Social class, coronary risk factors and undernutrition, a double burden ofdiseases, in women during transition, in five Indian cities

Objective: To find out the association between social class and coronary ri sk factors in women. Design and Setting: Cross-sectional surveys were condu cted in six-twelve urban streets in each of five cities from various region s of India following a common study protocol and criteria of diagnosis. Sub jects and Methods: We randomly selected 3257 women, aged 25-64 years inclus ive, from the cities of Moradabad (n=902), Trivandrum (n=760) Calcutta (n=4 10), Nagpur (n=405) and Bombay (n=780). Evaluation was by questionnaires va lidated at Moradabad. All subjects, after pooling of data, were divided int o social class 1 (n=985), social class 2 (n=790), social class 3 (n=674), s ocial class 4 (n=602) and social class 5 (n=206), based on various attribut es of socioeconomic status. Results: The prevalence of hypertension, diabet es mellitus, family history of coronary disease, obesity, central obesity a nd sedentary lifestyle were significantly associated with higher social cla sses and tobacco consumption was not associated with social class. Oral con traceptive intake and postmenopausal status were also more common among hig her social classes, which may be due to more education and a longer lifespa n among the higher social classes, respectively. Mean total cholesterol, hi gh density Lipoprotein cholesterol, systolic and diastolic blood pressure, mean body mass index and waist-hip ratio showed significant association wit h higher social classes. Mean age, body weight, body mass index, waist-hip ratio, systolic and diastolic blood pressure, total cholesterol and 2-h blo od glucose were significantly positively correlated with social class, as a ssessed by Spearman's rank correlation. Higher social classes 1-3 were more common in Trivandrum and Bombay than in Moradabad. The prevalence of hyper tension, diabetes mellitus and being overweight (body mass index >25 kg/m(2 )) were also more common in Trivandrum and Bombay compared to Moradabad. Un dernutrition was negatively associated with higher social classes and was m ore common in Moradabad and Nagpur than Trivandrum. Conclusions: Higher soc ial classes among Indian urban women have a higher prevalence of coronary r isk factors, hypertension, diabetes mellitus, being overweight, central obe sity, sedentary lifestyle, family history of coronary disease, oral contrac eptive intake and postmenopausal status. Mean concentrations of total and h igh density lipoprotein cholesterol were also significantly associated with higher social classes. (C) 1999 Elsevier Science Ireland Ltd. All rights r eserved.