Diabetes, hypertension, and other cardiovascular disease risk factors among adults in an urban underprivileged community in Bangalore city, India

David John, Avita R. Johnson, Farah N. Fathima, Rose Mundackal
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Abstract

ABSTRACT Diabetes and hypertension are major risk factors of cardiovascular disease, which is known to be the leading cause of global mortality in the world today. Studies have shown that the prevalence of these risk factors is on the rise, with the burden of diabetes alone increasing by 80% in the last two decades. Complications of diabetes and hypertension result in huge public health challenges for the country and catastrophic medical expenditures for families among the urban poor. Our study aims to estimate the prevalence of diabetes, hypertension, and other cardiovascular risk factors among adults in an urban underprivileged community of Bengaluru city. A cross-sectional study was conducted over a period of 6 months where 2245 individuals aged 30 or older were interviewed using a structured interviewer-administered questionnaire used to capture sociodemographic details that assessed modifiable risk factors for diabetes and hypertension. Inclusion criteria for diabetes were considered if the random blood sugar reading was ≥200 mg/dL, whereas a diagnosis of hypertension was taken into consideration if the systolic blood pressure reading was ≥140 mmHg and/or diastolic blood pressure was ≥90 mmHg. Among the 2245 participants that took part in the study, 15.5% were diabetics and 17.2% were hypertensive. There was a strong association of diabetes among consumers of alcohol, with more than one-third having a high prevalence of the disease (odds ratio (OR): 2.09, 95% confidence interval (95% CI): 1.1–3.9). More than half the population were consumers of junk food; the prevalence of diabetes in this group was 1.35 times higher than that in their counterparts (OR: 1.35, 95% CI: 1.0–1.8). A significant association of diabetes was also seen among those identified with central obesity (OR: 1.83, 95% CI: 1.4–2.5). One-third of the population who consumed alcohol were found to be diagnosed with hypertension (OR: 3.08, 95% CI: 1.6–5.9), and one-fifth of individuals who were regular consumers of junk food had a higher prevalence of hypertension (OR: 1.41, 95% CI: 1.1–1.8). A higher prevalence of hypertension was also seen among individuals with central obesity or a body mass index (BMI) of >30 (OR: 1.59, 95% CI: 1.2–2.1; OR: 1.92, 95% CI: 1.4–2.6). The findings from our study conducted in an urban underprivileged area of Bengaluru city shed light on the significant associations between diabetes and hypertension and various demographic and lifestyle factors. Specifically, male gender and lower educational status were found to have a significant association with diabetes, whereas being unmarried and having a high BMI status were strongly linked to hypertension. In addition, the study revealed that elderly individuals, alcohol consumers, junk food eaters, and those with central obesity demonstrated an increased risk for both diabetes and hypertension. By identifying these risk factors, targeted interventions can be developed to address the unique challenges faced by this vulnerable section of society. Strategies can be designed to raise awareness, encourage healthier lifestyle choices, and improve access to healthcare services to effectively prevent and manage diabetes and hypertension in this community.
印度班加罗尔市一个城市贫困社区成年人的糖尿病、高血压和其他心血管疾病风险因素
摘要 糖尿病和高血压是心血管疾病的主要风险因素,众所周知,心血管疾病是当今世界全球死亡的主要原因。研究表明,这些风险因素的发病率呈上升趋势,在过去二十年中,仅糖尿病的负担就增加了 80%。糖尿病和高血压的并发症给国家带来了巨大的公共卫生挑战,也给城市贫困家庭带来了灾难性的医疗支出。我们的研究旨在估算班加罗尔市一个城市贫困社区成年人中糖尿病、高血压和其他心血管风险因素的患病率。 我们开展了一项为期 6 个月的横断面研究,使用由访谈员发放的结构化问卷对 2245 名年龄在 30 岁或以上的人进行了访谈,该问卷用于收集社会人口详情,评估糖尿病和高血压的可改变风险因素。糖尿病的纳入标准是随机血糖读数≥200 mg/dL,而高血压的诊断标准是收缩压读数≥140 mmHg 和/或舒张压≥90 mmHg。 在参与研究的 2245 名参与者中,15.5% 患有糖尿病,17.2% 患有高血压。饮酒者中糖尿病的发病率很高,超过三分之一的人患有糖尿病(几率比(OR):2.09,95% 置信区间(95% CI):1.1-3.9)。半数以上的人喜欢吃垃圾食品;这一群体的糖尿病患病率是同类人群的 1.35 倍(比值比:1.35,95% 置信区间:1.0-1.8)。被确认为中心性肥胖的人群中,糖尿病发病率也明显高于其他人群(OR:1.83,95% CI:1.4-2.5)。饮酒人群中有三分之一被诊断出患有高血压(OR:3.08,95% CI:1.6-5.9),经常食用垃圾食品的人群中有五分之一患有高血压(OR:1.41,95% CI:1.1-1.8)。在中心性肥胖或体重指数(BMI)大于 30 的人群中,高血压患病率也较高(OR:1.59,95% CI:1.2-2.1;OR:1.92,95% CI:1.4-2.6)。 我们在班加罗尔城市贫困地区进行的研究结果表明,糖尿病和高血压与各种人口统计学和生活方式因素之间存在显著关联。具体而言,研究发现男性性别和教育程度较低与糖尿病有显著关联,而未婚和高体重指数则与高血压密切相关。此外,研究还发现,老年人、饮酒者、吃垃圾食品者和中心性肥胖者患糖尿病和高血压的风险都会增加。通过确定这些风险因素,可以制定有针对性的干预措施,以应对社会中这一弱势群体所面临的独特挑战。可以设计一些策略来提高认识,鼓励选择更健康的生活方式,并改善医疗保健服务的获取,从而有效预防和控制该社区的糖尿病和高血压。
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