Prevalence and factors associated with undiagnosed and uncontrolled heart disease: A study based on self-reported chronic heart disease and symptom-based angina pectoris among middle-aged and older Indian adults

Background This study aimed to examine the prevalence of heart diseases and angina pectoris and associated factors among middle-aged and older Indian adults. Additionally, the study examined the prevalence and associated factors of undiagnosed and uncontrolled heart disease among middle-aged and older adults based on self-reported chronic heart disease (CHD) and symptom-based angina pectoris (AP). Methods We used cross-sectional data from the first wave of the Longitudinal Ageing Study of India, 2017–18. The sample consists of 59,854 individuals (27, 769 males and 32,085 females) aged 45 years and above. Maximum likelihood binary logistic regression models were employed to examine the associations between morbidities, other covariates (demographic factors, socio-economic factors and behavioral factors) and heart disease and angina. Results A proportion of 4.16% older males and 3.55% older females reported the diagnosis of heart diseases. A proportion of 4.69% older males and 7.02% older females had symptom-based angina. The odds of having heart disease were higher among those who were hypertensive and who had family history of heart disease, and it was higher among those whose cholesterol levels were higher. Individuals with hypertension, diabetes, high cholesterol and family history of heart disease were more likely to have angina than their healthy counterparts. The odds of undiagnosed heart disease were lower but the odds of uncontrolled heart disease were higher among those who were hypertensive than non-hypertensive individuals. Those having diabetes were less likely to have undiagnosed heart disease while among the diabetic people the odds of uncontrolled heart disease were higher. Similarly, higher odds were observed among people with high cholesterol, having stroke and also among those who had a history of heart disease than their counterparts. Conclusions The present study provided a comparative prevalence of heart disease and agina and their associations with chronic diseases among middle-aged and older adults in India. The higher prevalence of undiagnosed and uncontrolled heart disease and their risk factors among middle-aged and older Indians manisfest alarming public health concerns and future health demand.

[1]  H. Sahoo,et al.  The burden of disease-specific multimorbidity among older adults in India and its states: evidence from LASI , 2023, BMC Geriatrics.

[2]  A. Ravn-Fischer,et al.  Prevalence and risk factors of angina pectoris and its association with coronary atherosclerosis in a general population, a cross-sectional study , 2022, European Heart Journal.

[3]  B. Lee,et al.  Association of myocardial infarction and angina pectoris with obesity and biochemical indices in the South Korean population , 2022, Scientific Reports.

[4]  W. Aronow,et al.  Previously undiagnosed angina pectoris in individuals without established cardiovascular disease: Prevalence and prognosis in the United States: FundingNone. , 2022, American Journal of the Medical Sciences.

[5]  N. Saikia,et al.  Differentials and predictors of hospitalisation among the elderly people in India: evidence from 75th round of National Sample Survey (2017-2018) , 2022, Working with Older People.

[6]  S. Srivastava,et al.  Socioeconomic vulnerability and frailty among community-dwelling older adults: cross-sectional findings from longitudinal aging study in India, 2017–18 , 2022, BMC Geriatrics.

[7]  S. Chauhan,et al.  Prevalence, factors and inequalities in chronic disease multimorbidity among older adults in India: analysis of cross-sectional data from the nationally representative Longitudinal Aging Study in India (LASI) , 2022, BMJ Open.

[8]  Jhumki Kundu,et al.  Cardiovascular disease (CVD) and its associated risk factors among older adults in India: Evidence from LASI Wave 1 , 2021, Clinical Epidemiology and Global Health.

[9]  Jun-xi Lu,et al.  Waist-to-height ratio has a stronger association with cardiovascular risks than waist circumference, waist-hip ratio and body mass index in type 2 diabetes. , 2021, Diabetes research and clinical practice.

[10]  Suryakant Yadav,et al.  Multimorbidity and its associated risk factors among older adults in India , 2021, BMC Public Health.

[11]  M. Gulati,et al.  Income disparity and utilization of cardiovascular preventive care services among U.S. adults , 2021, American journal of preventive cardiology.

[12]  L. Dwivedi,et al.  Diagnosis and Treatment of Hypertension Among People Aged 45 Years and Over in India: A Sub-national Analysis of the Variation in Performance of Indian States , 2021, Frontiers in Public Health.

