Rising prevalence of Coronary Heart Disease (CHD) in urban Delhi, India- results from a repeat cross-sectional study

Abstract

Purpose: India is witnessing rapid epidemiological transition and coronary heart disease (CHD) and its risk factors are projected to become leading cause of mortality and morbidity. However, there is little data on the changing prevalence of CHD in the Indian population. The major objective of this study was to estimate the prevalence of CHD among residents of urban Delhi and to compare it to a previous study in the same population between 1991-1994. Methods: We used a multistage cluster random sampling method stratified for age and gender to select a representative population, aged 35-64 years, from urban Delhi. The sample size of baseline and repeat survey were 3, 021 and 2, 052 respectively. CHD was diagnosed on the basis of a positive Rose Angina Questionnaire and/or ECG (Minnesota codes: 1-1-1 to 1-1-7, 4-1-1 to 4-1-3, 5-1 to 5-3, 7-1-1). The age and sex adjusted prevalence estimate was then compared to data from the previous survey which used the same criteria to diagnose CHD Results: The age-wise and the age adjusted prevalence rates of CHD in men and women in the two surveys were as in Table 1. The total prevalence of CHD in the population increased from 10.19% (95% CI: 9.11-11.27) to 13.91% (95% CI 12.41-15.41). There was a significant increase in the overall prevalence of CHD in women. The prevalence of premature CHD among men (age 45-54 years) also increased. (table Presented) Conclusion: This survey reveals a significant rise in the prevalence of CHD in urban Delhi in a short span of less than 20 years. The rising prevalence rate of premature CHD is especially disturbing for its impact on the potentially productive life years necessitating an urgent need for policies and programmes to meet this public health challenge.