International Journal of Trend in Scientific Research and Development (IJTSRD)

Volume 7 Issue 4, July-August 2023 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470

A Comparative Study to Assess the Knowledge of the Risk

Factors and Identify Risk for Coronary Vascular Diseases
(CVD) among Students Studying in Selected High Schools
of Urban and Rural Areas of Gwalior
Mr. Gagan Raj, Mr. Farukh Khan
Department of Community Health Nursing, The Academy of Nursing Sciences, Gwalior, Madhya Pradesh, India

ABSTRACT How to cite this paper: Mr. Gagan Raj |

The present study has been conducted to know assess the knowledge Mr. Farukh Khan "A Comparative Study
of the risk factors and identify risk for coronary vascular diseases to Assess the Knowledge of the Risk
(CVD) among students studying in selected high schools of urban Factors and Identify Risk for Coronary
Vascular Diseases (CVD) among
and rural areas of Gwalior. The selection of sample was done through
Students Studying in Selected High
convenient sampling. The sample size was 300. The method of data
Schools of Urban and Rural Areas of
collection was through demographic variables and self-structured Gwalior" Published
knowledge questionnaire, compersion regarding risk for coronary in International
vascular diseases (CVD) studying in selected high schools students. Journal of Trend in
Scientific Research
KEYWORDS: knowledge, Comperative Study, Effectiveness, coronary and Development
vascular disease (ijtsrd), ISSN:
2456-6470, IJTSRD58615
Volume-7 | Issue-4,
August 2023, pp.69-80, URL:
www.ijtsrd.com/papers/ijtsrd58615.pdf

Copyright © 2023 by author (s) and

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INTRODUCTION
Coronary vascular disease (CVD) is responsible for of the risks and to promote preventive measures. The
about thirty percent of all death worldwide each year. risk factors can be categorized as non-modifiable and
In India at the onset of 21st century CVD accounts for modifiable. Unmodifiable factors are age, gender,
nearly fifty percent of all deaths. It was noticed that ethnicity and genetic inheritance. Modifiable risk
there was a steady increase of heart disease from factors include elevated serum lipids, hypertension,
1940 and 1967. So the World Health Organization smoking, obesity, physical inactivity and stress.
concluded that heart disease is the world’s most The data on risk factors obtained from several
serious epidemic.
research studies reveals that, the risk factors are
Coronary vascular disease is a type of blood vessel positively related to an increased incidence of CVD.
disorder that is included in the general category of Studies have also shown that the risk factors often
atherosclerosis. Many risk factors have been have their roots in childhood. Findings from the
associated with the CVD. Risk factor means ‘any trait Bogalusa study indicated that the pathological
or habit that can predict an individual’s probability of evidence for atherosclerosis in the aorta and coronary
development of a particular disease.’ The more risk arteries begin in the early childhood. A 30-year study
factors you have the greater chance you have of conducted in Framingham on 5,127 people between
developing CVD. Knowledge on risk factors of 30 and 60 years showed no signs of heart diseases.
coronary vascular disease will increase the awareness Every two years the participants underwent a

