Download CARDIOVASCULAR RISK BEHAVIOUR AND LIFESTYLE: A POPULATION BASED STUDY AMONG MEN AND WOMEN.

International journal of Research in Management
CARDIOVASCULAR RISK BEHAVIOUR
AND LIFESTYLE: A POPULATION
BASED STUDY AMONG MEN AND
WOMEN.
Vijay Pratap Raghuvanshi#1 (M.Phil, PGDHM), Dr. Rajkishore Agrawal#2 (MS, MBBS)
#1
Assistant Professor, Institute of Health Management and Research (IIHMR), 1 Prabhu Dayal Marg, Near Airport,
Sanganer, Jaipur -302011 India.
#2
Senior Consultant, Wockhardt Hospitals, Plot No- 1139, Sirpattani Road, Bhavnagar, Gujarat, India.
__________________________________________________________________
ABSTRACT
Background: Cardiovascular diseases (CVDs) are the leading cause of death among men and
women. Lifestyle related behavioural risk factors are mainly implicated for increased burden of
cardiovascular diseases. Cardiovascular disease is the leading cause of death in the all regions of
India, with the highest proportion in the Southern region (25%) and the lowest in the Central
region (12%). The other prominent causes of death across different regions are respiratory
diseases, diarrhoeal diseases, perinatal conditions, tuberculosis and cancer. Coronary heart
disease is linked to various lifestyle factors such as diet, physical activity, smoking and stress.
Objective: To identify lifestyle behaviours related to risk of Cardiovascular Disease and to
understand the perceived risk of different lifestyle behaviours among men and women.
Materials and Methods: A cross sectional study was carried out among the men and women in
Gujarat. A self administered questionnaire with combining questions on risk factors, alcohol,
tobacco consumption, exercise program, nutrition habits, personal health history, covering major
aspects of lifestyle and behaviour related to cardiovascular diseases. The ethically questionnaire
was distributed to the people and information collected on risk behaviours within age group
between 25-65 years. Conclusion: Developing strategies at these risk behaviours and
determining factors is necessary to promote healthy lifestyle among men and women.
Keywords: Cardiovascular, risk behaviors, Coronary Heart disease, alcohol, smoking,
exercise, lifestyle
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International journal of Research in Management
1.1 INTRODUCTION
Coronary artery disease (CAD) is the leading cause of morbidity and mortality in the
industrialized world. According to the projections, it will become the leading cause of disease
globally in the twenty- first century [1]. According to the WHO, in 2002 there were 7.22 million
deaths from coronary heart disease globally. This is about one-third of all deaths globally. By
2020 heart disease and stroke will become the leading cause of both death and disability
worldwide, with the number of fatalities projected to increase to more than 20 million a year and
to more than 24 million a year by 2030. The WHO predicts 11.1 million deaths from coronary
heart disease in 2020. Today, men, women and children are at risk, and 80 percent of the burden
is in low and middle-income countries. [2] Cardiovascular disease (CVDs) is the leading cause of
death (19%) in India. CVDs among the age group 25-69, the mortality rate rises sharply and
causes(25%) of the deaths.[3] Coronary heart disease is linked to various lifestyle factors such as
diet, physical activity, smoking and stress.
[4,5]
Now infectious disease burdens are reduced and
nutrition improves, diseases related to hypertension, such as hemorrhagic stroke and hypertensive
heart disease, become more common, as life expectancy continues to improve, high-fat diets,
cigarette smoking and sedentary lifestyles become more common. Non-communicable diseases
then predominate, with the highest mortality caused by atherosclerotic CVD, most frequently
ischemic heart disease and athero-thrombotic stroke, especially at ages below 50 years. This is
found in urban India.[6] The explanation for this increase in cardiovascular disease is that most of
the world is in process of developing, and as populations develop their exposure to the standard
risk factors for cardiovascular disease increase for example, people get older, they smoke more,
exercise less and intake of potassium intake decrease (because of lower consumption of fresh
fruit and vegetables).[7] Lifestyle-related behavioral risk factors are mainly implicated for this
increased burden, and research related to these risk factors is essential. Thus, the following study
was carried out with the objective of evaluating the prevalence of cardiovascular risk behaviors
among men and women.
