Abstract               Background: CVD’s (Cardiovascular diseases) are the number 1 cause of death globally: more people die annually from CVD’s than from any other cause. Over three quarters of CVD deaths take place in low- and middle-income countries. Most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol using population-wide strategies. Police personnel as per their duty schedule more prone these risk factors. Objective: The present study was done to assess cardiovascular risk factors among police personnel. Materials and Methods: A cross sectional study was conducted among 98 police personnel by taking Health Camp At Police Station. Data were collected for various risk factor associated with Cardiovascular Disease by using the structured questionnaire and risk asses by taking ECG (Electrocardiogram) and General Examination. Data was analyzed using the chi-square test. Results: Total 17(18.48%) Police Personnel were at High risk of Cardiovascular Disease as per their ECG changes. The prevalence of cardiovascular risk factors were high body mass index 52.2%, hypertension 40.2%, diabetes 18.5%, tobacco use 40.2%, smoking 2.2%, and alcohol use 15.2%. Of the total Hypertensive 56% participants were previously known to have had hypertension while Among the Diabetic 70% were previously known their status. Conclusions: Most of these risk factor are for cardiovascular disease are modifiable with timely intervention and regular health check up. With life style modification we can prevent on larger extent hence routine screening health camp needed as one of the intervention.

Key Words: cardiovascular risk factor.

INTRODUCTION

CVD’s (cardiovascular diseases) are the number 1 cause of death globally: more people die annually from CVD’s than from any other cause. At least three quarters of the world's deaths from CVDs occur in low- and middle-income countries.¹ In terms of attributable deaths, the leading CVD risk factor is raised blood pressure (to which 13 per cent of global deaths is attributed), followed by tobacco use (9 per cent), raised blood glucose (6 per cent), physical inactivity (6 per cent) and overweight and obesity (5 per cent).The majority of cardiovascular disease (CVD) is caused by risk factors that can be controlled, treated or modified, such as high blood pressure, cholesterol, overweight/obesity, tobacco use, lack of physical activity and diabetes. However, there are also some major CVD risk factors that cannot be controlled.² With the epidemiologic transition, the CVD burden continues to rise in developing countries including India.³ Appropriate assessment and management of cardiovascular risk is vital to prevent fatal and non-fatal heart attacks and strokes and to improve health outcomes in individuals at high risk of cardiovascular events.⁴ (Jayalakshmy Ramakrishnan) Police Profession working pattern are Hectic and due to irregularity of Duty Schedule they get less time for proper Health attention. Police personnel constitute a special occupational group with exposure to cases of violence and stress at work, which directly and indirectly affects their health. A cohort study on Helsinki policemen found coronary heart disease as a major cause of mortality among policemen. Obesity, dietary factors, smoking, alcohol use, exposure to stress at work and lack of physical activity were important factors associated with cardiovascular disease.⁵ (Ganesh KS) Most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol using population-wide strategies. As number of study documented that all these risk factor more commonly associate with personnel of police department as compared to general population. Considering this vulnerable group hence study decided to conduct among police personnel.

MATERIALS AND METHODS

A cross sectional study was conducted in Health camp organized at Police station with prior permission from the superintendent of police of Ambajogai circle and Institutional Ethical Committee. The Ambajogai police division caters to the municipality area and the adjoining villages with a total population of about 1.5 lac. All the police personnel were taken as the study population. However, the division has total 120 police personnel out of these 98 personnel were present at time of study. The predesigned, pre-tested and semi-structured questionnaire for data collection was prepared. The questionnaire included details about socio-demographic characteristics, anthropometric and biochemical parameters, medical history, brief dietary details, regular physical exercise, smoking and alcohol habits. Written informed consent was taken from the police personnel. The officers were questioned about past history of ever consuming alcohol or smoking. Health status was assessed by conducting appropriate anthropometrical, clinical and laboratory examination of each subject. ‘Regular physical exercise’ was defined as regular recreational physical activity other than occupational, carried out for greater than 30 min on at least 5 days a week otherwise labeled as Physical Inactive.

Data collection: Anthropometric measurements Standing body height was measured with a commercial stadiometer in cm (to the nearest 0.5 cm). A digital scale, with an accuracy of ±100 g, was used to measure body weight and was recorded in kg. Waist circumference was measured in a horizontal plane, midway between the inferior margin of the ribs and the superior border of the iliac crest, using a standard inelastic measuring tape. Measurements were taken thrice and the mean was taken in all cases. All instruments used for measurement were calibrated twice weekly. Body mass index (BMI) (kg/m2) was calculated by dividing weight (in kg) by the square of height (in m). Systolic and diastolic blood pressures were measured using a standard sphygmomanometer with adult cuffs and recorded in mmHg. The measurements were repeated twice at an interval of 3 min in the sitting position and the mean was taken. Random blood sugar was conducted by using Glucometer by pricking on left ring finger after taking the blood sample in the early hours of morning before joining their duty. Standard supine 12-lead ECG data were collected; all amplitude and intervals were measured and finding of ECG categorized into Normal And Abnormal as per ECG changes observed. ECG done by ECG technician and evaluated by Physician. Statistical analysis was performed using the MS-Excel and applying chi square test. Unanimous questionnaires were given to the Police personnel of stations. Completed anonymous questionnaires were collected in sealed covers Box. Each questionnaire was sealed in a cover to maintain confidentiality. After survey, all policemen who had problems were requested to attend Health camps. These cases were examined and verified by a team of doctors and psychological counselors.

