Identification and Predictors for Cardiovascular Disease Risk Equivalents among Adults With Diabetes Mellitus

2021 ◽  
Author(s):  
Yanglu Zhao ◽  
Shaista Malik ◽  
Matthew J. Budoff ◽  
Adolfo Correa ◽  
Kellan E. Ashley ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Medication Use ◽  
Diabetes Duration ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Diabetes Medication ◽  
Diabetes Severity ◽  
Risk Equivalent

Objective: We examined diabetes mellitus (DM) as a cardiovascular disease (CVD) risk equivalent based on diabetes severity and other CVD risk factors. <p>Research Design and Methods: We pooled 4 US cohorts (ARIC, JHS, MESA, FHS-Offspring) and classified subjects by baseline DM/CVD. CVD risks between DM+/CVD- vs. DM-/CVD+ were examined by diabetes severity and in subgroups of other CVD risk factors. We developed an algorithm to identify subjects with CVD risk equivalent diabetes by comparing the relative CVD risk of being DM+/CVD- vs. DM-/CVD+. </p> <p>Results: The pooled cohort included 27,730 subjects (mean age of 58.5 years, 44.6% male). CVD rates per 1000 person-years were 16.5, 33.4, 43.2 and 71.4 among those with DM-/CVD-, DM+/CVD-, DM-/CVD+ and DM+/CVD+, respectively. Compared to those with DM-/CVD+, CVD risks were similar or higher for those with HbA1c≥7%, diabetes duration ≥10 years, or diabetes medication use while those with less severe diabetes had lower risks. Hazard ratios for DM+/CVD- vs. DM-/CVD+ were 0.96(0.86-1.07), 0.97(0.88-1.07), 0.96(0.82-1.13), 1.18(0.98-1.41), 0.93(0.85-1.02) and 1.00(0.89-1.13) among women, white race, age <55 years, triglycerides ≥2.26mmol/L, CRP≥2mg/L and eGFR<60mL/min/1.73m<sup>2</sup>, respectively. In DM+/CVD- group, 19.1% had CVD risk equivalent diabetes with a lower risk score but a higher observed CVD risk. </p> <p>Conclusion: Diabetes is a CVD risk equivalent in one-fifth of CVD-free adults living with diabetes. High HbA1c, long diabetes duration, and diabetes medication use were predictors of CVD risk equivalence. Diabetes is a CVD risk equivalent for women, white people, those of younger age, with higher triglycerides or CRP, or reduced kidney function. </p>

scholarly journals Identification and Predictors for Cardiovascular Disease Risk Equivalents among Adults With Diabetes Mellitus

2021 ◽  
Author(s):  
Yanglu Zhao ◽  
Shaista Malik ◽  
Matthew J. Budoff ◽  
Adolfo Correa ◽  
Kellan E. Ashley ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Medication Use ◽  
Diabetes Duration ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Diabetes Medication ◽  
Diabetes Severity ◽  
Risk Equivalent

Objective: We examined diabetes mellitus (DM) as a cardiovascular disease (CVD) risk equivalent based on diabetes severity and other CVD risk factors. <p>Research Design and Methods: We pooled 4 US cohorts (ARIC, JHS, MESA, FHS-Offspring) and classified subjects by baseline DM/CVD. CVD risks between DM+/CVD- vs. DM-/CVD+ were examined by diabetes severity and in subgroups of other CVD risk factors. We developed an algorithm to identify subjects with CVD risk equivalent diabetes by comparing the relative CVD risk of being DM+/CVD- vs. DM-/CVD+. </p> <p>Results: The pooled cohort included 27,730 subjects (mean age of 58.5 years, 44.6% male). CVD rates per 1000 person-years were 16.5, 33.4, 43.2 and 71.4 among those with DM-/CVD-, DM+/CVD-, DM-/CVD+ and DM+/CVD+, respectively. Compared to those with DM-/CVD+, CVD risks were similar or higher for those with HbA1c≥7%, diabetes duration ≥10 years, or diabetes medication use while those with less severe diabetes had lower risks. Hazard ratios for DM+/CVD- vs. DM-/CVD+ were 0.96(0.86-1.07), 0.97(0.88-1.07), 0.96(0.82-1.13), 1.18(0.98-1.41), 0.93(0.85-1.02) and 1.00(0.89-1.13) among women, white race, age <55 years, triglycerides ≥2.26mmol/L, CRP≥2mg/L and eGFR<60mL/min/1.73m<sup>2</sup>, respectively. In DM+/CVD- group, 19.1% had CVD risk equivalent diabetes with a lower risk score but a higher observed CVD risk. </p> <p>Conclusion: Diabetes is a CVD risk equivalent in one-fifth of CVD-free adults living with diabetes. High HbA1c, long diabetes duration, and diabetes medication use were predictors of CVD risk equivalence. Diabetes is a CVD risk equivalent for women, white people, those of younger age, with higher triglycerides or CRP, or reduced kidney function. </p>

