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Cardiovascular and Metabolic Risk
Prevalence of diabetes and cardiovascular risk factors in middle-class urban participants in India
  1. Arvind Gupta1,
  2. Rajeev Gupta2,
  3. Krishna Kumar Sharma3,
  4. Sailesh Lodha2,
  5. Vijay Achari4,
  6. Arthur J Asirvatham5,
  7. Anil Bhansali6,
  8. Balkishan Gupta7,
  9. Sunil Gupta8,
  10. Mallikarjuna V Jali9,
  11. Tulika G Mahanta10,
  12. Anuj Maheshwari11,
  13. Banshi Saboo12,
  14. Jitendra Singh13,
  15. Prakash C Deedwania14
  1. 1Department of Diabetes, Jaipur Diabetes Research Centre, Jaipur, Rajasthan, India
  2. 2Departments of Medicine and Endocrinology, Fortis Escorts Hospital, Jaipur, Rajasthan, India
  3. 3Department of Pharmacy, SMS Medical College, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India
  4. 4Department of Medicine, Patna Medical College, Patna, Bihar, India
  5. 5Department of Medicine, Government Medical College, Madurai, Tamil Nadu, India
  6. 6Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  7. 7Department of Medicine, SP Medical College, Bikaner, Rajasthan, India
  8. 8Department of Diabetes, Diabetes Care and Research Centre, Nagpur, Maharashtra, India
  9. 9Department of Medicine, JN Medical College, Belgaum, Karnataka, India
  10. 10Department of Community Medicine, Assam Medical College, Dibrugarh, Assam, India
  11. 11Department of Medicine, BBD College of Dental Sciences, Lucknow, Uttar Pradesh, India
  12. 12Department of Diabetes, DiaCare and Research, Ahmadabad, Gujarat, India
  13. 13Department of Medicine, Government Medical College, Jammu, Jammu and Kashmir, India
  14. 14Department of Cardiology, University of California San Francisco VA Medical Center, Fresno, California, USA
  1. Correspondence to Dr Rajeev Gupta; rajeevgg{at}gmail.com

Abstract

Objectives To determine the prevalence of diabetes and awareness, treatment and control of cardiovascular risk factors in population-based participants in India.

Methods A study was conducted in 11 cities in different regions of India using cluster sampling. Participants were evaluated for demographic, biophysical, and biochemical risk factors. 6198 participants were recruited, and in 5359 participants (86.4%, men 55%), details of diabetes (known or fasting glucose >126 mg/dL), hypertension (known or blood pressure >140/>90 mm Hg), hypercholesterolemia (cholesterol >200 mg/dL), low high-density lipoprotein (HDL) cholesterol (men <40, women <50 mg/dL), hypertriglyceridemia (>150 mg/dL), and smoking/tobacco use were available. Details of awareness, treatment, and control of hypertension and hypercholesterolemia were also obtained.

Results The age-adjusted prevalence (%) of diabetes was 15.7 (95% CI 14.8 to 16.6; men 16.7, women 14.4) and that of impaired fasting glucose was 17.8 (16.8 to 18.7; men 17.7, women 18.0). In participants with diabetes, 27.6% were undiagnosed, drug treatment was in 54.1% and control (fasting glucose ≤130 mg/dL) in 39.6%. Among participants with diabetes versus those without, prevalence of hypertension was 73.1 (67.2 to 75.0) vs 26.5 (25.2 to 27.8), hypercholesterolemia 41.4 (38.3 to 44.5) vs 14.7 (13.7 to 15.7), hypertriglyceridemia 71.0 (68.1 to 73.8) vs 30.2 (28.8 to 31.5), low HDL cholesterol 78.5 (75.9 to 80.1) vs 37.1 (35.7 to 38.5), and smoking/smokeless tobacco use in 26.6 (23.8 to 29.4) vs 14.4 (13.4 to 15.4; p<0.001). Awareness, treatment, and control, respectively, of hypertension were 79.9%, 48.7%, and 40.7% and those of hypercholesterolemia were 61.0%, 19.1%, and 45.9%, respectively.

Conclusions In the urban Indian middle class, more than a quarter of patients with diabetes are undiagnosed and the status of control is low. Cardiovascular risk factors—hypertension, hypercholesterolemia, low HDL cholesterol, hypertriglyceridemia, and smoking/smokeless tobacco use—are highly prevalent. There is low awareness, treatment, and control of hypertension and hypercholesterolemia in patients with diabetes.

  • Cardiovascular
  • Hypertension
  • Hypercholesterolemia

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjdrc-2014-000048

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