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Background: Cardiovascular disease (CVD) prevalence in urban India has increased 9-fold over the past decade and attributes to nearly 25% of deaths nationwide. It has been shown that diabetes and hypertension are 2 of the greatest risk factors for developing CVD. The goal of this study was to explore factors influencing the likelihood of CVD care follow-up in diabetic and hypertensive patients in a primary care setting in Coimbatore, India. This project evaluated the relationship between CVD knowledge, personal risk perceptions, healthcare barriers and self-reported CVD-related followup care plans. The study was designed to address CVD care limitations and to initiate effective educational programs in India. Methods: A survey instrument was administered to patients attending a primary care center in Coimbatore, India. The participants were Indians greater than 18 years of age, who had a confirmed diagnosis of diabetes and/or hypertension and were not previously diagnosed with CVD. The primary outcome of the study was to investigate the factors contributing to the likelihood of receiving CVD care and the relationships between these predictors. The study was approved by the Kovai Medical Center and Hospital ethics committee and University of Connecticut IRB. After accepting the invitation to participate, participants were read the informed consent form and verbal consent was obtained. Findings: 229 subjects (82 diabetics, 81 hypertensives, 66 both) were analyzed in this study. Patients with DM alone had increased knowledge scores compared to those with HTN alone (19.43 2.5 vs 16.56 3.37, p< 0.05). In those with a single diagnosis, there was a higher risk perception in diabetics (25.8 7.45) than hypertensives (21.2 2.47) p < 0.01. There was also a positive correlation between increasing BMI and risk perception (r1⁄40.169, p < 0.01). There was a positive correlation between CVD knowledge and risk perception (r1⁄40.369, p< 0.001), healthcare barriers and GP follow-up for CVD care (r1⁄4 0.164, p < 0.05) and cardiologist (r1⁄40.229, p< 0.001). Conversely, an inverse correlation between healthcare barriers and cardiologist follow-up was demonstrated (r1⁄4-0.279, p < 0.001). Interpretation: These findings suggest that increased CVD knowledge is associated with greater personal risk perception. Greater risk perception is associated with self-reported intention to receive preventive CVD care. Individuals with greater barriers to healthcare are more likely to follow-up with a GP than a cardiologist. These data suggest a role for primary preventive CVD care and education in primary care settings. Interventions focused on patients with HTN may be particularly effective in this setting. The small sample size and self-reported variables were limitations. This study was funded by the UCHC Student Research Program. Funding: No funding listed. Abstract #: 02NCD001

Impact of CVD knowledge, risk perception, and barriers to healthcare on routine CVD management in Coimbatore, India