Quantifying Socioeconomic and Lifestyle Related Health Risks: Burden of Cardiovascular Disease Among Indian Males

Main Article Content

Neetu Purohit
Divya K. Bhati
Shiv D. Gupta
Azad S. Kundu


Background: Non-communicable diseases account for a significant disease burden in the South East Asia region. India is facing an increased incidence of lifestyle-related diseases, such as cardiovascular disease. Socioeconomic and lifestyle risk factors for cardiovascular disease (CVD) have been under investigated in India. This study was designed to explore risk factors contributing to the development of cardiovascular disease among Indian males.

Methods: A population-based cross-sectional study was conducted among 2,235 males in the age group of 18-60 years across three states of India. A household survey was used to collect demographic and socioeconomic status information in addition to lifestyle-related attributes such as smoking, alcohol consumption, diet, and physical activity. Descriptive statistics and logistic regression were performed to identify the role of various factors that may be associated with the development of cardiovascular disease in this population.

Results: The prevalence of cardiovascular disease among the male respondents contacted through a household survey was reported to be 9.8%. Logistic regression revealed that males with higher education and higher income were more likely to report CVD. With age as a strong predictor of CVD, the risk of CVD was found to be five times higher in the older age group. Current smokers were 1.3 times more likely to have CVD compared to those who never smoked. Those who were engaged in physical activity were less likely to have CVD; however, the adverse effects of smoking and excessive consumption of red meat showed a stronger association with CVD than the protective effects of physical activity.

Conclusion: In developing countries, where the increase in earning capacity and change in lifestyle has been found to be accompanied by substantial risk of heart disease for males, public health measures like health promotion programs need to be implemented to decrease CVD burden.

Article Details

How to Cite
Purohit, N., Bhati, D. K., Gupta, S. D., & Kundu, A. S. (2015). Quantifying Socioeconomic and Lifestyle Related Health Risks: Burden of Cardiovascular Disease Among Indian Males. Central Asian Journal of Global Health, 4(2). https://doi.org/10.5195/cajgh.2015.218
Author Biographies

Neetu Purohit, Indian Institute of Health Management Research University

PhD. and Associate Professor (Public Health)

Divya K. Bhati, Indian Institute of Health Management Research University

MSc., Research Scholar, Public Health

Shiv D. Gupta, Indian Institute of Health Management Research University

MD, PhD (John Hopkins), President, IIHMR University


World Health Organization. Preventing chronic diseases: A vital investment. 2005; http://www.who.int/chp/chronic_disease_report/en/. Accessed Sept. 9, 2015.

Anand SS, Yusuf S. Stemming the global tsunami of cardiovascular disease. Lancet. 2011;377(9765):529-532.

Murray CJL, Lopez AD. Global comparative assessments in the health sector. 1994; http://www.nap.edu/openbook.php?record_id=5513&page=44. Accessed Sept. 10, 2015.

Leeder S, Raymond S, Greenberg H, Liu H, Esson K. A race against time: The challenge of cardiovascular disease in developing economies. New York: Columbia University Press; 2004.

Awad A, Al-Nafisi H. Public knowledge of cardiovascular disease and its risk factors in Kuwait: A cross-sectional survey. BMC Public Health. 2014;14:1131.

World Health Organization. The world health report 2002 - Reducing risks, promoting healthy life. 2002; http://www.who.int/whr/2002/en/. Accessed Sept. 9, 2015.

Chadha SL, Radhakrishnan S, Ramachandran K, Kaul U, Gopinath N. Epidemiological study of coronary heart disease in urban population of Delhi. Indian J Med Res. 1990;92:424-430.

Rastogi T, Reddy KS, Vaz M, et al. Diet and risk of ischemic heart disease in India. Am J Clin Nutr. 2004;79(4):582-592.

Pais P, Pogue J, Gerstein H, et al. Risk factors for acute myocardial infarction in Indians: A case-control study. Lancet. 1996;348(9024):358-363.

Xavier D, Pais P, Devereaux PJ, et al. Treatment and outcomes of acute coronary syndromes in India (CREATE): A prospective analysis of registry data. Lancet. 2008;371(9622):1435-1442.

Gupta R. Epidemiology and regional variations in cardiovascular disease and risk factors in India. J Preventive Cardiology. 2011;1(1):7-15.

Anjana RM, Ali MK, Pradeepa R, et al. The need for obtaining accurate nationwide estimates of diabetes prevalence in India - Rationale for a national study on diabetes. Indian J Med Res. 2011;133(369-380).

Gupta R, Joshi P, Mohan V, Reddy KS, Yusuf S. Epidemiology and causation of coronary heart disease and stroke in India. Heart. 2008;94(1):16-26.

