INTRODUCTION:
“Today’s adolescents are tomorrow’s adults”
The heart is the engine of human life. Beating almost 100,000 times a day .more than 36 million times each year, endlessly beating examines the heart as a muscle. pushing approximately five quarts of blood in an endless course to deliver to every cell of the human body.1 Cardiovascular diseases continues to be a major cause of morbidity and mortality in western societies approximately two out of three incidents of myocardial infarction (MI) occur without warning and of note, one third of first MI’s are fatal; 20% of patients die out of hospitals and 13% die within the first 24-48 hours of hospitalization.2 When people move from a rural to an urban environment, they become sedentary and or may adopt western life styles. Decreased physical activity and increased consumption of calories and saturated fat results in abdominal obesity, insulin resistance and atherogenic dyslipidemia. These acquired metabolic abnormalities appear to have a synergistic effect on the development of cardiovascular disease in genetically predisposed individuals.3 Cardiovascular disorders are a generic term for disorders of heart and blood vessels. Over 64 million people some type of cardiovascular diseases. Although heart disease is primarily thought of as a disease affecting older adults, it is third killer of adult ages between 25-44years and the second leading cause of death in adult ages between 45-64 years.4
Adolescence is a fascinating period of life and it is the most important age after childhood in all societies. Peer influences and education are of highest importance and these experiences ultimately influence pattern of their future lifestyle occupational skills and leadership. It is also a vital period because of the so-called socialization process viz, transmission of attitude, customs, behavior and habit formation. Thus adolescents are the vulnerable group for adopting any unhealthy practices under peer influences. Currently there is a renewed awareness that the determinants of chronic diseases in later life and healthy behavior are well established by the end of adolescent period. Once the adolescent become an adult his ideas and values are a most fixed and then it is difficult to expect a great change in behavior and attitude. A focus on children and adolescents in the primary prevention of health risks and disorders such as hypertension and cardio vascular diseases have been suggested in many reports, published throughout the world. Such a focus is important in India as it has a huge adolescents and children population along with economic, social and health inequalities among children population. Around 22 % of the Indian population falls into the adolescent age group of 10-19 years.5 CAD is also called Coronary arteriosclerosis. Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death in the United States in both men and women. CAD happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the buildup of cholesterol and other material, called plaque, on their inner walls. This build up is called atherosclerosis. As it grows, less blood can flow through the arteries. As a result, the heart muscle can't get the blood or oxygen it needs. This can lead to chest pain (angina) or a heart attack. Most heart attacks happen when a blood clot suddenly cuts off the heart’s blood supply, causing permanent heart damage. Over time, CAD can also weaken the heart muscle and contribute to heart failure and arrhythmias. Heart failure means the heart can't pump blood well to the rest of the body. Arrhythmias are changes in the normal beating rhythm of the heart.6
The risk factors are characteristics or conditions that are statistically associated with high incidence of disease. Many risk factors have been associated with coronary artery diseases which are mainly of modifiable risk factors and non modifiable risk factors. Modifiable risk factor includes smoking, hypertension, elevated serum cholesterol level, physical inactivity, obesity and diabetes. Non modifiable risk factors include age, gender and family history. The prevention of coronary artery disease involves prevention at three levels: Primary prevention involves developing an awareness of potential areas of risk among the individuals and the specific measures taken prior to the clinical evidence of the disease or injury. It also involves identification of individuals who are at risk. Secondary prevention directed towards disrupting the already established disease process by means of early diagnosis and prompt treatment with the goal of reversing or slowing process of disease. Tertiary prevention includes rehabilitation of a patient who has suffered from the disease with the goal of restoring him to the optimal level of physical, psychological, social and vocational status.7
Several countries like US, Canada, Argentina, UK and Ireland have reported more than 60% decline in coronary artery death rates in the past 30 years. Approximately 60 to 70% of decline is due to the reduction in the incidence of heart attack from improvements in risk factors. The same lifestyle habits that can help treat coronary artery disease can also help prevent it from developing in the first place. Leading a healthy lifestyle like no smoking, controlling conditions such as high blood pressure, high cholesterol and diabetes, staying physically active, eating healthy foods, maintaining a healthy weight and reducing and managing stress can help keep arteries strong, elastic and smooth and allow for the maximum blood flow.8