Abstract 14434: Identification and Predictors for Cardiovascular Disease Risk Equivalents Among Adults With Diabetes Mellitus

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yanglu Zhao ◽  
Shaista Malik ◽  
Matthew J Budoff ◽  
Adolfo Correa ◽  
Kellan E Ashley ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Medication Use ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Hba1c Control ◽  
Event Rates ◽  
Risk Equivalent

Background: It is not well quantified if diabetes mellitus (DM) as a cardiovascular disease (CVD) risk equivalent depends on DM severity and other CVD risk factors. Methods: We pooled 4 US community-based cohorts (ARIC, JHS, MESA, FHS Offspring) and classified subjects by baseline DM/CVD status. DM+/CVD- was further classified by DM duration, HbA1c control or DM medication. Hazard ratios (HR) were estimated for CVD during a median follow-up of 14 years. Subgroup analysis comparing the HR of DM+/CVD- vs. DM-/CVD+ was done by CVD risk factors. We integrated all factors that impacted DM-conferred CVD risk and defined one with DM+/CVD- as CVD risk equivalent when his/her CVD risk was as high or higher than that if he/she had DM-/CVD+. CVD risk profile and event risk were compared between the CVD risk equivalent subgroups in DM+/CVD-. Results: The pooled cohort included 27,732 adults (mean age of 58 years, 45% males). CVD event rates per 1000 P-Y were 16.3, 33.3, 40.9 and 69.0 among those with DM-/CVD-, DM+/CVD-, DM-/CVD+ and DM+/CVD+, respectively. DM participants with HbA1c≥7%, DM duration over 10 years, or DM medication use had similar CVD risk as those with DM-/CVD+ while those without these factors had lower CVD risk; DM+/CVD- had similar CVD risk as those DM-/CVD+ among women, age <55 years, White race, or high triglyceride groups (Figure). Among those with DM+/CVD-, 17.5% were found to be CVD risk equivalents. Compared to those non-CVD risk equivalent DM, they had lower 10-year PCE scores (14.8% vs. 22.7%, p<0.0001) however higher actual CVD event rates (44.9 vs. 31.0 per 1000 P-Y). Conclusion: Among CVD-free adults with DM, fewer than 20% are actually CVD risk equivalents. Poor HbA1c control, long DM duration, and current diabetes medication use were identified as predictors of CVD risk equivalent status and DM was more detrimental for CVD risk if one is female, younger age, White, or with high triglycerides. These risk enhancing factors should be considered in the treatment decision.

