SaffolalifeStudyTM 2010

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SaffolalifeStudyTM 2010

Findings

The Indian Risk Factor
About 4 in 10 Urban Indians carry a risk factor due to their lipid profiles

Net Population at High Risk 2009
A predisposition amongst Indians

“Indians in urban settings are known to have coronary artery disease [CAD] up to 3-4 times higher than other ethnic groups worldwide, irrespective of gender or social class.”
Trehan , J. Ind. Acad. Clin. Med. 2001.


“Even while urban Indians have higher rates of CAD than rural settings; the latter is still higher than western levels. While the CAD rates have reduced by half with western societies in the past 30 years, the rates doubled in India with no apparent signs of abatement.”
Enas,Indian Heart J., 2001


“Indians tend to have CAD 5-10 years earlier than other ethnic groups as well as a higher incidence. Among Asian Indians about 50% of all myocardial infraction occurs under the age of 50years and 25% under the age of 40. ”
Enas, Internet Journal of Cardiology, 2002


“Compared to 2000, the number of years of productive life lost to CVD will have increased in 2030 by only 20 percent in the United States and by 30 percent in Portugal. For Brazil the figure is 64 percent, for China, 57 percent, and for India, 95 percent.”
Statistical Fact Sheet — Populations 2007 Update. American Heart Association


Relevance of an under emphasised risk factor: Tryglycerides
While urban populations had high levels of routinely assessed markers such as LDL (≥ 130mg/dl) 24.3%; Triglycerides (≥ 150mg/dl) were also high at 28.7% and TGL: HDL ratio (≥ 5) of 17.7%

“Nearly all routinely assessed lipid variables were associated with the extent of coronary disease, but only the ratio of triglycerides to HDL-cholesterol or to HDL-c were robustly associated with disease extent. Elevation in the ratio of TG to HDL-c was the single most powerful predictor of extensive coronary heart disease among all the lipid variables
examined.”
da Luz PL, Favarato D, Faria-Neto Jr JR, Lemos P; Chagas ACP. CLINICS 2008; 64:427-32


“In Indian patients with CAD, high triglyceride levels are found more often than high cholesterol …An increase of triglycerides from 90 mg/dl to 180 mg/dl is associated with doubling the incidence of CAD. Increase in triglycerides by 90 mg/dl has the same effect on coronary atherosclerosis, as increase in age by 10 years. Earlier there was an under-emphasis on the significance of triglycerides as a risk factor. Indians worldwide demonstrate a triad of high triglycerides with high LDL-C levels and low HDL levels.”
HS Rissam*, S Kishore*, N Trehan*. Journal, Indian Academy of Clinical Medicine Vol. 2, No. 3 July-September 2001.




Risk Factor Based on: Gender and Age |Cities

Risk Factor Based on Gender and Age
Men at far greater risk than women

Men at far greater risk than women


Proportion of women at low risk is higher

Proportion of women at low risk is higher


Men 30-49 yr and women 50-59 yr at greatest risk

Net Population at High Risk
In Men:
Risk levels are high in the 30-39 age group Risk levels start to fall post 60 years of age

Risk levels are high in the 30-39 age group
  • In men the risk window is around 30 years of age in urban areas, primarily on account of central obesity, lack of physical activity and change in dietary habits.
  • Smoking is an important supporting cause of risk.
  • “Evidence that males in the age group greater than 60 are probably at lower risk than their younger counterparts could be possibly attributed to more carefully regulated diet, lower stress and lifestyle on account of management of other disorders such as hypertension and diabetes.”
    Dr.V.S.Sachdev, M.D.D.Card, Sachdev Clinic, Chandigarh
Appearance of High Risk Indicators In Men

While the 30 – 49 year olds are at the most risk, the indicators start appearing earlier





 