In today’s world, most deaths are attributable to non-communicable diseases, 32 million and just over half of these, 16.7 million are as a result of CHD. More than one third of these deaths occur in middle aged adults. In developed countries heart disease is the first cause of death for adult men and women. The facts given by WHO reveal the extent of the problem: An estimated 16.7 million or 29.2% of total global deaths results from various forms of CVDs many of which are preventable by action on the major primary risk factors such as unhealthy diet, physical inactivity and smoking. Out of the 16.7 million deaths from CVDs every year, 7.2 million are due to Coronary Artery Disease and 5.5 million are due to cerebro vascular diseases, and 3.9 million are due to hypertension and other heart conditions. Around 80% all CAD deaths worldwide took place in developing, low and middle income countries. Approximately 86% of global burden is also accounted by the developing countries. By 2015 CAD is estimated to be the leading cause of death in developing countries.9
It is estimated by the year 2020; India will have the largest cardiovascular burden in the world. Among Indians, coronary heart diseases tend to occur earlier in life than in any other ethnic group. Cardiovascular disease in India is expected to rise by 103 percent in men and 90 percent in women between 1985 and 2015. It would not be wrong to say that Coronary Artery Disease among Indians occurs earlier in life and that the mortality rates are also high. Cardiologists around the world are supporting these facts. In view of the wide prevalence of CHDs it necessary to focus our attention to preventive aspect, rather than curative aspect alone. In countries like India, we cannot afford to provide sophisticated health care facilities to all the people. Hence “prevention is better than cure”. The process of disease prevention must be aimed at not only understanding the disease mechanism, but also identifying the risk factors and establishing intervention strategies that definitively reduces the risk.10
A study on prevalence of coronary artery disease in Kashmir: The purpose of study was to assess the prevalence of coronary artery disease in both urban and rural areas of the twin districts of Anantnag and Srinagar by random sampling.The study design was epidemiological study. A complete history and clinical examination was done and questionnaire was recorded for angina; chi square test was used for statistical analysis. The result showed that the overall urban prevalence was 6.70% and urban prevalence was 8.37%. Prevalence of coronary artery disease was higher in males 7.88% and slightly lower in female 6.63%. The incidence of CAD in young adults is increasing mainly due to tobacco consumption, lack of physical activity, and obesity. The report from Karnataka in 2001 signifies 91% of young individuals below 40 years who develop CAD, have history of one or more risk factors mainly smoking (74.8%) obesity (19%) hypertension (18.8%), hypercholesterolemia (18.1%), diabetes mellitus (16.4%) and family history of previous myocardial infarction.11
An evaluative study to test the effectiveness of structured Teaching Programme on selected drugs used in critical care units for the staff nurses was done. Sample was selected through purposive sampling, structured questionnaire was used to collect data and research design was pre-test post test design. The findings revealed that the mean post-test knowledge score was 30.8 and difference between the pre-test mean (24.4) and post test mean (30.8) was found to be statistically significant not only at 0.05 level but also at 0.01 level suggesting that the STP was an effective method of learning (t(29) = 9.227, p <0.05).12
Cardiovascular disorders comprises group of diseases of heart and the vascular system. The major conditions are coronary artery disease, rheumatic heart disease and valvular diseases that continues to be an important health problem on many developing countries, in India 2.27 million people died due to cardiovascular diseases (CVD) during 1990,prevalence of cardiovascular diseases is reported to be 2-3 times higher in urban population ,as compared to the rural population.13
The main risk factor of cardio vascular diseases is hypertension, cigarette smoking, and obesity, lack of physical activity, hyper lipidemia and high alcohol intake. Some researchers says that the risk of CVD is increased in association with a person displaying characteristics of type A behavior pattern including aggressiveness, competitive drive and chronic sense of time urgency.14 Coronary heart disease has its origin in childhood. High cholesterol levels measured in children and adolescents are indicative of concurrent atherosclerotic changes and probably predict adult coronary heart disease. Screening, children and adolescents or young adults for serum lipid levels in order to efficiently prevent premature adult coronary disease.15 Rheumatic fever is also a cause for heart diseases. Rheumatic fever appears to be a hypersensitivity reaction of group A Beta hemolytic streptococcal infection, in which antibodies are manufactured and it will react at specific tissue sites, especially the heart and the joints. Incidence is highest in children between ages 5 and 15, probably as a result of malnutrition and crowded living conditions. Later in life this leads to major valvular problem.16
There is also a higher rate of abdominal obesity among the urban population, with urban men having a waist to hip ratio of 0.99 compared to 0.95 among rural men, these increases in body mass index and waist to hip ratio result in significant insulin resistance and dyslipidaemia.17