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complete physical examination. At the end of the Certain modifiable risk factors for CVD have their
study it provided priceless profile information for beginnings in childhood. The incidence of adolescent
predicting heart disease3. obesity is dramatically increased and it is associated
Risk factors in children are many, because, the risk with the risk of hypertension, adverse lipid profile
behaviours are first established in childhood. The and type II diabetes mellitus. Children who are at risk
major risk factors of heart disease are for obesity related cardio vascular diseases should
hypercholestrolemia, obesity, sedentary lifestyle, receive family based treatment. Nurses are
hypertension and smoking. Off springs of parent with responsible to help in primary care settings for diet
coronary heart disease have a significant increase in modification and exercis.
risk factors. National Cholesterol Educational NEED OF THE STUDY:
Programme stated that high intake of saturated fatty Cardiovascular diseases (CVD) comprise a group of
acids increases the level of total serum cholesterol diseases of the heart and vascular system. In India
and low-density lipoprotein (LDL) cholesterol. there are over 5 million persons suffering from CVD.
Elevated serum cholesterol increases the risk of CVD. The prevalence of CVD is reported to be two to three
Most cases of hypercholestrolemia are a result of times higher in the urban population. The aetiology of
environmental factors. Childhood levels of total CVD is multifactorial. Several risk factors are
cholesterol and LDL are good predictors of adult identified for developing CVD. The greater the
level. number of risks factors present, the more likely one is
to develop CVD. A novel approach to primary
Hypertension is diagnosed when average systolic or
prevention of CVD is primordial prevention. Since
diastolic blood pressure greater than or equal to the
95th percentile to the patient’s age and sex. the aetiology is multifactorial the prevention should
Hypertension disrupts the permeability of the arterial be aimed at controlling or modifying as many risk
wall and contributes to the increased lipid deposition. factors as possible. Cardiovascular diseases remain a
This causes arterial stenosis and reduces the flow of major cause of mortality, morbidity and disability. As
blood. a result therapeutic and preventive measures are taken
to control CVD/CHD. Primary prevention of all
The third major risk factor in CVD is cigarette major risk factors starts early in the lifetime.
smoking. The risk is proportional to the number of Prospective population based research studies reveal
cigarettes smoked. Nicotine in cigarette smoke causes that lower age specific CVD and total mortality rates
catecholamine release. These hormones cause increases life expectancy.
increased heart rates, peripheral vasoconstriction and
increased blood pressure. Nicotine also causes A case control study was conducted in Karachi to
increased platelet adhesion. investigate the risk factors of premature myocardial
infarction among South Asians between the age group
Fast foods are fast killers. These foods do not contain of 15 to 45. A standard questionnaire was developed
enough vitamins. Junk food usually refers to foods and anthropometric measurement including height,
with limited nutritional value. They are high in sugar, weight, waist circumference and hip circumference
salt, fat and low or minimal in nutrient content. Fast were obtained. ECG, fasting blood glucose and lipid
food and junk food stalls in India never display their were measured within 24 hours of admission. The
nutritional content and calorific value of foods. result of the study supported that the risk factors like
Nutrient deficiencies streaming from eating junk tobacco use, ghee intake, raised fasting glucose, high
foods, fast foods, readymade foods and precooked cholesterol level, parental history of CVD, low
foods can easily open the doors of illness. income and low level of education are associated with
Physical inactivity is the fourth major modifiable risk premature acute myocardial infarctions.
factor. Physically active people have increased high- The investigator also observed that there is a need to
density lipoprotein (HDL) cholesterol and exercise understand the inter relationship of each risk factor to
enhances the fibrolytic activity. This decreases the CVD. Prevention of the disease is more effective than
risk of clot formation. treating the disease. The development of overweight
Elevated levels of plasma insulin are common in in childhood is linked with increased rates of
adults and are often associated with CVD. Cross hypertension, hyperlipidemia, type II diabetes and
sectional studies both in children and adults have early atherosclerotic lesions. In the near future we
shown that hyperinsulinemia are associated with an may face more epidemic of CVD. Thus the
adverse pattern of cardio vascular risk factors that investigator with self-interest and experience is
include obesity. motivated to assess the knowledge and risk status on
risk factors of CVD. Identification of knowledge on

