Longitudinal change in cardiovascular risk factors in rural Kerala, India: a community-based cohort study (2003 to 2010)

INTRODUCTION: Cardiovascular diseases are the leading causes of deaths in India and other developing countries. We aimed to assess the longitudinal change in behavioural and clinical cardiovascular risk factors over seven years in rural Kerala, India.

METHODS: We conducted a cohort study (2003-2010) enrolling 495 individuals aged 15 to 64 years in a rural area of Kerala, India. We analyzed the data of 451 individuals (91.1%) who participated in the follow-up study. We used the World Health Organization STEPwise approach to surveillance method to collect data at baseline and follow-up. Mean of risk factors was compared using Paired t test and prevalence of risk factors was compared using McNemar’s test.

RESULTS: The mean of risk factors at baseline showed a significant increase during follow-up for systolic blood pressure (130.4-133.7 mmHg, p<0.001), diastolic blood pressure (80.3-81.4 mmHg, p=0.037), weight (54.3-59.5 kg, p<0.001), body mass index (BMI; 22.0-24.0 kg/m², p<0.001) and waist circumference (83.3-88.5 cm, p<0.001). The prevalence of risk factors at baseline showed a significant increase during follow-up for current smokeless tobacco use (11.1-17.1%, p<0.001), current alcohol use (21.3-37.0%, p<0.001), hypertension (34.1-40.1%, p=0.014), BMI ≥23 kg/m² (38.4-55.9%, p<0.001), BMI ≥25 kg/m² (22.2-39.5%, p<0.001) and central obesity (54.3-69.6%, p<0.001).

CONCLUSIONS: There was a significant worsening of cardiovascular risk factors in this rural sample, which calls for urgent intervention to curtail the impending cardiovascular disease outbreak in this population.