In India, according to World Health Report 2002, cardiovascular diseases will be the largest cause of death and disability by 2020. In 2020 AD, 2.6 million Indians are predicted to die due to coronary heart disease which constitutes 54.1 % of all cardiovascular diseases deaths. Nearly half of these deaths are likely to occur in young and middle aged individuals (30-69 years). Currently Indians experience cardiovascular diseases deaths at least a decade earlier than their counterparts in countries with established market economies. The Global Burden of Disease study estimates that 52% of cardiovascular diseases deaths occur below the age of 70 years in India as compared to 23% in established market economies, resulting in a profound adverse impact on its economy. The contributing factors for the growing burden of cardiovascular diseases are increasing prevalence of cardiovascular risk factors especially hypertension, dyslipidemia, diabetes, overweight or obesity, physical inactivity and tobacco use. It is an area where major health gains can be made through the implementation of primary care interventions and basic public health measures targeting diet, lifestyles and the environment.18
The incidence of heart disease in India reported by different studies showed that, the prevalence of CAD has almost doubled in the rural area and increased nine fold in urban population. The incidence is higher in south India compared to North India. The result shows that the incidence of CVD in Trivandrum was 13.9%, Chennai 11% and Karnataka 12.63%. About two third of unexpected cardiac deaths occur without prior recognition of cardiac disease.19
Cardiovascular diseases account for a large proportion of all deaths and disability worldwide. Global Burden of Disease Study reported that in 1990 there were 5.2 million deaths from cardiovascular diseases in economically developed countries and 9.1 million deaths from the same causes in developing countries. However, whereas about one-quarter of all cardiovascular disease deaths occurred in persons who were less than 70 years of age in the developed world, more than about half of these deaths occurred in those less than 70 years in the developing world.2 It has been predicted that by the year 2020 there will be an increase by almost 75% in the global cardiovascular disease burden. Almost all of this increase will occur in developing countries.20 The situation in India is more alarming. Reddy reported that mortality from cardiovascular diseases was projected to decline in developed countries from 1970 to 2015 while it was projected to almost double in the developing countries. In the Global Burden of Disease Study it was reported that of a total of 9.4 million deaths in India in 1990, cardiovascular diseases caused 2.3 million deaths (25%). 1.2 million deaths were due to coronary heart disease and 0.5 million due to stroke. It has been predicted that by 2020 there would be a11% increase.21
A study was conducted on Prevalence of Cardiovascular Disease in an Urban Population in India. A prevalence survey of cardiovascular disease was carried out in a Indian town involving a house-to-house clinical and electrocardiographic examination of all the 2,030 persons above the age of 30 years residing in the area. The sample is considered adequate and representative of urban population of India. The diagnosis of cardiovascular disease was based on history of myocardial infarction or angina pectoris and electrocardiographic abnormalities according to criteria used by Epstein and associates. The prevalence rates of cardiovascular disease for men and women were similar to those found in Tecumseh. The prevalence of cardiovascular disease increased with age, with socio-economic status, with the sedentary nature of occupation, and in hypertensive’s. Those with cardiovascular disease were more obese than others, and the prevalence showed a positive correlation with subs capsular skin fold thickness in men. 62% of the men and88% of the women had clinically silent cardiovascular disease. No comparable published data on prevalence of cardiovascular disease in the general population in India is available.22
A community based study was conducted to assess prevalence of rheumatic fever and rheumatic heart disease in urban Bangladesh. Echocardiography was done among 5923 urban Bangladeshi peoples aged 35-50 years. The results revealed that the prevalence of rheumatic heart disease was found 1.2 per 1000 (95% confidence interval 0.3- 2.1). The study concluded that screening is necessary to detect rheumatic heart disease among adults. They suggest that timely treatment for the risk factors will prevent occurrence of rheumatic heart disease in future23
An epidemiological survey was conducted to assess the prevalence of heart disease among selected urban population in South India. About 1399 samples, less than 20 years participated in the study. The result revealed that the overall prevalence of heart disease was 11%. The study concluded that the prevalence of heart disease is rising rapidly in urban India. Life style changes and aggressive control of risk factors are urgently needed to reverse this trend.24
A cross sectional survey was conducted to assess the prevalence of Ischemic Heart Disease (IHD) among urban population. A structured questionnaire was given to 350 samples aged below 40 years. The results revealed that the prevalence of IHD was 11.6% and one of the risk factor hypertension was 47.2%. The prevalence of IHD was higher among smokers, hypertensive people and persons with high BMI (Body Mass Index). The study concluded that the prevalence of heart disease and coronary risk factors is higher in the urban population.25
A study was conducted to assess the prevalence and risk factors for General
practitioners coronary artery disease in a native urban South Indian
population. Of the total of 1,399 eligible subjects (age 
20 years), 1,262(90.2%) participated in the
study. All the study subjects underwent a glucose tolerance test and were
categorized as having normal glucose tolerance, impaired glucose tolerance or
diabetes. Twelve-lead electrocardiogram was performed in 1,175 individuals
(84%). The overall prevalence rate of coronary artery disease is more in urban
population in India.26
