European Journal of Cardiovascular Medicine

The global pattern of disease is shifting at an alarming rate in low-income countries.¹ Worldwide, the prevalence of numerous diseases has increased as a result of human behavior altering. In most countries, non-communicable diseases (NCDs) are now the focus of attention, displacing communicable diseases as the primary cause of death.²

Conditions or diseases classified as non-communicable (also known as non-infectious or non-transmissible) when they are not brought on by infectious agents. Chronic respiratory diseases, malignancies, diabetes, and cardiovascular disorders are the four primary categories of non-communicable diseases.³ Globally, NCDs are the primary cause of illness and mortality. Non-communicable diseases account for 38 million deaths worldwide each year (NCDs).⁴ By 2020, these NCDs are predicted to account for 60% of the world's disease burden and 73% of all deaths worldwide based on current trends.⁵

A report published by the World Health Organization (WHO) in 2015 stated that every fourth Indian person dies from a non-communicable disease (NCD) before reaching the age of 70. 5.8 million people worldwide pass away each year as a result of NCDs, accounting for over 60% of all deaths. India is the world's first nation to create precise targets and indicators in this area with the goal of lowering the worldwide burden of deaths from NCDs by 25% by the year 2025.⁶

Any characteristic or exposure that raises a person's chance of contracting a non-communicable disease is referred to as a risk factor. By being aware of these risk variables, one can lower the level at which these risk factors are distributed.⁷ The increasing frequency of behavioral and metabolic risk factors for non-communicable diseases (NCDs) is the cause of the growing burden of these diseases.⁸

The three categories of risk factors for non-communicable diseases are metabolic, biochemical, and behavioral. Use of alcohol, smoke, poor diet, and inactivity are examples of behavioral risk factors. Diabetes, hypertension, obesity, and overweight are examples of metabolic risk factors. Hypertriglyceridemia and hypercholestremia are two examples of biochemical risk factors.³

As part of a worldwide surveillance strategy, WHO created the STEPS approach in response to the increasing demand for country-level trends in non-communicable illnesses. The same standardized questions and methods can be used to compare nations; this method is applicable to all nations. It focuses on a small set of risk factors that determine how common major non-communicable diseases will be. In turn, this data can be utilized to create strategies for reducing risk factors and preventing disease.^9,10

With this background, this study was planned study the prevalence of risk factors of NCDs in Howrah rural area of West Bengal.

This community based cross sectional study was conducted in Howrah, West Bengal, India from January 2024-March 2024. Total 300 people who were aged 15 and above were enrolled for the study. Statistical data were analysed by using Microsoft Excel and SPSS V.20 software.

This present community based cross sectional study was carried out in Howrah, West Bengal, India, between January 2024-March 2024.

Study population and sampling technique : People who are aged 15 and above were enrolled for the study. As per the WHO STEPS approach sample size was calculated using the formula n=Z 2 P(1-P)/e2 =384, with design effect of 1.5, 4 age-sex estimates desired for the study and 1.8 to adjust for the anticipated 20% non-response rate the final sample size came as 300.

Inclusion criteria : The inclusion criteria for the study were adult population of aged 15 years and above residing in the study area, who were apparently healthy and willing to participate in the study.

Exclusion criteria : The exclusion criteria for the study were participants severely ill and those who rejected to participate in the study.

Study variables: Utilizing a systematic random sampling procedure, the study individuals were chosen. The study participants were chosen through a multistage sampling procedure. The WHO STEPS tool was utilized to gather data from each participant. The purpose of study was explained to the study participants and written consent was obtained individually. Important information about sociodemographics and risk factors for noncommunicable diseases (NCDs), such as alcohol and tobacco use, was included in the pre-tested proforma. Study participants were categorized according to per-capita monthly income using an updated version of B.G. Prasad's socioeconomic status scale.¹¹

In the supine posture, blood pressure was taken with an inflatable mercury sphygmomanometer. Five minutes separated the two readings, and the average measurement result was used for the analysis. The JNC VII classification standards were applied to the blood pressure.¹²

A computerized weighting machine was used to measure weight, and a stadiometer was utilized to measure height. The formula : weight (kg)/height (m2) was used to determine BMI based on measurements of height and weight. The International Classification of Adult Underweight, Overweight, and Obesity was used for classification, with BMI being used to determine obesity.¹³

Data Analysis plan- The data was tabulated in Microsoft Excel software and analysed with SPSS V.20 software and appropriate statistical tests were employed.

Table 1: Socio demographic profile of study population (n=300)

A total of 300 respondents were interviewed of which 186 were male and 114 were female. The socio demographic characters among the study population, maximum 140 (46.67%) belong to the age group of 15 – 35 years. Maximum 210 (70%) were having educational qualification below secondary/higher secondary. Hindus constituted 250 (83.33%). Total 132 (44%) belonged to lower middle and 110 (36.67%) belonged to lower socioeconomic class. Majority 142 (47.33%) of them were either farmers or labour/ unskilled workers. (Table 1)

Table 2: Prevalence of tobacco consumption as risk factor of NCD (n=300).

