Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Cardiol. Apr 26, 2012; 4(4): 112-120
Published online Apr 26, 2012. doi: 10.4330/wjc.v4.i4.112
Regional variations in cardiovascular risk factors in India: India heart watch
Rajeev Gupta, Soneil Guptha, Krishna Kumar Sharma, Arvind Gupta, Prakash Deedwania
Rajeev Gupta, Krishna Kumar Sharma, Department of Medicine, Fortis Escorts Hospital, Jaipur 302017, India
Rajeev Gupta, Soneil Guptha, Jaipur Heart Watch Foundation, Jaipur 302017, India
Arvind Gupta, Jaipur Diabetes Research Centre, Jaipur 302017, India
Prakash Deedwania, Department of Cardiology, VA Medical Center, University of California San Francisco, Fresno, CA 93701, United States
Author contributions: Gupta R conceptualized the article and wrote the first and subsequent drafts; all authors provided important scientific input and critical comments, and helped in revision of the manuscript.
Supported by Ad hoc research grant from South Asian Society of Atherosclerosis and Thrombosis, Bangalore, India and Minneapolis, United States
Correspondence to: Dr. Rajeev Gupta, Department of Medicine, Fortis Escorts Hospital, JLN Marg, Jaipur 302017, India.
Telephone: +91-141-547000 Fax: +91-141-4008151
Received: October 28, 2011
Revised: January 17, 2012
Accepted: January 24, 2012
Published online: April 26, 2012

Cardiovascular disease (CVD) is an important cause of mortality and morbidity in India. Mortality statistics and morbidity surveys indicate substantial regional variations in CVD prevalence and mortality rates. Data from the Registrar General of India reported greater age-adjusted cardiovascular mortality in southern and eastern states of the country. Coronary heart disease (CHD) mortality is greater in south India while stroke is more common in the eastern Indian states. CHD prevalence is higher in urban Indian populations while stroke mortality is similar in urban and rural regions. Case-control studies in India have identified that the common major risk factors account for more than 90% of incident myocardial infarctions and stroke. The case-control INTERHEART and INTERSTROKE studies reported that hypertension, lipid abnormalities, smoking, obesity, diabetes, sedentary lifestyle, low fruit and vegetable intake, and psychosocial stress are as important in India as in other populations of the world. Individual studies have reported that there are substantial regional variations in risk factors in India. At a macro-level these regional variations in risk factors explain some of the regional differences in CVD mortality. However, there is need to study the prevalence of multiple cardiovascular risk factors in different regions of India and to correlate them with variations in CVD mortality using a uniform protocol. There is also a need to determine the “causes of the causes” or fundamental determinants of these risk factors. The India Heart Watch study has been designed to study socioeconomic, anthropometric and biochemical risk factors in urban populations in different regions of the country in order to identify regional differences.

Keywords: Cardiovascular disease, Risk factors, Socioeconomics, Epidemiology, Hypertension, Obesity, Lipids