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risk factors of CVD will help at primary, secondary HYPOTHESIS:
and tertiary level of prevention and to minimize the To achieve the stated objectives the following
CVD risk factors, thereby minimizing the future hypotheses were formulated at 0.05 level of
associated morbidity and mortality. significance.
H1: There will be significant difference in the mean
OBJECTIVES-
knowledge score regarding the risk factors of
Objectives of the study
1. To assess the knowledge of the risk factors of coronary vascular diseases among students
from selected high schools in urban and rural
coronary vascular diseases among students
studying in selected high schools of urban and areas of Gwalior.
H2: There will be significant difference between the
rural areas of Gwalior.
risk of coronary vascular diseases among
2. To identify the risk of coronary vascular diseases students from selected urban and rural areas of
among students studying in selected high schools Gwalior.
of urban and rural areas of Gwalior. H3: There will be a significant correlation between
3. To compare the knowledge of the risk factors of the level of knowledge and the risk of coronary
coronary vascular diseases among students vascular diseases among students from selected
studying in selected high schools of urban and high schools in urban and rural areas of
rural areas of Gwalior. Gwalior.
H4: There will be significant association between
4. To compare the risk and knowledge of the risk the risk and selected factors regarding coronary
factors of coronary vascular diseases among vascular diseases among students of selected
students studying in selected high schools of high schools in urban and rural areas of
urban and rural areas of Gwalior. Gwalior.
OPERATIONAL DEFINITION: H5: There will be an association between risk for
1. Knowledge: In this study, knowledge refers to coronary vascular disease and selected baseline
the correct responses of the students to the characteristics such as age, monthly income,
knowledge questionnaire on risk factors of and family history of heart disease.
coronary vascular diseases. RESEARCH APPROACH
2. Risk factors: Factors in the environment, or A descriptive comparative approach is a research
chemical, psychological, physiological or genetic design that involves comparing and contrasting two
elements that are thought to predispose an or more samples on one or more variables, often at a
individual to the development of a disease19. In single point of time. A descriptive comparative
this study the risk factors refers to obesity, approach has been used to determine the knowledge
physical inactivity, dietary factors, heredity, on risk factors and risk for CVD among students
gender, and habits such as smoking and studying in selected schools of urban and rural areas
alcoholism. of Gwalior.
3. Risk: The term risk refers to the chance of danger RESEARCH DESIGN
to any disease19. In this study risk refers to the A researcher’s overall plan for obtaining answers to
risk factors of CVD such as obesity, physical the research questions for testing the research
inactivity, dietary factors, heredity, gender, habits hypothesis is referred to as the research design18. It
and stress which will help to categories the spells out the basic strategies that the researcher
students as low, moderate and high risk for adopts to develop information that is accurate and
developing CVD as elicited by self-administered interpretable. A comparative survey utilises set
tool to identify risk for CVD. criteria to contrast two or more groups of designated
variables. A descriptive comparative design was used
4. Urban: In this study urban refers to high school in this study. The study was intended to assess the
students studying in the schools which are knowledge on risk factors and identified risk for CVD
situated in the city or town (Gwalior city). among high school students studying in urban and
5. Rural: In my study rural refers to high school rural areas.
students studying in the schools which are RESEARCH SETTING
situated in villages (kedarpur & Veerpur). The setting is where the population is being studied
6. Students: In this study students refer to those and where the study is carried out. The investigator
who are studying in 10th standards in selected had selected four high schools, two from urban areas
high schools in urban and rural areas of Gwalior. and two from rural areas of Gwalior. The high

