Educational status and cardiovascular risk profile in Indians
Educational status and cardiovascular risk profile in Indians
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DOI：
10.1073/pnas.0700933104
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发表时间：
2007-10-09
影响因子：
11.1
通讯作者：
Ahmed, Farooque
中科院分区：
文献类型：
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作者：
Reddy, K. Srinath;Prabhakaran, Dorairaj;Ahmed, Farooque
据报道，西方人群的教育程度与冠心病（CHID）危险因素呈负相关。为了研究CHID的危险因素是否受印度工业人口教育水平的预测和城市化水平的影响，我们对印度高度城市化、城市和城郊地区10个大中型工业的员工及其家庭成员进行了横断面调查（n = 19973，回复率为87.6%）。通过标准化仪器获取冠心病的行为、临床和生化危险因素信息，并以最高受教育程度评价受教育程度。来自19969个人的数据被用于分析。与高学历人群（分别为12.5%和22.7%,P < 0.001）相比，低学历人群中吸烟和高血压的患病率明显更高（分别为56.6%和33.8%）。然而，高学历组的血脂异常患病率明显更高（27.1%，而低学历组为16.9%,P < 0.01）。当按城市化水平分层时，观察到位于高度城市化中心的工业人口在烟草使用、高血压、糖尿病和超重方面具有反比等级关系（即，高学历群体的患病率较低），而在城市化程度较低的地区，我们发现这种关系仅存在于烟草使用和高血压之间。这项研究表明，社会经济地位较低的群体对冠心病的脆弱性越来越大。减少主要冠心病危险因素的预防策略应侧重于有效解决这些社会差异。
The inverse graded relationship of education and risk factors of coronary heart disease (CHID) has been reported from Western populations. To examine whether risk factors of CHID 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.