Coronary Artery Disease Risk Factors among Females in a Tertiary Cardiac Center in Nepal: A Case Control Study

Background: Although in recent decades risk factors of Coronary Artery Disease (CAD) have markedly increased, little is known about its relationship among Asian females. The principal aim of the study is to determine the prevalence of CAD risk factors among a target female population in Nepal.
Methods: A case control study was conducted at tertiary cardiac centre of Kathmandu from August 2013 to September 2014. Study participants identified with CAD (n=52) were matched for age with controls (n=52). Anthropometric and laboratory data were collected and a semi-structured interview was utilized to obtain information on socio-demographic, behavioural, psychosocial and physiological/biochemical risk factors. Variables were assessed using frequency tables and Pearson’s Chi-Square tests for two independent proportions. Binary logistic regression was used to investigate the potential predictors of CAD.
Results: CAD was significantly associated with ethnicity, ever smoked, harmful use of alcohol, moderate physical activity, more than 12 sitting hours per day, family history, total cholesterol, HDL-C and hypertension. Regression analysis indicated alcohol intake (P<0.01), LDL-C, diabetes (P<0.01), BMI ≥ 27.5 kg/m2 (P<0.01) as
significant predictors of CAD.
Conclusion: Diabetes, drinking alcohol, LDL-C and generalized obesity were found to be significant predictors of CAD. Aside from family history, all associated risk factors within our study population are modifiable risk factors. CAD has been identified as public health priority in Nepal given the current and predicted burden of all forms of heart disease within the country. Further research in women in developing countries will be key, given the rising levels of risk factors and morbidity rates within the region.