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schools in urban area were Carmel convent High 3. Students who were willing to participate in the
School and Silver bells high schools while from rural study.
areas were Bhartiyam vidhya niketan High School, 4. Between the age of 14 and 17 years.
kedarpur and Saraswati Shishu Mandir Veerpur. All
Exclusion criteria
the students were studying in 10th standard in English 1. Students diagnosed to have coronary vascular
medium high schools.
diseases.
POPULATION Those students whose parents are in the medical
Population is the aggregate of objects, animate or
profession
inanimate, under study in any statistical investigation.
In this study the population consists of 3255 students RESULTS
studying in selected high schools in urban (2033) and Plan for data analysis
rural areas (1222) of Gwalior Data analysis is the systematic organisation and
synthesis of the research data and the testing of the
SAMPLE SIZE research hypotheses using those data. The data will be
Sampling refers to the process of selecting a portion
entered into a master sheet. Descriptive and
of the population to represent entire population18. For
inferential statistics will be used for data analysis.
the present study 150 students studying in 10th
The data will be analysed as shown below:
standard in urban and rural areas who fulfilled the
sampling criteria were selected. The list of all English Section I: Sample characteristics would be analysed
medium schools in Gwalior was collected. From this, by frequency and percentage.
two high schools from urban and two from rural areas Section II: Comparison of knowledge of risk factors
were selected using convenient sampling method. The of CVD between students studying in urban and rural
population consisted of 150 students from urban areas would be made by mean, standard deviation,
schools and 150 from rural schools (total 300). The mean percentage and unpaired ‘t’ test.
first and second high schools in urban area had two,
divisions whereas all two high schools in rural areas Section III: Comparison of identified risk for CVD
had two divisions each in 10th standard high schools between students studying in urban and rural areas
in rural area respectively. The total numbers of would be made by mean, standard deviation, mean
students (boys + girls) were 154 in schools of urban percentage and unpaired ‘t’ test.
area and 150 in schools of rural area. Out of these Section IV: Correlation between knowledge and
students were selected from each school by lottery identified risk for CVD between students studying in
method. urban and rural areas of Gwalior would be found
CRITERIA FOR SAMPLE SELECTION using Karl-Pearson coefficient of correlation.
Criteria for sample selection Section V: Risk and selected factors of coronary
Inclusion criteria vascular disease among students from urban and rural
The samples were selected with the following areas would be analysed by Karl-Pearson coefficient
predetermined set of criteria: of correlation.
1. Students from English medium high schools.
2. The students who were studying in 10th standard Section VI: Association between risk for coronary
in selected schools of urban and rural areas in vascular disease and selected variables would be
Gwalior. analysed by chi-square test.
Section I: Sample characteristics
Table 1: Frequency and percentage distribution of sample characteristics among students studying in
urban and rural areas
N = 75 + 75 = 150
Urban Rural
Sl. No. Variable
f % f %
1. Age (in years)
14 – 15 65 87 64 85
16 – 17 10 13 11 15
2. Religion
Hindu 60 80 27 36
Muslim 11 15 20 27
Christian 4 5 28 37
Any other - - - -

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3. Occupation of father
Unemployed 2 3 5 7
Labourer/coolie 3 4 26 34
Semi-skilled 17 23 32 43
Technical 16 21 11 15
Professional 37 49 1 1
4. Occupation of mother
Unemployed 51 68 57 76
Labourer/coolie 1 1 5 7
Semi-skilled 8 11 4 5
Technical 6 8 6 8
Professional 9 12 3 4
5. Monthly income (in rupees)
< 3,000 4 5 5 7
3,000 – 4,000 6 8 13 17
4,000 – 5,000 12 16 14 19
> 5,000 53 71 49 57
6. Family pattern
Nuclear family 70 93 63 84
Joint family 5 7 12 16
Extended family - - - -
7. Education of father
Primary 1 1 14 17
SSLC 18 24 16 21
PUC/Diploma 16 21 29 39
Graduate 31 41 15 20
Postgraduate 9 12 1 1
8. Education of mother
Primary 3 4 17 23
SSLC 20 27 18 24
PUC/Diploma 24 32 26 35
Graduate 20 27 13 17
Postgraduate 12 8 1 1
9. Does anyone have heart disease?
Yes 8 11 5 7
No 67 89 70 93
10. Source of health information
Newspaper 16 21 20 27
Magazine 13 17 11 15
Books 18 24 18 24
Television 28 37 26 35
The data presented in Table 1 shows the following:
Age
Majority of the students in urban area (87%) and rural area (85%) were in the age group of 14-15 years.
Religion
Majority of the students studying in urban area (80%) were Hindus whereas in rural areas only 36% were Hindus
and 37% were Christians.
Occupation of father
Nearly half (49%) of the fathers of students studying in urban area were professionals whereas among students
studying in rural area 43% were semi-skilled workers.
Occupation of mother
Most of the mothers of students studying in urban area (68%) and students studying in rural area (76%) were
unemployed.

