title: Determinants of urban-rural differences in cardiovascular risk factors in middle-aged women in India: a cross-sectional study.
abstract: OBJECTIVE
  Cardiovascular diseases (CVD) are the most important cause of death amongst middle-aged Indian women. To determine prevalence of CVD risk factors and their determinants we performed a nationwide study.
  
  
  METHODS
  Population based studies amongst women 35-70 years were performed in four urban and five rural locations in India. Location based stratified sampling was performed and we enrolled 4624 (rural 2616, urban 2008) of eligible 8000 women (58%). Demographic details, medical history, diet, physical activity and anthropometry were recorded using standardised techniques. Blood haemoglobin, glucose and total cholesterol were determined. Risk factors were diagnosed using current guidelines. Descriptive statistics are reported. Stepwise multivariate logistic regression was performed to identify determinants of urban-rural differences.
  
  
  RESULTS
  In urban women mean body mass index (BMI), waist circumference, waist-hip ratio (WHR), systolic BP, haemoglobin, fasting glucose and cholesterol were significantly greater (p<0.01). Age-adjusted prevalence of risk factors (%) in urban vs rural was of obesity BMI ≥ 25 kg/m(2) (45.6 vs 22.5), truncal obesity WHR>0.9 (44.3 vs 13.0), hypertension (37.5 vs 29.3), hypercholesterolemia ≥ 200 mg/dl (27.7 vs 13.5), and diabetes (15.1 vs 4.3) greater whilst any tobacco use (19.6 vs 41.6) or smoking lower. Significant determinants of urban-rural differences were greater income and literacy, dietary fats, low physical activity, obesity and truncal obesity (p<0.01).
  
  
  CONCLUSIONS
  Greater prevalence of CVD risk factors in urban middle-aged women is explained by greater income and literacy, dietary fat, low physical activity and obesity.
authors: All India Institute of Medical Sciences, New Delhi, India. rmpandey@gmail.com
authors: Ravindra M
authors: RM
authors: Pandey
authors: Rajeev
authors: R
authors: Gupta
authors: Anoop
authors: A
authors: Misra
authors: Puneet
authors: P
authors: Misra
authors: Vasundhara
authors: V
authors: Singh
authors: Aachu
authors: A
authors: Agrawal
authors: Sanjit
authors: S
authors: Dey
authors: Shobha
authors: S
authors: Rao
authors: V Usha
authors: VU
authors: Menon
authors: N
authors: N
authors: Kamalamma
authors: K P Vasantha
authors: KP
authors: Devi
authors: K
authors: K
authors: Revathi
authors: Vinita
authors: V
authors: Sharma
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008019:Life Style; D008875:Middle Aged; D012307:Risk Factors; D012423:Rural Health; D012959:Socioeconomic Factors; D014504:Urban Health