Browsing by Author "Joshi, P"

Now showing 1 - 8 of 8
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    Educational status and cardiovascular risk profile in Indians
    (Proceedings of the National Academy of Sciences, USA, 2007) Reddy, KS; Prabhakaran, D; Jeemon, P; Thankappan, KR; Joshi, P; Chaturvedi, V; Ramakrishnan, L; Ahmed, F
    The inverse graded relationship of education and risk factors of coronary heart disease (CHD) has been reported from Western populations. To examine whether risk factors of CHD are predicted by level of education and influenced by the level of urbanization in Indian industrial populations, a cross-sectional survey (n = 19,973; response rate, 87.6%) was carried out among employees and their family members in 10 medium-to-large industries in highly urban, urban, and periurban regions of India. Information on behavioral, clinical, and biochemical risk factors of CHD was obtained through standardized instruments, and educational status was assessed in terms of the highest educational level attained. Data from 19,969 individuals were used for analysis. Tobacco use and hypertension were significantly more prevalent in the low- (56.6% and 33.8%, respectively) compared with the high-education group (12.5% and 22.7%, respectively; P < 0.001). However, dyslipidemia prevalence was significantly higher in the high-education group (27.1% as compared with 16.9% in the lowest-education group; P < 0.01). When stratified by the level of urbanization, industrial populations located in highly urbanized centers were observed to have an inverse graded relationship (i.e., higher-education groups had lower prevalence) for tobacco use, hypertension, diabetes, and overweight, whereas in less-urbanized locations, we found such a relationship only for tobacco use and hypertension. This study indicates the growing vulnerability of lower socioeconomic groups to CHD. Preventive strategies to reduce major CHD risk factors should focus on effectively addressing these social disparities.
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    Impact of a worksite intervention program on cardiovascular risk factors: A demonstration project in an industrial population
    (Journal of American College of Cardiology, 2009) Prabhakaran, D; Jeemon, P; Goenka, S; Lakshmy, R; Thankappan, KR; Ahmed, F; Joshi, P; Mohan, BVM; Meera, R; Das, MS; Ahuja, RC; Saran, RK; Chaturvedi, V; Reddy, KS
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    Impact of alcohol on coronary heart disease in Indian men
    (Atherosclerosis, 2010) Roy, A; Prabhakaran, D; Jeemon, P; Thankappan, KR; Mohan, V; Ramakrishnan, L; Joshi, P; Ahmed, F; Mohan, BV; Saran, RK; Sinha, N; Reddy, KS
    BACKGROUND: Moderate alcohol consumption is known to be protective against coronary heart disease (CHD). However, the INTERHEART study, a case-control study of acute myocardial infarction (MI) patients, revealed that alcohol consumption in South Asians was not protective against CHD. We therefore planned to study cardiovascular risk factor and CHD prevalence among male alcohol users as compared to age matched lifetime abstainers. METHODS: The subjects for this study were recruited from a cross-sectional survey carried out among employees and their family members aged 20-69 years in 10 medium-to-large industries from diverse sites in India, using a stratified random sampling technique. Information on education, behavioral, clinical and biochemical risk factors of CHD and alcohol use was obtained through standardized instruments. CHD diagnosis was based on Rose Questionnaire or a prior physician diagnosed CHD. RESULTS: A total of 4465 subjects were present or past alcohol users. The mean age of alcohol users and lifetime abstainers was 42.8+/-11.0 years and 42.8+/-11.1 years, respectively (p=0.90). Systolic blood pressure and diastolic blood pressure were significantly higher in alcohol users (128.7+/-17.6 mmHg/80.1+/-11.3 mmHg) as compared to lifetime abstainers (126.9+/-15.9 mmHg/79.5+/-10.3 mmHg, p<0.01). Fasting blood sugar in alcohol users (98.7+/-30.5 mg%) was also significantly higher than lifetime abstainers (96.6+/-26.0 mg%, p<0.01). Total cholesterol was lower in alcohol users (179.1+/-41.1 mg%) as