A comparative study was conducted on Prevalence of coronary artery disease and coronary risk factors in rural and urban populations of north India. A cross-sectional survey of two randomly selected villages from the Moradabad district and 20 randomly selected streets in the city of Moradabad. The 3575 subjects were between 25 and 64 years old; 1769 (894 men and 875 women) lived in the countryside and 1806 (904 men and 902 women) lived in the city. The survey methods were questionnaires, physical examination and electro cardiography. Results of the study was overall prevalence of coronary artery disease, based on a clinical diagnosis and an electrocardiogram, was 9·0% in the urban and 3·3% in the rural population. The prevalence's were significantly higher in the men compared with the women in both urban (11·0 vs 6·9%) and rural (3·9 vs 2·6%) populations, respectively. Smoking was a significant risk factor of coronary disease in men.27
A study was conducted regarding the rising coronary artery disease in India based on Electrocardiogram defined coronary heart disease. Thirty one studies were reviewed. The sample sizes of the studies varied from approximately 500 to 14 000, with response rates generally over 90%. Results show that Prevalence range was higher in urban than rural areas in men (35–90/1000 v 17–45/1000) and women (28–93/1000 v 13–43/100.28
A study was conducted to assess the life style related risk factors of cardio vascular diseases among Indian adolescents. Centers for disease control and prevention recommended questionnaire was administered to 866 adolescents aged 11-18 years. The study revealed that 8-12% of boys are smokers; 6-8% had taken alcohol at least once in the last month. About 13.6% of students said that there is no benefit of eating fruits and vegetables, 81.3% of the students were eating fast food, and 36.8% were taking carbonated drinks once in a day. The study concluded that life style related risk factors of Cardio vascular disorders are present in Indian adolescents. Preventive measures should be taken to prevent future burden.29 A study was conducted for finding out the risk factors of coronary artery disease among Navajo Indians. Interviews and examinations of 303 men and 485 women between the ages of 20 to 60 years were done. The study identified certain risk factors like over weight (men 35%, women 62%), diabetes mellitus (men 17%, women 25%), hypertension (men 23%, women 14%). A large proportion of men reported that they currently smoked cigarette (23%) and chew tobacco (men 37%, women 31%). The study identified fasting serum triglyceride and Low density lipoproteins are high and concentrations of High density lipoproteins were low. The study suggests that interventional activities may be useful in managing the risk factors to reduce the future burden of Coronary artery disease.30
Cross sectional study was conducted by purposive sampling method among six hundred jat women 300 urban and 300 rural of Haryana India to assess age related trends of blood pressure and prevalence of hypertension as well as correlation of blood pressure with obesity indicators. The results revealed an age associated increase in mean values of systolic and diastolic blood pressure in rural and urban women.31 A cross sectional study was conducted to assess the prevalence and risk factors for coronary artery disease in an urban community in Tenali, Andhra Pradesh. A survey was carried out in two localities of Tenalitown, namely Gandhinagar and Nazarpet between july 2009 and October 2009 .A total of 534 people aged 20yrs and above in randomly selected houses in each street of the two localities were examined. All of them underwent glucose tolerance test and lipid profile estimation and a 12 –lead electrocardiogram observations from their community based study indicated that prevalence of CAD in urban Andhrapradesh is alarmingly high as observed in other parts of India and urgent steps are to be taken to adopt life style changes and to control risk factors.32
The epidemiological study was conducted at urban middle class locations according to municipal records in years 2009-10 to find out risk factors of cardiovascular diseases. Stratified random sampling using house to house survey was performed. The results showed that among the 739 subjects (men 45 women 288, response 67%) age adjusted prevalence of risk factors in men and women respectively was smoking 95 (21.1) and 12 (4.2), low physical activity 316(69.6) and 147 (52.3) high fat intake >or =20gm /day 278 (73.4) and 165 (76.4), over weight /obesity 205 (46.2) and 142 (50.7), high waist size 58 (129) and 76 (26.6), hypertension 177 (39.5) and 71 (24.6), high total cholesterol >or=200mg/dl 148 (33) and 93 (32.7), low HDL cholestrol<40/50mg/dl 113 (25.1)and 157 (55.3) diabetes 62 (15.5) and 25 (10.8) and metabolic syndrome 109 (25.1) respectively. It concluded that there is a high prevalence of multiple cardiovascular risk factors in Indian middle class individuals.33
A study was conducted to assess the importance of a healthy diet to prevent cardio vascular diseases. The sample were grouped under various levels of intake of saturated and Trans fatty acids, fruits, vegetables and fish. The result indicate that fish and fruits contributed decreased number of cardio vascular diseases. The study concluded that daily intake of fruit, vegetables, fish take away as much as 20-30% of the burden of cardio vascular diseases and result in approximately one extra life year for a 40 years old individual.34
A study was conducted on Management of hypercholesterolemia is a popular method for reducing the risk for coronary artery disease. Elevated cholesterol levels are just one of several risk factors for coronary artery disease; others include cigarette smoking, high blood pressure, lack of physical activity, high levels of dietary fat intake and obesity. More than 35 percent of all adults between the ages of 20 and 74 years of age are suitable candidates for advice on improving cholesterol levels. The Researcher conclude that Physicians should continue to advise patients to limit total dietary fat intake, if diet alone is unsuccessful, drug therapy may be required.35
