LESSONS FOR PREVENTION FROM A CORONARY HEART-DISEASE EPIDEMIOLOGIC-STUDY IN WESTERN INDIA

Coronary heart disease, a major health problem in India and many other developing countries, is more prevalent in urban than in rural areas. To determine causes for this urban-rural difference in prevalence, we performed studies in the western Indian state of Rajasthan, Coronary heart disease prevalence was more in urban than in the rural Rajasthan (men 6.0% vs 3.4%; women 10.5% vs 3,7%, P < 0.01). Risk factor compar ison showed that smoking/tobacco consumption was more in rural than in urban men (51% vs 39%), but more in urban women (19% vs 5%), In urban men compared to rural men, the prevalence of a history of diabetes me llitus (1.1% vs 0.2%), hypertension (30% vs 24%), obesity (11% vs 5%), and truncal obesity (25% vs 4%) was significantly more (P < 0,01), Li kewise, in urban a omen (compared to rural women) the prevalence of a history of diabetes mellitus (1.0% vs 0,1%), hypertension (33% vs 17%) , obesity (11% vs 6%) and truncal obesity (17% vs 5%) was greater (P < 0.01). Prevalence of regular moderate-grade leisure-time physical act ivity was low among both urban and rural populations; lower in urban m en. In urban men (compared to rural men), mean levels of total cholest erol (175.8 +/- 43 vs 165.2 +/- 37 mg/dl) and LDL-cholesterol (107.6 /- 39 vs 96.8 +/- 33 mg/dl) were significantly greater (P < 0.01), Ser um levels of HDL-cholesterol and triglycerides in urban and rural men were similar. Higher prevalence of coronary risk factors such as hyper tension, diabetes mellitus, obesity, truncal obesity and higher total and LDL-cholesterol in urban subjects indicates that efforts should be directed towards controlling these risk factors in the urban populati on for coronary heart disease prevention in India.