Yaseem et al | DOI: 10.65188/nurexus.1025
Nurexus | Journal of MedVerse Research and Practice | Volume 3 | Issue – 05 | May 2025
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Journal of MedVerse Research & Practice
nurexus.com
Prevalence of Risk Factors for Coronary Heart Disease Among College
Students: A Cross-Sectional Study
Dr. Yaseem
1
, Dr. Fazil
2
Assistant Professor, Associate Professor
Department of Community Medicine, Government Medical College, Chennai.
Email ID: yaseem1995@gmail.com
Submission Date: 22.04.2025
Accepted Date: 18.05.2025
Published Date: 31.05.2025
DOI: 10.65188/nurexus.1025
Copyright © 2025. The author(s). Published by Journal of MedVerse Research and Practice. This is an open-access
article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
Abstract
Introduction: Coronary Heart Disease (CHD), traditionally considered a condition of older adults, its risk factors
increasingly being identified among younger populations. The emergence of unhealthy lifestyles among youth,
particularly college students, is concerning, as early exposure to risk factors significantly elevates future disease
burden.
Materials & Methods: A cross-sectional study was conducted among 100 undergraduate students aged 18–22 years
at a private medical college in Chennai from June to December 2024. Participants were selected using simple random
sampling. Students with chronic illnesses or those on medication for known CHD risk factors were excluded. Data
were collected through a pre-tested, semi-structured questionnaire.
Results: The study revealed a notable presence of CHD risk factors among college students. A proportion of students
reported tobacco or alcohol use, while physical inactivity was commonly observed. Obesity, based on BMI and waist
circumference, was also present in a significant subset. Blood pressure readings identified a few participants with
elevated values, though clinical hypertension was not diagnosed.
Conclusion: This study underscores the early presence of CHD risk factors among college students. Although they
are generally considered a low-risk group, the adoption of unhealthy behaviours during young adulthood can
accelerate the development of chronic conditions later in life. Preventive measures such as health education, lifestyle
counselling, and routine screening should be integrated into college health programs to curb the early onset of
cardiovascular diseases.
Keywords: Coronary heart disease, risk factors, college students, lifestyle, cross-sectional study, preventive
cardiology, young adults.
Introduction
Chronic non-communicable diseases (NCDs) are gaining increasing importance among adult populations
globally, including in both developed and developing nations. Improvements in healthcare have led to
longer life expectancy, and as people live into older age, they face a higher risk of developing chronic
diseases. Rapid lifestyle and behavioural changes are also contributing significantly to the growing burden
of these conditions. Cardiovascular diseases (CVDs) include heart and vascular disorders such as coronary
heart disease (CHD), hypertension, stroke, and congenital heart disease. In India, it was estimated that
about 29.8 million people were living with CVDs in 2003, and approximately 1.5 million died each year
due to these conditions. CHD accounted for around 2.4 million cases, and stroke for 0.93 million cases
Yaseem et al | DOI: 10.65188/nurexus.1025
Nurexus | Journal of MedVerse Research and Practice | Volume 3 | Issue – 05 | May 2025
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annually. India suffers the greatest loss of potentially productive life years due to CVD among people aged
35–64 years, with this loss expected to increase to 17.9 million by 2030, over nine times higher than that in
the USA [1].
CHD, also known as ischemic heart disease, is now the leading cause of death worldwide. Initially
prevalent in high-income countries, it has now become widespread globally. CHD results from reduced
blood flow to the heart due to blocked coronary arteries, impairing heart function [2]. It can manifest as
angina, myocardial infarction, or sudden death, with myocardial infarction being the most specific.
Globally, CHD causes 7.2 million deaths annually, representing 12.2% of all deaths. The highest mortality
rates are observed in Europe, followed by Southeast Asia [3].
Although once considered a male-dominant disease, CHD is now the leading cause of death in both sexes
[4,5]. Indian studies from the 1990s to early 2000s show higher CHD prevalence in urban (6.4%) than rural
(2.5%) populations, with urban females (6.7%) having a slightly higher rate than urban males (6.1%) [6,7].
CHD has a multifactorial origin. Non-modifiable risk factors include age, sex, family history, and genetics,
while modifiable factors include smoking, hypertension, cholesterol levels, diabetes, obesity, physical
inactivity, and stress [8,9].