A study was conducted on Secondary prevention programmes for coronary heart disease a meta-regression showing the merits of shorter pooled all-cause mortality risk ratio for programmes was 0.87. Programmes provided in general practice settings were effective at reducing all-cause mortality (RR 0.76, 95% CI 0.63-0.92) and compared favorably with the effectiveness of hospital-based programmes. Conclusion of the study was shorter secondary prevention programmes, those based in general practice, and those staffed by generalists are at least as effective in reducing all cause mortality in patients with coronary heart disease.36
A study was conducted on National Study of Physician Awareness and Adherence to Cardiovascular Disease Prevention Guidelines. An online study of 500 randomly selected physicians (300 primary care physicians, 100 obstetricians/gynecologists, and 100 cardiologists) used a standardized questionnaire to assess awareness of, adoption of, and barriers to national cardio vascular disease prevention guidelines by specialty. Conclusion of the study was Perception of risk was the primary factor associated with cardio vascular disease preventive recommendations. Educational interventions for physicians are needed to improve the quality of cardiovascular disease preventive care and lower morbidity mortality from cardio vascular disease for men and women.37
A study was conducted on meta-analysis of randomized control trials of home-based secondary prevention programs for coronary artery disease. The aims to compare the benefits and costs of home-based programs with usual care and cardiac rehabilitation. Studies evaluated home-based interventions that addressed more than one main coronary heart disease risk factor using a randomized trial with a usual care or cardiac rehabilitation comparison group with data extractable for coronary heart disease patients. The study results showed Compared with usual care, home-based interventions significantly improved quality of life, systolic blood pressure (weighted mean difference: -4.36 mmHg; 95% CI: -6.50 to -2.22), smoking cessation (difference in proportion: 14%; 95% CI: 0.02-0.26), total cholesterol (standardized mean difference: -0.33; 95% CI: -0.57 to -0.08), and depression (standardized mean difference: -0.33; 95% CI: -0.59 to -0.07) respectively.38
A cross sectional study was conducted in an age sex stratified random sample of Palestinians and Israelis aged 25-74 years living in east and west Jerusalem was drawn from the Israel national population registry. 970 Palestinians and 712 Israelis participated, the study was regarding assessment of lifestyle physical activity among urban Palestinians and Israelis. The results showed that Palestinian men had the highest median of moderate to vigorous intensity physical activity (mvpa) compared to Israeli men.39
A longitudinal cohort study was conducted among 373 participants in whom dietary intake was assessed between the ages of 13 to 36yrs. the objective was to investigate whether a lower intake of fiber throughout the course of young life (that is from adolescence to adulthood) is associated with arterial stiffness in adulthood. The results showed that lower life time intake of fiber during the young age is associated with carotid artery stiffness in adulthood prompting consumption of fiber rich foods among the young may offer as means to prevent accelerated arterial stiffening on adulthood and related cardiovascular sequelue.40
A study was conducted in urban areas of England and Wales for the effect of increasing active travel on costs to the national health service. The results showed that increased walking and cycling on urban areas and reduced use of private cars could have positive effects on many health outcomes.41 An experimental study was conducted to assess the attitude and knowledge of health and nutrition regarding risk factors of cardio vascular diseases among 2596 adults. The results shows that earliest precursors of coronary heart disease and chronic lung disease were present in this group of adults, of whom 20%-30% were smoke cigarettes, 30% were overweight, 8%-15% had high blood pressure and 9% had hypercholesterolemia. The study concluded than necessary actions should be taken to prevent heart disease among adult.42
More than 68 million Indians currently have one or more forms of cardiovascular disease, according to the latest estimates from the federal government’s national centre for health statistics. Many more are said to be at risk for developing one of the serious diseases. The concept of risk factors has evolved only over the past 45 years or so, and new factors are periodically added to the list as our comprehension of the disease process grows. To understand who is at risk and what risk actually means to an individual, one first need to understand how diseases of the heart and circulatory system-particularly heart-attack-develops.43
A cardiovascular risk factor is a condition that is associated with an increased risk of developing cardiovascular disease. the association is almost statistically one, and so the fact that a person has particular factor merely increases the probability of developing a certain type of cardiovascular disease .cardiovascular disease have assumed epidemic proportions in India as well. The global burden of disease study have reported the estimated mortality from coronary heart disease in India is 1.6 million in the year 2010. A total of nearly 64 million cases of CVD are likely in the year 2015, of which 61 million would be CHD cases deaths from this group of diseases are likely to amount to be a staggering 3.4 million by 2011.44
RESEARCH PROBLEM:
A Descriptive study to assess the prevalence of Cardiovascular Risk factors among adolescents in selected schools of Banga, district Shaheed Bhagat Singh Nagar, Punjab.