[13]  S. Srivastava,et al.  Interaction of physical activity on the association of obesity-related measures with multimorbidity among older adults: a population-based cross-sectional study in India , 2021, BMJ Open.

[14]  P. Dixit,et al.  Declining trend of smoking and smokeless tobacco in India: A decomposition analysis , 2021, PloS one.

[15]  Sathish Kumar Jayapal,et al.  Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019 , 2020, Journal of the American College of Cardiology.

[16]  Jacob L. Stubbs,et al.  Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019 , 2020, The Lancet.

[17]  M. Woodward,et al.  Sex differences in prevalence, treatment and control of cardiovascular risk factors in England , 2020, Heart.

[18]  V. Howard,et al.  Impact of Multiple Social Determinants of Health on Incident Stroke , 2020, Stroke.

[19]  Maria R. Shirey,et al.  Addressing Social Determinants of Health in the Care of Patients With Heart Failure: A Scientific Statement From the American Heart Association. , 2020, Circulation.

[20]  S. Chuang,et al.  The association between psychological distress and angina pectoris: A population-based study , 2019, PloS one.

[21]  Vijay Trehan,et al.  Prevalence of hypertension among Indian adults: Results from the great India blood pressure survey , 2019, Indian heart journal.

[22]  S. Panguluri,et al.  Cardiovascular Risks Associated with Gender and Aging , 2019, Journal of cardiovascular development and disease.

[23]  E. V. van Beek,et al.  Coronary CT Angiography and 5‐Year Risk of Myocardial Infarction , 2018, The New England journal of medicine.

[24]  A. Kossaify,et al.  Predictors of Undiagnosed and Uncontrolled Hypertension in the Local Community of Byblos, Lebanon , 2018, Health services insights.

[25]  Liang Wang,et al.  Uncontrolled hypertension increases risk of all-cause and cardiovascular disease mortality in US adults: the NHANES III Linked Mortality Study , 2018, Scientific Reports.

[26]  M. Mansournia,et al.  Risk of Coronary Heart Events Based on Rose Angina Questionnaire and ECG Besides Diabetes and Other Metabolic Risk Factors: Results of a 10-Year Follow-up in Tehran Lipid and Glucose Study , 2017, International journal of endocrinology and metabolism.

[27]  G. Mini,et al.  Pattern, correlates and implications of non-communicable disease multimorbidity among older adults in selected Indian states: a cross-sectional study , 2017, BMJ Open.

[28]  S. Yusuf,et al.  Community health worker-based intervention for adherence to drugs and lifestyle change after acute coronary syndrome: a multicentre, open, randomised controlled trial. , 2016, The lancet. Diabetes & endocrinology.

[29]  Indu Mohan,et al.  Trends in Coronary Heart Disease Epidemiology in India. , 2016, Annals of global health.

[30]  J. Spertus,et al.  Association of Smoking Status With Angina and Health-Related Quality of Life After Acute Myocardial Infarction , 2015, Circulation. Cardiovascular quality and outcomes.

[31]  P. Arokiasamy,et al.  Multi-Morbidity, Functional Limitations, and Self-Rated Health Among Older Adults in India , 2015 .

[32]  M. Kolber,et al.  Family history of cardiovascular disease. , 2014, Canadian family physician Medecin de famille canadien.

[33]  E. Mathiesen,et al.  Long-term cardiovascular consequences of Rose angina at age 20–54 years: 29-years’ follow-up of the Tromsø Study , 2014, Journal of Epidemiology & Community Health.

[34]  P. Liyanage,et al.  Prevalence of myocardial ischaemia among diabetics determined by validated Sinhala version of the WHO Rose angina questionnaire , 2013 .

[35]  A. Hoes Should we screen for heart failure in the elderly? , 2013, European journal of heart failure.

[36]  K. Fiscella,et al.  Low Education as a Risk Factor for Undiagnosed Angina , 2012, The Journal of the American Board of Family Medicine.

[37]  I. Kawachi,et al.  Education and coronary heart disease risk associations may be affected by early-life common prior causes: a propensity matching analysis. , 2012, Annals of epidemiology.

[38]  Mahmudur Rahman,et al.  Is There Any Association between Use of Smokeless Tobacco Products and Coronary Heart Disease in Bangladesh? , 2012, PloS one.

