The Framingham Heart Study: Impact on the Prevention and Control of Cardiovascular Diseases in India

Progress in Cardiovascular Diseases

Volumn 53, Issue 1, 2010, Pages 21-27

  Reddy, Kolli Srinath ^a   Satija, Ambika ^a  

^a PUBLIC HEALTH FOUNDATION OF INDIA   (India)

Author keywords

Cardiovascular disease; Framingham Heart Study; India; Public health impact

Indexed keywords

ARTICLE; BEHAVIOR CHANGE; CARDIOVASCULAR DISEASE; CARDIOVASCULAR RISK; CIGARETTE SMOKING; EPIDEMIC; ETHNIC DIFFERENCE; HEALTH PROGRAM; HEALTH PROMOTION; HIGH RISK POPULATION; HUMAN; INDIA; LIFESTYLE MODIFICATION; MORTALITY; PREVALENCE; PUBLIC HEALTH PROBLEM; RISK ASSESSMENT; RISK REDUCTION; SCORING SYSTEM; SMOKELESS TOBACCO; SMOKING CESSATION; EVIDENCE BASED MEDICINE; HEALTH; HEALTH SURVEY; HEART DISEASE; HISTORY; INTERNATIONAL COOPERATION; NATIONAL HEALTH ORGANIZATION; PUBLIC HEALTH; RISK FACTOR; TIME; UNITED STATES;

EVIDENCE-BASED MEDICINE; HEART DISEASES; HISTORY, 20TH CENTURY; HISTORY, 21ST CENTURY; HUMANS; INDIA; INTERNATIONAL COOPERATION; NATIONAL HEALTH PROGRAMS; NATIONAL INSTITUTES OF HEALTH (U.S.); POPULATION SURVEILLANCE; PUBLIC HEALTH; RISK ASSESSMENT; RISK FACTORS; TIME FACTORS; UNITED STATES; WORLD HEALTH;

EID: 77954153504     PISSN: 00330620     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.pcad.2010.02.011     Document Type: Article

References (70)