Statistical Analysis

Statistical analysis was performed using the MS Excel 2010 for Windows 8. Mean and standard deviations were derived for numerical data. Prevalences are reported in percentages. Significance level was defined as P < 0.05.

RESULTS

Out of total 92 police personnel 84 (91.3%) were males and 8(8.7%) were females. Majority (41%) were between 40-50 years. The age of the study population ranged from 22 to 58 years. The mean age of study population were 41.08.Their Average year of spending in service had.17.6 (+ 9.1).Mean Calculated BMI of Police personnel was 25.6 (+4.25) For other variable Mean with Standard Deviation (SD) shown in Table 1.

Table 1: General characteristics of the study population

BMI: Body mass index; DBP: Diastolic blood pressure; SBP: Systolic blood pressure

Tobacco chewing 40.2% was the most common form of addiction, followed by alcohol 15.2% in study subjects. It was observed that 43% of subjects were overweight and 9.2% were obese (according to their BMI). The study revealed that 13% of study subjects were hypertensive. Among the persons who were obese (BMI >25), 21% were hypertensive and among normal/thin (BMI <25), 5% were hypertensive and this difference of BMI and hypertension was significant.

Table 2: Comparison of various cardiovascular risk factors in the groups with Normal ECG and ECG Changes along with the total study population

ECG Changes (70.6%) were significantly associated among personnel with High BMI (>25) and Physically Inactive followed by Personnel having Hypertension (58.8%) as shown in Table 2.

DISCUSSION

The present study revealed a high prevalence of CVD risk factors especially Physical Inactive 65.2%, high BMI52.2%, Tobacco use 40.2% along with Non veg diet 72.8% (even though not significantly associated with ECG changes p>0.05). However the prevalence of hypertension (13%) and diabetes (18.5%) were low compared to other studies conducted among police in India.⁶ This difference may be due to the fact that the study was conducted in a rural area. In this study we find out most of ECG changes observed among police personnel those are physically inactive, High BMI(>25) and who were hypertensive similar finding also seen in other studies conducted at various place in India among police in Kerala⁷ and in Chennai.⁸ However the prevalence of hypertension (13%) compared to other studies 30.5% by Ramakrishnan et al,⁹ 58.5% by Shabana et al,¹⁰ 30.5% by Jayalakshy,¹¹ 46.3 by Rajnish Joshi,¹² 34.5% by Ganesh¹³ and 37.7% by Jayakrishan⁷ were low while the prevalence of diabetes (18.5%) compared to other 30.5% by Ramakrishnan et al,⁹ 32.1% by Shabana et al¹⁰and 23% by Jayalakshy¹¹ were low may be due to the fact that the some study were conducted among a general population where as present study conducted in police personnel in rural area other reason may be different in defining level of Hypertensive and Diabetic scale. However 4.9% by Rajnish Joshi¹² and 7% by Jayakrishan⁷ reported low prevalence of hypertension it may be due to more younger population in these study. The High BMI in this study was (52.2%) low as compared to study done in Puducherry s⁹ (75.8%).,  Chennai s⁸ (62.9%) and Kerala⁷ (66%). A waist circumference (>85 cm) of police personell (11.5%) low comapared to 71.5% and 65.1% reported by Ramakrishnan et al⁹ and Shabana et al¹⁰ respectively. Prevalence of smoking (2.2%) and alcohol consumption (15.2%) in this study was low as compared to Meshram FA¹² et al and Tharkar S¹⁰ et al studies on Indian policemen.^12,14 it may be due to reporting bias.

CONCLUSION

Most of studies focused on General population in past taking consideration of police as this occupational group most of the time in their duty schedule under stress and many of factor associated with this profession in which they can easily succumb to risk factor for cardiovascular disease. As this profession are engaged in protecting society and many time they play role model for general population so attention to their health necessary in order make healthy and secure force. From our study it noted that even if most of cardiovascular risk factor are preventable there should be timely intervention to halt their progress and make awareness of risk factor among them by giving health education about life style changes and arranging more and more screening programmed for this police personnel in future.

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