Determining the Cardiovascular Disease Risk Factor Knowledge and Related Factors Among Adults With Type 2 Diabetes Mellitus

2021 ◽  
pp. 105477382110464
Author(s):  
Emine Karaman ◽  
Aslı Kalkım ◽  
Banu Pınar Şarer Yürekli
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Related Factors

In this study was to determine knowledge of cardiovascular disease (CVD) risk factors and to explore related factors among adults with type 2 diabetes mellitus (DM) who have not been diagnosed with CVD. This descriptive study was conducted with 175 adults. Data were collected individual identification form and Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) scale. A negative correlation was found between age and CARRF-KL score. A significant difference was found between educational status and CARRF-KL score. The individuals described their health status as good, managed their condition with diet and exercise, received information from nurses, adults with DM in their family and those with no DM complications had significantly higher scores in CARRF-KL. The knowledge of an individual with DM about CVD risk factors should be assessed, CVD risks should be identified at an early stage, and individuals at risk should be subjected to screening.

scholarly journals Disentangling the Links Between Psychosocial Stress and Cardiovascular Disease

2020 ◽  
Vol 13 (8) ◽  
Author(s):  
Michael T. Osborne ◽  
Lisa M. Shin ◽  
Nehal N. Mehta ◽  
Roger K. Pitman ◽  
Zahi A. Fayad ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Stress ◽  
Psychosocial Stress ◽  
Human Experience ◽  
Cvd Risk Factors ◽  
Cvd Risk

Stress is a pervasive component of the human experience. While often considered an adversity to be ignored, chronic stress has important pathological consequences, including cardiovascular disease (CVD). Stress also increases the prevalence and severity of several CVD risk factors, including hypertension, diabetes mellitus, and obesity. Yet even after adjustment, stress’ attributable CVD risk is similar to those risk factors, suggesting it is a particularly potent contributor. Nevertheless, there has been insufficient study of mechanisms linking stress to CVD or of methods to attenuate stress’ pathological impact. This review covers the current concepts of how stress impacts CVD and emerging approaches to mitigate stress-attributable CVD risk.

scholarly journals Incidence of and Risk Factors for Recurrent Cardiovascular Disease Events in Middle-Eastern Adults

2019 ◽  
Author(s):  
Romona Devi Govender ◽  
Saif Al-Shamsi ◽  
Elpidoforos S. Soteriades ◽  
Dybesh Regmi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Incidence Rate ◽  
United Arab Emirates ◽  
Middle Eastern ◽  
Eastern Region ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
History Of

Abstract Background Individuals with established cardiovascular disease (CVD) are at a much higher risk of either recurrent cardiovascular events or death. Previous research has shown that the incidence rate for recurrent CVD events varies across countries and populations. The association of traditional CVD risk factors, such as age, smoking, hypertension and diabetes mellitus increases the risk of recurrent CVD events or death particularly in individuals with a history of cardiovascular disease (CVD). The United Arab Emirates (UAE) has one of the highest age-standardized death rate for CVD worldwide. The aim of our study was to estimate the incidence rates and determine the predictors of recurrent CVD events among UAE nationals. Methods We investigated an outpatient-based cohort of patients with a history of prior CVD visiting Tawam Hospital between January 1, 2008 and December 31, 2008 and followed-up until the end of study period, July 31, 2018. Univariable and multivariable-adjusted Cox proportional hazard regression models were used to explore the association between different major CVD risk factors and the risk of recurrent CVD. Results A total of 216 patients (167 males, 49 females) with a history of CVD were included in our study. They were followed for a median of 8.1 years (interquartile range 5.5 to 9.3 years), with a total of 1184 patient-years of follow-up. The overall incidence rate of recurrent CVD events was 92.1 per 1000 patient-years. The 8-year cumulative incidence was 73.7%. Age, female sex, and diabetes mellitus were significant predictors of recurrent CVD events. Females had an 85% higher probability of recurrent CVD than males. Conclusion The overall incidence rate of recurrent CVD events in the UAE is 92.1 per 1000 patient-years and is one of the highest in Middle Eastern region. Primary and tertiary preventive measures are urgently needed in order to improve CVD morbidity and mortality and attempt to reverse the alarming rates of new and recurrent CVD events among UAE nationals. These interventions should comply with international guidelines for CVD management.