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Income of the family
Family income of majority of the students studying in urban area (71%) and students studying in rural area
(57%) was above Rs. 5,000.
Family pattern
Majority of the students studying in urban area (93%) and students studying in rural area (84%) belonged to
nuclear families.
Education of father
In the urban area most of the subjects’ fathers were graduates (41%) while in the rural area 39% had studied up
to PUC or were diploma holders.
Education of mother
Many of the mothers of both the students studying in urban area (32%) and rural area (35%) had studied up to
PUC or were diploma holders.
Family history of heart disease
Among the students studying in urban area 11% had family history of heart disease while among the students
studying in rural area it was 7%.
Section II: Comparison of knowledge of risk factors of coronary vascular disease among students studying
in urban and rural areas
This section deals with the analysis of knowledge score.
Table 2: Distribution of knowledge score of students studying in urban and rural areas
N = 75 + 75 = 150
Urban Rural
Knowledge level Range
f % f %
Average 8-10 0 0 7 9
Good 11-13 47 63 68 91
Very good 14-16 28 37 0 0
Maximum score = 16
The data presented in Table 2 shows that majority of the subjects from the urban area (63%) and 91% from rural
area had good knowledge score between the range of 11-13 and 37% students from urban area had very good
knowledge score between the range of 14-16.
Table 3: Area-wise mean, mean percentage and standard deviation of knowledge score of students
studying in urban areas
N = 75
Area Max. score Mean Mean % SD Remarks
Meaning 2 1.420 71.0 0.573 Good
Risk factors 2 1.650 82.5 0.557 Very good
Causes 8 6.680 85.0 0.974 Very good
Symptoms 1 0.830 83.0 0.327 Very good
Prevention 3 2.560 85.0 0.499 Very good
Maximum score = 16
The data in Table 3 shows that the subjects had very good knowledge score in the areas of “meaning” (71.0%),
“risk factors” (82.5%), “causes” (85.0%), “symptoms” (83.0%) and “prevention” (85.0%).
Table 4: Area-wise mean, mean percentage, and standard deviation of knowledge score of students
studying in rural areas
N = 75
Area Max. score Mean Mean % SD Remarks
Meaning 2 1.386 69.30 0.634 Good
Risk factors 2 1.480 74.00 0.577 Good
Causes 8 5.880 73.50 0.715 Good
Symptoms 1 0.693 69.30 0.464 Good
Prevention 3 2.173 72.43 0.554 Good
Maximum score = 16

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The data in Table 4 and Figure 5 shows that the subjects had good knowledge score in the areas of “meaning”
(69.3%), “risk factors” (74%), “causes” (73.5%), “symptoms” (69.3%) and “prevention” (72.43%).
Table 5: Mean, standard deviation, mean difference and ‘t’ value of knowledge of risk factors of
coronary vascular disease among students studying in urban and rural areas
N = 75 + 75 = 150
Group Mean SD Mean difference ‘t’ value
Urban 13.146 0.818 10.292
1.526
Rural 11.620 0.818 Significant
tα 1.960 (P < 0.05)
The unpaired ‘t’ test value as presented in Table 5 shows that there is significant difference between knowledge
of risk factors of CVD among students in urban and rural areas (t148 = 10.292, P < 0.05). Hence the alternate
hypothesis is accepted.
Table 6: Area-wise mean, standard deviation and‘t’ value of knowledge of risk factors of coronary
vascular disease among students studying in urban and rural areas
N = 75 + 75 = 150
Urban Rural
Variable ‘t’ value
Mean SD Mean SD
Meaning 1.42 0.57 1.38 0.63 0.405
Causes 1.66 0.55 1.46 0.57 5.729*
Risk factors 6.58 0.97 5.88 0.71 1.870
Symptoms 0.88 0.32 0.69 0.46 2.847*
Prevention 2.55 0.55 2.17 0.49 0.486
(tα= 1.960, P < 0.05) * = Significant
The unpaired ‘t’ test value as presented in Table 6 shows that there is significant difference between the causes
and symptoms since the calculated value is higher than the table value (t148 = 5.729, P < 0.05).No significant
difference was found between meaning, risk factors and prevention of risk factors of CVD.
Section III: Comparison of identified risk for coronary vascular disease among students studying in urban
and rural areas
This section deals with the analysis of risk for CVD among students studying in urban and rural areas.
Table 7: Distribution of students according to their identified risk for CVD
N = 75 + 75 = 150
Urban Rural
Risk status score Inference
Frequency Percentage Frequency Percentage
1 – 30 Low risk 62 83 73 97
31 – 50 Moderate risk 13 17 2 3
51 – 70 High risk - - - -
Maximum score = 70
Table 8: Mean, standard deviation and ‘t’ value of identified risk for coronary vascular disease among
students studying in urban and rural areas
N = 75 + 75 = 150
Group Mean SD Df ‘t’ value
Urban 25.80 4.420 3.353
148
Rural 23.53 3.839 Significant
t148 = 1.960, P < 0.05
The data presented in Table 8 shows that there is significant difference between the identified risk for CVD
between students studying in urban and rural areas (t148 = 3.353, P < 0.05). Hence the alternate hypothesis is
accepted.

