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Why heart disease risk varies across states: wealth, facilities, other reasons

"Our findings could be helpful in deciding how to allocate resources to prevent cardiovascular disease to those most in need,” study author Dr Pascal Geldsetzer, of the Harvard T H Chan School of Public Health, said.

Written by Anuradha Mascarenhas | Pune | Updated: June 20, 2018 8:35:23 am
cardiovascular damage, vascular damage, heart and air travel, airplane and heart conditions, flight and breathing problems, heart attack in flight, In-flight heart attack, disadvantages of air travel, indian express, indian express news Heart disease risk across states vary and why, explained (Representational)

Wealthier and more urbanised states tend to face a higher risk of cardiovascular disease (CVD). Kerala faces the highest risk at 19.5% and Jharkhand the lowest at 13.5%, a study published online Tuesday in PLOS Medicine has found.

The study calculated the average 10-year risk of a CVD event using an index called the Framingham risk score. It analysed data for nearly 8 lakh adults and found that the risk tended to be highest in the Northern, Northeastern and Southern states. Gujarat and Jammu and Kashmir were not part of the study, for lack of data.

“Cardiovascular disease risk varied widely among states and we also observed important variation of risk factors, such as smoking and diabetes, by adults’ socio-demographic characteristics. Our findings could be helpful in deciding how to allocate resources to prevent cardiovascular disease to those most in need,” study author Dr Pascal Geldsetzer, of the Harvard T H Chan School of Public Health, said.

Researchers of the T H Chan School and Public Health Foundation of India (PHFI) used data from the Annual Health Survey (round 2) and the District-level Household and Facility Survey (round 4) carried out between 2012 and 2014.
In the North, Northeast and South, higher body mass index (BMI), hypertension, diabetes and smoking prevalence contributed to the risk. BMI and blood glucose and blood pressure were associated with wealth and living in an urban area. Also, the prevalence of high blood glucose and high BP was high in middle and old age among the poorer groups, and in rural areas.

Smoking was more common in the poorer groups, in rural areas, and among males. It was most prevalent among males in the Northeastern states and West Bengal.

“Non-communicable diseases (NCDs) and communicable diseases (CDs) have an inverse relation,” PHFI’s Dr Ashish Awasthi, one of the authors, said. “So states like Jharkhand have higher [prevalence of] CDs, while there is a low prevalence of NCD. Developed states have a higher NCD burden and lower CD burden.”

In less developed states like Jharkhand, life expectancy at birth is less than in developed states like Kerala. Life expectancy is affected by disease pattern. Some states are at high risk of CVDs as they are ahead in development and have better healthcare facilities.

Lifestyle, dietary patterns and other factors have played a role in the variations, Awasthi said. Another factor is obesogenic environment — one that promotes weight gain and is not conducive to weight loss. Such an environment includes higher urbanisation, using a car rather than walking, or a lift rather than stairs, and easy availability of high-calorie food in the surroundings.

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