Abstract MP69: Relationships Between Sleep Apnea, Cardiovascular Disease Risk Factors, and Aortic Pulse Wave Velocity over 9 Years: The Wisconsin Sleep Cohort

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Rebecca Stern ◽  
Claudia E Korcarz ◽  
Paul E Peppard ◽  
Jodi H Barnet ◽  
Erika W Hagen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Sleep Apnea ◽  
Pulse Wave ◽  
Aortic Pulse Wave Velocity ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Longitudinal Associations

Background: Cardiovascular disease (CVD) risk factors associated with obstructive sleep apnea (OSA) contribute to endothelial dysfunction and arterial stiffening. We hypothesized that OSA severity would predict aortic pulse wave velocity (PWV) after nearly a decade of aging in the Wisconsin Sleep Cohort (WSC). Methods: Subjects were 596 participants in the WSC that underwent overnight polysomnography between 2000 and 2008; subsequent tonometry data was acquired a mean of 8.8 (standard deviation, 2.1) years later. OSA severity was described by the apnea-hypopnea index (AHI), mean and minimum nocturnal blood oxygen saturation level (SaO 2 , %), and time with SaO 2 <90%. AHI+1 was log transformed. Participants using positive airway pressure therapy (PAP) at the tonometry visit were evaluated as a distinct categorical variable. Non-invasive applanation tonometry was used to derive aortic (carotid-to-femoral) PWV. Multivariable linear and logistic regression models that included CVD risk factors, antihypertensive, and lipid medications were fit to evaluate longitudinal associations between baseline OSA markers and future PWV. Results: At baseline, the 596 participants were mean 55.9 (7.3) years old (53% male, 97.5% Caucasian). Their mean body-mass index (was 31.4 (6.9) kg/m 2 , 89 (14.9%) had diabetes mellitus, and 252 (42.3%) were hypertensive. Excluding the 40 CPAP users, the mean AHI was 5.8 (7.6) events/hour (range 0.0-53.6); 54 (9.1%) had AHI ≥15 events/hr. Mean SaO 2 was 94.7% (2.1%) and minimum SaO 2 was 82.8% (9.5%). Time with SaO 2 <90% did not predict PWV. In models adjusted for age and sex, lower mean SaO 2 (β=-0.16, SE 0.06, p=0.004), lower minimum SaO 2 (β=-0.04, SE 0.01, p=0.005) and higher log 10 (AHI+1) (β=0.55, SE 0.20, p=0.005) predicted higher PWV a mean of approximately 9 years after OSA assessment. However, none of these associations were statistically significant after waist circumference (p≤0.005 for all 3 outcomes) and height were added to the models. For models with mean SaO 2 , waist circumference independently predicted PWV, but after addition of CVD risk factors, only age (β=0.14, SE 0.01, p<0.001), systolic blood pressure (β=0.02, SE 0.01, p<0.001), and diabetes status (β=0.96, SE 0.28, p=0.002) were independent predictors. Very similar results were observed for models with minimum Sa0 2 and PWV. None of the OSA parameters interacted with age or smoking status to predict PWV. Presence of Metabolic Syndrome did not predict PWV; it did not interact with OSA parameters to predict PWV. Conclusions: The longitudinal associations between OSA and PWV are confounded by body size and influenced by diabetes mellitus and blood pressure. These results suggest that weight management and blood pressure control may help prevent arterial stiffening associated with sleep apnea.

scholarly journals Effects of a Paleolithic Diet on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 10 (4) ◽  
pp. 634-646 ◽  
Author(s):  
Ehsan Ghaedi ◽  
Mohammad Mohammadi ◽  
Hamed Mohammadi ◽  
Nahid Ramezani-Jolfaie ◽  
Janmohamad Malekzadeh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Lipid Profile ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cvd Risk Factors ◽  
Paleolithic Diet ◽  
Cvd Risk ◽  
Randomized Controlled