[39]  David C Hoaglin,et al.  Prediction of First Events of Coronary Heart Disease and Stroke With Consideration of Adiposity , 2008, Circulation.

[40]  E. Barrett-Connor,et al.  Prevalence of Angina in Women Versus Men: A Systematic Review and Meta-Analysis of International Variations Across 31 Countries , 2008, Circulation.

[41]  N. Pedersen,et al.  Genetic influences on angina pectoris and its impact on coronary heart disease , 2007, European Journal of Human Genetics.

[42]  J. Gardin,et al.  Burden of valvular heart diseases: a population-based study , 2006, The Lancet.

[43]  Ralph B D'Agostino,et al.  Prediction of Lifetime Risk for Cardiovascular Disease by Risk Factor Burden at 50 Years of Age , 2006, Circulation.

[44]  Colin Simpson,et al.  Prevalence, incidence, primary care burden and medical treatment of angina in Scotland: age, sex and socioeconomic disparities: a population-based study , 2006, Heart.

[45]  L. Rydén,et al.  Abnormal glucose tolerance – a common risk factor in patients with acute myocardial infarction in comparison with population‐based controls , 2004, Journal of internal medicine.

[46]  V. Fuchs Reflections on the socio-economic correlates of health. , 2004, Journal of health economics.

[47]  C. Fischbacher,et al.  The performance of the Rose angina questionnaire in South Asian and European origin populations: a comparative study in Newcastle, UK. , 2001, International journal of epidemiology.

[48]  Suzanne L. Weaver,et al.  The sense of control as a moderator of social class differences in health and well-being. , 1998, Journal of personality and social psychology.

[49]  P. Sorlie,et al.  Repeatability and validity of the Rose questionnaire for angina pectoris in the Atherosclerosis Risk in Communities Study. , 1996, Journal of clinical epidemiology.

[50]  S. Mcphee,et al.  Pathophysiology of Disease: An Introduction to Clinical Medicine , 1995 .

[51]  M. Trevisan,et al.  Prevalence and Correlates of Angina Pectoris in the Italian Nine Communities Study , 1991 .

[52]  C. Bulpitt,et al.  Predicting death from coronary heart disease using a questionnaire. , 1990, International journal of epidemiology.

[53]  A. LaCroix,et al.  Chest pain and coronary heart disease mortality among older men and women in three communities. , 1990, Circulation.

[54]  L. Weissfeld,et al.  The prevalence and correlates of Rose Questionnaire angina among women and men in the Lipid Research Clinics Program Prevalence Study population. , 1987, American journal of epidemiology.

[55]  P. Richardson,et al.  Relationship between hypertension and angina pectoris. , 1979, British journal of clinical pharmacology.

[56]  T. Nealon The American Association for Thoracic Surgery , 1972 .

[57]  W. Kannel,et al.  Premature mortality from coronary heart disease. The Framingham study. , 1971, JAMA.

[58]  G. Rose,et al.  Variability of angina. Some implications for epidemiology. , 1968, British journal of preventive & social medicine.

[59]  W. Kannel,et al.  Factors of risk in the development of coronary heart disease--six year follow-up experience. The Framingham Study. , 1961, Annals of internal medicine.

[60]  C. Dolea,et al.  World Health Organization , 1949, International Organization.

[61]  S. Leeder,et al.  Rose Angina Questionnaire: validation with cardiologists' diagnoses to detect coronary heart disease in Bangladesh. , 2013, Indian heart journal.

[62]  Ann C. Haas,et al.  Literacy Skills and Calculated 10-Year Risk of Coronary Heart Disease , 2010, Journal of General Internal Medicine.

[63]  F. Hadaegh,et al.  Prevalence of coronary heart disease among Tehran adults: Tehran Lipid and Glucose Study. , 2009, Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit.

[64]  F. Lampe,et al.  Chest pain on questionnaire and prediction of major ischaemic heart disease events in men. , 1998, European heart journal.

[65]  J. Erikssen,et al.  Coronary heart disease without angina pectoris: silent ischemia. , 1988, Zeitschrift für Kardiologie.

[66]  G. A. Rose The diagnosis of ischaemic heart pain and intermittent claudication in field surveys. , 1962, Bulletin of the World Health Organization.