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Table 9: Area-wise comparison of identified risk for coronary vascular disease between students
studying in urban and rural areas
N = 75 + 75 = 150
Urban Rural
Areas SD ‘t’ value
Mean SD Mean
Family history 0.720 1.44 0.77 1.63 0.032
BMI 1.017 1.64 0.72 1.07 1.458
Physical activity 8.250 2.67 6.03 2.73 4.726*
Food pattern 12.630 2.57 12.20 2.27 1.024
Habits 0.160 0.63 0.05 0.32 0.126
Expression of tension 2.840 1.13 2.89 0.98 0.277
t148 = 4.273, P < 0.05 * = Significant
The data presented in Table 9 shows that there is significant difference between the physical activity (t148 =
4.273, P < 0.05) of students studying in urban and rural areas. There is no significant difference in other areas
such as family history of heart disease, BMI, food pattern and expression of tension between students from urban
and rural areas.
Section IV: Correlation between knowledge on risk factors and identified risk for coronary vascular
diseases among students from urban and rural areas
H03: There will be no correlation between the level of knowledge and risk factors of coronary vascular disease
among students from selected schools in urban and rural areas of Gwalior.
Table 10: Coefficient of correlation of knowledge on risk factors of CVD and identified risk for CVD
among students from urban and rural areas
N = 75 + 75 = 150
Urban Rural
Variable
Mean SD ‘r’ value Mean SD ‘r’ value
Knowledge 13.14 0.982 11.62 0.818
0.091 0.159
Risk 25.80 4.420 23.53 3.830
r148 = 0.217, P < 0.05
The data presented in Table 10 shows that there is no correlation between knowledge of risk factors of CVD and
identified risk for CVD in students studying in urban (r=0.091, P > 0.05) and rural areas (r=0.159, P > 0.05).
Hence the null hypothesis is accepted.
Section V: Risk and selected factors of CVD among students from urban and rural areas
This section deals with the analysis and interpretation of selected factors of CVD among students studying in
urban and rural areas.
Table 11: Mean, mean percentage score, and standard deviation of selected risk factors of CVD
among students from urban and rural areas
N = 75 + 75 = 150
Urban Rural
Risk factors Max. Score
Mean SD Mean score Mean SD Mean score
Family history 8 1.06 1.62 13 0.80 1.64 10
BMI 6 1.04 1.62 17 0.85 1.14 14
Physical activity 4 2.66 1.24 66 0.86 1.41 22
Exercise 4 2.08 1.47 52 1.57 1.39 39
Participation in sports 4 1.88 1.26 47 1.72 1.31 43
Use of leisure time 4 1.55 0.20 39 1.36 1.49 34
Food pattern 1 6 4.12 1.66 69 3.74 1.43 52
Food pattern 2 6 4.34 1.42 73 4.32 1.32 72
Junk food 6 4.48 1.42 75 4.16 1.41 69
The data presented in Table 11 shows the risk and selected factors of CVD. The mean percentage of family
history of heart disease was 13% and 10%, body mass index – 17% and 14%, physical activity – 66% and 22%,
exercise – 52% and 39%, participation in sports – 47% and 43%, use of leisure time – 39% and 34%, food