Doctors’ Explanation of the Early Appearance of Indicators in Men

“Risk factors and Atherosclerosis start earlier in men than women .During the Korean war, it was found that American soldiers at the age of 17 years had evidence of atherosclerosis. One factor is genetic, second is the higher incidence of tobacco consumption in young men. Dietary indiscretion is also more common in young men.”
S.S. Ramesh, MBBS MD DM ( Cardiology ), VIVUS Life, Bangalore

“With an increase in standard of living and urbanization, populations in developing countries such as India are exposed to a new class of health risks: arising from physical inactivity; overweight and obesity, long working hours, frequent travel, working stress of deadlines and work demands.”
Dr.Arun Kochar , MD , Fortis Hospital, Mohali, Punjab

“The lipid abnormalities are partly genetically determined and partly dependent on environmental factors, like diet & physical activity. Accordingly the abnormalities appear relativity early in life much before the onset of actual disease. This is consistent with the early appearance of indicators in both males and females in the Saffolalife Study.”
Dr.Arvind Kaul , M.D.( AIIMS), Silver Oaks hospital Mohali, Silver Oaks Hospital Mohali

“Genetics, family history, food habits, Most of them eat outside food fried in local made oils used repeatedly.”
Dr. Ganesh Mathan, MBBS,MD,DM, Yashoda Hospitals, Hyderabad

“Young people are more of smokers. 80% of the time they smoke. Affluence is also one of the reasons.”
Dr Suman Bhandari, MD,DM,FCSI,FACC,FESC,FSCAI,FIMSA, Escorts Hospital, Delhi

“Lifestyle, especially their eating habits. Also at this age men are at more stress due to more responsibilities. Their ignorance, lack of time for exercise or for general checkups with doctors are other reasons.”
S K Agarwal, MD, FIMSA, FICA (USA), FAMS, DHA, FIACM, FGSI, IIT Hospital, Delhi

“Another reason could be genetic factors and dietary habits.”
Dr.G.Gnanavelu, DM Cardiology, Senior Resident, Madras Medical College & Govt General Hospital

“Central obesity, dyslipidemia, lack of physical activity, change of dietary habits, concomitant diabetes, hypertension, smoking, etc.”
Dr Arup Das Biswas , MD (Med), DM (Cardiology), Director, ICVS, IPGME &R, Kolkata

In Women:
Risk among women increases after 40

Risk among women increases after 40
  • Below 40 years, 1 in 30 women are at risk (LDL >=130 & TGL >=150) but among those aged 40 years & over, as many as 1 in 5 women are at risk
  • “Women are protected till the age of 40-45 years. This is attributed to the presence of high level of estrogen & progesterone in women in the child bearing age. Once women attains menopause, the risk of atherosclerosis is the same as in men.”
    S.S. Ramesh, MBBS MD DM ( Cardiology ), VIVUS Life, Bangalore

Menopause a risk factor in women

“Estrogen deficiency has been linked to the rapid increase in CVD in women who have undergone natural or surgical menopause. CVD risk after the menopause which may be related to metabolic and hormonal changes. Mean age at menopause was 49.35 years.”
V.R Tandon, A Mahajan, S Sharma, A Sharma. www.jmidlifehealth.org

“The incidence of cardiovascular disease in Indian women has been noted to have significantly risen. The projected deaths from cardiovascular diseases by 2020 are estimated to be 42% of the total deaths. The average of menopause is 47.5 years in Indian women with an average life expectancy of 71 years. ”
Jyothi Unni : www.jmidlifehealth.org

Appearance of High Risk Indicators In Women

While the 50 – 59 year olds are at the most risk, the indicators start appearing earlier





Doctors’ Explanation of the Early Appearance of Indicators In Women

“Due to metabolic changes in their body. Also, at this age weight gain occurs. At this age, women generally take pills treatment."
S K Agarwal, MD, FIMSA, FICA (USA), FAMS, DHA, FIACM, FGSI, IIT Hospital, Delhi

“The lipid abnormalities are partly genetically determined and partly dependent on environmental factors, like diet & physical activity. Accordingly the abnormalities appear relativity early in life much before the onset of actual disease. This is consistent with early appearance of indicators in both males and females in the Saffolalife study.”
Dr.Arvind Kaul , M.D.( AIIMS), Silver Oaks hospital Mohali, Silver Oaks hospital Mohali

