Department of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
Department of Community Medicine, Ibrahim Medical College, 122 Kazi Nazrul Islam Avenue Shahbag, Dhaka-1000.
Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
Department of Internal Medicine, Ibrahim Medical College, 122 Kazi Nazrul Islam Avenue Shahbag, Dhaka-1000.
The prevalence of cardiovascular diseases (CVD) are on the increase worldwide
and more in the developing countries. Coronary artery disease (CAD) constitutes
the major brunt of CVD. Despite the increasing morbidity and mortality,
Bangladesh has a few published data on CAD in rural population. This study
addressed the prevalence of CAD and its risk factors in rural population of
Sixteen villages were purposively selected in a rural area. A population census
was conducted in the selected area. The census yielded eligible participants,
who reached at least eighteen years of age. Those who willingly consented to
participate were enlisted. Each participant was interviewed regarding CAD risk
(age, sex, social class, occupation, illness, family history). Anthropometry (height,
weight, waist- and hip-girth) was recorded. Resting blood pressure (BP) was
measured. Blood sample was collected for fasting blood glucose (FBG), total cholesterol
(Chol), triglycerides (Tg), low density lipoproteins (LDL), very low density
lipoproteins (VLDL) and high density (HDL). All participants having
FBG>5.5mmol/l or systolic (SBP) ³135 or diastolic BP
(DBP) ³85mmHg underwent
electrocardiography (ECG). A team of cardiologists selected and accomplished
exercise tolerance test (ETT) and echocardiography (Echo).
Results: The prevalence of CAD
was 4.5% (95% CI: 3.85 – 5.15). Compared with the female (3.5%, CI,
2.76 – 4.24) the male participants had significantly higher prevalence of CAD
(6.0%, CI, 4.83 – 7.13). Comparison of characteristics between participants
with and without CAD showed that age, SBP, DBP and FBG were significantly
higher in CAD group. Bivariate analysis showed that age, sex, social class,
glycemic status, metabolic syndrome (MetS) and smoking were significantly
related to CAD. Stepwise logistic regression proved only male sex, rich social
class, hypertension and diabetes had independent risk of CAD; whereas, age,
obesity and dyslipidemia were proved not significant.
Conclusions: The study concludes that the prevalence of CAD in a Bangladeshi rural
population is comparable to other developed countries. The male sex, rich
social class, hypertension and diabetes were proved to have excess risk of CAD.
Neither obesity nor dyslipidemia were found significant for CAD. The younger
people had similar risk as the aged ones, which necessitate primordial and
primary prevention of CAD. Further study may be undertaken, which should
include and consider physical activity and diet; and if possible, C-reactive protein,
Vitamin D and homocysteine level.
IMC J Med Sci 2017; 11(2): 61-69
Correspondence: Prof. M. Abu Sayeed, Department of Community Medicine,
Ibrahim Medical College, 122 Kazi Nazrul Islam Avenue Shahbag, Dhaka-1000.