2.1 MATERIALS AND METHODS
A cross-sectional study was conducted among men and women in Gujarat, from January,2010 to
December, 2010.Through systematic random sampling, 750 sample was collected using a pre77
International journal of Research in Management
tested, structured, anonymous, and self-administered questionnaire. Out of 750 men and women,
700 responded giving a response rate of 93.3%. The Questionnaire was divided into 5 sections
i.e. non-controllable risk factors, alcohol & tobacco consumption, exercise program, nutrition
habits, personal health history and habits. The Data collected with the closed ended questions.
The questions were based on the information about e.g. age, habits, physical activity, type of
work, socioeconomic status, personal history of the patients having cardiovascular diseases,
hypertension and diabetes, family history of disease, recent food intake, lifestyle, medical
history, dietary habits, use of alcohol & smoking, and frequency of intake of various food items
and vitamin supplements. The data collected from the population represented by CVD patients
attending OPD or clinics or admitted in the wards or hospital. SPSS version 13 and EPI-Info
software was applied to assess the association between risk behaviours and age, gender and
lifestyle.
3.1 RESULTS AND DISCUSSION
Majority of the population belonged to 25-62 years with the mean age of 36 years. Out of 750
Samples, 700 responded (100%), the proportion of males 547 (78.1%) was higher than females
153 (21.8%).
3.1.1 Non – Controllable risk factors
From total samples 42.3 % responded that they are suffer from any one of the non-controllable
risk factors i.e. Ischemic heart disease (IHD) (2%), High cholesterol (10%), High Blood Pressure
(14.7%), Diabetes (8.3%), obesity (5%) and Dyslipidemia (2.3%). [Chart- 1]
Chart -1: Non – Controllable risk factors (N=700)
2.3% Dyslipdiemi
a
5% - Obesity
2% - IHD
10% - High
Cholestrol
8.3% Diabetes
14.7 % High BP
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International journal of Research in Management
3.1.2 Smoking, Tobacco and alcohol use
Only 17% of the men used to smoke cigarettes, from which 5.7% smoke 1-2 cigarettes per day,
9.8% smokes 2-5 cigarettes per day, 3.9% smokes 6-10 cigarettes per day. 26.2 % used any form
of tobacco, while 22.9 % of male consumed alcohol occasionally or regularly. Consumption of
both smoking and alcohol together significantly more than the tobacco and alcohol. Use of
tobacco with Katha and chuna (called Mawwa) is more than cigarette. [Chart No. 2]
Chart No. 2: Consumption of Alcohol, Smoking, and Tobacco (N=700)
12% Smoking
23% Alcohol
26% Tobacco
3.1.3 Diet-related risk behavior
Current evidence supports an association between a limited number of dietary factors and
patterns with coronary heart disease.
[8, 9]
Consumption of fruit and vegetables seem to be heart
protective and decreases the risk of coronary heart events and mortality.
[10, 11]
The minimum
recommendation of taking at least 1 piece of fruit per day of fruits and vegetables
[12]
was
complied only by 46.3% following the habit. The Consumption of fruits and vegetable per week
is 27.2 %. The consumption of egg (1-2 eggs per day) is 17.1% only, the eating habit of meat or
egg is not preferred in Gujarat region [Table 1, 2, 3].