“Genetics, lack of Exercise, high incidence of Obesity & Diabetes”
Dr. Ganesh Mathan, MBBS,MD,DM, Yashoda Hospitals, Hyderabad

“Genetic factors and dietary habits”
Dr.G.Gnanavelu, DM Cardiology, Senior Resident, Madras Medical College & Govt. General Hospital, Chennai

Risk Factor Based on: The Indian Risk Factor | Gender and Age | Cities

Risk Factor Based on Cities
Kolkata is relatively better off
  Delhi Mumbai Bangalore Chennai Hyderabad Kolkata
Base 4650 3713 554 714 187 569
LDL >= 130 OR
TGL >=150 OR
HDL<= 30		 48 43 54.3 51.2 40.7 35.4
LDL >= 130 27.6 25.6 27.9 25.4 21.2 17.3
TGL >= 150 25.3 25.5 36.4 33.4 29.4 26.5
HDL<=30 8.4 3.5 13 7.5 3.7 2

 

Kolkata
“Genetically they are so. Use of fish and the way they take their food like having something after food to make its digestion faster.”
Dr Suman Bhandari, MD,DM,FCSI,FACC,FESC,FSCAI,FIMSA, Escorts Hospital, Delhi


“Impact of a risk factor may vary from one population to another and could be explained by the presence of possible protective factors, such as physical activity and less consumption of saturated fats. Increased consumption of fish as a staple diet might also be a good contributory factor for the same. Along with above mentioned reasons, lower stress levels might be responsible for this data.”
Dr.Arund Kochar , MD , Fortis Hospital, Mohali, Punjab


“Could possibly be due to high intake of fish in that regions."
Dr.Arvind Kaul , M.D.( AIIMS), Silver Oaks hospital, Mohali, Silver Oaks hospital Mohali


“Besides yet unidentified genetic factors, it may be that people in Kolkata take less of butter, ghee and other dairy products, take more of fish and Consume less oil .”
Dr Arup Das Biswas , MD (Med), DM (Cardiology), Director, ICVS, IPGME &R, Kolkata


 

Bangalore has a high proportion with TGL over 150
  Delhi Mumbai Bangalore Chennai Hyderabad Kolkata
Base 4650 3713 554 714 187 569
LDL >= 130 OR
TGL >=150 OR
HDL<= 30		 48 43 54.3 51.2 40.7 35.4
LDL >= 130 27.6 25.6 27.9 25.4 21.2 17.3
TGL >= 150 25.3 25.5 36.4 33.4 29.4 26.5
HDL<=30 8.4 3.5 13 7.5 3.7 2

 

Bangalore
Hypertriglyceridemia is common among diabetics and people who consume high carbohydrate diet. South Indians are predominantly rice eaters. Rice predominantly contains carbohydrates. Diabetes is also more common among South Indians than North Indians. Because of these two factors high triglycerides is more common among Bangaloreans.”
S.S. Ramesh, MBBS MD DM ( Cardiology ), VIVUS Life, Bangalore


“Due to their busy lifestyle and higher stress level, less physical activities.”
Dr Suman Bhandari, MD,DM,FCSI,FACC,FESC,FSCAI,FIMSA, Escorts Hospital, Delhi


“South Indians’ habit of taking junk food and oily food.”
Dr.G.Gnanavelu, DM Cardiology, Senior Resident, Madras Medical College & Govt. General Hospital, Chennai


 

City Findings

  All India Delhi Chandigarh Mumbai Bangalore Chennai Hyderabad Kolkata
Base 60332 4650 953 3713 554 714 187 569
LDL >= 130 OR
TGL >=150 OR
HDL<= 30		 44.8 48 59.1 43 54.3 51.2 40.7 35.4
LDL >= 130 24.3 27.6 22.4 25.6 27.9 25.4 21.2 17.3
TGL >= 150 28.7 25.3 44.7 25.5 36.4 33.4 29.4 26.5
HDL<=30 5.2 8.4 8.4 3.5 13 7.5 3.7 2
  • Significantly higher proportion at risk vs. All India Average
  • Significantly lower proportion at risk vs. All India Average
  • Proportion at risk at par with All India Average

