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309869
Risk factors for cardiovascular diseases in low-income settings may be higher than previously estimated: Preliminary findings from the Dhulikhel Heart Study, Nepal
Monday, November 17, 2014
Rajendra Koju, MD
,
Department of Medicine, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal
Archana Shrestha, MPH
,
Department of Epidemiology, School of public health, Seattle, WA
Sachita Shrestha, BPH
,
Department of Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal
Prabin Shakya, BPH
,
Department of Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal
Bibush Amatya, MBBS, MPh
,
Department of Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Kavre, Nepal
Chandra Yogal, BPH
,
Hebrew University Braun School of Public Health, Jerusalem, Israel
Prabin Gyawali
,
Department of Biochemistry, Dhulikhel Hospital Kathmandu University Hospital, Kavre, Nepal
Shrinkhala Shrestha, MPH
,
Department of Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal
Samita Giri, MPH
,
Department of Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal
Akina Shrestha, MPH
,
Department of Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal
Roshan Mahato, BPH
,
Department of Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal
Annette L. Fitzpatrick, PhD, MA
,
Departments of Epidemiology and Global Health, University of Washington, School of Public Health, Seattle, WA
Despite alarming rise of Cardio Vascular Diseases (CVDs) in low-income countries, there are very few population-based epidemiological studies in these settings. The Dhulikhel Heart Study (DHS), recently launched in central Nepal targeting all adults (approximately 9000) ≥ 18 years, residing in the town of Dhulikhel, is one of the first population-based, prospective, longitudinal cohort studies on CVDs and risk factors in a low-income country. We present here the preliminary findings from the baseline study on 302 participants from randomly selected households (to be updated during presentation). The mean age of the respondents was 41.8 years (SD:17.9) and majority were females (60.93%). About half of all males (51.69%) and 16.84% females were past or current smokers. Nearly half of the males (44.06%) and females (46.73%) were obese (BMI ≥ 25kg/m2). A total of 131 (43.48%) were identified to have prevalent HTN (classified as previously diagnosed hypertension or current SBP>140mm Hg or current DBP>90mmHg). Almost half of the hypertensives (n=63) were unaware of the condition and were diagnosed for the first time. Males had significantly higher prevalence of HTN (54.2%) compared to females (36.41%, p=0.002). In a 67 random sub-population among these participants (mean age: 50.65yrs,SD:16.61; Males: 43.28%), one quarter (25.37%) were diagnosed as diabetic (HbA1C>6.4%) and 41.79% were diagnosed as pre-diabetic (HbA1C:5.7-6.4%). Total cholesterol level was in high borderline category (200-239mg/dl) in 43.28% and in high category (≥240mg/dl) in 26.87%. Although the findings are based on small number of participants, it strongly suggests that the risk factors for CVDs are staggeringly high in this population. DHS can serve as a model for conducting epidemiological studies in low-income settings in order to explore population characteristics and CVD trends for an evidence-based prevention and management of CVDs.
Learning Areas:
Chronic disease management and prevention
Epidemiology
Planning of health education strategies, interventions, and programs
Learning Objectives:
Describe the implementation of probably the first population-based cohort study on CVD risk factors in a low-income setting.
Demonstrate the high prevalence of CVD risk factors in a low-income setting.
Keyword(s): Chronic Disease Management and Care, Heart Disease
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am qualified to be an abstract Author on the content I am responsible for because I conceived this study and was involved in the planning and implementation of the study. I also did the data analysis that I presented and drafted the abstract myself.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
