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Prevalence and pattern of cardiovascular risk factors in a population in India
  1. Aditya Khetan1,
  2. Melissa Zullo2,
  3. Vittal Hejjaji3,
  4. Dweep Barbhaya4,
  5. Sushil Agarwal5,
  6. Rishab Gupta6,
  7. Sri Krishna Madan Mohan1,
  8. Richard Josephson1
  1. 1 Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Centre, Case Western Reserve University, Cleveland, Ohio, USA
  2. 2 Kent State University, Kent, Ohio, USA
  3. 3 Department of Medicine, University Hospitals Cleveland Medical Centre, Case Western Reserve University, Cleveland, Ohio, USA
  4. 4 Seth GS Medical College, Mumbai, India
  5. 5 Society for Enhanced Health and Access to Treatments, Dalkhola, India
  6. 6 AIIMS, New Delhi, India
  1. Correspondence to Dr Aditya Khetan, Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Centre, Cleveland, OH 44106, USA; aditya.khetan{at}


Background Cardiovascular disease is the leading cause of mortality in India. Since it is largely driven by risk factors such as hypertension, diabetes and smoking, it is important to study the treatment cascade for these conditions and identify areas for improvement.

Methods This is a cross-sectional study from Project SEHAT (Study to Enhance Heart Associated Treatments), an ongoing cluster randomised controlled trial testing the hypothesis that a community health worker-led intervention can improve the control of cardiovascular risk factors in a community in West Bengal, India. For the baseline data, 3556 adults, between the ages of 35 and 70, were screened for hypertension, diabetes and smoking. For hypertension and diabetes, an elevated reading was confirmed on a repeat visit.

Results 18.3% (n=650), 9.0% (n=317) and 14.1% (n=500) of adults were diagnosed with hypertension, diabetes and smoking, respectively. Overall, 35.0% (n=1242) adults had at least one of the three risk factors. 55.1% (n=358) of participants with hypertension and 40.4% (n=128) of participants with diabetes were unaware of their respective condition. 36.6% (n=238) of those with hypertension and 58.0% (n=184) of diabetics were on treatment. 8.2% (n=53) hypertensives were controlled (blood pressure <140/90 mm Hg) while 13.6% (n=43) diabetics were controlled (defined as fasting blood sugar <126 mg/dL). Less than 1% diabetics were on insulin, and average number of medications for a patient with hypertension was 1.2.

Conclusions In our population in semiurban India, one in three adults have a major cardiovascular risk factor, with low control rates. There is a large burden of undiagnosed cardiovascular risk factors and a large gap between treatment and control, which may be explained by lack of treatment intensification.

  • Risk Factors
  • Smoking
  • Hypertension
  • Community Cardiology
  • Epidemiology

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  • Contributors AK, RG, SM and RJ designed the study. AK, DB and SA conducted the study. MZ did the statistical analysis. AK, MZ, VH and RJ wrote the manuscript. AK obtained funding. All authors reviewed the final manuscript. AK is responsible for the overall content as guarantor.

  • Funding The study was funded by Marwari Yuva Manch, Dalkhola, India.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval University Hospitals IRB (USA) and SPECT IRB (India).

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data sharing statement The primary data can be made available to anyone who requests it by sending email to the corresponding author.

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