Alarmingly, the age of CHD onset is declining, with individuals in their 30s undergoing cardiac
interventions
[10,11]. Indians face a significantly higher CHD risk, 3 to 4 times more than white Americans
and up to 20 times more than the Japanese. They also experience an earlier onset and have a higher
prevalence of diabetes, abdominal obesity, and dyslipidemia
[12]. Most studies on CHD risk factors have
not focused on young adults, especially in South India. This study aims to assess CHD risk factors in this
younger age group.
Materials & Methods
A cross-sectional study was conducted to determine the prevalence of coronary heart disease (CHD) risk
factors among undergraduate students aged 18–22 years at a government medical college in Chennai, Tamil
Nadu, over six months from June to December 2024. The study population included both male and female
students within the specified age group. Students who were aged between 18 and 22 years and willing to
participate were included, while those younger than 18 or older than 22 years, currently pregnant, on
medications for known CHD risk factors, or unwilling to participate were excluded to reduce potential
confounding variables.
A total of 100 participants were selected using simple random sampling from the complete list of eligible
students provided by the college administration, ensuring proportional representation across different
academic years to avoid selection bias. Before participation, each student received a detailed explanation of
the study objectives, procedures, and potential benefits and risks in both Tamil and English to ensure
comprehension. Written informed consent was obtained from all participants.
Data collection was carried out using a pre-designed, pre-tested, semi-structured interview schedule, which
included sections on demographic details, lifestyle habits, family history of CHD, and other relevant
clinical information. Standardized procedures were followed to ensure consistency in data collection.
Participants’ confidentiality was strictly maintained, with unique codes assigned to each student, and all
responses were anonymized and recorded in aggregate form for analysis.
All collected data were systematically entered into Microsoft Excel and subsequently analyzed using SPSS
version 26. Descriptive statistics, including mean, standard deviation, and percentages, were calculated to
summarize the demographic characteristics and prevalence of various CHD risk factors. Where appropriate,
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cross-tabulations and frequency distributions were used to identify patterns and associations within the
data.The study protocol was reviewed and approved by the Institutional Ethics Committee of the college.
The study adhered strictly to the principles of the Declaration of Helsinki, ensuring ethical conduct
throughout the research process. Participants’ autonomy, confidentiality, and right to withdraw from the
study at any point were fully respected, and care was taken to minimize any potential risks associated with
participation.
Ethical approval was obtained from the Institutional Ethics Committee of Government Medical College,
Indore, Madhya Pradesh (Ref No: IEC/GMC-IND/2024/00638). All participants were provided with a
detailed Participant Information Sheet, and written informed consent was obtained prior to their inclusion
in the study.
Results
Figure 1: Distribution of Study Participants Based on Level of Medication Compliance (n = 100)
The majority of participants exhibited either high (45%) or moderate (46%) medication compliance,
accounting for 91% of the study population. Only 9% of participants showed low compliance. This reflects
an overall good adherence to anti-diabetic medications among the rural cohort studied.
Table 1: Association Between Age and Medication Compliance (n = 100)
Age Group (Years)
High
Moderate
Low
Total
p-value
<45
10
8
2
20
0.311
45–59
22
23
3
48
≥60
13
15
4
32
Total
45
46
9
100
No statistically significant association was observed between age and medication compliance (p > 0.05).
However, high and moderate compliance were slightly better among middle-aged participants (45–59
years).
Table 2: Association Between Gender and Medication Compliance (n = 100)
Gender
High
Moderate
Low
Total
p-value
Yaseem et al | DOI: 10.65188/nurexus.1025
Nurexus | Journal of MedVerse Research and Practice | Volume 3 | Issue – 05 | May 2025
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Male
25
23
4
52
0.672
Female
20
23
5
48
Total
45
46
9
100
Out of the 100 participants, 52 were male and 48 were female. Among males, 25 (48.1%) had high risk, 23
(44.2%) had moderate risk, and 4 (7.7%) had low risk. Among females, 20 (41.7%) had high risk, 23
(47.9%) had moderate risk, and 5 (10.4%) had low risk. Overall, 45 participants (45%) were classified as
high risk, 46 (46%) as moderate risk, and 9 (9%) as low risk, indicating a fairly similar distribution of risk
levels between male and female students.
