Distribution and determinants of coronary artery disease in an urban Pakistani setting.

OBJECTIVE We assessed the distribution of coronary artery disease (CAD) and its association with the major biological risk factors and behaviors among Pakistanis presenting at a tertiary care hospital in Karachi, Pakistan. METHOD An epidemiologic cross-sectional study was conducted at the Aga Khan University Hospital (a teaching hospital) in Karachi, Pakistan. A total of 600 adult (> or =18 years of age) patients visiting family practice clinics for general check-up were included. The association of biological risk factors with CAD (smoking, obesity [body mass index (BMI)], hypertension, family history of ischemic heart diseases [IHD], sedentary lifestyle, diabetes mellitus, total cholesterol, low density lipoprotein [LDL] levels, high density lipoprotein [HDL] levels, and triglycerides) were assessed. RESULTS On univariate analysis, age > or =40 years, early menopause, BMI > or =29.9 kg/m2, diabetes, high cholesterol, and positive family history of IHD were independently associated with CAD. We found age > or =40 years, diabetes, and positive family history of IHD strongly related with CAD on multivariate analysis. CONCLUSION Looking at the strong association of major risk factors with CAD, the unique characteristics of Pakistanis must be studied in depth, with focus on high-risk groups.