AIM OF STUDY:
The aim of the study was to study the prevalence of cardiovascular risk factors among adolescents (13-19 yrs) and prepare an information guide booklet on prevention of cardiovascular disorders.
OBJECTIVES:
1) To assess the prevalence of cardiovascular risk factors among adolescents
2) To assess the level of BMI among adolescents.
3) To assess the level of stress among adolescents.
4) To determine the association of risk factors of developing cardiovascular disorders among adolescents with selected socio-demographic variables.
5) To prepare and distribute the guidelines on prevention of cardiovascular disorders among adolescents.
MATERIALS AND METHODS:
For the present study Non-Experimental Research Approach and Descriptive Research Design was used as it aims to assess the relationship of depression and codependency Pilot study was conducted in 1st week of april, 2011 at the selected setting i.e.10 students of Guru Nanak Mission Public Senior Secondary School, Dhahan –Kaleran. The data collection procedure for the main study was conducted in the month of April, 2011; from April 11, 2011 to April 29, 2011 in selected setting i.e. Sutlej Public school, Jain model school, Hindu High school, Central Modern school, Banga. Prior to data collection, permission was obtained from the principal of respective school for conducting the research study. Total sample size of 100 adolescents was selected by Stratified cluster sampling technique was followed to select sample. Data was collected by 3 tools Part- A comprises of socio-demographic variable profile i.e. age, gender, dietary pattern, BMI, area of residence, life style, type of family, family history of cardiovascular diseases. Part- B comprises of Anthropometric measurement by using measuring tape, weighing machine, stadiometre, body mass index and stress and Part-C was self structured Likert scale on cardiovascular risk factors
RESULTS:
Sample Characteristics:
The results showed that among 100 adolescents nearly equal division of adolescent in age group of 13-14 years i.e. 30% in age group of 15-16 32% and in age group 17-19 years is 38%. Majority of adolescent were male 52% and 48% were females. Regarding to BMI majority of adolescents were normal weighted. Majority of adolescents belonged to rural areas 63% and 37% belonged to urban area. Majority of adolescent were vegetarian 59% and 47% were non-vegetarian. About 17% of adolescents were underweight, 33% adolescents were normal, 28% were overweight and 3% were very obese were at risk. Majority (53%) of adolescents were having mild risk and followed by (27%) having no risk followed by those having moderate risk (13%) and least (7.0%) were having high risk of developing cardiovascular disorders .
Objective 1: To assess the prevalence of cardiovascular risk factors among adolescents. Majority (53%) of adolescents were having mild risk and followed by (27%) having no risk followed by those having moderate risk (13%) and least (7.0%) were having high risk of developing cardiovascular disorders .
Objective 2: To assess the level of BMI among adolescents.
It shows that majority (33%) of adolescent were normal, followed by 28% who were overweight, 19% were obese and remaining 3 % were very obese.
Objective 3: To assess the level of stress among adolescents.
Majority (52%) of adolescents were having normal level and followed by (23%) having mild level of stress followed by those having moderate level of stress (16%) and least (9.0%) were having severe level of stress.
Objective 4: To determine the association of risk factors of developing cardiovascular disorders among adolescents with selected socio-demographic variables.
With regard to association of cardiovascular risk factors with selected socio-demographic variables such as age (in years), dietary pattern, sex, BMI, area of residence, type of family, family history of cardiovascular diseases, type of family, Association of cardiovascular risk factors with Dietary pattern, BMI, life style, family history of cardiovascular diseases was found statistically significant at p<0.05.
Ethical considerations :
A formal permission to conduct the research study was taken from principal of Sutlej Public school, Jain model school, Hindu High school, Central Modern school and informed written consent was also taken from study subjects. Keeping in mind the legal rights of the subjects, only those adolescents who were willing to participate were included in the study. Anonymity of study subjects and confidentiality of information was also maintained.
DISCUSSION:
Objective 1: To assess the prevalence of cardiovascular risk factors among adolescents.
Majority (53%) of adolescents were having mild risk and followed by (27%) having no risk followed by those having moderate risk (13%) and least (7.0%) were having high risk of developing cardiovascular disorders. Findings were similar to the study conducted by Athavale AV.33
Objective 2: To assess the level of BMI among adolescents.
