Cardiovascular Risk Factors in North Indians: A Case-Control Study

There is no large study from North India which has addressed association of (CAD) in angiographically proven cases with lipid levels and the conventional risk factors. In the present study risk factor assessment was done in 200 consecutive patients admitted for coronary angiography and in 200 age and sex matched controls. We have found that the most important predictor of CAD is current smoking (odds ratio [OR] 3.05, p<0.0001). In subjects with cases, the levels of mean lipid and apolipoprotein levels were significantly higher than controls. The younger CAD group, age (≤45 years) had significantly higher levels of total cholesterol (p<0.001), LDL-cholesterol (p<0.001) and apolipoprotein B (p<0.04) than the older patients group, age (>45 years), Diabetic CAD patients had significantly higher levels of total cholesterol (p=0.03) and triglycerides (p=0.005) than non-diabetics. The conventional risk factor in diabetics was hypertension and, in younger age group (≤45 years), it was smoking and a family history of CAD. In univariate analysis, higher socioeconomic status (OR 0.30, p=0.005 highest vs. lowest; OR 0.73 middle vs. lowest) was observed. In the multiple logistic regression analysis only total cholesterol (p<0.01), HDL- cholesterol (p<0.01), apolipoprotein B (p<0.01), and smoking (p<0.01) had a significant independent association with CAD. Smoking cessation, treatment of hypertension, the ATP-III guidelines for the treatment of dyslipidemia and improving the level of education are likely to have a profound effect on the burden of premature coronary artery disease in North India.