and erythrocyte sedimentation rate, fasting plasma glucose and insulin resistance in patients with ischemic stroke whereas there was an inverse correlation between leptin and high density lipoproteins. Similarly leptin was found to have positive association with systolic blood pressure, body mass index and CIMT in patients. Conclusion: Hyperleptinemia is a common finding in patients with ischemic stroke and is significantly associated with various cardiovascular risk factors known to predispose to ischemic stroke. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases (CVDs) cause significant morbidity and mortality worldwide. Task shifting in various forms has been adopted extensively around the world in an effort to increase access to CVD risk assessment for early identification of high-risk individuals. Present study explored the feasibility of task shifting of CVD risk assessment by anganwadi workers (AWWs). Method: An operational study was carried out with the objective to develop the knowledge and skill of AWWs in CVD risk assessment. The study was carried out in the anganwadi centres of Northern India. A total of 40 AWWs were enrolled by using purposive sampling technique. They were trained in CVD risk assessment till they fully developed the skill. These trained AWW carried out CVD risk assessment among subjects aged ≥40 years. Cohen Kappa was used to determine the reliability of risk assessment by AWWs. Communication skills of AWWs were measured by using a standardized communication checklist. Result: Result revealed high interrater reliability of risk scores generated by AWWs and researcher (k = 0.91). Majority of the AWWs (87%) demonstrated good communication skills. Conclusion: Study concludes that AWWs can be trained in CVD risk assessment using WHO/ISH risk prediction charts. With proper training and supervision, the task of the CVD risk assessment can be shifted to AWWs. [ABSTRACT FROM AUTHOR]

Introduction: Obesity is the established risk factor for the development of cardiovascular diseases like hypertension, diabetes mellitus, chronic heart diseases and atrial fibrillation. Cytokines such as Interleukin-6 and Interleukin-12 (IL-6,IL-12) play a significant role in the development of obesity related disorders. Cluster of differentiation 40 (CD40) Ligand, a trimetric protein structurally related to Tumor Necrosis Factor alpha (TNF-a) family contributes to atherothrombosis by being a link between platelets, inflammation, thrombosis and atherogenesis. The present study was undertaken to explore the interplay between inflammatory cytokines and CD40 Ligand (CD40L) in young obese tribal subjects. Aim: To estimate the level of proinflammatory cytokines like IL-6, IL-12 and CD40 Ligand in obese subjects and compare with non obese tribal subjects of Tripura, India. Materials and Methods: In this observational study, 60 non obese and 60 young obese tribal subjects within age group of 18-36 years were enrolled, over a period of 2 years from March 2014 to March 2016 at Tripura Medical College (TMC) and Dr. BRAM Teaching Hospital. Serum levels of IL-6, IL-12 and CRP were estimated by Enzyme-Linked Immunoassay (ELISA). Plasma level of fibrinogen activity was measured by coagulation assay. The Homeostasis Model Assessment (HOMA) of insulin resistance was calculated as insulin (micro unit per milliliter) x glucose (milimoles/Ltr)/22.5. Soluble Cluster of differentiation 40 Ligand (sCD40L) in serum was determined by ELISA. Statistical analysis was performed using Mann-Whitney test, Chi-square test and regression analysis. Results: Cohort consisted of 19 (31%) males and 41 (68.3%) females whereas the control non obese group comprised of 16 (26.6%) males, and 44 (73.3%) females. In the present study, the authors had observed that the biochemical parameters like fasting blood glucose, cholesterol, triglycerides and High-Density Lipoprotein (HDL) cholesterol were significantly higher in obese subjects compared to non obese subjects. Further, the authors observed that C-reactive Protein (CRP), IL-6, IL-12 and Fibrinogen level were statistically higher in obese subjects. A statistical significant difference was found in fasting insulin level and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) between obese and the non obese group. Finally, there was positive relationship between CD40 Ligand and cytokines with obesity. Conclusion: The present study has demonstrated that the circulating levels of IL-6 and IL-12 have a strong relationship with obesity and other parameters of metabolic risk. It was also observed that there is a clear positive relationship between CD-40L and cytokine families. [ABSTRACT FROM AUTHOR]

