Research article

Knowledge of modifiable risk factors of Coronary Atherosclerotic Heart Disease (CASHD) among a sample in India

Omar Saeed¹ , Vineet Gupta² , Naveen Dhawan³ , Leanne Streja⁴ , John S Shin⁵ , Melvin Ku⁶ , Sanjeev Bhoi² and Sanjay Verma²

¹Department of Medicine, Emory University, Atlanta, GA, USA

²Department of Emergency Medicine (JPNATC), All India Institute of Medical Sciences, (AIIMS), New Delhi, India

³Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA

⁴Department of Biostatistics, University of California at Los Angeles, Los Angeles, CA, USA

⁵Department of Medicine, University of California at Irvine, Irvine, CA, USA

⁶Department of Medicine, Michigan State University, East Lansing, MI, USA

author email corresponding author email

BMC International Health and Human Rights 2009, 9:2doi:10.1186/1472-698X-9-2

Published:	4 February 2009

Abstract

Background

The prevalence of Coronary Atherosclerotic Heart Disease (CASHD) is increasing in India. Several modifiable risk factors contribute directly to this disease burden. Public knowledge of such risk factors among the urban Indian population is largely unknown. This investigation attempts to quantify knowledge of modifiable risk factors of CASHD as sampled among an Indian population at a large metropolitan hospital.

Methods

A hospital-based, cross sectional study was conducted at All India Institute of Medical Sciences (AIIMS), a major tertiary care hospital in New Delhi, India. Participants (n = 217) recruited from patient waiting areas in the emergency room were provided with standardized questionnaires to assess their knowledge of modifiable risk factors of CASHD. The risk factors specifically included smoking, hypertension, elevated cholesterol levels, diabetes mellitus and obesity. Identifying 3 or less risk factors was regarded as a poor knowledge level, whereas identifying 4 or more risk factors was regarded as a good knowledge level. A multiple logistic regression model was used to isolate independent demographic markers predictive of a participant's level of knowledge.

Results

41% of the sample surveyed had a good level of knowledge. 68%, 72%, 73% and 57% of the population identified smoking, obesity, hypertension, and high cholesterol correctly, respectively. 30% identified diabetes mellitus as a modifiable risk factor of CASHD. In multiple logistic regression analysis independent demographic predictors of a good knowledge level with a statistically significant (p < 0.05) adjusted odds ratio (aOR) were: routine exercise of moderate intensity, aOR 8.41 (compared to infrequent or no exercise), no history of smoking, aOR 8.25, and former smokers, aOR 48.28 (compared to current smokers). Although statistically insignificant, a trend towards a good knowledge level was associated with higher levels of education.

Conclusion

An Indian population in a hospital setting shows a lack of knowledge pertaining to modifiable risk factors of CASHD. By isolating demographic predictors of poor knowledge, such as current smokers and persons who do not exercise regularly, educational interventions can be effectively targeted and implemented as primary and secondary prevention strategies to reduce the burden of CASHD in India.