Article Text

Educational status-related disparities in awareness, treatment and control of cardiovascular risk factors in India
  1. Rajeev Gupta1,
  2. Krishna Kumar Sharma1,
  3. Bal Kishan Gupta2,
  4. Arvind Gupta3,
  5. Revant R Gupta4,
  6. Prakash C Deedwania5
  1. 1Department of Medicine, Fortis Escorts Hospital, Jaipur, Rajasthan, India
  2. 2Department of Medicine, SP Medical College, Bikaner, India
  3. 3Jaipur Diabetes Research Centre, Jaipur, India
  4. 4Jaipur Heart Watch Foundation, Jaipur, India
  5. 5Department of Cardiology, University of California San Francisco, Fresno, California, USA
  1. Correspondence to Dr Rajeev Gupta, Department of Medicine, Fortis Escorts Hospital, JLN Marg, Jaipur, Rajasthan 302017, India; rajeevgg{at}


Objective To determine association of socioeconomic status, defined by educational status (ES), with awareness, treatment and control of cardiovascular risk factors.

Methods We performed an epidemiological study at 11 cities in India using cluster sampling. 6198 subjects (3426 men, 2772 women, response 62%, age 48±10 years) were evaluated for sociodemographic, lifestyle, anthropometric and biochemical factors. ES was categorised according to years of schooling into low (≤10 years), medium (11–15 years) and high (>15 years). Risk factors were diagnosed according to current guidelines. Awareness, treatment and control status were determined for hypertension, diabetes and hypercholesterolaemia. For smoking/tobacco use, quit rate was determined. Descriptive statistics are reported.

Results Age-adjusted and sex-adjusted prevalence (%) of various risk factors in low, medium and high ES subjects was hypertension 31.8, 29.5 and 34.1, diabetes 14.5, 15.3 and 14.3, hypercholesterolaemia 24.0, 23.9 and 27.3, and smoking/tobacco use 24.3, 14.4 and 19.0. Significantly increasing trends with low, medium and high ES were observed for hypertension awareness (30.7, 37.8, 47.0), treatment (24.3, 29.2, 35.5) and control (7.8, 11.6, 15.5); diabetes awareness (47.2, 51.5, 56.4), treatment (38.3, 41.3, 46.0) and control (18.3, 15.3, 22.8); hypercholesterolaemia awareness (8.9, 22.4, 18.4), treatment (4.1, 6.2, 7.9) and control (2.8, 3.2, 6.9), as well as for smoking/tobacco quit rates (1.6, 2.8, 5.5) (χ2 for trend, p<0.05).

Conclusions Low ES subjects in India have lower awareness, treatment and control of hypertension, diabetes and hypercholesterolaemia and smoking quit rates.

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