Background: According to NFHS-4 survey, obesity has doubled in India. BMI cannot differentiate body fat from lean mass. Normal weight obesity was defined to distinguish people with normal BMI and increased body fat percentage (BF%). In contrast to conventional atherogenic prediction, Apolipoprotein B level is elevated before LDL cholesterol. Adiposity is also known for causing insulin resistance. Hence this study is an attempt to find the correlation of apo B and Insulin sensitivity in predicting future cardiovascular risk among normal weight obese. To study the role of apoB and insulin resistance in predicting cardio vascular risk. Methods: 269 participants of age group 18-24 in a medical teaching institute were selected for the first phase of the study through systematic random sampling. BF% was calculated with Harpenden skinfold callipers using Jackson Pollock's method. Second phase of the study involved biochemical investigation of 30 NWO participants. ApoB level and insulin sensitivity using HOMA model was estimated. Spearman correlations and simple linear regression were used. Analysis done using SPSSv16. Results: Male and Females were 56.4% and 43.6%, respectively. Out of 269, 44 were found to be having NWO. Hence Prevalence was 16.4%. There is a positive correlation found between apoB and insulin resistance with increasing body fat percentage. Conclusions: Elevated levels of apo B and insulin resistance are seen in NWO individuals as the BF% increases. NWO should be diagnosed early and thus apoB and insulin resistance can be screened for cardio vascular risk prediction. [ABSTRACT FROM AUTHOR]

Introduction: In menopause, changes in body fat distribution lead to increasing risk of cardiovascular and metabolic diseases. Therefore, the prediction of cardiovascular disease (CVD) by the presence of risk factors is of importance in elderly women. Objective: To find out the conicity index (CI) and its association with different CVD risk factors among rural elderly women of West Bengal. Materials and Methods: The study was conducted among 236 rural elderly women, selected randomly from 30 villages of Amdanga block, West Bengal. Components of metabolic syndrome (MS), body fat percentage, different lipid profile fractions, CI, and body mass index (BMI) were measured. Statistical tests were calculated using SPSS software version 20.0. P ≤ 0.05 was considered statistically significant. Results: High CI (median 1.25 and interquartile range 1.05–1.45) was found. The proportion of participants with high CI were significantly higher among those with MS (87.95%), waist circumference having 80 cm or more (99.09%), blood pressure having ≥ 130/85 mm of Hg (75.66%), body fat percentage ≥25% (80.14%), and BMI ≥23 (93.18%). Conclusion: High prevalence of CI existed among rural elderly women. Significant correlation existed between CI and different CVD risk factors as well as some of the components of MS indicating a possible coexistence of different CVD risks. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a common, T-cell-mediated disease, affecting 0.44–2.8% of the general population in India. It is associated with a higher risk of cardiovascular disease possibly due to chronic inflammation. Those patients with severe psoriasis are at a higher risk of death due to cardiovascular disease. The use of scoring tools may help the care providers to assess cardiovascular risks in these patients. Aims: The aim of this study was to assess the cardiovascular risks in patients with severe psoriasis using the commonly used risk-assessment tools (Framingham risk score [FRS] and Pooled cohort equations [PCE]) and to understand the utility of these tools in practice. Methods: It is a case-control study performed in the dermatology outpatient department of a tertiary care center during the study period from January to December 2020. Consenting adults with chronic plaque psoriasis and psoriasis area and severity index (PASI) more than 10 were included in the study. The FRS and PCE risk scores were calculated for the patients and age- and sex-matched healthy controls. Results: A total of 213 patients were assessed and 30 patients were excluded. Of the 183 patients, 152 patients were assessed using FRS and 135 patients using PCE. Equal number of age- and sex-matched healthy controls were also assessed. The mean age of the patients assessed using the FRS and PCE was 47 ± 10.9 and 52.84 ± 8.9 years, respectively. The mean age of the controls was 45.52 ± 8.7 and 51.76 ± 8.1 years in the FRS and PCE groups, respectively. The male to female ratio was 1.92:1 and 2:1 in the FRS and PCE risk-score groups, respectively. The mean PASI score was 16.45 ± 7.88 and 15.6 ± 7.6 in the two groups, respectively. The 10-year risk estimate using FRS in the patients ranged from 0 to 26.9%. The mean and median estimates were 4.95 ± 5.7 and 2.8%, respectively, while 2.65 ± 4.7 and 0.8% in the controls (P = 0.001). The 10-year risk estimate in the patients using the PCE risk score ranged from 0.3 to 39.6%. The mean and median estimate in the patients was 8.17 ± 9.9 and 5.2%, respectively while they were 5.68 ± 7.5% and 2.6% in the controls (P = 0.024). The agreement between the FRS and PCE was found to be poor (Ϗ, 0.049). There was no statistically significant correlation of PASI to either the PCE risk score (P = 0.498) or FRS (P = 0.630). Limitations: A small sample size, and study in a tertiary care center may have resulted in sampling bias. Conclusion: Psoriasis is associated with a higher risk of cardiovascular disease. These tools may help a dermatologist in the primary prevention of cardiovascular disease. It can also help in the awareness of the increased risk of cardiovascular disease in patients. [ABSTRACT FROM AUTHOR]