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pattern 1 – 69% and 62%, food pattern 2 – 73% and 72%, and junk food – 75% and 69% for students studying in
urban and rural areas respectively.
Table 12: Mean, standard deviation and ‘r’ value of risk and selected factors of CVD among students
studying in urban and rural areas
N = 75 + 75 = 150
Urban Rural
Risk factors
Mean SD ‘r’ value Mean SD ‘r’ value
Family history 1.066 1.620 0.384* 0.800 1.643 0.377*
BMI 1.040 1.622 0.425* 0.853 1.147 0.036
Physical activity 2.660 1.244 0.285* 0.863 1.410 0.315*
Exercise 2.080 1.477 0.300* 1.573 1.369 0.240*
Participation in sports 1.880 1.261 0.345* 1.720 1.351 0.055
Use of leisure time 1.690 1.550 0.202 1.360 1.494 -180.000
Food pattern 1 4.120 1.660 0.327 3.746 1.434 0.158
Food pattern 2 4.340 1.409 0.428* 4.324 1.325 0.083
Junk food 4.480 1.427 0.183 4.166 1.412 0.013
r23 = 0.232, P < 0.05 * = significant
The data presented in Table 12 shows that there was significant correlation between the risk and selected factors
such as family history (r = 0.384, P < 0.05), BMI (r = 0.425, P < 0.05), physical activity (r = 0.285, P < 0.05),
exercise (r = 0.300, P < 0.05), participation in sports (r = 0.345, P < 0.05) and food pattern 2 (r = 0.428,
P < 0.05) among the students studying in schools of urban areas. Among those studying in rural areas significant
correlation was found between the risk and selected factors like family history of heart disease (r = 0.377, P <
0.05), physical activity (r = 0.315, P < 0.05) and exercise (r = 0.240, P < 0.05).
Section VI: Association between coronary vascular disease and selected variables
Table 13: Chi-square values showing the association between risk for coronary vascular disease and
selected variables in students studying in urban and rural areas
N = 150
Urban Rural
Variable
≤ median ≥ median χ2
≤ median ≥ median χ2
Age in years
14 – 15 35 31 28 36
0.02 0.02
16 – 17 4 5 4 7
Monthly income (in rupees)
≥ 4,000 38 32 27 30
1.04 1.03
≤ 4,000 1 4 11 7
Family history of heart disease
Yes 6 1 4 1
1.60 1.47
No 36 32 29 41
(χ2 = 3.84, P < 0.05)
The data presented in Table 13 shows that chi-square computed between risk for CVD and selected variables
like age, monthly income, and family history of heart disease were not found to be significant at 0.05 level of
significance in students studying in urban and rural areas. Hence the alternate hypothesis is accepted.
DISCUSSION professionals, whereas 43% fathers of students from
Sample characteristics rural areas were semiskilled workers. Most of the
Majority of the students in urban area (87%) and rural mothers of students from urban area (68%) and rural
area (85%) were in the group of 14-15 years. The area (76%) were unemployed. Majority of the
above findings of the study were consistent with a students’ family income in urban area (71%) and rural
survey conducted among the adolescents in USA. The area (57%) was above Rs. 5,000. Majority of the
age of the children was 12 to 17 years. Majority of the students from urban (93%) and students from rural
students from urban area were Hindus (80%) and (84%) belonged to nuclear families. In the urban
37% from rural area were Christians. Majority of areas most of the students’ fathers were graduates
fathers (49%) of the students from urban area were (41%) while in the rural area 39% had studied up to

