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)

OBJECTIVES The aim of this study was to assess the prevalence and risk factors for coronary artery disease (CAD) in a native urban South Indian population. BACKGROUND High prevalence rates of premature CAD have been reported in migrant Asian Indians. There are very few studies on CAD in native Indians living in the Indian subcontinent. METHODS The Chennai Urban Population Study (CUPS) is an epidemiological study involving two residential areas in Chennai in South India. Of the total of 1,399 eligible subjects (age ≥20 years), 1,262 (90.2%) participated in the study. All the study subjects underwent a glucose tolerance test and were categorized as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT) or diabetes. Twelve-lead electrocardiogram (ECG) was performed in 1,175 individuals (84%). Coronary artery disease was diagnosed based on previous medical history or Minnesota coding of ECGs. RESULTS The overall prevalence rate of CAD is 11.0% (age standardized, 9.0%). The prevalence rates of CAD were 9.1%, 14.9% and 21.4% in those with NGT, IGT and diabetes, respectively. Prevalence of CAD increased with an increase in total cholesterol (trend chi-square: 26.2, p < 0.001), low-density lipoprotein (LDL) cholesterol (trend chi-square: 24.5, p < 0.001), triglycerides (trend chi-square: 9.96, P = 0.002) and total cholesterol/high-density lipoprotein ratio (trend chi-square: 6.14, P = 0.0132). Multiple logistic regression analysis identified age (odds ratio [OR]: 1.05, p < 0.001) and LDL cholesterol (OR: 1.009, P = 0.051) as the risk factors for CAD. CONCLUSIONS The prevalence of CAD is rising rapidly in urban India. Lifestyle changes and aggressive control of risk factors are urgently needed to reverse this trend.