Changing socioeconomic and geographic gradients in cardiovascular disease risk factors among Indians aged 15-49 years - evidence from nationally representative household surveys.
Cardiovascular diseases
Diabetes
Hypertension
India
Obesity
Overweight
Risk factor
Smoking
Socioeconomic gradients
Socioeconomic status
Tobacco consumption
Journal
The Lancet regional health. Southeast Asia
ISSN: 2772-3682
Titre abrégé: Lancet Reg Health Southeast Asia
Pays: England
ID NLM: 9918419282806676
Informations de publication
Date de publication:
May 2023
May 2023
Historique:
received:
08
12
2022
revised:
21
03
2023
accepted:
23
03
2023
medline:
29
6
2023
pubmed:
29
6
2023
entrez:
29
6
2023
Statut:
epublish
Résumé
Cardiovascular diseases (CVDs) are the leading cause of death in most low- and middle-income countries (LMICs). CVDs and their metabolic risk factors have historically been concentrated among urban residents with higher socioeconomic status (SES) in LMICs such as India. However, as India develops, it is unclear whether these socioeconomic and geographic gradients will persist or change. Understanding these social dynamics in CVD risk is essential for mitigating the rising burden of CVDs and to reach those with the greatest needs. Using nationally representative data with biomarker measurements from the fourth (2015-16) and fifth (2019-21) Indian National Family and Health Surveys, we investigated trends in the prevalence of four CVD risk factors: smoking (self-reported), unhealthy weight (BMI ≥25 Unhealthy weight increased among all social and geographic groups but both the absolute and the relative changes were substantially higher among people with low SES (as measured by education or wealth) and in rural areas. For diabetes and hypertension, the prevalence increased for those from disadvantaged groups while staying constant or even decreasing among the wealthier and more educated. In contrast, smoking consumption declined for all social and geographic groups. In 2015-16, CVD risk factors were higher among more advantaged subpopulations in India. However, between 2015-16 and 2019-21, the prevalence of these risk factors grew more rapidly for less wealthy and less educated subpopulations and those living in rural areas. These trends have resulted in CVD risk becoming far more widespread throughout the population; CVD can no longer be characterized as a wealthy urban phenomenon. This work was supported by the Alexander von Humboldt Foundation (grant received by NS); the Stanford Diabetes Research Center [grant received by PG] and the Chan Zuckerberg Biohub [grant received by PG].
Sections du résumé
Background
UNASSIGNED
Cardiovascular diseases (CVDs) are the leading cause of death in most low- and middle-income countries (LMICs). CVDs and their metabolic risk factors have historically been concentrated among urban residents with higher socioeconomic status (SES) in LMICs such as India. However, as India develops, it is unclear whether these socioeconomic and geographic gradients will persist or change. Understanding these social dynamics in CVD risk is essential for mitigating the rising burden of CVDs and to reach those with the greatest needs.
Methods
UNASSIGNED
Using nationally representative data with biomarker measurements from the fourth (2015-16) and fifth (2019-21) Indian National Family and Health Surveys, we investigated trends in the prevalence of four CVD risk factors: smoking (self-reported), unhealthy weight (BMI ≥25
Findings
UNASSIGNED
Unhealthy weight increased among all social and geographic groups but both the absolute and the relative changes were substantially higher among people with low SES (as measured by education or wealth) and in rural areas. For diabetes and hypertension, the prevalence increased for those from disadvantaged groups while staying constant or even decreasing among the wealthier and more educated. In contrast, smoking consumption declined for all social and geographic groups.
Interpretation
UNASSIGNED
In 2015-16, CVD risk factors were higher among more advantaged subpopulations in India. However, between 2015-16 and 2019-21, the prevalence of these risk factors grew more rapidly for less wealthy and less educated subpopulations and those living in rural areas. These trends have resulted in CVD risk becoming far more widespread throughout the population; CVD can no longer be characterized as a wealthy urban phenomenon.
Funding
UNASSIGNED
This work was supported by the Alexander von Humboldt Foundation (grant received by NS); the Stanford Diabetes Research Center [grant received by PG] and the Chan Zuckerberg Biohub [grant received by PG].
Identifiants
pubmed: 37384058
doi: 10.1016/j.lansea.2023.100188
pii: S2772-3682(23)00048-3
pmc: PMC10305936
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100188Informations de copyright
© 2023 The Author(s).
Déclaration de conflit d'intérêts
Outside the scope of the submitted manuscripts, Mohammed K. Ali received personal advisory board fees from Eli Lilly and Bayer and Emory University received a grant from Merck & Co. The other authors declare no conflict of interest.
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