Mortality data were obtained from the Registrar General of India. In 1998 the annual death rate for India was 840/100,000 population.
Cardiovascular diseases contribute to 27% of these deaths and its crude mortality rate was 227/100,000. Major differences in
cardiovascular disease mortality rates in different Indian states were reported varying from 75-100 in sub-Himalayan states of Nagaland, Meghalaya, Himachal Pradesh and Sikkim to a high of 360-430 in Andhra Pradesh, Tamil Nadu, Punjab and Goa. Lifestyle data were obtained from national surveys conducted by the government of India. The second National Family Health Survey (26 states, 92,447 households, 301,984 adults) conducted in 1998-1999 reported on various demographic and lifestyle variables and India Nutrition Profile Study reported dietary intake of 177,841 adults (18 states, 75,229 men, 102,612 women).
Cardiovascular disease mortality rates were correlated with smoking, literacy levels, prevalence of
stunted growth at 3-years (as marker of fetal
undernutrition), adult mean body mass index, prevalence of
overweight and
obesity, dietary consumption of calories, cereals and pulses, green leafy vegetables, roots, tubers and other vegetables, milk and milk products,
fats and
oils, and
sugar and
jaggery. As a major confounder in different states is poverty, all the partial correlation coefficients were adjusted for illiteracy, fertility rate and infant mortality rate. There was a significant positive correlation of
cardiovascular disease mortality with prevalence of
obesity (R=0.37) and dietary consumption of
fats (R=0.67), milk and its products (R=0.27) and
sugars (R=0.51) and negative correlation with green leafy vegetable intake (R=-0.42) (p<0.05).
CONCLUSIONS: