Distribution and determinants of coronary artery disease in an urban Pakistani setting.
OBJECTIVE
We assessed the distribution of coronary artery disease (CAD) and its association with the major biological risk factors and behaviors among Pakistanis presenting at a tertiary care hospital in Karachi, Pakistan.


METHODS
An epidemiologic cross-sectional study was conducted at the Aga Khan University Hospital (a teaching hospital) in Karachi, Pakistan. A total of 600 adult (> or =18 years of age) patients visiting family practice clinics for general check-up were included. The association of biological risk factors with CAD (smoking, obesity [body mass index (BMI)], hypertension, family history of ischemic heart diseases [IHD], sedentary lifestyle, diabetes mellitus, total cholesterol, low density lipoprotein [LDL] levels, high density lipoprotein [HDL] levels, and triglycerides) were assessed.


RESULTS
On univariate analysis, age > or =40 years, early menopause, BMI > or =29.9 kg/m2, diabetes, high cholesterol, and positive family history of IHD were independently associated with CAD. We found age > or =40 years, diabetes, and positive family history of IHD strongly related with CAD on multivariate analysis.


CONCLUSIONS
Looking at the strong association of major risk factors with CAD, the unique characteristics of Pakistanis must be studied in depth, with focus on high-risk groups.
Dodani
Sunita
S
Department of Epidemiology; University of Pittsburgh, Pittsburgh, PA 15101, USA. sud0@pitt.edu
MacLean
David D
DD
LaPorte
Ronald E
RE
Joffres
Michel
M
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005192:Family Health; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010154:Pakistan / Q000453:epidemiology; D012307:Risk Factors; D012959:Socioeconomic Factors; D014505:Urban Population