1. Murray C.J.L., Lopez A.D. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet 1997, 349:1269-1276.
2. World Health Organisation The impact of chronic disease in India, WHO Global Database Available from:, Last accessed January 2, 2009. http://www.who.int/chp/chronic_disease_report.
3. World Health Organisation The Global Burden of Disease: 2004 Update. Death and DALY estimates for 2004 by cause for WHO Member States 2009, WHO, Geneva, Available from:, Last accessed October 30, 2009. http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html.
4. Yusuf S., Reddy K.S., Ôunpuu S., et al. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 2001, 104:2746-2753.
5. Gupta R., Joshi P., Mohan V., et al. Epidemiology and causation of coronary heart disease and stroke in India. Heart 2008, 94:16-26.
6. Joshi R., Cardona M., Iyengar S., et al. Chronic diseases now a leading cause of death in rural India: Mortality data from the Andhra Pradesh Rural Health Initiative. Int J Epidemiol 2006, 35:1522-1529.
7. Ministry of Health & Family Welfare NCMH background papers-Burden of disease in India 2005, Nirman Bhawan, New Delhi.
8. Hughes L.O., Raval U., Raftery E.B. First myocardial infarctions in Asian and white men. BMJ 1989, 298:1345-1350.
9. Enas E.A., Dhawan J., Petkar S. Coronary artery disease in Asian Indians: lessons learnt and the role of lipoprotein-a. Indian Heart J 1996, 49:25-34.
10. Prabhakaran D., Yusuf S., Mehta S., et al. Two-year outcomes in patients admitted with non-ST elevation acute coronary syndrome: results of the OASIS registry 1 and 2. Indian Heart J 2005, 57:217-225.
11. Reddy K.S. India wakes up to the threat of cardiovascular diseases. JACC 2007, 50:1370-1372.
12. World Health Organisation The WHO Global Infobase (Online). Available from:, Last accessed January 3, 2009. https://apps.who.int/infobase/report.aspx.
13. Centers for Disease Control and Prevention Achievements in Public Health, 1900-1999: Decline in Deaths from Heart Disease and Stroke: United States, 1900-1999 1999, MMWR Weekly, Washington, DC, Available from:, Last accessed January 20, 2010. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4830a1.htm.
14. O'Donnell C.J., Elosua R. Cardiovascular risk factors: insights from Framingham Heart Study. Rev Esp Cardiol 2008, 61:299-310.
15. The Framingham Heart Study Research milestones Available from:, Last accessed January 21, 2010. http://www.framinghamheartstudy.org/about/milestones.html.
16. Grundy S.M., Balady G.J., Criqui M.H., et al. Primary prevention of coronary heart disease: guidance from Framingham: a statement for healthcare professionals from the AHA Task Force on Risk Reduction. Circulation 1998, 97:1876-1887.
17. Joshi P., Islam S., Pais P., et al. Risk factors for early myocardial infarction in South Asians compared with individuals in other countries. JAMA 2007, 297:286-294.
18. Cupples L.A., D'Agostino R.B. Some risk factors related to the annual incidence of cardiovascular disease and death using pooled repeated biennial measurements: 30-year follow-up. The Framingham Study: an epidemiological investigation of cardiovascular disease 1971, NHLBI National Printing Office, Washington, DC, section 34; as cited in Kannel WB, Vasan RS, Levy D: Is the relation of systolic blood pressure to risk of cardiovascular disease continuous and graded, or are there critical values? Hypertension 42:453-456, 2003, p. 454. W.B. Kannel, P.A. Wolf (Eds.).
19. Mohan V., Deepa R., Rani S.S., et al. Prevalence of coronary artery disease and its relationship to lipid in a selected population in South India. J Am Coll Cardiol 2001, 38:682-687.
20. Ramachandran A., Snehalatha C., Kapur A., et al. High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia 2001, 44:1094-1101.
21. Goel P.K., Bharti B.B., Pandey C.M., et al. A tertiary care hospital-based study of conventional risk factors including lipid profile in proven coronary artery disease. Indian Heart J 2003, 55:234-240.
22. Razak F., Anand S.S., Shannon H., et al. Defining obesity cut points in a multiethnic population. Circulation 2007, 115:2111-2118.
23. Dudeja V., Misra A., Pandey R.M., et al. BMI does not accurately predict overweight in Asian Indians in northern India. Br J Nutr 2001, 86:105-112.