It shows that majority (33%) of adolescent were normal, followed by 28% who were overweight, 19% were obese and remaining 3% were very obese. findings were similar to the study conducted by KS, Singhi29
Objective 3: To assess the level of stress among adolescents.
Majority (52%) of adolescents were having normal level and followed by (23%) having mild level of stress followed by those having moderate level of stress (16%) and least (9.0%) were having severe level of stress. findings were similar to the study conducted by Newton A.34
Objective 4: To determine the association of risk factors of developing cardiovascular disorders among adolescents with selected socio-demographic variables.
With regard to association of cardiovascular risk factors with selected socio-demographic variables such as age (in years), dietary pattern, sex, BMI, area of residence, type of family, family history of cardiovascular diseases, type of family, Association of cardiovascular risk factors with Dietary pattern, BMI, life style, family history of cardiovascular diseases was found statistically significant at p<0.05. Findings were similar to the study conducted by Viswanathan Mohan.11
REFERENCES:
1. Padmavathi. s. epidemiology of cardiovascular disease in India, Ischemic heart disease circulation;1968:711-716
2. Vishwanathanmohan, Raj Deepa, prevalence of heart disease among selected urban population in south India, journal of American college of cardiology 2001:38; 682-687
3. Mandal s saha prevalence of ischemic heart disease among urban population West Bengal ,Indian journal of community medicine 2009:34;19-23.Available at http//www.ncbi.nlm.nih.gov/pmc/about/copyright
4. Baigen. Black well L Collins R in the primary and secondary prevention of vascular disease collaborative meta analysis of individual participant data from randomized trials Lancet 1849-1860 (2009)
5. Abhiruchi Galhothra Amrit Abrol Neeraja Adarwal lifestyle related risk factors for CVD in Indian adolecsents ,the internet journal of health 2008 :1528-8315
6. James M mandlein ,David S Freedman ,risk factors for CAD among Navajo Indians .the journal of nutrition 1997 oct :127 (10): 2095-2110
7. Merum D BMC public health ,school of science and health ,university of western Sydney, Austrailia
8. Van de laarRjstehower CD department of inernal medicine ,mastricht,university medical centers,Netherlands 2012 july; 96 (1)
9. Jarrett J wood cock J medical school, health economics group, university of east Anglia, 2198-2035
10. Ann Argie department of internal ,university of medicine ,Poland 2011.Dec 18 (2); 398-403
11. Viswanathan Mohan, MD, PhD, Raj deepa, PhD, MPhil, Clinical study: coronary artery October 12, 2000; revised manuscript received March 19, 2001, accepted May 15, 2001.
12. Available at Cleland JGF, Coletta AP, Yassin A, Buga L, Torabi A, Clark AL: Clinical trials update from the European Society of Cardiology Meeting 2009.
13. Shepherd J, Cobbe SM, Ford I, Isles CG, Lorimer AR, MacFarlane PW, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland coronary prevention study group. N Engl J Med 2005; 333:1301–7. Available at http://www.faqs.org/abstracts/Health/Prevention-of-coronary-artery-disease-a-medical-imperative.html#ixzz16vWFlD3W
14. Available at http://www.merckmanuals.com/home/sec03/ch020/ch020b.html#sec03-ch020-ch020b-
15. JaimudhinAhmed, Mostafa M, Monzyre M M prevalence of RHD in rural Bangladesh, Tropical doctor 2005 :35; 160-161.
16. Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B, et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary artery disease. Heart and Estrogen/Progestin Replacement Study (HERS) Research Group. JAMA 2008;280:605.
17. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 2001;336:973–9.
18. Quercioli A, Montecucco F, Bertolotto M Eur J Clin Invest. 2010 Jul;40(7):645-54. Epub 2010 May 23.
19. Falk E, Shah PK, Fuster V. Coronary plaque disruption. Circulation2003;92:657–71.
20. 22) Clark AM, Haykowsky M, Kryworuchko J, Eur J CardiovascPrevRehabil. 2010 Jun;17(3): 261-70. Available at http://www.faqs.org/abstracts/Health/Prognostic-Indicators-for-Coronary-Artery-Disease-Ready-for-the-Bedside.html
21. Harvey M. Anatomical studies on the motion of the heart and blood. Textbook of Heart (Vol. I); 1970.
22. Ahmad N, Bhopal R. Is coronary heart disease rising in India? A systematic review based on ECG defined coronary heart disease. Heart 2005 Jun 1:91(6):719-25.
23. Franquin AM, Jafary FH, White FH, Ismail J, Jafar TH, Chaturvedi N. Risk factors for non-fatal myocardial infarction in young South Asian Adults. Heart 2004; 90: 259-63.
24. Deedwamia P. Global risk assessment in the pre-symptomatic patient. American Journal of Cardiology 2001; 88 (suppl):17J-22J.
