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Prevalence of Ischemic Heart Disease Among Urban Population of Siliguri, West Bengal

Prevalence of Ischemic Heart Disease Among Urban Population of Siliguri, West Bengal. Mandal S, Saha J B, Mandal S C, Bhattacharya R N, Chakraborthy M, Pal P P . Ind. J Comm. Med.34(1):19-23,2009. Learning Objective-. To study the prevalence of IHD

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Prevalence of Ischemic Heart Disease Among Urban Population of Siliguri, West Bengal

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  1. Prevalence of Ischemic Heart Disease Among Urban Population of Siliguri, West Bengal Mandal S, Saha J B, Mandal S C, Bhattacharya R N, Chakraborthy M, Pal P P Ind. J Comm. Med.34(1):19-23,2009

  2. Learning Objective- • To study the prevalence of IHD • To study the causative risk factors associated with IHD

  3. Introduction- • Cardiovascular disease has become a major public health problem in many developing countries. • About two-thirds of the global estimated 14.3 million annual cardiovascular disease deaths occur in the developing world. • By the year 2015, cardiovascular diseases could be the most important cause of mortality in India. • The prevalence of coronary artery disease in India increased from 1% in 1960 to 9.7% in 1995 in urban populations, and in rural populations it has almost doubled in the last decade

  4. Objective Of Study- • To determine the prevalence of IHD and associated risk factors among the urban population

  5. Methodology- • Study Design- Cross sectional study • Study Setting- Study area - Population from the Municipal Corporation area of Siliguri was included in the study. - Out of 47 wards in Siliguri Municipal corporation area, ward no.23 (Dabgram) and 47 (Pati colony) were selected for the study. Sample Size- The sample size of 246 was calculated using expected prevalence of IHD among urban population in India as 9.7%, worst acceptable prevalence as 6% and confidence level of 95%. - Considering a non-response of 10%, a sample size of 271 individuals was decided. Study subjects-From the updated voter list of 2 wards, all members who were permanent residents aged >40 yrs old were selected. - By using systematic random sampling method, a list of 271 members aged > 40 yrs with name & address was prepared.

  6. Methodology- • Data collection- - Necessary data was collected after obtaining informed consent - A pre-tested, semi-structured questionnaire was used for data collection (modifications to Rose questionnaire) - the smoking habit was stratified according to number of cigarettes smoked per day and the duration of smoking -Physical activity was categorized as sedentary lifestyle if a person walked less than 14.5 km a week. - BMI was calculated and obesity defined as BMI > 27Kg/m2 and overweight as BMI > 25Kg/m2 - Hypertension was diagnosed when SBP > 140 mmHg, and DBP > 90 mmHg, as per guidelines of British hypertension society. - 12 lead ECGs were taken using BPL108 ECG machine on each individual and ECGs were reviewed with the cardiologist.

  7. Criteria for diagnosis of ihd • History of angina or infarction and previously diagnosed disease • An affirmative response to the Rose questionnaire • ECG findings namely Minnesota codes 1-1, 4-1, 5-9, 5-2 or 9-2. The presence of all three criteria were taken as the confirmation of the diagnosis of ischemic heart disease. DATA ANALYSIS: Data was entered in EPIINFO software, version 3.2 and then exported to SPSS version 10 for analysis. Association between the prevalence of IHD and risk factors were examined.

  8. Results- • Of the 271 individuals >40 years enrolled in the study, 250 took part in the study. • 29 (11.6%) among them had IHD. The prevalence was higher among males (13.5%) as compared with females (9.4%)

  9. Table 1: The prevalence of ihd in different age groups among study population P value < 0.01

  10. Table 2: Distribution of study population according to coronary risk factors and presence of ihd

  11. Table 2: Distribution of study population according to coronary risk factors and presence of ihd

  12. Table 3: Association between ihd and coronary risk factors by binary logistic regression analysis

  13. Discussion- TABLE 4: COMPARATIVE ANALYSIS BETWEEN STUDIES WITH REGARD TO REPORTED PREVALENCE OF CHD

  14. Conclusion- • The prevalence of coronary artery disease and coronary risk factors is high in urban population in India. • Further research is required to document the impact of lifestyle modification and controlling the stated risk factors.

  15. Critical comments- Strengths- • An updated voter list is used to select study subjects by systematic random sampling • Standard questionnaire(Rose Questionnaire) and standard Classification for BMI for SEAR are used Limitations- • Physical activity is not assessed correctly • Factors like Smoking, Physical activity are not adequately analyzed • Known coronary risk factors like Diabetes and lipid profile were not included in the study • OR for risk factor variables is not mentioned in logistic regression analysis.

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