title: Prevention of cardiovascular disease in a rural region of India and strategies to address the unmet need.
abstract: OBJECTIVE
  To determine levels of cardiovascular disease (CVD) prevention and to model the potential impact of improved prevention strategies for a large rural Indian region.
  
  
  METHODS
  A cross-sectional study with modelling of coronary heart disease (CHD) events over 10 years.
  
  
  METHODS
  Rural Andhra Pradesh, India.
  
  
  METHODS
  A stratified random sample of 1,079 adults 30 years and older.
  
  
  METHODS
  Proportion on medical and behavioural treatments for prevention of CVD; estimated number of CHD events using a locally recalibrated Framingham risk equation.
  
  
  RESULTS
  Among the 3.5% (95% CI 2.1% to 4.9%) with existing CVD, 49.3% (95% CI 28.8% to 69.8%) were on blood pressure (BP)-lowering medication, 4.7% (95% CI 0 to 10.4%) were on cholesterol-lowering medication, 24.6% (95% CI 9% to 40.3%) had increased exercise and 26.9% (95% CI 2.6% to 51.1%) attempted to quit smoking. Among the 7.6% (95% CI 6.2% to 8.9%) with a high global CHD risk (>20% over 10 years), 29.5% (95% CI 19.5 to 39.5%) were on BP-lowering medication, 2.8% (95% CI 0 to 6.7%) were on cholesterol-lowering medication, 19.4% (95% CI 10.9% to 28%) had increased exercise and 24.8% (95% CI 15.8% to 33.8%) attempted to quit smoking. If confirmed drug therapies were provided to all individuals at high risk there would be a 28% reduction in cardiovascular events over 10 years at an approximate annual treatment cost of US$533 per event avoided.
  
  
  CONCLUSIONS
  There are serious deficiencies in CVD prevention in rural areas of India. Addressing these with simple confirmed drug treatments could produce a large reduction in the future cardiovascular burden in India.
authors.affiliation: The George Institute for Global Health, Sydney, Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Wood
authors.forename: Jill
authors.initials: J
authors.lastname: Pell
authors.forename: Anushka
authors.initials: A
authors.lastname: Patel
authors.forename: Bruce
authors.initials: B
authors.lastname: Neal
authors.forename: P Krishnam
authors.initials: PK
authors.lastname: Raju
authors.forename: Clara K
authors.initials: CK
authors.lastname: Chow
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention; D018570:Risk Assessment; D012307:Risk Factors; D012423:Rural Health; D012424:Rural Population; D055502:Secondary Prevention