title: Location of residence or social class, which is the stronger determinant associated with cardiovascular risk factors among Pakistani population? A cross sectional study.
abstract: BACKGROUND
  The prevalence of cardiovascular disease and associated risk factors are increasing globally, particularly in the developing world. Those in the South Asian region are especially at risk of cardiovascular disease due to an increasing prevalence of its risk factors. This study was undertaken to investigate the association of social class with location of residence in the distribution of cardiovascular risk factors (mainly hypertension and diabetes mellitus) in Pakistan.
  
  
  METHODS
  A cross-sectional study of 2495 subjects aged between 30-75 years was conducted in Punjab Province, which includes urban and rural areas. Subjects completed a detailed questionnaire, and anthropometric measurements and blood samples were taken after a written informed consent. Participants were categorized as urban or rural and assigned a social class according to their occupation. A logistic regression model was used to explore the association between social class and location of residence.
  
  
  RESULTS
  The overall prevalence of hypertension and diabetes was 24.2% and 16.6%, respectively. Of the total number of participants, 56.8% (n=1417) were rural residents and 43.2% (n=1078) were urban. Urban individuals were significantly more likely (p<0.001) to be hypertensive (OR=3.03, 95% CI 2.14-4.30) and more likely (p<0.001) to be diabetic (OR=1.77, 95% CI 1.29-2.42) than rural dwellers, after multivariate adjustments for age, sex, BMI and social class. Social class was not significantly associated with the prevalence of either hypertension or diabetes.
  
  
  CONCLUSIONS
  In the Pakistani population, rural or urban location of residence is a more powerful determinant of cardiovascular risk factors than social class.
authors.affiliation: Afra General Hospital, Waris Pura near Gol Chowk, Faisalabad, Pakistan. almustafadr@googlemail.com
authors.forename: Muhammd F
authors.initials: MF
authors.lastname: Tareen
authors.forename: Kashif
authors.initials: K
authors.lastname: Shafique
authors.forename: Saira S
authors.initials: SS
authors.lastname: Mirza
authors.forename: Zain I
authors.initials: ZI
authors.lastname: Arain
authors.forename: Ishtiaque
authors.initials: I
authors.lastname: Ahmad
authors.forename: Priya
authors.initials: P
authors.lastname: Vart
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D012424:Rural Population; D012923:Social Class; D014505:Urban Population