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.