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      Epidemiological study of non-communicable diseases (NCD) risk factors in tribal district of Kinnaur, HP: A cross-sectional study

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          Abstract

          Background

          There are no data available on the prevalence of non-communicable diseases (NCD) risk factors among the tribal population of hill state of Himachal Pradesh (HP). The epidemiological study of NCD risk factors was done in the tribal population of district Kinnaur of HP to estimate the burden of NCD risk factors and their risk determinants.

          Methods

          WHO STEP wise approach was used for screening of the core NCD risk indicators in 3582 randomly selected natives of Kinnaur aged 20–70 years by trained Health workers of the district health services.

          Results

          The hypertension was prevalent in 19.7% (18.4–21.1%) and diabetes in 6.9% (6.1–7.8%) of the population. Awareness of hypertension and diabetes was 39.8% and 40.8% respectively. The adherence to prescribed medications was reported in 52.1% and 56.4% of patients of aware hypertension and diabetes respectively. Overall, 23.3% and 8.5% of the patients with hypertension and diabetes had controlled BP and blood glucose respectively. Overweight and obesity were observed in 38.2% (36.6–39.9%) and 8.8% (7.9–9.8%) of the population respectively. The consumption of tobacco and alcohol was reported in 22.6% and 24.9% of the population, respectively, and 34.5% were physically inactive. Physical inactivity, BMI, high alcohol consumption, and age were independently associated with risk of hypertension, while age was the only determinant of risk of diabetes. Education and women gender had a significant influence on tobacco and alcohol consumption behavior adjusted for age.

          Conclusion

          NCD risk factors are prevalent in the tribal district of Kinnaur. The awareness, treatment, control of blood pressure and blood glucose were found to be suboptimum in the study subjects.

          Interpretation

          Strengthening of primary health care services and community based interventions are urgently required to improve awareness and control of NCD risk factors in this tribal district of HP.

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          Most cited references12

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          Emerging epidemic of cardiovascular disease in developing countries.

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            Epidemiology and causation of coronary heart disease and stroke in India.

            Cardiovascular diseases are major causes of mortality and disease in the Indian subcontinent, causing more than 25% of deaths. It has been predicted that these diseases will increase rapidly in India and this country will be host to more than half the cases of heart disease in the world within the next 15 years. Coronary heart disease and stroke have increased in both urban and rural areas. Case-control studies indicate that tobacco use, obesity with high waist:hip ratio, high blood pressure, high LDL cholesterol, low HDL cholesterol, abnormal apolipoprotein A-1:B ratio, diabetes, low consumption of fruits and vegetables, sedentary lifestyles and psychosocial stress are important determinants of cardiovascular diseases in India. These risk factors have increased substantially over the past 50 years and to control further escalation it is important to prevent them. National interventions such as increasing tobacco taxes, labelling unhealthy foods and trans fats, reduction of salt in processed foods and better urban design to promote physical activity may have a wide short-term impact.
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              Estimation of contribution of changes in classic risk factors to trends in coronary-event rates across the WHO MONICA Project populations.

              From the mid-1980s to mid-1990s, the WHO MONICA Project monitored coronary events and classic risk factors for coronary heart disease (CHD) in 38 populations from 21 countries. We assessed the extent to which changes in these risk factors explain the variation in the trends in coronary-event rates across the populations. In men and women aged 35-64 years, non-fatal myocardial infarction and coronary deaths were registered continuously to assess trends in rates of coronary events. We carried out population surveys to estimate trends in risk factors. Trends in event rates were regressed on trends in risk score and in individual risk factors. Smoking rates decreased in most male populations but trends were mixed in women; mean blood pressures and cholesterol concentrations decreased, bodymass index increased, and overall risk scores and coronary-event rates decreased. The model of trends in 10-year coronary-event rates against risk scores and single risk factors showed a poor fit, but this was improved with a 4-year time lag for coronary events. The explanatory power of the analyses was limited by imprecision of the estimates and homogeneity of trends in the study populations. Changes in the classic risk factors seem to partly explain the variation in population trends in CHD. Residual variance is attributable to difficulties in measurement and analysis, including time lag, and to factors that were not included, such as medical interventions. The results support prevention policies based on the classic risk factors but suggest potential for prevention beyond these.
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                Author and article information

                Contributors
                Journal
                Indian Heart J
                Indian Heart J
                Indian Heart Journal
                Elsevier
                0019-4832
                Sep-Oct 2016
                29 March 2016
                : 68
                : 5
                : 655-662
                Affiliations
                [a ]Professor and Head, Department of Cardiology, Indira Gandhi Medical College, Shimla, H.P., India
                [b ]Senior Resident, Department of Community Medicine, Indira Gandhi Medical College, Shimla, H.P., India
                [c ]D.M. Resident, Department of Cardiology, Indira Gandhi Medical College, Shimla, India
                [d ]District NCD Control Officer, Kinnaur, Himachal Pradesh, India
                [e ]OSD State NCD Programme Officer, Shimla, Himachal Pradesh, India
                Author notes
                [* ] Corresponding author. negiprakash59@ 123456gmail.com
                Article
                S0019-4832(16)00103-6
                10.1016/j.ihj.2016.03.002
                5079134
                27773404
                3ffbe702-652d-4f00-a2ca-3fd85b36aac0
                © 2016 Cardiological Society of India. Published by Elsevier B.V.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 24 August 2015
                : 5 March 2016
                Categories
                Original Article

                bmi, body mass index,bp, blood pressure,cad, coronary artery disease,cva, cerebrovascular accident,cvd, cardiovascular diseases,dm, diabetes mellitus,hp, himachal pradesh,htn, hypertension,mi, myocardial infarction,ncd, non communicable diseases,cardiovascular diseases,epidemiology,ncd risk factors,surveillance

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