RAPID ESCALATION OF CARDIOVASCULAR RISK FACTOR BURDEN IN RURAL AREAS OF NATIONAL CAPITAL REGION OF DELHI OVER TWENTY YEARS

Managing urban growth has become one of the important challenges of the 21st century in the Global South, where agglomerations are being formed by the coalescence of urban and rural areas. The scale and speed of transformation have outstripped the capacity of local governments to provide adequate basic amenities. Using the National Capital Region as a case study, and census data and spatial boundaries, this chapter attempts to understand the process of urbanization underway in India. Results show that the region is currently in the stage of sub-urbanization, and that recent growth has been predominantly in ‘census towns' as informal urbanization. Three main reforms are required to achieve sustainable urbanization: First, integration of infrastructure development into spatial planning at the national level and in lower tiers of planning. Second, empowering local authorities to incentivize urban development in order to fund urban infrastructure. Third, notifying census towns with municipalities, thereby providing for urban infrastructure and controlling unplanned growth.

Download Full-text

Abstract P611: Vascular-mediated Preterm Birth is Associated with Cardiovascular Risk after Pregnancy

Hypertension ◽

10.1161/hyp.66.suppl_1.p611 ◽

2015 ◽

Vol 66 (suppl_1) ◽

Author(s):

Janet M Catov ◽

Steven E Reis ◽

Matthew F Muldoon ◽

Roberta B Ness ◽

Lananh Nguyen ◽

...

Keyword(s):

Blood Pressure ◽

Risk Factor ◽

Cardiovascular Risk ◽

Preterm Birth ◽

Chronic Inflammation ◽

Cardiovascular Risk Factor ◽

Subclinical Atherosclerosis ◽

Carotid Imt ◽

Term Births ◽

Risk Factor Burden

Objective: To investigate whether preterm birth and placental evidence of malperfusion is associated with subclinical atherosclerosis and a higher cardiovascular risk factor burden 4 to 12 years after pregnancy. Methods: A cohort of women with preterm (n=119) and term births (n=242), mean age 38 years, was examined on average eight years after pregnancy for carotid artery intima-media thickness (IMT), fasting lipids, blood pressure and inflammatory markers (C-reactive protein [hsCRP] and Interleukin-6 [IL-6]). Pregnancy characteristics included placental pathology evidence of malperfusion (vasculopathy, infarct, advanced villous maturation, perivillous fibrin, fibrin deposition), infection (chorioamnionitis, funisitis, deciduitus), villitis (chronic inflammation), fetal thrombosis or chorangiosis. Vascular-mediated preterm births were those with malperfusion lesions, and by design, those with preeclampsia were excluded. Results: Women with malperfusion lesions had a higher mean carotid IMT (+0.055 cm), total cholesterol (+17.49 mg/dl), LDL-C (+11.44), triglycerides (+17%), apolipoprotein-B (+8.95) and systolic and diastolic blood pressure (+4.58/+2.62 mmHg) compared to women with term births, independent of age, race, smoking and adiposity assessed before and after pregnancy (all p<0.05). Women with preterm birth and evidence of malperfusion accompanied by other lesions related to infection or chronic inflammation had the most atherogenic profile after pregnancy, and carotid IMT differences were independent of traditional risk factors (+0.04 cm; p=0.027). Conclusions: Vascular-mediated preterm birth is associated with maternal subclinical atherosclerosis and a higher cardiovascular risk factor burden in the decade after pregnancy compared to term birth. The placenta may offer unique insight into how pregnancy complications can portend the emergence of maternal cardiovascular disease.

Download Full-text