ABSTRACTThere is some evidence supporting the beneficial effects of a Paleolithic diet (PD) on cardiovascular disease (CVD) risk factors. This diet advises consuming lean meat, fish, vegetables, fruits, and nuts and avoiding intake of grains, dairy products, processed foods, and added sugar and salt. This study was performed to assess the effects of a PD on CVD risk factors including anthropometric indexes, lipid profile, blood pressure, and inflammatory markers using data from randomized controlled trials. A comprehensive search was performed in the PubMed, Scopus, ISI Web of Science, and Google Scholar databases up to August 2018. A meta-analysis was performed using a random-effects model to estimate the pooled effect size. Meta-analysis of 8 eligible studies revealed that a PD significantly reduced body weight [weighted mean difference (WMD) = −1.68 kg; 95% CI: −2.86, −0.49 kg], waist circumference (WMD = −2.72 cm; 95% CI: −4.04, −1.40 cm), BMI (in kg/m2) (WMD = −1.54; 95% CI: −2.22, −0.87), body fat percentage (WMD = −1.31%; 95% CI: −2.06%, −0.57%), systolic (WMD = −4.75 mm Hg; 95% CI: −7.54, −1.96 mm Hg) and diastolic (WMD = −3.23 mm Hg; 95% CI: −4.77, −1.69 mm Hg) blood pressure, and circulating concentrations of total cholesterol (WMD = −0.23 mmol/L; 95% CI: −0.42, −0.04 mmol/L), triglycerides (WMD = −0.30 mmol/L; 95% CI: −0.55, −0.06 mmol/L), LDL cholesterol (WMD = −0.13 mmol/L; 95% CI: −0.26, −0.01 mmol/L), and C-reactive protein (CRP) (WMD = −0.48 mg/L; 95% CI: −0.79, −0.16 mg/L) and also significantly increased HDL cholesterol (WMD = 0.06 mmol/L; 95% CI: 0.01, 0.11 mmol/L). However, sensitivity analysis revealed that the overall effects of a PD on lipid profile, systolic blood pressure, and circulating CRP concentrations were sensitive to removing some studies and to the correlation coefficients, hence the results must be interpreted with caution. Although the present meta-analysis revealed that a PD has favorable effects on CVD risk factors, the evidence is not conclusive and more well-designed trials are still needed.

scholarly journals Cardiovascular Disease Risk in Bears and Other Gay Men: A Descriptive Study from Poland

2021 ◽  
Vol 18 (3) ◽  
pp. 1044
Author(s):  
Magdalena Mijas ◽  
Karolina Koziara ◽  
Andrzej Galbarczyk ◽  
Grazyna Jasienska
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Gay Men ◽  
Disease Risk ◽  
Older Age ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Wide Range

A risk of cardiovascular disease (CVD) is increased by multiple factors including psychosocial stress and health behaviors. Sexual minority men who identify as Bears form a subculture distinguished by characteristics associated with increased CVD risk such as elevated stress and high body weight. However, none of the previous studies comprehensively investigated CVD risk in this population. Our study compared Bears (N = 31) with other gay men (N = 105) across a wide range of CVD risk factors. Logistic regression and analysis of covariance (ANCOVA) models were performed to compare both groups concerning behavioral (e.g., physical activity), medical (e.g., self-reported hypertension), and psychosocial (e.g., depressiveness) CVD risk factors. Bears were characterized by older age and higher body mass index (BMI) than the control group. We also observed higher resilience, self-esteem, as well as greater prevalence of self-reported hypertension, diabetes, and hypercholesterolemia in Bears. None of these differences remained statistically significant after adjusting for age and, in the case of self-reported diagnosis of diabetes, both age and BMI. Our study demonstrates that Bears are characterized by increased CVD risk associated predominantly with older age and higher BMI. Health promotion interventions addressed to this community should be tailored to Bears’ subcultural norms and should encourage a healthier lifestyle instead of weight loss.

scholarly journals Effect of DASH Diet Versus Healthy Dietary Advice on the Estimated Atherosclerotic Cardiovascular Disease Risk

2021 ◽  
Vol 12 ◽  
pp. 215013272098095
Author(s):  
Marwa S. Said ◽  
Inas T. El Sayed ◽  
Eman E. Ibrahim ◽  
Ghada M. Khafagy
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Dietary Advice ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Post Intervention ◽  
Dash Diet ◽  
Significant Difference ◽  
Diet Versus

