Prevalence, Awareness and Control of Hypertension in Chennai - The Chennai Urban Rural Epidemiology Study (CURES – 52)

Objective : To study the prevalence, awareness and control of hypertension in Chennai representing Urban South India. Methods : The Chennai Urban Rural Epidemiology Study (CURES) is one of the largest epidemiological studies on diabetes carried out in India, where 26,001 individuals aged ≥ 20 years were screened using systematic random sampling method. Every tenth subject recruited in Phase 1 of CURES was requested to participate in Phase 3 of CURES and the response rate was 2,350/26,001 or 90.4%. An oral glucose tolerance test was performed in all individuals except self-reported diabetic subjects. Anthropometric measurements and lipid estimations were done in all subjects. Hypertension was diagnosed in all subjects who were on drug treatment for hypertension or if the blood pressure ≥ 140/90 mmHg. Results : Hypertension was present in 20% [men:23.2% vs. women:17.1%, p<0.001] of the study population. Isolated systolic hypertension (Systolic BP ≥ 140 and Diastolic BP<90 mmHg) was present in 6.6% while isolated diastolic hypertension (DBP ≥ 90 and SBP<140 mmHg) was present in 4.2% of the population. Among the elderly population (aged ≥ 60 years), 25.2% had isolated systolic hypertension. Age, body mass index, smoking, serum cholesterol and triglycerides were found to be strongly associated with hypertension. Among the total hypertensive subjects, only 32.8% were aware of their blood pressure, of these, 70.8% were under treatment and 45.9% had their blood pressure under control. Conclusion : Hypertension was present in one-fifth of this urban south Indian population and isolated systolic hypertension was more common among elderly population. Majority of hypertensive subjects still remain undetected and the control of hypertension is also inadequate. This calls for urgent prevention and control measures for hypertensio

Incidence of Diabetes and Pre-diabetes in a Selected Urban South Indian Population (Cups - 19)

Abstract Objectives: Several cross-sectional studies have reported on the prevalence of diabetes in India. However, there are virtually no longitudinal population-based studies on the incidence of diabetes from India. The aim of the study was to determine the incidence of diabetes and prediabetes in an urban south Indian population. Methods: The Chennai Urban Population Study [CUPS], an ongoing epidemiological study in two residential colonies in Chennai [the largest city in southern India, formerly called Madras] was launched in 1996; the baseline study was completed in 1997. Follow-up examination was performed after a mean period of 8 years. At follow-up, 501 [47.0%] subjects had moved out of this colonies and were lost to follow-up. Of the remaining 564 individuals, 513 [90.9%] provided blood samples for biochemical analysis. Regression analysis was done using incident diabetes as dependant variable to identify factors associated with development of diabetes or pre-diabetes. Results: Among subjects with normal glucose tolerance (NGT) at baseline [n=476], 64 (13.4%) developed diabetes and 48 (10.1%) developed pre-diabetes (IGT or IFG). The incidence rate of diabetes was 20.2 per 1000 person years and that of pre-diabetes was 13.1 per 1000 person years among subjects with NGT. Of the 37 individuals who were pre-diabetic at baseline, 15 (40.5%) developed diabetes [incidence rate: 64.8 per 1000 person years], 16 (43.2%) remained as pre-diabetic and 6 (16.2%) reverted to normal during the follow-up period. Regression analysis revealed obesity [Odds Ratio (OR): 2.1, p=0.001], abdominal obesity [OR: 2.23, p<0.001] and hypertension [OR: 2.57, p<0.001] to be significantly associated with incident diabetes. The Indian Diabetes Risk Score (IDRS) showed the strongest association with incident diabetes [OR: 5.14, p<0.001]. Conclusion: The study shows that the incidence of diabetes is very high among urban south Indians. While obesity, abdominal obesity and hypertension were associated with incident diabetes, IDRS was th

SOME CLASSES OF NONPARAMETRIC TESTS FOR SPECIAL TWO-SAMPLE LOCATION PROBLEM BASED ON SUBSAMPLE EXTREMES

The special two-sample location problem is an important problem which is useful in comparing the performance of two measuring instruments. The problem of comparing the performances of two packing machines in which one machine may underfill the packets and the other may overfill the packets on an average, fits into special twosample location setup wherein one wishes to test for the point of symmetry versus an appropriate alternative. The only test available in the literature to the best of our knowledge is the class of tests due to Shetty and Umarani [13] which is based on U-statistics. In this paper, two classes of test statistics are proposed which are based on extremes of subsamples. The performances of the proposed classes of tests ar

