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CLINICAL STUDY: CORONARY ARTERY DISEASE

Prevalence of coronary artery disease and its relationship to lipids in a selected population in South India

The Chennai Urban Population Study (CUPS No. 5)

^a Madras Diabetes Research Foundation, Gopalapuram, Chennai, India

Manuscript received October 12, 2000; revised manuscript received March 19, 2001, accepted May 15, 2001.

Reprint requests and correspondence: Dr. V. Mohan, Madras Diabetes Research Foundation, 35 Conran Smith Road, Gopalapuram, Chennai - 600 086 India
mvdsc{at}vsnl.com

OBJECTIVES

The aim of this study was to assess the prevalence and risk factors for coronary artery disease (CAD) in a native urban South Indian population.

BACKGROUND

High prevalence rates of premature CAD have been reported in migrant Asian Indians. There are very few studies on CAD in native Indians living in the Indian subcontinent.

METHODS

The Chennai Urban Population Study (CUPS) is an epidemiological study involving two residential areas in Chennai in South India. Of the total of 1,399 eligible subjects (age 20 years), 1,262 (90.2%) participated in the study. All the study subjects underwent a glucose tolerance test and were categorized as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT) or diabetes. Twelve-lead electrocardiogram (ECG) was performed in 1,175 individuals (84%). Coronary artery disease was diagnosed based on previous medical history or Minnesota coding of ECGs.

RESULTS

The overall prevalence rate of CAD is 11.0% (age standardized, 9.0%). The prevalence rates of CAD were 9.1%, 14.9% and 21.4% in those with NGT, IGT and diabetes, respectively. Prevalence of CAD increased with an increase in total cholesterol (trend chi-square: 26.2, p < 0.001), low-density lipoprotein (LDL) cholesterol (trend chi-square: 24.5, p < 0.001), triglycerides (trend chi-square: 9.96, p = 0.002) and total cholesterol/high-density lipoprotein ratio (trend chi-square: 6.14, p = 0.0132). Multiple logistic regression analysis identified age (odds ratio [OR]: 1.05, p < 0.001) and LDL cholesterol (OR: 1.009, p = 0.051) as the risk factors for CAD.

CONCLUSIONS

The prevalence of CAD is rising rapidly in urban India. Lifestyle changes and aggressive control of risk factors are urgently needed to reverse this trend.

Abbreviations and Acronyms   ACE = angiotensin-converting enzyme   BMI = body mass index   BP = blood pressure   CAD = coronary artery disease   CUPS = Chennai Urban Population Study   ECG = electrocardiogram or electrocardiography   HDL = high-density lipoprotein   IGT = impaired glucose tolerance   LDL = low-density lipoprotein   MI = myocardial infarction   OR = odds ratio   SHARE = Study of Health Assessment and Risk in Ethnic Groups   UKPDS = United Kingdom Prospective Diabetes Study   WHR = waist-hip ratio

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