24. Misra A., Pandey R.M., Sinha S. Receiver operating characteristics curve analysis of body fat and body mass index in dyslipidaemic Asian Indians. Indian J Med Res 2003, 117:170-179.
25. Singh S.P., Sikri G., Garg M.K. Body mass index and obesity: tailoring "cut off" for an Asian Indian male population. MJAFI 2008, 64:350-353.
26. Misra A., Madhavan M., Vikram N.K., et al. Simple anthropometric measures identify fasting hyperinsulinemia and clustering of cardiovascular risk factors in Asian Indian adolescents. Metabolism 2006, 55:1569-1573.
27. Mohan V., Deepa M., Farooq S., et al. Anthropometric cut points for identification of cardiometabolic risk factors in an urban Asian Indian population. Metabolism 2007, 56:961-968.
28. Snehalatha C., Viswanathan V., Ramachandran A. Cutoff values for normal anthropometric variables in Asian Indian adults. Diabetes Care 2003, 26:1380-1384.
29. Wilson W.F., Meigs J.B., Sullivan L., et al. Prediction of incident diabetes mellitus in middle-aged adults. Arch Intern Med 2007, 167:1068-1074.
30. Foster M.C., Hwang S.-J., Larson M.G., et al. Overweight, obesity and the development of stage 3 CKD: The Framingham Heart Study. Am J Kidney Dis 2008, 52:39-48.
31. Walter R.E., Wilk J.B., Larson M.G., et al. Systemic inflammation and COPD: the Framingham Heart Study. Chest 2008, 133:19-25.
32. Quan S.F., Connor G.T., Quan J.S., et al. Association of physical activity with sleep-disordered breathing. Sleep and Breathing 2007, 11:149-157.
33. Tan Z.S., Beiser A.S., Vasan R.S., et al. Inflammatory markers and the risk of Alzheimer disease: the Framingham Study. Neurology 2007, 68:1902-1908.
34. Moore L.L., Bradlee M.L., Singer M.R., et al. BMI and waist circumference as predictors of lifetime colon cancer risk in Framingham Study adults. Int J Obes Relat Metab Disord 2004, 28:559-567.
35. Gupta R., Gupta V.P. Hypertension epidemiology in India: lessons from Jaipur Heart Watch. Current Science 2009, 97:349-355.
36. Reddy K.S., Prabhakaran D., Chaturvedi V., et al. Methods for establishing a surveillance system for cardiovascular diseases in Indian industrial populations. Bull World Health Organ 2006, 84:461-469.
37. Reddy K.S., Prabhakaran D., Jeemon P., et al. Educational status and cardiovascular risk profile in Indians. Proc Natl Acad Sci U S A 2007, 104:16263-16268.
38. Shanthi Rani C.S., Rema M., Deepa R., et al. The Chennai Urban Population Study (CUPS)-Methodological Details-(CUPS paper no. 1). Int J Diab Dev Countries 1999, 149-155.
39. Deepa M., Pradeepa R., Rema M., et al. The Chennai Urban Rural Epidemiology Study (CURES)-study design and methodology (Urban Component) (CURES-1). JAPI 2003, 51:863-870.
40. Mohan V., Deepa R., Velmurugan K., et al. Association of small dense LDL with coronary artery disease and diabetes in urban Asian Indians-the Chennai Urban Rural Epidemiology Study (CURES-8). J Assoc Physicians India 2005, 53:95-100.
41. Radhika G., Sudha V., Mohan S.R., et al. Association of fruit and vegetable intake with cardiovascular risk factors in urban south Indians. Br J Nutr 2008, 99:219-220.
42. Mohan V., Shanthirani S., Deepa R., et al. Intra-urban differences in the prevalence of the metabolic syndrome in southern India-the Chennai Urban Population Study (CUPS No. 4). Diabet Med 2001, 18:280-287.
43. Gupta P.C., Pednekar M.S., Parkin D.M., et al. Tobacco associated mortality in Mumbai (Bombay) India. Results of the Bombay Cohort Study. Int J Epidemiol 2005, 34:1395-1402.
44. MRC Epidemiology Resource Centre Studies in Developing Populations: India Available from:, Last accessed December 20, 2009. http://www.mrc.soton.ac.uk/index.asp?page=231.
45. Wilson P, Greenberg H: Interview of William Kannel, MD. Prog Cardiovasc Dis 2010;53:4-9.
46. Press Information Bureau Health minister invites diaspora to join in developing healthcare. Press Information Bureau, Government of India: Chennai, January 8, 2009 Available from:, Last accessed December 20, 2009. http://www.pibchennai.gov.in/karuvoolam/Releases%202009/January%202009/08012009/080109er6.htm.
47. District Programme for Prevention and Control of Diabetes, Cardiovascular Diseases and Stroke: A Pilot (Draft copy).