Background: Rising obesity epidemic and dyslipidemia majorly contribute to cardiovascular disease burden. Emerging evidence has reported an increasing trend of metabolic disorders among rural tribal populations in developing countries. Hence, the present study attempts to estimate the prevalence of obesity and dyslipidemia and explore their association among Bhil tribal population from India. Materials and methods: This was a cross-sectional study consisting of 277 adults recruited through household survey. Data on socio-demographic and lifestyle variables were collected and obesity was determined using anthropometric measurements. Biochemical assay was done using fasting blood samples. Logistic regression was employed to identify obesity variables associated with dyslipidemia. Results: Almost 40% of the population had generalized obesity (high BMI) while abdominal obesity was found to be relatively higher in terms of WHR (76.9%) followed by WHtR (59.2%) and WC (44.8%). Dyslipidemia in form of low HDL-C was found to be highest (52.3%) followed by high TG (40.8%), TC (7.9%), and LDL-C (6.5%). Sex-wise distribution of obesity and dyslipidemia variables revealed women were significantly more obese and dyslipidemic (low HDL-C) as compared to men. Logistic regression analysis after controlling for confounders revealed a significant association of abdominal obesity with all abnormal lipids except for high TG. Conclusion: The observed high prevalence of obesity and dyslipidemia, particularly low HDL-C and hypertriglyceridemia, warrants a public health concern. This study emphasizes the need for population-specific disease documentation to highlight underlying mechanisms of risk factors and to set forth a targeted approach to disease treatment and management. [ABSTRACT FROM AUTHOR]

Background: With the increase in elderly population, the risk of cardiovascular diseases (CVD) among Indian older adults is also increasing. The present paper tries to assess how different anthropometric measures of obesity and physical activity affects cardiovascular disease risk among older adults in India. Methods: The data from Longitudinal Ageing Study in India (LASI) has been used. The total sample size for the present study is 31,464 older adults aged 60 years and above. Chi-square test and binary logistic regression has been used to measure the association of obesity measures and CVD prevalence. Results: About 35.2% (n = 11,058) of the older adults suffered from CVD. Moreover, 22.2% (n = 6,217) of the older adults were obese/overweight, 23.7% (n = 6,651) had high risk waist circumference and 77.0% (n = 21,593) had high risk waist-Hip ratio. The likelihood of CVD was 60%, 50%, and 34% significantly higher among older adults who were obese/overweight [Adjusted odds ratio (AOR): 1.60; CI: 1.48–1.72], had high risk waist circumference [AOR: 1.50; CI: 1.39–1.62] and high risk waist-Hip ratio [AOR: 1.34; CI: 1.25–1.44], respectively compared to older adults with normal BMI and those who do not have a high risk waist circumference and high risk waist hip ratio. Moreover, older adults who never did physical activity had 22 per cent higher risk of CVD than those who did frequent [AOR: 1.22; CI: 1.13–1.32] physical activity. Conclusion: The burden of overweight and obesity along with physical inactivity increases the risk of CVD in older adults. These findings highlight the urgent need for framing direct and indirect strategies to control obesity in order to reduce the burden of CVD among older adults in India. [ABSTRACT FROM AUTHOR]