Shah B, Mathur P. Surveillance of cardiovascular disease risk-factors in India: The need and scope. Indian J Med Res. 2010;132(634-642).

Stein AD, Thompson AM, Waters A. Childhood growth and chronic disease: Evidence from countries undergoing the nutrition transition. Matern Child Nurs. 2005;1(3):177-184.

Lwanga SK, Lemeshow S. Sample size determination in health studies: A practical manual. 1991; http://apps.who.int/iris/bitstream/10665/40062/1/9241544058_(p1-p22).pdf. Accessed Sept. 11, 2015.

World Health Organization. A global brief on hypertension: Silent killer, global public health crisis. 2013; http://apps.who.int/iris/bitstream/10665/79059/1/WHO_DCO_WHD_2013.2_eng.pdf. Accessed Sept. 10, 2015.

Registrar General of India. Report on causes of deaths in India 2001-2003. 2009; http://www.cghr.org/wordpress/wp-content/uploads/Causes_of_death_2001-03.pdf. Accessed Sept. 10, 2015.

Mukherjee A, Satija D. The consumption pattern of the rising middle class in India. 2012; http://www.boaoreview.com/plus/view.php?aid=38. Accessed Sept. 10, 2015.

Global Tobacco Surveillance System. Global Adult Tobacco Survey (GATS) Indicator guidelines: Definition and syntax. 2009; http://www.who.int/tobacco/surveillance/en_tfi_gats_indicator_guidelines.pdf. Accessed Sept. 11, 2015.

US Department of Health and Human Services. The health consequences of smoking - 50 years of progress. A report of the surgeon general. 2014. Accessed Sept. 10, 2015.

World Health Organization. Global recommendations on physical activity for health 2010; http://apps.who.int/iris/bitstream/10665/44399/1/9789241599979_eng.pdf. Accessed Sept. 10, 2015.

Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: Part I: General considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104(22):2746-2753.

Gupta R, Guptha S, Sharma KK, Gupta A, Deedwania P. Regional variations in cardiovascular risk factors in India: India heart watch. World J Cardiol. 2012;4(4):112-120.

Sanderson JE, Mayosi B, Yusuf S, et al. Global burden of cardiovascular diseases. Heart. 2007;93(10):1175.

Van Uffelen JG, Wong J, Chau JY, et al. Occupational sitting and health risks: A systematic review. Am J Prev Med. 2010;39(4):379-388.

Kutty VR, Balakrishnan KG, Jayasree AK, Thomas J. Prevalence of coronary heart disease in the rural population of Thiruvananthapuram district, Kerala, India. Int J Cardiol. 1993;39(1):59-70.

National Institutes of Health. Institute of Medicine (US) Committee on preventing the global epidemic of cardiovascular disease: Meeting the challenges in developing countries. Washinton, DC: National Academies Press; 2010.

Stuckler D. Population causes and consequences of leading chronic diseases: A comparative analysis of prevailing explanations. Milbank Q. 2008;86(2):273-326.

Nissinen AK. The increasing importance of chronic diseases. In: Karis L, Staffan, B., & Hellena, M. P., ed. Health and diseases in developing countries. New York: Macmillan Press; 1994:317-322.

Bartecchi CE, MacKenzie TD, Schrier RW. The costs of tobacco use (1). N Engl J Med. 1994;330(13):907-912.

World Health Organization. Global status report on noncommunicable diseases 2010. 2010; http://www.who.int/nmh/publications/ncd_report_full_en.pdf. Accessed Sept. 10, 2015.

Micha R, Wallace SK, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke and diabetes mellitus: A systematic review and meta-analysis. Circulation. 2010;121(21):2271-2283.

Bernstein AM, Pan A, Rexrode KM, et al. Dietary protein sources and the risk of stroke in men and women. Stroke. 2012;43(3):637-644.

Capizzi S, de Waure C, Boccia S. Global burden and health trends of non-communicable diseases. A systematic review of key issues in public health. Switzerland: Springer; 2015:19-32.

Reynolds K, Lewis B, Nolen JD, Kinney GL, Sathya B, He J. Alcohol consumption and risk of stroke: A meta-analysis. JAMA. 2003;289(5):579-588.

Directorate General of Health Services Ministry of Health & Family Welfare, Government of India. National programme for prevention and control of cancer, diabetes, cardiovascular diseases and stroke (NPCDCS): Operational guidelines. 2011; http://health.bih.nic.in/Docs/Guidelines/Guidelines-NPCDCS.pdf. Accessed Sept. 10, 2015.