Prevalence of Coronary Artery Disease and Its Relationship to Lipids in a Selected Population in South India: The Chennai Urban Population Study (CUPS No. 5)

Objectives: The aim of this study was to assess the prevalence and risk factors for coronary artery disease (CAD) in a native urban South Indian population.

Background: High prevalence rates of premature CAD have been reported in migrant Asian Indians. There are very few studies on CAD in native Indians living in the Indian subcontinent.

Methods: The Chennai Urban Population Study (CUPS) is an epidemiological study involving two residential areas in Chennai in South India. Of the total of 1,399 eligible subjects (age > or =20 years), 1,262 (90.2%) participated in the study. All the study subjects underwent a glucose tolerance test and were categorized as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT) or diabetes. Twelve-lead electrocardiogram (ECG) was performed in 1,175 individuals (84%). Coronary artery disease was diagnosed based on previous medical history or Minnesota coding of ECGs.

Results: The overall prevalence rate of CAD is 11.0% (age standardized, 9.0%). The prevalence rates of CAD were 9.1%, 14.9% and 21.4% in those with NGT, IGT and diabetes, respectively. Prevalence of CAD increased with an increase in total cholesterol (trend chi-square: 26.2, p < 0.001), low-density lipoprotein (LDL) cholesterol (trend chi-square: 24.5, p < 0.001), triglycerides (trend chi-square: 9.96, p = 0.002) and total cholesterol/high-density lipoprotein ratio (trend chi-square: 6.14, p = 0.0132). Multiple logistic regression analysis identified age (odds ratio [OR]: 1.05, p < 0.001) and LDL cholesterol (OR: 1.009, p = 0.051) as the risk factors for CAD.

Conclusions: The prevalence of CAD is rising rapidly in urban India. Lifestyle changes and aggressive control of risk factors are urgently needed to reverse this trend.