Background-India is experiencing a rapid health transition, with large and rising burdens of chronic diseases, which were estimated to account for 53% of all deaths in 2005. Earlier estimates projected that the number of deaths attributable to chronic diseases would rise from 3.78 million in 1990 (40.4% of all deaths) to 7.63 million in 2020 (66.7% of all deaths). Aims and Objectives-To find out the prevalence of Complications of Type 2 Diabetes Mellitus and its association with different risk factors in Urban Etawah (U.P.) including tobacco, alcohol, fatty meals and physical activity. Material and Methods-The present study is a community-based study performed among 400 participants using cluster sampling technique in the field practice area of Urban health training centre, Department of Community Medicine, UPUMS, Saifai, Etawah. The participants were interviewed using a pre-tested questionnaire using Diabetes Complication Index. Results-Among the diabetics, the prevalence of coronary heart disease (CHD), peripheral vascular disease (PVD), cerebrovascular accidents (CVA), cataract, neuropathy and foot problems were 24%, 24%, 7%, 15.4%, 38%, 26% and 2% respectively. A statistically significant association was seen with fatty meals and complications. Conclusion - All the diabetic complications observed need to be addressed in prevention and control strategies in the study area. Heath screening camps will be organized for the people for awareness. [ABSTRACT FROM AUTHOR]

Background-Increased carotid intima media thickness or ventricular hypertrophy and they are also at increased risk of cardiovascular disease in adulthood. Moreover, BP tracks from childhood to adulthood. Consequently, detection and management of elevated BP at an early age may be an important mean for limiting the disease burden due to hypertension. The causes for increase in blood pressure are attributed to obesity. Aim and objectives- to find out the prevalence and the risk factors of hypertention in school going children in uttar Pradesh, India. Materials and method-Children those who were having positive family history, findings were reconfirmed by telephonic interview of parents, about their current medications and doctor visits. All the entries were double checked for any possible key-board error. Association of each of the categorical with hypertension (outcome variable) is assessed with chi-square test. Results -55 were hypertensive while in the female population 35 were hypertensive. 10 hypertensive males were <10 years of age and 18 were between the age of 10-12 years. In female population 2 were <10, 20 were between 10-13 and 12 were <13 years of age. Conclusion-Life style modification which includes weight control, encouragement of exercise, reduction in dietary sodium and fat and, where appropriate, cessation of smoking and alcohol. It is essential to assess and, wherever possible, modify all cardiovascular risk factors. Prevention of the problem through healthy lifestyle choices and prevention of obesity is important. [ABSTRACT FROM AUTHOR]

Background: The impact of bariatric surgery on atherosclerosis is a relatively less studied subject. Obesity has been identified as an independent risk factor for cardiovascular disease (CVD). Carotid intima-media thickness (CIMT), a surrogate marker for atherosclerosis and risk of CVD, has been found to be associated with obesity. Recent literature has shown that there is significant reduction in CIMT following bariatric surgery. The aim of this study was to evaluate the impact of bariatric surgery on CIMT and risk of CVD in an Indian population.Methods: This is a prospective study conducted in a tertiary referral centre in India. Patients undergoing bariatric surgery from December 2017 to September 2019 were included. CIMT measurements and American College of Cardiology/American Heart Association (ACC/AHA)-pooled cohort CVD risk scores were done before and at 6 months and 12 months after surgery.Results: Fifty-four patients were enrolled, of which 70% were females. Mean age was 40.8 ± 10.7 years. Mean pre-operative weight and mean BMI were 115.2 ± 21.9 kg and 45.9 ± 6.5 kg/m2, respectively. Patients who completed 12-month follow-up were considered for analysis of outcomes. There was significant reduction in BMI to 33.1 ± 5.7 kg/m2 at 12 months after surgery (p < 0.0001). Mean CIMT reduced significantly from 0.58 ± 0.08 mm at baseline to 0.52 ± 0.10 mm at 12 months. Lipid profile, fasting blood sugar and HbA1C also improved, which resulted in reduction of lifetime and 10-year CVD risk from 42.3 to 26% and 4 to 1.5%, respectively, at 12 months after surgery.Conclusions: Bariatric surgery results in significant reduction in CIMT and CVD risk in patients with morbid obesity. [ABSTRACT FROM AUTHOR]