CORONARY HEART DISEASE

RISK FACTORS ASSOCIATED WITH CLINICAL EVIDENCE AMONG ADULT POPULATION IN MAJOR HOSPITAL IN CHENAB NAGAR

Abstract

Objective: To identify risk factors associated with clinical evidence of
coronary heart disease (CHD) among adult population reporting in a major hospital, in Chenab Nagar. Study design:
Case control study Settings: Fazle Omar Hospital, Chenab Nagar. Period: From Mar 2000 to Jun 2002.Total
population is approximately 50,000. Fazle Omar Hospital is the only major hospital in the area. All patients from Chenab
Nagar and from suburbs report to the hospital. Cases: Men and women of 35 years and above, having CHD, confirmed
by history and ECG and/or exercise tolerance test, where indicated. Controls: Men and women of 35 years and above,
not having CHD as evidenced by history and ECG and/or exercise tolerance test. Results: We enrolled 190 cases and
343 controls in our study. Of 190 cases, 96 (50.5%) were males and 94 (49.5%) were females. Age of study subjects
ranged between 35 years and 85 years. Mean age was 52.9 years. BMI was almost equal in both cases and controls.
Hypertension, smoking, and diabetes were more prevalent in cases. In univariate analysis, males were at a higher
disadvantage. Incidence of disease continued to rise with increasing age. Cases were more likely to have family history
of CHD, hyperlipidemia, and hypertension. Duration of hypertension was also compared. With increase in duration,
incidence increased. Cases were more than 3 times more likely to be smokers. There was a clear dose-response
relationship. Diabetes was two times more common in cases than controls.Raised systolic blood pressure, raised
diastolic blood pressure, increased levels of serum cholesterol and triglycerides showed positive association with
disease. However serum LDL, serum HDL, and BSF levels failed to show any significant difference among cases and
controls. The final multi variate model included independent effects of age, family history of CHD, family history of
hyperlipidemia, greater duration of HBP, being smoker, and having high serum cholesterol levels. Conclusion: Our study shows that established risk factors are also prevalent in our population. Higher age, being male, heredity, family
history of CHD, hyperlipidemia and hypertension were positively associated with CHD. Longer duration of hypertension,
smoking and diabetes enhanced the risk. Levels of serum cholesterol and triglycerides were found elevated more in
cases compared to controls. HDL and LDL failed to show association with disease.