AN INVESTIGATION IN TO THE RISK FACTORS ASSOCIATED WITH CARDIOVASCULAR DISORDERS AMONG THE PAKHTUN POPULATION OF KHYBER PAKHTUNKHWA, PAKISTAN
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Abstract
OBJECTIVE: To determine demographic, dietary and psychological factors leading to coronary heart disease in Khyber Pakhtunkhwa, Pakistan.
METHODS: This cross-sectional retrospective study was conducted at
the cardiac unit of Hayatabad Medical Complex, Peshawar from September 2012 to December 2012. A random sample of 200 Pakhtun cardiac patients were thoroughly investigated for demographic parameters, anthropometric measurement, food frequency record, and “Depression Anxiety Stress Scales” was submitted for the prevalence of depression,anxiety and stress.
RESULTS: In factors assessed; rural background (75%), complex family structures (71%), illiteracy (68.5%), male smokers (64.75%), large families (9.84±2.57 members), low income (Rs. 8610±953) and less activity were identified as major risk factors. Being overweight (BM1=31.2±5.58 males and 27.98±1.92 females) with low High-density lipoproteins (HDL) (16.85±5.6), higher blood cholesterol (325±13.5 mg/dl), high triglycerides levels (232±10.7), diabetes mellitus (45%) and hypertension (29.5%) were the major biological factors. Dietary intake revealed high beef intake per week (65.5%), milk (97%), carbohydrates mostly wheat as staple food (90.5%) and low consumption of fresh vegetables and fruits. Daily intake of saturated fat (Ghee) (92%), animal fat, while fried and bakery items were also frequently consumed. The study also found a greater percentage of patients having moderate to mild anxiety, depression and stress posing to be health risks in CVD.
CONCLUSION: Coronary heart disease follows a multidimensional
scenario in KP which needs to be addressed to prevent people of this
region from vicious cycle of disease.
KEY WORDS: Risk factors (Non-MeSH), demographic factor, dietary
intake patterns, biological factors, DAAS psychological test
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References
Abbas S, Kitchlew AR, Abbas S. Disease burden of ischemic heart disease in Pakistan and its risk factors. Ann. Pak. Inst. Med. Sci.2009; 5(3): 145-150.
Adeyi O, Smith O, Robles S. Public Policy and the challenge of non-communicable diseases 2007; Washington DC the World Bank.
Adil M, Maula F, Nadeem M, Zaman S, Bilal M, Nawaz R, Safi MA. Prevalence of over weight and obesity in health employees gomal J. Med. Sci. 2013; 11: 59-62.
Ahmad K, Jafary FH, Jehan I, Hatcher, Qayum A, Chaturvedi N. Prevalence and predictors of smoking in Pakistan: results of the national health survey of Pakistan. Eur. J. Cardiovasc Prev. Rehabil 2005; 12: 203-8.
Akhtar S and Ashar N. Risk factors of cardiovascular disease in district swat. J Pak Med Assoc 2015; 66(9): 1001-1004.
Barquera S, Hernandez – Barrera L, Tolentino ML, Espinosa J, Shu WN, Rivera JA, Popkia BM. Energy Intake from beverages is increasing among Mexican adolescents and adults. Journal of Nutrition 2005; 138(12): 2454-2461.
Beaglehole R, Bonita R. Global public health: A score card Lancet 2008; 372 (9654): 1988-1996.
Cramer D. Type A behaviour pattern, extraversion, neuroticism and psychological distress Br. J. Med. Psychol 1991; 64(pt 1): 13-83.
Dogar IA, Khwaja IS, Azeem MW, Awan H, Ayub A, Iqbal J, Thuras P, Prevalence and risk factos for depression and anxiety in hospitalized cardiac patients in Pakistan. Psychiatry (Edgmort) 2008; 5(2): 38-41.
Guthold R, Ono T, Strong KL, Chatter JIS, Morabia A. Worldwide variability in physical inactivity – a 51 country survey. American Journal of Preventive Medicine 2008 ; 34 (6): 486 – 494.
Hartan WR. Physical and psychological stress and the cardiovascular system circulation 1981; 63(1): 266A – 271 A.
Hu FB. Globalization of food patterns and cardiovascular disease risk. Circulation 2008; (9): 1913-1914.
Jafar TH, Jafary FH, Jessani S, Chaturvedi N. Heart disease epidemic in Pakistan: Women and men at equal risk. Am Heart J 2005; 150: 221-6.
Jha P, Chaloupke EJ 1999. Curbing the Epidemic: Government and the economics of tobacco control Washington DC 1999; World Bank.
Khan M, and Mensah G. (2009) Changing practices to improve dietary out comes and reduce cardiovascular risk: A food company’s perspective purchase 2009; NY: Background paper commissioned by the Committee.
Lane D, Caroll D, Ring C, Beevers DG, Lip GY. Effect of depression and anxiety on mortality and quality of life 4 months after myocardial infarction J. Psychosom Res 2000; 49(4): 229-238.
Leon GR, Finn SE, Murray D, Bailey JM. Inability to predict cardiovascular disease from hostility scores or MMDI items related to type A behaviour. J. Consult Clin Psychol 1988; 56(4): 597-600.
Lopez AD, Mathers CD, Eszati M, Jamison DT, Murray CJL. Global burden of disease and risk factors Washington DC 2006; World Bank.
Lovibond SH and Lovibond PF .Manual for the depression, anxiety stress scales 1995; 2nd Ed. Sydney: Psychology Foundation.
Minc S. Some psychological factors in coronary heart disease. 1962. http://www.psychosomaticmedicine.org/content/25/2/133.full.pdf.
Mustafa M, Najam N. Depression Anxiety, Stress and demographic determinants of hypertension disease Pak. J. Med. Sci 2014; 30(6): 1293-1298.
Nazli R, Akhtar T, Latfullah G, Akmal MK, Haider J, Aslam H. Prevalence of obesity and associated risk factors in a female population of rural Peshawar-Pakistan. KMUJ 2015; 7(1): 19-24.
Neukovei ZK, Yousafy A, Manshaee G, Nickneshan S. Comparing anxiety in cardiac patients for angiography with the normal population. ARYA Atherscler 2011; 7(3): 93-96.
Sarwar G, Khan I, Iqbal R, Afridi AK, Khan A, Sarwar R. Risk factors of Islamic heart disease in Peshawar. JPMR 2011; 18(4): 685-688.
Smith F, Leseprance F, Talajic M. Depression and 18 month prognosis after myocardial infarction circulation 1995; 91(4): 999-1005.
Stapel Berg N, Hamitton-Craig I, Neumann, DL, Shum DH, McConnell H. Mind and Heart: Heart rate variability in major depressive disorder and coronary heart disease – a review and recommendations. Aust NZ J Psychiatry 2012; 46 (10): 956-957.
Turin TC, Shahana N, Wang chu KLZ, Specogna AV, Mamun MA, Khan M A. The burden of cardiovascular and cerebro vascular diseases and the conventional risk factors in south Asian population 2012; http://www.sciencedirect.com/science/arbile/pii
WHO. Preventing chronic diseases. A vital investment 2005. http://www.who.int/chp/chronic_diseases_report/fullreport.pdf
WHO. The global burden of disease: 2004 Updates. Geneva World Health Organization 2008 b.
WHO. World Health Statistics 2008. Geneva: World Health organization; 2009 e.
World Health Federation (2015). Cardiovascular risk factors. http://www.world_heart_federation.org/cardiovascular_health
Yusuf PS, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisbeug L. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART Study): Case Control Study: Lancet 2004; 364 (9438): 937-952.