Migrating husbands and changing cardiovascular risk factors in the wife: a cross sectional study in Asian Indian women
- Rajeev Gupta1,
- Rajiv Gupta2,
- Aachu Agrawal3,
- Anoop Misra4,
- Soneil Guptha1,
- Ravindra M Pandey5,
- Puneet Misra5,
- Naval K Vikram6,
- Sanjit Dey7,
- Shobha Rao8,
- V Usha Menon9,
- N Kamalamma10,
- K Revathi11,
- Beena Mathur3,
- Vinita Sharma12
- 1Department of Medicine, Fortis Escorts Hospital, Jaipur, India
- 2Department of Sociology, University of Rajasthan, Jaipur, India
- 3Department of Home Science, University of Rajasthan, Jaipur, India
- 4Department of Medicine, Fortis Rajan Dhall Hospital, New Delhi & National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India
- 5Department of Community Medicine, All India Institute of Medical Sciences, New Delhi, India
- 6Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
- 7Department of Physiology, University of Calcutta, Kolkata, India
- 8Department of Endocrinology, Agharkar Institute, Pune, India
- 9Amritha Institute of Medical Sciences, Kochi, India
- 10Gandhigram Rural Institute, Gandhigram, Dindigul, India
- 11Pondicherry Science Forum, Pondicherry, India
- 12Department of Science and Technology, Government of India, New Delhi, India
- Correspondence to Dr Rajeev Gupta, Department of Medicine, Fortis Escorts Hospital, JLN Marg, Jaipur 302017, India;
Contributors All authors have contributed significantly to the concept, design and conduct of the study. The authors have also provided critical comments on the manuscript.
- Accepted 18 October 2011
- Published Online First 6 December 2011
Objective The authors studied the influence of migration of husband on cardiovascular risk factors in Asian Indian women.
Methods Population-based studies in women aged 35–70 years were performed in four urban and five rural locations. 4608 (rural 2604 and urban 2004) of the targeted 8000 (57%) were enrolled. Demographic details, lifestyle factors, anthropometry, fasting glucose and cholesterol were measured. Multivariate logistic and quadratic regression was performed to compare influence of migration and its duration on prevalence of risk factors.
Results Details of migration were available in 4573 women (rural 2267, rural–urban migrants 455, urban 1552 and urban–rural migrants 299). Majority were married, and illiteracy was high. Median (interquartile) duration of residence in urban locations among rural–urban migrants was 9 (4–18) years and in rural areas for urban–rural migrants 23 (18–30) years. In rural, rural–urban migrants, urban and urban–rural migrants, age-adjusted prevalence (%) of risk factors was tobacco use 41.9, 22.7, 18.8 and 38.1; sedentary lifestyle 69.7, 82.0, 79.9 and 74.6; high-fat diet 33.3, 54.2, 66.1 and 61.1; overweight 21.3, 42.7, 46.3 and 29.7; large waist 8.5, 38.5, 29.2 and 29.2; hypertension 30.4, 49.4, 47.7 and 38.4; hypercholesterolaemia 14.4, 31.3, 26.6 and 9.1 and diabetes 3.9, 15.8, 14.9 and 8.4, respectively (p<0.001). In rural–urban migrants, there was a significant correlation of duration of migration with waist size, waist-to-hip ratio and systolic blood pressure (quadratic regression, p<0.001). Association of risk factors with migration remained significant, though attenuated, after adjustment for socioeconomic, lifestyle and obesity variables (logistic regression, p<0.01).
Conclusions Compared with rural women, rural–urban migrants and urban have significantly greater cardiometabolic risk factors. Prevalence is lower in urban–rural migrants. There is significant correlation of duration of migration with obesity and blood pressure. Differences are attenuated after adjusting for social and lifestyle variables.
- CHD/coronary heart
- blood pressure
- access to health care
- birth weight
- breast feeding
Funding This work was supported by ad-hoc research grant from Science and Society Division, Department of Science and Technology, Government of India, New Delhi.
Competing interests None.
Patient consent Obtained.
Ethics approval Ethical approval was provided by Institutional Ethics Committee, All India Institute of Medical Sciences, New Delhi, India.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The data have been shared with central coordinating unit to all the investigators interested in specific research questions.