title: Disparities in Prevalence of Cardiometablic Risk Factors in Rural, Urban-Poor, and Urban-Middle Class Women in India.
abstract: OBJECTIVE
  Urbanization is an important determinant of cardiovascular disease (CVD) risk. To determine location-based differences in CVD risk factors in India we performed studies among women in rural, urban-poor and urban middle-class locations.
  
  
  METHODS
  Population-based cross-sectional studies in rural, urban-poor, and urban-middle class women (35-70 y) were performed at multiple sites. We evaluated 6853 women (rural 2616, 5 sites; urban-poor 2008, 4 sites; urban middle-class 2229, 11 sites) for socioeconomic, lifestyle, anthropometric and biochemical risk factors. Descriptive statistics are reported.
  
  
  RESULTS
  Mean levels of body mass index (BMI), waist circumference, waist-hip ratio (WHR), systolic BP, fasting glucose and cholesterol in rural, urban-poor and urban-middle class women showed significantly increasing trends (ANOVAtrend, p <0.001). Age-adjusted prevalence of diabetes and risk factors among rural, urban-poor and urban-middle class women, respectively was, diabetes (2.2, 9.3, 17.7%), overweight BMI ≥25 kg/m2 (22.5, 45.6, 57.4%), waist >80 cm (28.3, 63.4, 61.9%), waist >90 cm (8.4, 31.4, 38.2%), waist hip ratio (WHR) >0.8 (60.4, 90.7, 88.5), WHR>0.9 (13.0, 44.3, 56.1%), hypertension (31.6, 48.2, 59.0%) and hypercholesterolemia (13.5, 27.7, 37.4%) (Mantel Haenszel X2 ptrend <0.01). Inverse trend was observed for tobacco use (41.6, 19.6, 9.4%). There was significant association of hypertension, hypercholesterolemia and diabetes with overweight and obesity (adjusted R2 0.89-0.99).
  
  
  CONCLUSIONS
  There are significant location based differences in cardiometabolic risk factors in India. The urban-middle class women have the highest risk compared to urban-poor and rural.
authors.affiliation: Department of Preventive and Social Medicine, RUHS College of Medical Sciences, Jaipur, Rajasthan, India.
authors.forename: Indu
authors.initials: I
authors.lastname: Mohan
authors.affiliation: Department of Medicine, Fortis Escorts Hospital, Jaipur, Rajasthan, India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Department of Diabetes & Metabolic Diseases, Fortis C-DOC Centre of Excellence, Chiragh Enclave, New Delhi, India.
authors.forename: Anoop
authors.initials: A
authors.lastname: Misra
authors.affiliation: Department of Pharmacology, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India.
authors.forename: Krishna Kumar
authors.initials: KK
authors.lastname: Sharma
authors.affiliation: Department of Home Science, University of Rajasthan, Jaipur, Rajasthan, India.
authors.forename: Aachu
authors.initials: A
authors.lastname: Agrawal
authors.affiliation: Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Naval K
authors.initials: NK
authors.lastname: Vikram
authors.affiliation: Science and Society Division, Department of Science and Technology, Government of India, New Delhi, India.
authors.forename: Vinita
authors.initials: V
authors.lastname: Sharma
authors.affiliation: Department of Diabetes & Metabolic Diseases, Fortis C-DOC Centre of Excellence, Chiragh Enclave, New Delhi, India.
authors.forename: Usha
authors.initials: U
authors.lastname: Shrivastava
authors.affiliation: Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Ravindra M
authors.initials: RM
authors.lastname: Pandey
mesh_terms: D000328:Adult; D000886:Anthropometry; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002947:Cities; D016001:Confidence Intervals; D004041:Dietary Fats; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007194:India / Q000453:epidemiology; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*
chemical_list: D004041:Dietary Fats