 

City Findings

  All India Delhi Chandigarh Mumbai Bangalore Chennai Hyderabad Kolkata
Base 60332 4650 953 3713 554 714 187 569
LDL >= 130 OR TGL >=150 OR HDL<= 30 44.8
LDL >= 130 24.3
TGL >= 150 28.7
HDL<=30 5.2
  • Significantly higher proportion at risk vs. All India Average
  • Significantly lower proportion at risk vs. All India Average
  • Proportion at risk at par with All India Average

 

Delhi

  All India Delhi
Base 60332 4650
LDL >= 130 OR TGL >=150 OR HDL<= 30 44.8 48
LDL >= 130 24.3 27.6
TGL >= 150 28.7 25.3
HDL<=30 5.2 8.4
  • Significantly higher proportion at risk vs. All India Average
  • Significantly lower proportion at risk vs. All India Average
  • Proportion at risk at par with All India Average

 

Delhi

  All India Delhi
Base 60332 4650
LDL >= 130 OR TGL >=150 OR HDL<= 30 44.8
LDL >= 130 24.3
TGL >= 150 28.7
HDL<=30 5.2
  • Significantly higher proportion at risk vs. All India Average
  • Significantly lower proportion at risk vs. All India Average
  • Proportion at risk at par with All India Average

 

Chandigarh

  All India Chandigarh
Base 60332 953
LDL >= 130 OR TGL >=150 OR HDL<= 30 44.8 59.1
LDL >= 130 24.3 22.4
TGL >= 150 28.7 44.7
HDL<=30 5.2 8.4
  • Significantly higher proportion at risk vs. All India Average
  • Significantly lower proportion at risk vs. All India Average
  • Proportion at risk at par with All India Average

 

Chandigarh

  All India Chandigarh
Base 60332 953
LDL >= 130 OR TGL >=150 OR HDL<= 30 44.8
LDL >= 130 24.3
TGL >= 150 28.7
HDL<=30 5.2
  • Significantly higher proportion at risk vs. All India Average
  • Significantly lower proportion at risk vs. All India Average
  • Proportion at risk at par with All India Average

 

Mumbai

  All India Mumbai
Base 60332 3713
LDL >= 130 OR TGL >=150 OR HDL<= 30 44.8 43
LDL >= 130 24.3 25.6
TGL >= 150 28.7 25.5
HDL<=30 5.2 3.5
  • Significantly higher proportion at risk vs. All India Average
  • Significantly lower proportion at risk vs. All India Average
  • Proportion at risk at par with All India Average

 

Mumbai

  All India Mumbai
Base 60332 3713
LDL >= 130 OR TGL >=150 OR HDL<= 30 44.8
LDL >= 130 24.3
TGL >= 150 28.7
HDL<=30 5.2
  • Significantly higher proportion at risk vs. All India Average
  • Significantly lower proportion at risk vs. All India Average
  • Proportion at risk at par with All India Average

 

Bangalore

  All India Bangalore
Base 60332 554
LDL >= 130 OR TGL >=150 OR HDL<= 30 44.8 54.3
LDL >= 130 24.3 27.9
TGL >= 150 28.7 36.4
HDL<=30 5.2 13
  • Significantly higher proportion at risk vs. All India Average
  • Significantly lower proportion at risk vs. All India Average
  • Proportion at risk at par with All India Average

 

Bangalore

  All India Bangalore
Base 60332 554
LDL >= 130 OR TGL >=150 OR HDL<= 30 44.8
LDL >= 130 24.3
TGL >= 150 28.7
HDL<=30 5.2
  • Significantly higher proportion at risk vs. All India Average
  • Significantly lower proportion at risk vs. All India Average
  • Proportion at risk at par with All India Average

