Shahid Abbas, Shazia Abbas, Asad Riaz, Naeem Malik.
Risk factors for Coronory Artery Disease in Pakistan.
Pak Armed Forces Med J Jan ;53(1):12-9.

The objective of this study was to look for the presence of risk factors in patients with ischemic heart disease (IHD) in the Pakistani population. The study was undertaken in collaboration with the World Health Organization (WHO) and the Ministry of Health, Government of Pakistan. One thousand patients, 25 to 64 years of age, of both genders and with diagnosed coronary artery disease, were questioned and investigated regarding the known risk factors for coronary artery disease. World Health Organization (WHO) MONICA (Monitoring of Trends and Determinants in Cardiovascular Disease) project protocol was followed in diagnosis, questioning and investigations as far as possible. Coronary heart disease (CHD) was much more common in men compared to women in all age groups (78.2% vs. 21.8%). Relative difference in CHD prevalence between sexes was largest among the youngest subjects (86.5% vs. 13.5%), and smallest among the oldest subjects (73.8% vs. 26.2%). There were more men aged 50-59 who had CHD (43.2%) compared to other age groups (16.4% and 40.4%); whereas over half the women (51.4%) with IHD were between 60 and 64. Smoking was much more common in men (57.8% vs. 1.37%). Total cholesterol was higher (230 vs. 221) and LDL cholesterol was lower (122.66 vs. 130.33) in women, whereas HDL cholesterol was higher in women (43.0 vs. 41.3) compared to men so as to result in the same HDL/total cholesterol ratio in the two genders. With age, total and LDL cholesterol rose whereas HDL cholesterol reduced in both sexes. In all age groups and both sexes, HDL cholesterol was lower than the desirable levels (41.3 in men and 43.0 in women). Both systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher than desirable in both men and women and increased further with increasing age (151.2/86.1 to 167.1/102.8 in men and 132.6/79.6 to 165.6/99.7 in women). Both SBP and DBP were higher in men compared to women although this difference became less marked in the older age groups. BMI was higher among women in all age groups and was more marked in the older age groups (28.4 to 30.1 vs. 28.4 to 33.2). The prevalence of diabetes mellitus was higher in women with IHD compared to men, in all age groups and increased in both men and women with increasing age but more so in women (5.0% to 16.9% vs. 3.1% to 10.1%).

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