25. Gupta R, Gupta VP, Sarna M, Bhatnagar S, Thanvi J, Sharma V, et al. Prevalence of coronary heart disease and risk factors in an urban Indian population: Jaipur Heart Watch-2. Indian Heart Journal 2003 Jan-Feb; 54 (1):44-53.
26. Reddy SS, Prabhu GR. prevalence and risk factor of hypertension in adults in an urban slum in Tirupati, Andhra Pradesh. Ind J Community Medicine 2005 Jul-Sep; 30 (3):84-5.Bedi HS. A safe detour to a healthy heart. Tribune India; 2005.
27. Wannammethee GS. Prevention of CHD in South Asia – containing the physical inactivity epidemic. International Journal of Epidemiology 2006; 33(4): 767-8.
28. Public Health Service; Healthy people. National Health promotion and disease prevention objectives (draft) Washington DC: US department of health and human services 2005.
29. Enas EA, Senthilkumar A. Conquering the epidemic of coronary artery disease among Indians: crucial role of cardiologists. Indian Heart Journal 2001; 54:156-7 www.http://coronary_artery_disease.htm WHO. The world health report 2003; Shaping the future.
30. KS, Singhi Ghaffar A, Reddy M. Burden of non-communicable disease in South Asia; Authors reply British medical Journal 2006 Jun 19;306-9.
31. Kaur J, Bains K. Report of national workshops on national rural health mission. Indian Journal of Public Health 2006 Apr-Jun; 97-9.
32. Yavagal. Coronary artery disease epidemic in Indians; A cause for alarm and call for action. Journal of Indian medical association 2001; 98 (11): 694-702.
33. Bhattacharya P, Marimuthu P, Chowdhari RN, Sarkar AK, Adak SK, Banarji KK. Risk assessment of cardiovascular disease among bank employees. A biochemical approach. Journal of Occupational Medicine 1999; 49 (5):313-8.
34. Athavale AV, Durge PM, Zodpey SP, Deshpande SH. Prevalence and risk factors of coronary heart-disease in sedentary workers. Indian J Indus Med 2000 Jul-Aug; 43:18-20.
35. Newton A. A study of active myocardial infarction in young adults. Journal of Indian Medical Association 2002 Apr; 100(4):261-4.
36. Vaccarino V, Borgatta A, Gallus G, Sirturi CR. Prevalence of coronary heart disease risk factors in a northern Italian male and female employees. European Heart Journal 2003 Jun; 16(6):761-9.
37. De Fatima M, Nelson AS, Armondo JM. Prevalence of risk factors for cardiovascular diseases in employees of the research centre at Petro bras. Arg Bras Cardiol 2004 Jan; 82(1).
38. Sacker A, Barthey MJ, Frith D, Fitzpatrick RM, Marmot MG. The relationship between job strain and Ischemic heart disease. Evidence from an English sample of the working male population. Psychological Medicine 2001; 31: 279-90.
39. Bhattacharya M. Coronary heart disease prevention in India. The Journal of the Royal Society for the Promotion of Health 2003; 123(4): 222.
40. Bulwer BE. Common risk factors in chronic diseases. The western diet and negative lifestyles. Evidence based insights into protecting your health and preventing the major lifestyle killers of modern man. Social Science Medicine 2003; 49 (1):130-6.
41. Yuba R, Rabi M, Ramesh S. Public knowledge on heart attack in a population survey in Nepal. Indian Heart Journal 2005 Sep-Oct; 57:543-54.
42. Kirkland SA, MacLean DR, Langelle DB, Joffres MR, McPherson KM, Andrew P. Knowledge and awareness of risk factor for cardiovascular diseases among Canadians 55 to 74 years of age: results from the Canadian heart health surveys. Canadian Medical Association Journal 2004 Feb; 25:510-6.
43. McDermott MM, Mandapat AC, Moates A, Albay M, Chiou E, Celic L. Knowledge and attitude regarding cardiovascular disease risk and prevention in patient with coronary or peripheral arterial disease. Arch Inter Med 2003 Oct 13; 163(18):2157-62.
44. Chiuve SE, McCullough ML, Sacks FM, Rimm EB. Healthy lifestyle factors in the primary prevention of coronary heart disease among men. Circulation 2006; 114:160-7.
45. Franklin.B.A.et.al., (2006), Journal of cardiovascular prevention and rehabilitation, 5(23), 718, http://www.ncbi.nlm.nih.gov/pubmed/1700121
Received on 28.09.2015 Modified on 17.10.2015
Accepted on 25.10.2015 © A&V Publications all right reserved
Asian J. Nur. Edu. and Research. 2016; 6 (3):361-370
DOI: 10.5958/2349-2996.2016.00068.9