EPIDEMIOLOGIC-STUDY OF CORONARY-ARTERY DISEASE AND ITS RISK-FACTORS IN AN ELDERLY URBAN-POPULATION OF NORTH-INDIA

Objective: In view of the rapid increase in the prevalence of coronary artery disease (CAD) in developing countries, our aim was to determin e the prevalence of CAD and its risk factors and lifestyle factors in an elderly population from north India. Methods: A random sample of 59 5 elderly subjects between 50 to 84 years of age was obtained from the urban population of Moradabad. The response rate was 90.1%. The surve y methods included a questionnaire containing information on 7-day foo d intake, other lifestyle factors, Rose questionnaire for diagnosis of angina pectoris, a standard 12-lead electrocardiogram, blood pressure measurements and blood examination. Results: The total prevalence of CAD based on clinical history and electrocardiogram was 121/1000 (95% Cl 72 to 165). The prevalence rate was slightly higher in males (130/1 000) than in females (110/1000). The prevalence of CAD based on the Ro se questionnaire was 57/1000 and based on electrocardiogram in 561 asy mptomatic subjects was 67/1000. CAD was significantly higher in the el derly (65 to 84 years) group than in the middle-aged (50 to 64 years) group (168 vs. 97 per 1000), respectively. While the prevalence of hyp ertension was significantly higher in the elderly than middle-aged gro up respectively (214 vs. 168 per 1000), the prevalence of central obes ity was significantly higher in the middle-aged than elderly group (67 4 vs. 632 per 1000). Other risk factors including smoking were compara ble in the two subgroups. Prevalence of major risk factors and central obesity were significantly higher among patients with CAD than in the rest of the subjects. Prevalence of CAD was significantly higher in t he middle and higher socio-economic groups compared to the lower incom e group. These higher income groups were also eating significantly hig her amounts of visible fat and had a higher prevalence of physical ina ctivity (93.3%) compared to the lower income group. Conclusions: CAD a nd its risk factors such as hypertension, hypercholesterolemia, diabet es and central obesity are of sufficient magnitude in the elderly popu lation of India to be a major public health problem. The findings also indicate that CAD is more commonly associated with middle and higher socio-economic status which may be due to greater consumption of dieta ry fat and more sedentariness compared to lower socioeconomic groups.