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Cardiovascular diseases including coronary heart disease, stroke, and hypertension are the leading causes of morbidity and mortality in both developed and developing countries. Elevated blood pressure (BP) has been linked to ischemic heart disease, peripheral vascular diseases, stroke, myocardial infarction, and renal failure. Individuals with hypertension possess twofold higher risk of developing coronary artery disease (CAD) and four times higher risk of congestive heart failure compared with normotensive subjects. The ‘‘Global Burden of Disease Study’’ has projected CAD and cerebrovascular disease as the leading causes of death worldwide by the year 2020. Medications for Hypertension treatment watch in Canadian Health Mall Pharmacy online.
Hypertension is one of the major global risks factors, and its prevalence is rapidly increasing worldwide. Hypertension has been reported to be responsible for 57% of all stroke deaths and 24% of all cardiovascular deaths in East Asia. In addition, there is an increasing prevalence of hypertension in the Indian population, especially in the urban areas.
This global risk factor affects all populations of the world including the special occupational group, the policemen. Police work has been regarded as one of the stressful occupation in the world.
The physical threats in police operational duties have been regarded as inherent causes of stress in police work, but organizational factors such as work overload, time pressure, inadequate resources, manpower shortage, and lack of support and consultation and commu- nication with the higher authorities in the organization have also been identified as the potential factors responsible for the stress in the policemen.To relieve from this occupational stress, the policemen tend to stick to unhealthy habits such as smoking, consumption of alcohol and smokeless tobacco, and irregular dietary pattern, and they are not habituated in leisure time physical activity. As a result, they face many adverse effects pertaining to these habits.
Various studies have reported significantly high prevalence of stress-related disorders such as hypertension, diabetes, and cardiovascular diseases among the policemen. In a study, coronary heart disease has been identified as a major cause of mortality in this population.
A number of important contributory factors for hypertension have been identified, which include overweight/obesity, excessive dietary sodium intake, low physical activity, smoking tobacco and smokeless tobacco consumption, high alcohol intake, and family history of hypertension. Furthermore, there exist several studies that not only identified the anthropometric and other risk factors of hypertension but also determined the cutoff values of those anthropometric parameters. Unfortunately, the cutoff values of the latter parameters from the police population are lacking till date.
As not many studies has been carried out with the police professionals of Kolkata, West Bengal, India, this cross-sectional survey-based study was aimed to provide the baseline information on prevalence of hypertension among policemen, if any, and to identify the associated risk factors for hypertension in this population. Determination of the relation- ship between different anthropometric indicators and BP levels among the policemen is also an additional objective of this investigation. Moreover, the cutoff values of those indicators have also been determined for the first time in this study.
This cross-sectional survey-based study was conducted in 2013 among randomly selected 916 healthy men (policemen = 507, civilian = 409) from central Kolkata, with age ranged 20–60 years. Of these, 4.36% subjects (n = 40) were excluded because of presence of either physical disability or based on medical history such as any major surgery, pacemaker insertion, and cerebral or cardiac stroke. Finally, 876 subjects participated in this study.
Policemen of different designation were included after obtaining necessary permission from Ministry of Home Affairs, Government of West Bengal, India. The civilian group was composed of persons residing at and around central Kolkata and engaged in various occupations other than police department. A self-structured questionnaire was designed for the purpose of data collection, which included all the details about age, sex, caste, religion, occupation, education, record- ing of anthropometric parameters, medical history of hyperten- sion, food habits, smoking and alcohol consumption status, and history of regular physical activity. Subjects were requested to make an appointment, and measurements were made at their respective working place during their free time.
This noninvasive study was approved by the ‘‘Institutional Ethics Committee for Biomedical Research involving Human Subjects, Rammohan College,’’ constituted in accordance to the guidelines framed by Indian Council of Medical Research. Written consent was obtained from each participant to act as volunteers in the study without any support in terms of cash or kind.
The BP was measured using standard mercury manometer (Life Line, Kolkata, West Bengal, India) and stethoscope (Duo Sonic, Kolkata, West Bengal, India) by auscultatory method. At least two readings at 5-min interval were recorded, and if a high BP (X140/90 mm Hg) was noted, a third reading was taken after 30 min. The lowest of the three readings was taken as BP. Resting pulse rate was measured from the radial artery for 1 min with the help of stopwatch (Racer, Coimbatore, Tamil Nadu, India). A person was considered as suffering from hypertension if systolic blood pressure (SBP) was 140 mm Hg or above and/or diastolic blood pressure (DBP) 90 mm Hg and above or is already under treatment for hypertension. Facebook HealthCare Canadian – try now.
Height and weight of the individuals were measured to the nearest 0.1 cm and 0.1 kg by an anthropometric rod and portable weighing machine (Advanced Technocracy, Ambala City, Haryana, India), respectively, with the subjects standing barefoot and in light clothing.
The body mass index (BMI) was calculated as weight in kilograms divided by squared height in meters. BMI 4 23.0 and 425.0 kg/m2 was taken as cutoff value for overweight and obesity, respectively. The waist circumference (WC) was measured at the midpoint between the inferior border of the subcostal margin and iliac crest in the midaxillary line after normal expiration in standing posture; the hip circumference (HC) was measured at the widest part of the hip across both greater trochanters, from which the waist-to-hip circumference ratio (WHR) was calculated according to the WHO guidelines. Truncal obesity was diagnosed when WHR was 40.90 and abdominal obesity, when WC was 490 cm in men.
For the study, subjects who have smoked regularly and smoked at least one cigarette on an average each day during previous 30 days were defined as the current smokers. Smokeless tobacco consumption is defined as any form of tobacco consumed orally and not smoked. Subjects currently consuming alcohol or left this habit for last 6 months were considered as alcoholics. Physical activity was measured by asking about both work-related and leisure-time activities. Leisure-time physical activity for 430 min a day and for at least 3 days in a week was considered as regular. Information regarding dietary habits, that is, whether meals taken at proper intervals or not was also noted.
