Browsing by Author "Mohan, BVM"

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    Distribution of 10-year and lifetime predicted risk for cardiovascular disease in the Indian Sentinel Surveillance Study population (cross-sectional survey results)
    (BMJ OPEN, 2011) Jeemon, P; Prabhakaran, D; Huffman, MD; Ramakrishnan, L; Goenka, S; Thankappan, KR; Mohan, V; Joshi, PP; Mohan, BVM; Ahmed, F; Ramanathan, M; Ahuja, R; Chaturvedi, V; Lloyd-Jones, DM; Reddy, KS
    Introduction: Cardiovascular disease (CVD) prevention guidelines recommend lifetime risk stratification for primary prevention of CVD, but no such risk stratification has been performed in India to date. Methods: The authors estimated short-term and lifetime predicted CVD risk among 10 054 disease-free, adult Indians in the 20-69-year age group who participated in a nationwide risk factor surveillance study. The study population was then stratified into high short-term (>= 10% 10-year risk or diabetes), low short-term (<10%)/high lifetime and low short-term/low lifetime CVD risk groups. Results: The mean age (SD) of the study population (men=63%) was 40.8 +/- 10.9 years. High short-term risk for coronary heart disease was prevalent in more than one-fifth of the population (23.5%, 95% CI 22.7 to 24.4). Nearly half of individuals with low short-term predicted risk (48.2%, 95% CI 47.1 to 49.3) had a high predicted lifetime risk for CVD. While the proportion of individuals with all optimal risk factors was 15.3% (95% CI 14.6% to 16.0%), it was 20.6% (95% CI 18.7% to 22.6%) and 8.8% (95% CI 7.7% to 10.5%) in the highest and lowest educational groups, respectively. Conclusion: Approximately one in two men and three in four women in India had low short-term predicted risks for CVD in this national study, based on aggregate risk factor burden. However, two in three men and one in two women had high lifetime predicted risks for CVD, highlighting a key limitation of short-term risk stratification.
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    Distribution of 10-year lifetime predicted risk for cardiovascular disease in the Indian Sentinel Surveillance Study population (Cross –sectional survey results).
    (BMJ Open, 2011) Jeemon, P; Prabhakaran, D; Huffman, MD; Ramakrishnan, L; Goenka, S; Thankappan, KR; Mohan, V; Joshi, PP; Mohan, BVM; Ahmed, F; Ramanathan, M; Ajuja, R; Chaturvedi, V; Lloyd-Jones, D; Reddy, KS
    Introduction:Cardiovascular disease (CVD) prevention guidelines recommend lifetime risk stratification for primary prevention of CVD, but no such risk stratification has been performed in India to date.METHODS:The authors estimated short-term and lifetime predicted CVD risk among 10,054 disease-free, adult Indians in the 20-69-year age group who participated in a nationwide risk factor surveillance study. The study population was then stratified into high short-term (? 10% 10-year risk or diabetes), low short-term (<10%)/high lifetime and low short-term/low lifetime CVD risk groups.RESULTS: The mean age (SD) of the study population (men=63%) was 40.8 ± 10.9 years. High short-term risk for coronary heart disease was prevalent in more than one-fifth of the population (23.5%, 95% CI 22.7 to 24.4). Nearly half of individuals with low short-term predicted risk (48.2%, 95% CI 47.1 to 49.3) had a high predicted lifetime risk for CVD. While the proportion of individuals with all optimal risk factors was 15.3% (95% CI 14.6% to 16.0%), it was 20.6% (95% CI 18.7% to 22.6%) and 8.8% (95% CI 7.7% to 10.5%) in the highest and lowest educational groups, respectively.CONCLUSION: Approximately one in two men and three in four women in India had low short-term predicted risks for CVD in this national study, based on aggregate risk factor burden. However, two in three men and one in two women had high lifetime predicted risks for CVD, highlighting a key limitation of short-term risk stratification.
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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 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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    Methods for establishing a surveillance system for cardiovascular diseases in Indian industrial populations
    (BULLETIN OF THE WORLD HEALTH ORGANIZATION, 2006) Reddy, KS; Prabhakaran, D; Chaturvedi, V; Jeemon, P; Thankappan, KR; Ramakrishnan, L; Mohan, BVM; Pandav, CS; Ahmed, FU; Joshi, PP; Meera, R; Amin, RB; Ahuja, RC; Das, MS; Jaison, TM
    Objective To establish a surveillance network for cardiovascular diseases (CVD) risk factors in industrial settings and estimate the risk factor burden using standardized tools. Methods We conducted a baseline cross-sectional survey (as part of a CVD surveillance programme) of industrial populations from 10 companies across India, situated in close proximity to medical colleges that served as study centres. The study subjects were employees (selected by age and sex stratified random sampling) and their family members. Information on behavioural, clinical and biochemical determinants was obtained through standardized methods (questionnaires, clinical measurements and biochemical analysis). Data collation and analyses were done at the national coordinating centre. Findings We report the prevalence of CVD risk factors among individuals aged 20-69 years (n = 19 973 for the questionnaire survey, n = 10 442 for biochemical investigations); mean age was 40 years. The overall prevalence of most risk factors was high, with 50.9% of men and 51.9% of women being overweight, central obesity was observed among 30.9% of men and 32.8% of women, and 40.2% of men and 14.9% of women reported current tobacco use. Self-reported prevalence of diabetes (5.3%) and hypertension (10.9%) was lower than when measured clinically and biochemically (10.1% and 27.7%, respectively). There was marked heterogeneity in the prevalence of risk factors among the study centres. Conclusion There is a high burden of CVD risk factors among industrial populations across India. The surveillance system can be used as a model for replication in India as well as other developing countries.
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    Methods for establishing a surveillance system for cardiovascular diseases in Indian industrial populations.
    (Bulletin of the World Health Organization, 2006) Reddy, KS; Prabhakaran, D; Chaturvedi, V; Jeemon, P; Thankappan, KR; Ramakrishnan, L; Mohan, BVM; Pandav, CS; Ahmed, FU; Joshi, PP; Meera, R; Amin, RB; Ahuja, RC; Das, MS; Jaison, TM
    OBJECTIVE:To establish a surveillance network for cardiovascular diseases (CVD) risk factors in industrial settings and estimate the risk factor burden using standardized tools. METHODS: We conducted a baseline cross-sectional survey (as part of a CVD surveillance programme) of industrial populations from 10 companies across India, situated in close proximity to medical colleges that served as study centres. The study subjects were employees (selected by age and sex stratified random sampling) and their family members. Information on behavioural, clinical and biochemical determinants was obtained through standardized methods (questionnaires, clinical measurements and biochemical analysis). Data collation and analyses were done at the national coordinating centre. FINDINGS:We report the prevalence of CVD risk factors among individuals aged 20-69 years (n = 19 973 for the questionnaire survey, n = 10 442 for biochemical investigations); mean age was 40 years. The overall prevalence of most risk factors was high, with 50.9% of men and 51.9% of women being overweight, central obesity was observed among 30.9% of men and 32.8% of women, and 40.2% of men and 14.9% of women reported current tobacco use. Self-reported prevalence of diabetes (5.3%) and hypertension (10.9%) was lower than when measured clinically and biochemically (10.1% and 27.7%, respectively). There was marked heterogeneity in the prevalence of risk factors among the study centres. CONCLUSION:There is a high burden of CVD risk factors among indus
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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) 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.