Urbanization increases CV risk factors in Indian men
MedWire News: Urbanization is associated with significant increases in conventional and novel cardiovascular (CV) risk factors in men, shows results of an Indian study published in the International Journal of Cardiology.
The study also suggests, however,that urbanization has no significant impact on carotid intima media thickness (IMT).
Chittaranjan Yajnik and team, from King Edward Memorial Hospital and Research Centre in Pune, explain that Indians are at a higher risk for CV disease than other ethnic groups, and develop the condition at a younger age. They add that India is undergoing rapid epidemiologic and nutritional transition, largely as a consequence of rapid urbanization.
Therefore, to investigate the potential CV effect of urbanization, the researchers measured conventional (obesity, blood pressure, lipids, smoking habits) and novel (proinflammatory and prothrombotic factors) CV risk factors, as well as markers of vascular damage (carotid IMT, von Willebrand Factor [vWF], and e-selectin) in 149 rural, 142 urban slum-resident, and 150 urban middle class Indian men.
The teamfound that there was a progressive increase in most of the conventional CV risk factors from rural to slum to urban middle class men. For example, plasma total cholesterol levels were 3.72 mmol/l (143.63 mg/dl) for rural men, compared with 3.89 and 4.13 mmol/l (150.19 and 159.46 mg/dl) for slum and urban middle class men, respectively.
Similar patterns were seen for proinflammatory and prothrombotic factors, say the researchers, namely plasminogen activator inhibitor-1 (PAI-1), platelet count, total homocysteine, and C-reactive protein (CRP).All of the conventional risk factors and levels of PAI-1, CRP, and interleukin-6 were related to measures of obesity, they note.
Despite the rural-urban differences in CV risk factors, Yajnik et alfound that urban middle class men did not have the highest levels of vascular damage markers; IMT was similar in rural, urban slum, and urban middle class men. This was true for both mean and maximum IMT measurements, they say.
Plasma vWF concentrations were highest in rural men whilst e-selectin concentrations were highest in the urban slum men.Furthermore, there were no significant correlations between the three markers of vascular damage.
"The similarity of IMT in the three groups suggests that this may not be a good marker of atherosclerosis in Indians," say Yajnik and team.
They propose that "nutritional factors, lack of physical activity, psychosocial stress, and atmospheric pollution may all contribute to increasing levels of [CV] risk factors in cities." Alternatively, the increased risk of CV disease in urban Indians may relatemore to "prothrombotic and inflammatory mechanisms, perhaps mediated through nutritional or other differences," they conclude.
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By Nikki Withers