48. Cigarettes And Other Tobacco Products (Prohibition Of Advertisement And Regulation Of Trade And Commerce, Production, Supply And Distribution) Act 2003 Available from the CommonLII, Indian Legislation, Last accessed December 20, 2009. http://www.commonlii.org/in/legis/num_act/caotpoaarotacpsada20031305/.
49. Section 6 (b), prohibition of sale and purchase of cigarettes and other tobacco products within 100 yards of education institution; now in force from 18th September 09″ Available from:(b).pdf. Last accessed December 20, 2009. http://www.aftcindia.org/pdf/notification_6.
50. Government notification on pictorial warnings, Available from: Last accessed December 20, 2009. http://www.aftcindia.org/may_4_notification.pdf.
51. Garrison R.J., Kannel W.B., Stokes J., et al. Incidence and precursors of hypertension in young adults: the Framingham offspring study. Prev Med 1987, 16:235-251.
52. Prabhakaran D., Jeemon P., Goenka S., et al. Impact of a worksite intervention programme on cardiovascular risk factors: a demonstration project in an Indian industrial population. JACC 2009, 53:1718-1728.
53. Deurenberg-Yap M., Chew S.K., Lin V.F., et al. Relationships between indices of obesity and its comorbidities in multi-ethnic Singapore. Int J Obes Relat Metab Disord 2001, 25:1554-1562.
54. Misra A., Vikram N.K. Insulin resistance syndrome (metabolic syndrome) and obesity in Asian Indians: evidence and implications. Nutrition 2004, 20:482-491.
55. McKeigue P.M., Shah B., Marmott M.G. Relationship of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet 1991, 337:382-386.
56. Kulkarni H.R., Nanda N.C., Segrest J.P. Increased prevalence of smaller and denser LDL particles in Asian Indians. Arterioscler Thromb Vasc Biol 1999, 19:2749-2755.
57. Bhalodkar N.C., Blum S., Rana T., et al. Comparison of levels of large and small high-density lipoprotein cholesterol in Asian Indian men compared with Caucasian men in the Framingham Offspring Study. Am J Cardiol 2004, 94:1561-1563.
58. Superko H.R., Enas E.A., Kotha P., et al. High-density lipoprotein subclass distribution in individuals of Asian Indian descent: the National Asian Indian Heart Disease Project. Prev Cardiol 2005, 8:81-86.
59. Enas E.A., Chacko V., Pazhoor S.G., et al. Dyslipidemia in South Asian patients. Current Atherosclerosis Reports 2007, 9:367-374.
60. Parish S., Peto R., Palmer A., et al. The joint effects of apolipoprotein B, apolipoprotein A1, LDL cholesterol, and HDL cholesterol on risk: 3510 cases of acute myocardial infarction and 9805 controls. Eur Heart J 2009, 30:2137-2146.
61. Morrison A., Hokanson J.E. The independent relationship between triglycerides and coronary heart disease. Vascular Health and Risk Management 2009, 5:89-95.
62. Braeckman L., De Bacquer D., Rosseneuf M., et al. Determinants of lipoprotein(a) levels in a middle-aged working population. Eur Heart J 1996, 17:1808-1813.
63. Lakka H.M., Laaksonen D.E., Lakka T.A., et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002, 288:2709-2716.
64. Yajnik C.S., Fall C.H.D., Coyaji K.J., et al. Neonatal anthropometry: the thin-fat Indian baby. The Pune Maternal Nutrition Study. Int J Obes 2003, 27:173-180.
65. Raji A., Seely E.W., Arky R.A., et al. Body fat distribution and insulin resistance in healthy Asian Indians and Caucasians. J Clin Endocrinol Metab 2001, 86:5366-5371.
66. Brindle P., May M., Gill P., Cappuccio F., et al. ETHRISK: a modified Framingham CHD and CVD risk calculator for British Black and minority ethnic groups Available from:, Last accessed January 17, 2010. http://www.epi.bris.ac.uk/CVDethrisk/.
67. Barker D.J., Fall C.H. Fetal and infant origins of cardiovascular disease. Arch Dis Child 1993, 68:797-799.
68. Barker D.J.P., Osmond C., Forsen T.J., et al. Trajectories of growth among children who have coronary events as adults. N Engl J Med 2005, 353:1802-1809.
69. Prentice A.M., Moore S.E. Early programming of adult diseases in resource poor countries. Arch Dis Child 2005, 90:429-432.
70. UNICEF Under-nutrition: a challenge for India Available from:, Last accessed January 22, 2010. http://www.unicef.org/india/nutrition_1556.htm.