In regard to tobacco consumption as risk factor for NCDs, 44.67% were using tobacco or tobacco products, of these majorities were males (94.03%). Among the tobacco products consumed most common was gutka followed by bidi and cigarette. (Table 2)

Table 3: Prevalence of alcohol consumption as risk factor. (n=86)

Alcohol consumption as risk factor for NCD 28.66% were currently consuming alcohol, of these males comprised 90.69%, of them 48.84% consumed hooch followed by whisky and brandy. Among these 6.98% consumed daily, whereas 74.42% consumed weekly once or twice. 46.51% consumed average of 90-180 ml of alcohol. (Table 3)

Table 4: Classification of blood pressure among the study population.

The classification of blood pressure among the study population is 19.33% and 10% were in pre- hypertensive stage. (Table 4)

Table 5: History of diabetes self and diabetes in family member among study population.

In the study population 11.33% were diabetic, of which 58.82% were males. Among males with diabetes 58.33% had BMI>25 and 56.25% had a family member with diabetes. (Table 5)

Non-communicable diseases (NCDs) account for the majority of morbidity and mortality worldwide. They are responsible for 47% of the world's illness burden and nearly 60% of deaths, according to the WHO Report 2004. The predicted death rate in India from non-communicable diseases was double that of communicable diseases. An increasing increase in the NCD disease pattern portends a significant public health concern. The main risk factors for non-communicable illnesses are poor diets, sedentary lifestyles, and overuse of nicotine and alcohol.¹⁴

The socio demographic characters like the age group, maximum belong to the age group of 15–35 years 46.67%), majority were having educational qualification below secondary/higher secondary (83.33%). Nearly 36.67% belonged  to lower middle or lower socioeconomic class and majority of them were either farmers or labour/ unskilled workers (47.33%). Similar finding were seen in study done by Bhagyalaxmi et al.¹⁵ In this study the 29.93% were using tobacco or tobacco products, of these majority were males (98.42%).

Among the tobacco products consumed most common was gutka followed by bidi and cigarette. In similar study done by Bhagyalaxmi et al showed prevalence of tobacco use as 22.8% among rural population.¹⁵ In The non-communicable diseases risk factor survey 2007-08 by IDSP, Ministry of Health & Family Welfare Government of India showed that tobacco use ranged from 9%-42%.¹⁴ Studies done by Chadha et al, Gupta et al and Thankappan et al showed prevalence of smoking among rural population as 54.45%, 44.6% and 24.3% respectively and in all three studies use of smokeless tobacco like gutka was most common which is similar to the present study.^16-18 According to the recently completed NFHS-4 state facts sheet for West Bengal, 59.9% of respondents said they consumed tobacco in any form, and more men than women.¹⁹

Alcohol consumption as risk factor for NCD, in the present study 28.66% were currently consuming alcohol, of these males comprised 90.69%, of them 48.84% consumed hooch followed by whisky and brandy. In similar study by Thankappan et al showed alcohol use among rural population as 10.1%.¹⁸ The Ministry of Health & Family Welfare, Government of India, the Non-Communicable Diseases Risk Factor Survey 2007–2008, and the NFHS–4 state fact sheet Alcohol use was found to be 11.20% and 28.7% in West Bengal, respectively.^14,19

The prevalence of hypertension among the study population is 19.33% and 10% were in pre- hypertensive stage. Among the hypertensive people 51.72% were males and 48.28% were females. In similar study done by Bhagyalaxmi et al showed prevalence of tobacco use as 12-17% among rural population.¹⁵ According to the Ministry of Health & Family Welfare, Government of India's Non-Communicable Diseases Risk Factor Survey 2007–2008, tobacco consumption ranged between 2–9%.^14,19 Similar studies done by Chadha et al, Allender et al and Thankappan et al showed prevalence of hypertension among rural population as 7.4%, 19.1% and 35.7% respectively.^16,18,20

In the study population 12.42% were aware of their diabetic status, of which 58.82% were males. The Non Communicable diseases risk factor survey 2007-08 by IDSP, Ministry of Health & Family Welfare Government of India showed that tobacco use ranged from 1-6%.¹⁴   NFHS-4 state facts sheet West Bengal showed prevalence of diabetes as 15.9%.¹⁵ Similar study done by Thankappan KR et al showed prevalence of diabetes among rural population as 63.7% which is very high compared to present study.¹⁸ Among those who were aware of their diabetic status 62.46% had one of their family member also having diabetes. Among the study population with diabetes 58.33% had BMI>25 and its was more in males compared to females. Similar observations were found in studies by Thankappan et al and Allender et al.^18,20

The current study found a significant burden of non-communicable risk factors as well as some interesting patterns in the relationships between sociodemographic and behavioral risk variables. These findings highlight the need for increased public awareness of non-communicable diseases and the risk factors associated with them.

Acknowledgements : Authors would like to acknowledge the patients who participated in this research study. 

Funding: No funding sources 

Conflict of interest: None declared 

Ethical approval:  The study was approved by the institutional ethics committee 

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