compared to lifetime abstainers (182.7+/-38.2 mg%, p<0.01). HDL cholesterol was higher in alcohol users (42.9+/-10.8 mg%) as compared to lifetime abstainers (41.3+/-10.0 mg%, p<0.01). Body mass index (BMI) was lower in alcohol users as compared to lifetime abstainers (22.7+/-4.1 kg/m2 vs. 24.0+/-3.3 kg/m2, p<0.001). Tobacco use was significantly higher in alcohol users (63.1% vs. 20.7%). The odds ratio (OR) of having CHD after adjusting for tobacco use, BMI and education was 1.4 (95%CI 1.0-1.9) in alcohol users as compared to controls. The OR was 1.2 (95%CI 0.8-1.6) in occasional alcohol users, 1.6 (95%CI 1.0-2.2) in regular alcohol users and 2.1 (95% CI 1.1-3.0) in past alcohol users as compared to controls.CONCLUSION:We did not observe an inverse (protective) association between alcohol intake and the prevalence of CHD. In contrast, our study indicated an association in the reverse direction, suggesting possible harm of alcohol for coronary risk in Indian men. This relationship needs to be further examined in large, prospective study.
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    Impact of comprehensive cardiovascular risk reduction program on risk factor clustering associated with elevated blood pressure in an Indian industrial population.
    (Indian Journal of Medical Research, 2012) Jeemon, P; Prabhakaran, D; Goenka, S; Ramakrishnan, L; Padmanabhan, S; Huffman, M; Joshi, P; Sivasankaran, S; Mohan, BVM; Ahmed, F; Ramanathan, M; Ahuja, R; Sinha, N; Thankappan, KR; Reddy, KS
    Cardiovascular risk factors clustering associated with blood pressure (BP) has not been studied in the Indian population. This study was aimed at assessing the clustering effect of cardiovascular risk factors with suboptimal BP in Indian population as also the impact of risk reduction interventions.
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    Impact of comprehensive cardiovascular risk reduction programme on risk factor clustering associated with elevated blood pressure in an Indian industrial population
    (INDIAN JOURNAL OF MEDICAL RESEARCH, 2012) Jeemon, P; Prabhakaran, D; Goenka, S; Ramakrishnan, L; Padmanabhan, S; Huffman, M; Joshi, P; Sivasankaran, S; Mohan, BVM; Ahmed, F; Ramanathan, M; Ahuja, R; Sinha, N; Thankappan, KR; Reddy, KS
    Background & objectives: Cardiovascular risk factors clustering associated with blood pressure (BP) has not been studied in the Indian population. This study was aimed at assessing the clustering effect of cardiovascular risk factors with suboptimal BP in Indian population as also the impact of risk reduction interventions. Methods: Data from 10543 individuals collected in a nation-wide surveillance programme in India were analysed. The burden of risk factors clustering with blood pressure and coronary heart disease (CHD) was assessed. The impact of a risk reduction programmme on risk factors clustering was prospectively studied in a sub-group. Results: Mean age of participants was 40.9 +/- 11.0 yr. A significant linear increase in number of risk factors with increasing blood pressure, irrespective of stratifying using different risk factor thresholds was observed. While hypertension occurred in isolation in 2.6 per cent of the total population, co-existence of hypertension and > 3 risk factors was observed in 12.3 per cent population. A comprehensive risk reduction programme significantly reduced the mean number of additional risk factors in the intervention population across the blood pressure groups, while continued to be high in the control arm without interventions (both within group and between group P < 0.001). The proportion of 'low risk phenotype' increased from 13.4 to 19.9 per cent in the intervention population and it was decreased from 27.8 to 10.6 per cent in the control population (P < 0.001). The proportion of individuals with hypertension and three more risk factors decreased from 10.6 to 4.7 per cent in the intervention arm while it was increased from 113.3 to 17.8 per cent in the control arm (P < 0.001). Interpretation & conclusions: Our findings showed that cardiovascular risk factors clustered together with elevated blood pressure and a risk reduction programme significantly reduced the risk factors burden.