Table – 1: Consumption of meals per day (N =700)
2 meals with healthy snacks
2 meals only
1 meal with healthy snacks
No regular eating habit
(% age)
82.3
12.4
4.5
0.8
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International journal of Research in Management
Table – 2: Consumption of Fruits and Vegetables (N =700)
1 Time Per day
2 Times per day
3-4 times per week
Rarely
Fruits
(%age)
46.3
8.1
36.3
9.3
Vegetable (%age)
50.6
29.3
18.1
2.0
Table –3: Consumption of egg (N =700)
Eggs (age %)
69.9
13.0
13.7
3.4
Not eating
Occasionally
1-2 eggs per day
8 or more per week
Frequent (either once or more per week) consumption of carbonated soft drinks was reported by
28.1% only. The consumption of lassi or chass is more preferred in-spite of cold drinks in
Gujarat. The soft drinks are more preferred in urban areas. The consumption of fast foods is
49.6% (either once or more per week). Consumption of fast food was significantly high on the
evening snacks and holidays compare to other days. High salt intake by adding extra salt or by
eating items, such as sauces/ pickles, and others, was reported by 14.7% but showed no
association with any covariates. Seemingly, fruits and vegetables consumption is gradually
replaced with fast foods or ready to eat foods [Table 4, 5].
Table –4: Consumption of Fast Food and Cold/ Soft Drink (N =700)
Occasionally
1- 2 Times per week
3 times per week
More than 4 times per week
Fast Food (%
age)
35.3
49.6
8.0
7.1
Soft Drink (%
age)
71.9
20.1
6.0
2.0
Table – 5 Consumption of Extra table salt in food (N =700)
Yes
No
Salt (% age)
14.7
85.3
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International journal of Research in Management
3.1.4 Physical and sedentary activity
Physical activity for at least 30 min/day for 4 or more days was reported by 33.3%, while
occasional 22.7% and nil physical activity was reported by 44.0% among men & women. About
58.2 % reported spending more than 3 h in sedentary activities by watching TV or working on
computer on a typical day. Only 40.2 % who were doing annual or regular health checkup, 18.7
% doing in 2 years while 41.1 % were not going for regular health checkup. [Table 6, 7, 8].
Table –6: Physical / any form of exercise (N =700)
Almost Never
Sometime
Quite Often
Mostly
(%age)
44.0
22.7
21.9
11.4
Table -7: Hours spend computer or watching Television (N =700)
Less 1 hr
2-3 Hrs
4-5 Hrs
More 6 Hrs
(%age)
41.7
47.7
8.4
2.1
Table – 8: Physician checkup or Regular Health check-up (N =700)
(%age)
Annual basis
At least every 2 years
Within 5 years
Never done
40.2
18.7
24.4
16.7
From 33.3 % (Quite often and mostly doing exercise) 51.7 % of men and women doing walking
and yoga while 39.0 % do cycling or machine exercise. Breaks during continued sedentary
activity (i.e., standing up, walking down the hall, and others), regardless of physical activity level
or energy expenditure of breaks have been reported to reduce a number of individual CVD risk
factors.
[13, 14]
The importance of performing light activities (e.g. walking/standing) in between
long sedentary hours must be emphasized. Increasing total volume of activity, increasing
intensity of aerobic exercise from low to moderate and from moderate to high, and adding weight
training to the exercise program are among the most effective strategies to reduce the risk of
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International journal of Research in Management
CDH in men”.
[15]
Similar findings have been shown for women. [16] Women who either walked
briskly or exercised vigorously at least 2.5 hours per week reduce their risk of CVD
approximately 30%. Performing both walking and vigorous activities further reduced the risk.
Both walking pace and furthermore time spent sitting was of importance. Women who spent 1215 hours per day sitting had 1.38 relative risk of CVD, and if 16 hours or more per day were
spent sitting the relative risk was 1.68.
4.1 Conclusion
Our study showed that several modifiable lifestyle-related factors at midlife may affect the later
development of CVDs. Daily intake of fruits and vegetables combined with a medium-high
intake of dairy fat are associated with a lower risk of coronary heart disease. Exercise and diet
lifestyle intervention targeted to a population at moderate to high risk for cardiovascular disease
can be delivered mainly by physiotherapists and dieticians. Regular CVDs screening and
assessment according to guidelines is thus, clearly indicated.
CVDs prevention including
therapeutic lifestyle intervention needs to be developed, evaluated and then systematically
implemented.
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