South India

• Coronary artery disease (CAD) and diabetes rates have been studied extensively in Chennai where the prevalence of both conditions is high and still increasing.

• The overall prevalence rate of CAD is 11% (9% age-standardized) in Chennai which is similar to North India and the Diasporas.^1-5 The prevalence of CAD increases with increasing degree of glucose intolerance; the prevalence was 9% for those with a normal glucose tolerance, 15% for those with prediabetes and 21% for those with diabetes.⁶

• Studies to determine the precise causes of death in urban Chennai and rural areas of Andhra Pradesh have revealed that cardiovascular diseases (CVD) cause about 40% of the deaths in urban areas and 30% in rural areas.⁷

• CAD mortality in rural Kerala is 6 times higher than in rural China and two times higher than in the US (seeKerala Heart Disease, Kerala Risk Factors, Kerala Women, Kerala Paradox).⁵

• Risk factors were generally more prevalent in South Indians compared with North Indians.^{8, 9} For example, the prevalence of dyslipidemia (cholesterol problems)was 50% higher (33%vs 21%) and obesity nearly double (24% vs. 13%) in South Indians vs. North Indians.¹⁰
• Over the past 30 years, the prevalence of diabetes has increased 3 times from 5% to 14% and prediabetes 5 times from 2% to 10% .¹¹

• Recent studies have shown a rapid conversion of prediabetes to diabetes in the southern states of India.¹¹ (See Diabetes South India)

Sources

1. Mohan V, Deepa R, Shanthi Rani S, Premalatha G. Prevalence of coronary artery disease and its relationship to lipids in a selected population in South India. The Chennai Urban Population Study (CUPS No. 5). J Am Coll Cardiol. 2001;38(3):682-687.

2. Chadha S. L., Radhakrishnan S, Ramachandran K, Kaul U, Gopinath N. Epidemiological study of coronary heart disease in urban population of Delhi. Indian J Med Res. Dec 1990;92:424-430.

3. Gupta R, Joshi P, Mohan V, Reddy KS, Yusuf S. Epidemiology and causation of coronary heart disease and stroke in India. Heart (British Cardiac Society). Jan 2008;94(1):16-26.

4. Sarvotham SG, Berry JN. Prevalence of coronary heart disease in an urban population in northern India. Circulation. 1968;37(6):939-953.

5. Soman C. R, Kutty VR, Safraj S, Vijayakumar K, Rajamohanan K, Ajayan K. All-Cause Mortality and Cardiovascular Mortality in Kerala State of India: Results From a 5-Year Follow-up of 161 942 Rural Community Dwelling Adults. Asia Pac J Public Health. May 10 2010.

6. Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res. Mar 2007;125(3):217-230.

7. Gupta R. Recent trends in coronary heart disease epidemiology in India. Indian heart journal. Mar-Apr 2008;60(2 Suppl B):B4-18.

8. Shah B, Mathur P. Surveillance of cardiovascular disease risk factors in India: the need & scope. Indian J Med Res. Nov 2010;132(5):634-642.

9. Thankappan K R, Shah B, Mathur P, et al. Risk factor profile for chronic non-communicable diseases: results of a community-based study in Kerala, India. Indian J Med Res. Jan 2010;131:53-63.

10. Kinra S., Bowen LJ, Lyngdoh T, et al. Sociodemographic patterning of non-communicable disease risk factors in rural India: a cross sectional study. BMJ. 2010;341:c4974.

11. Mohan V, Deepa M, Deepa R, et al. Secular trends in the prevalence of diabetes and impaired glucose tolerance in urban South India–the Chennai Urban Rural Epidemiology Study (CURES-17). Diabetologia. Jun 2006;49(6):1175-1178.