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 International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
PUC or were diploma holders. Among the students students of urban and rural areas (r=0.217, P<0.05).
from urban area 11% had history of heart disease, The findings of a study conducted among adult
while among students from rural area it was 7%. The Canadian population revealed similar findings. The
findings of a study conducted in Iowa to identify result showed that people at greater risk of CVD were
adolescents with adverse coronary risk factors level less able to recall important CVD risk factors. The
revealed that the history of parental CHD was rare. odds ratio of reporting and association of the risk and
This result is consistent with the result of the present knowledge varied between 0.16 for lack of
study. Television was the chief source of health knowledge to 0.55 for smoking.
information for students of both urban (37%) and
Section V
rural areas (35%).
The findings of the study showed significant
Section II correlation between the risk and selected factors such
Students from urban schools were more as family history (r=0.384, 0.377, P<0.05), physical
knowledgeable (x1 = 13.146) than those from rural activity(r=0.285, 0.315, P<0.05), exercise (r=0.300,
schools (x2 = 11.620) (t = 10.292, P < 0.05). The 0.240, P<0.05) in urban and rural areas respectively.
finding of a survey conducted among high school There is a significant correlation between risk and
students in Michigan revealed that most of the selected factors in students from urban area such as
students lack knowledge regarding the risk factors of BMI (r=0.425 P<0.05), participation in sports
CVD. This finding is contradictory to the findings of (r=0.345, P<0.05) and food pattern (r=0.327, 0.428,
the present study. Another study conducted at Kansas P<0.05). The findings of the present study are similar
showed that adolescents possess knowledge on to a study conducted in Karachi among subject aged
cardiovascular risk factors. Majority of the between 15-45 years. The result revealed that
participants agreed that obesity, smoking and high fat smoking, use of ghee, lack of education (P<0.001 for
diet may lead to heart disease. These findings are each) and parental history of myocardial infarction
consistent with the present study findings26. (P<0.05) were all associated with higher risk of acute
myocardial infarction17.
Section III
There is significant difference in identified risk Section VI
factors of CVD among students from urban and rural The findings of the study showed that there was no
schools (t=3.353, p<0.05). Area-wise comparison of association between risk for coronary vascular disease
risk factors of CVD among students from urban and and selected variables like age, monthly income, and
rural areas showed that, there is a significant family history of heart disease in students studying in
difference in physical activity (t=4.273, p<0.05) and urban and rural areas The findings of a study
no significant difference in areas like family history conducted among school children in Turkey showed
of heart disease, BMI, food pattern, habits and high risk for CVD in children of middle and higher
expression of tension. A similar study was conducted socioeconomic status53. This finding is contradictory
in Ludhiana among school students in urban and rural to the findings of the present study.
areas in the age of 11-17 years to evaluate the
NURSING IMPLICATION
prevalence of hypertension and obesity. The mean
Nursing administration
BMI of hypertensive population in both urban and
The findings of the study could be utilised by the
rural areas was significantly higher than the nursing administrators to provide quality care to the
respective normotensive population. Mean BMI in
clients in the community. They should encourage the
urban normotensive group was 20.34±3.72 kg/m2; staff and the students to carryout similar research in
hypertensive group – 24.91±4.92 kg/m2; BMI in rural
different populations and different settings to find out
normotensive group – 18.41±3.41 kg/m2;
the knowledge and risk factors of CVD, so that
hypertensive group – 2.37±3.71 kg/m2 (P < 0.01). The
necessary nursing interventions can be carried out and
findings were similar in a study conducted in Jaipur
the problem can be tackled. Nursing administrators
among adults. Prevalence of various factors was
should organise periodic in-service educational
determined. The prevalence of tobacco use and
programmes for the staff and students in collaboration
smoking was significantly greater in urban (50.0%) as
with both the community and the medical department
compared to rural groups (25.4%), while obesity,
for imparting knowledge on risk factors of CVD. The
hypertension, diabetes, LDL, cholestrolemia were
hospital should have a policy to provide health
significantly greater in urban adults (P<0.05).
education material to all inpatients and outpatients.
Section IV The nurses can encourage higher authorities to
There was no correlation between knowledge on risk conduct outreach programmes in the community to
factors of CVD and identified risk for CVD among improve the knowledge of the clients on CVD.

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 International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
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able to give health education to the patients, students,
Ronald M, et al. American heart association
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atherosclerotic cardiovascular disease
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