 

Chennai

  All India Chennai
Base 60332 714
LDL >= 130 OR TGL >=150 OR HDL<= 30 44.8 51.2
LDL >= 130 24.3 25.4
TGL >= 150 28.7 33.4
HDL<=30 5.2 7.5
  • Significantly higher proportion at risk vs. All India Average
  • Significantly lower proportion at risk vs. All India Average
  • Proportion at risk at par with All India Average

 

Chennai

  All India Chennai
Base 60332 714
LDL >= 130 OR TGL >=150 OR HDL<= 30 44.8
LDL >= 130 24.3
TGL >= 150 28.7
HDL<=30 5.2
  • Significantly higher proportion at risk vs. All India Average
  • Significantly lower proportion at risk vs. All India Average
  • Proportion at risk at par with All India Average

 

Hyderabad

  All India Hyderabad
Base 60332 187
LDL >= 130 OR TGL >=150 OR HDL<= 30 44.8 40.7
LDL >= 130 24.3 21.2
TGL >= 150 28.7 29.4
HDL<=30 5.2 3.7
  • Significantly higher proportion at risk vs. All India Average
  • Significantly lower proportion at risk vs. All India Average
  • Proportion at risk at par with All India Average

 

Hyderabad

  All India Hyderabad
Base 60332 187
LDL >= 130 OR TGL >=150 OR HDL<= 30 44.8
LDL >= 130 24.3
TGL >= 150 28.7
HDL<=30 5.2
  • Significantly higher proportion at risk vs. All India Average
  • Significantly lower proportion at risk vs. All India Average
  • Proportion at risk at par with All India Average

 

Kolkata

  All India Kolkata
Base 60332 569
LDL >= 130 OR TGL >=150 OR HDL<= 30 44.8 35.4
LDL >= 130 24.3 17.3
TGL >= 150 28.7 26.5
HDL<=30 5.2 2
  • Significantly higher proportion at risk vs. All India Average
  • Significantly lower proportion at risk vs. All India Average
  • Proportion at risk at par with All India Average

 

Kolkata

  All India Kolkata
Base 60332 569
LDL >= 130 OR TGL >=150 OR HDL<= 30 44.8
LDL >= 130 24.3
TGL >= 150 28.7
HDL<=30 5.2
  • Significantly higher proportion at risk vs. All India Average
  • Significantly lower proportion at risk vs. All India Average
  • Proportion at risk at par with All India Average

 

Doctors who can be contacted

Doctor Institution with which attached City
Dr Suman Bhandari Escorts Hospital Delhi
Dr. S K Agarwal IIT Hospital Delhi
Dr. Shashank Joshi Lilavati Hospital Mumbai
Dr. Prasanna KEM Hospital Mumbai
Dr. Arvind Kaul Silver Oaks Hospital Mohali
Dr.V.S.Sachdev Sachdev Clinic Chandigarh
Dr. Arun Kochar Fortis Hospital Mohali
Dr. Ganesh Mathan Yashoda Hospital Hyderabad
Dr. G. Gnanavelu Madras Medical College, Govt General Hospital Chennai
Dr. S.S. Ramesh Vivus Life Bangalore
Dr Arup Das Biswas ICVS, IPGME &R Kolkata

Risk Factor Based on: The Indian Risk Factor | Gender and Age

 

All rights in the Saffolalife Study 2010 are reserved by Marico Limited (Marico) and any breach will constitute an offence entailing legal action and prosecution without further notice. All data contained herein are based on extensive research and constitute original works. No part hereof shall be copied, reproduced, adapted or stored in a retrieval system or transmitted in any form whatsoever, without a prior written permission of Marico. Due precautions have been taken in collating, processing and analyzing the data by Marico and/or the independent agency engaged by it and the author(s) are not responsible either for the commission or omission of action or errors or the liability for any damages ensuing from use of information contained herein.