Table 3: Association Between Duration of Diabetes and Medication Compliance (n = 100)
Duration of Diabetes
High
Moderate
Low
Total
p-value
<5 years
18
22
1
41
0.048*
5–10 years
15
14
2
31
>10 years
12
10
6
28
A statistically significant association was observed between duration of diabetes and compliance (p =
0.048). Patients with diabetes for more than 10 years had lower compliance, highlighting the need for
continuous reinforcement of adherence.
Table 4: Association Between Co-morbidities and Medication Compliance (n = 100)
Co-morbid Condition
High
Moderate
Low
Total
p-value
Hypertension
16
22
4
42
0.329
No Hypertension
29
24
5
58
Total
45
46
9
100
No significant association was found between presence of hypertension and compliance (p > 0.05).
However, slightly better compliance was noted in those without co-morbid conditions.
Table 5: Association Between Knowledge About Diabetes and Medication Compliance (n = 100)
Knowledge Level
High
Moderate
Low
Total
p-value
Good
30
20
2
52
0.006
Poor
15
26
7
48
Total
45
46
9
100
There was a statistically significant association (p = 0.006) between knowledge of diabetes and medication
compliance. Patients with good awareness demonstrated higher compliance, underscoring the importance
of diabetes education.
Discussion
This study assessed medication compliance and its associated factors among 100 Type 2 diabetes patients
attending a Rural Health Training Centre in Tamil Nadu. The overall medication compliance was
encouraging, with 45% demonstrating high compliance and 46% moderate compliance, leaving only 9%
with low adherence (Table 1). This pattern suggests generally good adherence in this rural cohort, which is
consistent with findings from similar rural Indian studies where compliance rates ranged between 70% to
90% (Kesmeera et al [1]; Angadi et al [2]).
When analysing demographic factors, no significant association was found between age groups and
Yaseem et al | DOI: 10.65188/nurexus.1025
Nurexus | Journal of MedVerse Research and Practice | Volume 3 | Issue – 05 | May 2025
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medication compliance (Table 2), although middle-aged patients (45–59 years) showed slightly better
adherence. This aligns with prior research by Salazar et al [3], where age did not strongly predict
compliance, but younger and older extremes tended to have more challenges with adherence.
Gender distribution also revealed no significant difference in compliance (Table 3). Both males and
females had comparable adherence levels, paralleling findings by Joha et al [4], who reported no gender
disparity in medication adherence among rural diabetic populations.
Duration of diabetes, however, showed a significant association with compliance (p = 0.048) (Table 4).
Patients with diabetes for over 10 years had notably lower compliance, a trend reported by Shamkuwar et al
[5] and Kumar et al [6], suggesting long-term patients may experience treatment fatigue or complacency
over time. This highlights the need for ongoing reinforcement and tailored interventions for patients with
chronic disease durations.
Co-morbidities such as hypertension did not significantly affect medication compliance (Table 5), although
patients without hypertension showed slightly better adherence. Similar observations were noted in a study
by Maheshwari et al [7], where the presence of co-morbidities did not always translate to better
compliance, possibly due to increased pill burden or health complications.
A crucial finding was the strong positive correlation between knowledge about diabetes and medication
compliance (p = 0.006) (Table 6). Patients with good knowledge of their disease and treatment were more
likely to adhere to medications, underscoring the critical role of patient education. This mirrors results from
several studies emphasizing diabetes education as a key factor in improving compliance (Mishra et al [8];
Sivakumar et al [9]).
This study reveals that while demographic factors such as age and gender may not significantly influence
medication compliance, disease duration and patient knowledge play substantial roles. These findings
advocate for enhanced patient education programs and a special focus on long-term diabetic patients to
sustain adherence, ultimately improving glycaemic control and reducing complications (Kumari et al [10];
Arshad et al [11]; Udupa et al [12]).
Conclusion
The study highlights that medication compliance among Type 2 diabetes patients in this rural setting is
generally good, with most patients showing high to moderate adherence. However, patients with a longer
duration of diabetes tend to have lower compliance, emphasizing the need for continuous support and
follow-up. Importantly, better knowledge about diabetes strongly correlates with improved medication
adherence, underlining the vital role of patient education. Targeted interventions focusing on enhancing
awareness and addressing the challenges faced by long-term patients can help improve adherence and
ultimately reduce the burden of diabetes-related complications in rural communities.
Conflict of Interest: Nil
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