The Department of Endocrinology, 
Risk factors for incident cardiovascular events and their population attributable fractions in rural India: The Rishi Valley Prospective Cohort Study.
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
- George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
- George Institute for Global Health, New Delhi, India.
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Victoria, Australia.
- Pre-clinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia.
- Rishi Valley Rural Health Centre, Chittoor, Andhra Pradesh, India.
- Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
- National Centre for Healthy Ageing, Melbourne, Victoria, Australia.
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India.
Tropical medicine & international health : TM & IH Vol. 29 · Issue 5 · pp. 377-389
PMID 38403844 DOI 10.1111/tmi.13981
Cite This Article
Mulugeta Molla Birhanu, Ayse Zengin, Rohina Joshi, Roger G Evans, Kartik Kalyanram, Kamakshi Kartik, Michaela A Riddell, Oduru Suresh, Velandai K Srikanth, Simin Arabshahi, Nihal Thomas, Amanda G Thrift. Risk factors for incident cardiovascular events and their population attributable fractions in rural India: The Rishi Valley Prospective Cohort Study. Tropical medicine & international health : TM & IH. 2024;29(5):377-389. doi:10.1111/tmi.13981
Abstract
OBJECTIVE: We prospectively determined incident cardiovascular events and their association with risk factors in rural India.
METHODS: We followed up with 7935 adults from the Rishi Valley Prospective Cohort Study to identify incident cardiovascular events. Using Cox proportional hazards regression, we estimated hazard ratios (HRs) with 95% confidence intervals (95% CI) for associations between potential risk factors and cardiovascular events. Population attributable fractions (PAFs) for risk factors were estimated using R ('averisk' package).
RESULTS: Of the 4809 participants without prior cardiovascular disease, 57.7% were women and baseline mean age was 45.3 years. At follow-up (median of 4.9 years, 23,180 person-years [PYs]), 202 participants developed cardiovascular events, equating to an incidence of 8.7 cardiovascular events/1000 PYs. Incidence was greater in those with hypertension (hazard ratio [HR] [95% CI] 1.73 [1.21-2.49], adjusted PAF 18%), diabetes (1.96 [1.15-3.36], 4%) or central obesity (1.77 [1.23, 2.54], 9%) which together accounted for 31% of the PAF. Non-traditional risk factors such as night sleeping hours and number of children accounted for 16% of the PAF.
CONCLUSIONS: Both traditional and non-traditional cardiovascular risk factors are important contributors to incident cardiovascular events in rural India. Interventions targeted to these factors could assist in reducing the incidence of cardiovascular events.
Keywords
- cardiovascular events
- cohort
- epidemiology
- incidence
- low‐ and middle‐income countries
- population attributable fraction
- risk factors