Gravity waves observed from the Equatorial Wave Studies (EWS) campaign during 1999 and 2000 and their role in the generation of stratospheric semiannual oscillations

International audienceThe altitude profiles of temperature fluctuations in the stratosphere and mesosphere observed with the Rayleigh Lidar at Gadanki (13.5° N, 79.2° E) on 30 nights during January to March 1999 and 21 nights during February to April 2000 were analysed to bring out the temporal and vertical propagation characteristics of gravity wave perturbations. The gravity wave perturbations showed periodicities in the 0.5?3-h range and attained large amplitudes (4?5 K) in the mesosphere. The phase propagation characteristics of gravity waves with different periods showed upward wave propagation with a vertical wavelength of 5?7 km. The mean flow acceleration computed from the divergence of momentum flux of gravity waves is compared with that calculated from monthly values of zonal wind obtained from RH-200 rockets flights. Thus, the contribution of gravity waves towards the generation of Stratospheric Semi Annual Oscillation (SSAO) is estimated

Prevalence of Fibrocalculous Pancreatic Diabetes in Chennai in South India

Fibrocalculous pancreatic diabetes is a form of diabetes secondary to chronic pancreatitis found in tropical, developing countries. There is no population based data on prevalence of fibrocalculous pancreatic diabetes. This paper reports on prevalence of fibrocalculous pancreatic diabetes in Chennai in South India based on the Chennai Urban Rural Epidemiology Study

A Class of Nonparametric Tests for the Two-Sample Location Problem

The two-sample location problem is one of the fundamental problems encountered in Statistics. In many applications of Statistics, two-sample problems arise in such a way as to lead naturally to the formulations of the null hypothesis to the effect that the two samples come from identical populations. A class of nonparametric test statistics is proposed for two-sample location problem based on U-statistic with the kernel depending on a constant ’a’ when the underlying distribution is symmetric. The optimal choice of ’a’ for different underlying distributions is determined. An alternative expression for the class of test statistics is established. Pitman asymptotic relative efficiencies indicate that the proposed class of test statistics does well in comparison with many of the test statistics available in the literature. The small sample performance is also studied through Monte-Carlo Simulation techniqu

Association of Small Dense LDL with Coronary Artery Disease and Diabetes in Urban Asian Indians - The Chennai Urban Rural Epidemiology Study (CURES-8)

Objective: Earlier studies in Europeans have identified small dense LDL to be associated with coronary artery disease and diabetes. In this study we assessed the association of small dense LDL with diabetes and CAD in Asian Indians. Methods: Study subjects were selected from the Chennai Urban Rural Epidemiology Study (CURES), a population based study on representative sample of Chennai city in southern India. Group 1:non-diabetic subjects (n=30); Group 2: diabetic subjects without CAD (n=30); Group 3:diabetic subjects with CAD (n=30). LDL subfractions were estimated using LipoPrint LDL system. LDL subfractions 3 and above, defined as small dense LDL was summed up to determine the overall small LDL. 75th percentile of the overall small dense LDL in non-diabetic subjects was used as a cut-off for defining elevated levels of small dense LDL. Results: The mean age of the study subjects was not significantly different among groups. Overall small dense LDL was significantly higher in diabetic subjects with CAD (16.7 ± 11.1 mg/dl, p<0.05) and without CAD (11.1 ± 8.0 mg/dl, p<0.05) compared to non-diabetic subjects without CAD (7.2 ± 6.8 mg/dl). Small dense LDL showed a positive correlation with fasting plasma glucose (r=0.252, p=0.023), HbA1c (r=0.281, p=0.012), total cholesterol (r=0.443, p<0.001), triglycerides(r=0.685, p<0.001), LDL(r=0.342, p=0.002), total cholesterol/HDL ratio (r=0.660, p=<0.001) and triglycerides/HDL ratio(r=0.728, p<0.001) and a negative correlation with HDL cholesterol (r= -0.341, p=0.002) and QUICKI values (r= -0.260, p=0.019). ROC curves constructed to predict elevated small dense LDL ((9.0 mg/dl) revealed that triglycerides/HDL ratio and total cholesterol/HDL ratio had higher AUC values compared to other parameters. A triglycerides/HDL ratio of 3.0 had the optimum sensitivity (80.0%) and specificity (78.0%) for detecting elevated small dense LDL. Conclusion: This data suggests that in Asian Indians, small dense LDL is associated with both diabetes and CAD and that a triglycerides/HDL ratio (3.0 could serve a surrogate marker of small dense LDL