Introduction: Cardiovascular disease (CVD) is the most leading cause of mortality worldwide. Changes in diet can reduce subclinical cardiac injury and inflammation in parallel with reductions of other CVD risk factors. Aim: The study aimed to evaluate the beneficial effect of the DASH diet versus usual healthy dietary advice (HDA) on the estimated risk of atherosclerotic cardiovascular disease (ASCVD). Methods: It was a prospective interventional nonrandomized controlled study, conducted on 92 participants attending Family Medicine Outpatient Clinics, Cairo University. The participants were assigned to 2 dietary groups, the DASH and HDA groups, for 12 weeks. All subjects were subjected to anthropometric measurement, assessment of lipid profile, and the estimated cardiovascular risk pre-and post-intervention. Results: The estimated cardiovascular risk was reduced significantly in both the DASH and HDA groups, with no statistically significant difference between the 2 groups regarding the risk reduction. By comparing the percent change between pre and post-intervention in both DASH and HDA groups, the following are the results: BMI dropped by 6.5% versus 2.5%, systolic blood pressure decreased by 6.9% and 4.1%, fasting blood sugar dropped by 5.5% and 3.1%, total cholesterol dropped by 5.2% and 3.1%, LDL dropped by 8.2%, and 3.1%, and HDL increased by 8.2% and 2.4%, in DASH and HDA groups, respectively. Conclusion: Both the DASH diet and HDA are associated with improvement in CVD risk factors. Although better risk factors decline with the DASH diet, there was no statistically significant difference between the 2 groups.

scholarly journals Is night-time light intensity associated with cardiovascular disease risk factors among adults in early-stage urbanisation in South India? A cross-sectional study of the Andhra Pradesh Children and Parents Study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e036213
Author(s):  
Tina Bonde Sorensen ◽  
Robin Wilson ◽  
John Gregson ◽  
Bhavani Shankar ◽  
Alan D Dangour ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Andhra Pradesh ◽  
South India ◽  
Early Stage ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Night Time ◽  
Cross Sectional ◽  
Children And Parents

ObjectivesTo explore associations of night-time light intensity (NTLI), a novel proxy for continuous urbanisation levels, with mean systolic blood pressure (SBP), body mass index (BMI), fasting serum low-density lipoprotein (LDL) and fasting plasma glucose (FPG), among adults in early-stage urbanisation in Telangana, South India.DesignCross-sectional analysis of the third wave of the Andhra Pradesh Children and Parents Study cohort.Setting28 villages representing a continuum of urbanisation levels, ranging from rural settlement to medium-sized town in Telangana, South India.ParticipantsData were available from 6944 participants, 6236 of whom were eligible after excluding pregnant women, participants younger than 18 years of age and participants missing data for age. Participants were excluded if they did not provide fasting blood samples, had implausible or missing outcome values, were medicated for hypertension or diabetes or had triglyceride levels invalidating derived LDL. The analysis included 5924 participants for BMI, 5752 participants for SBP, 5287 participants for LDL and 5328 participants for FPG.ResultsIncreasing NTLI was positively associated with mean BMI, SBP and LDL but not FPG. Adjusted mean differences across the range of village-level NTLI were 1.0 kg/m2 (95% CI 0.01 to 1.9) for BMI; 4.2 mm Hg (95% CI 1.0 to 7.4) for SBP; 0.3 mmol/L (95% CI −0.01 to 0.7) for LDL; and −0.01 mmol/L (95% CI −0.4 to 0.4) for FPG. Associations of NTLI with BMI and SBP were stronger in older age groups.ConclusionThe association of NTLI with cardiovascular disease (CVD) risk factors identify NTLI as a potentially important tool for exploring urbanisation-related health. Consistent associations of moderate increases in urbanisation levels with important CVD risk factors warrant prevention strategies to curb expected large public health impacts from continued and rapid urbanisation in India.

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