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    Paradoxical impact of alcohol consumption on coronary heart disease
    (EUROPEAN HEART JOURNAL, 2009) Roy, A; Prabhakaran, D; Jeemon, P; Thankappan, KR; Mohan, V; Ramakrishnan, L; Joshi, P; Ahmed, FU; Mohan, BVM; Reddy, KS
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    Prevalence and determinants of diabetes mellitus in the Indian industrial population
    (DIABETIC MEDICINE, 2008)
    Aim To highlight the regional difference in the prevalence of diabetes mellitus (DM) and to explore determinants in variability in the Indian industrial population.Methods A cross-sectional survey was carried out among the employees and their family members (10 930 individuals, mean age 39.6 years, 6764 male) of eleven medium-to-large industries from diverse sites in India, using a stratified random sampling technique. Information on behavioural, clinical and biochemical risk factors of DM was obtained, through standardized instruments. DM was diagnosed when fasting blood glucose was >= 7.0 mmol/l and/or individuals took drug treatment for DM. Multiple logistic regression analysis was carried out to identify the potential predictors of DM.Result In the 20 to 69-year-old age group, the crude prevalence of DM and impaired fasting glucose was 10.1 and 5.3%, respectively. Urban sites had a higher prevalence and awareness of DM status. Individuals in the lower education group had a high prevalence of DM (11.6%). In diabetic subjects, 38.4% were unaware that they had diabetes. Waist-circumference-to-height ratio had a higher DM predictive power than waist circumference and body mass index. The risk factors associated with overall prevalence of DM were: age, sex, low-education level, family history of DM, hypertension and overweight/obesity. Interaction of risk factors was observed only in urban high-prevalence sites.Conclusion There are wide regional variations in the prevalence of DM in India. The high burden of undetected diabetes, even in settings with universal access to on-site health care, highlights the need for innovative prevention and control strategies.
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    Prevalence and determinants of diabetes mellitus in the Indian industrial population
    (Diabetic Medicine, 2008) Ajay, VS; Prabhakaran, D; Jeemon, P; Thankappan, KR; Mohan, V; Ramakrishnan, L; Joshi, P; Ahmed, FU; Mohan, BVM; Chaturvedi, R; Mukherjee, R; Reddy, KS
    AIM: To highlight the regional difference in the prevalence of diabetes mellitus (DM) and to explore determinants in variability in the Indian industrial population. METHODS: A cross-sectional survey was carried out among the employees and their family members (10 930 individuals, mean age 39.6 years, 6764 male) of eleven medium-to-large industries from diverse sites in India, using a stratified random sampling technique. Information on behavioural, clinical and biochemical risk factors of DM was obtained, through standardized instruments. DM was diagnosed when fasting blood glucose was > or = 7.0 mmol/l and/or individuals took drug treatment for DM. Multiple logistic regression analysis was carried out to identify the potential predictors of DM. RESULT: In the 20 to 69-year-old age group, the crude prevalence of DM and impaired fasting glucose was 10.1 and 5.3%, respectively. Urban sites had a higher prevalence and awareness of DM status. Individuals in the lower education group had a high prevalence of DM (11.6%). In diabetic subjects, 38.4% were unaware that they had diabetes. Waist-circumference-to-height ratio had a higher DM predictive power than waist circumference and body mass index. The risk factors associated with overall prevalence of DM were: age, sex, low-education level, family history of DM, hypertension and overweight/obesity. Interaction of risk factors was observed only in urban high-prevalence sites. CONCLUSION: There are wide regional variations in the prevalence of DM in India. The high burden of undetected diabetes, even in settings with universal access to on-site health care, highlights the need for innovative prevention and control strategies.