Cardiovascular Disease Epidemiology

A 52-year-old male from rural Maharashtra with no prior medical history presents to a primary health centre with chest discomfort for 2 hours. He is conscious, BP 145/92 mmHg, HR 88/min, RR 18/min. No dyspnoea. Physical examination is unremarkable. The health worker performs a 12-lead ECG which shows ST elevation in leads II, III, aVF. The nearest PCI-capable centre is 120 km away (3–4 hours by road). What is the most appropriate immediate next step?

In the Indian population, what is the most common anatomical site of acute myocardial infarction?

Which of the following risk factors shows the strongest population attributable risk (PAR) for cardiovascular disease in India?

A 52-year-old man from urban Delhi with a 10-year history of hypertension (BP 160/100 mmHg) and dyslipidemia presents for cardiovascular risk assessment. He is asymptomatic with no prior cardiac events. Which investigation is most appropriate to identify subclinical atherosclerosis and guide intensity of preventive therapy?

A 52-year-old woman from urban Delhi attends a workplace health screening. She is a sedentary office worker, non-smoker, no alcohol use. Her mother had a myocardial infarction at age 58. Vital signs: BP 132/86 mmHg, HR 76/min. Investigations: fasting glucose 102 mg/dL, total cholesterol 210 mg/dL, LDL 135 mg/dL, HDL 38 mg/dL, triglycerides 165 mg/dL, waist circumference 92 cm. She has no chest pain or dyspnoea. According to the Indian cardiovascular risk assessment guidelines, which of the following best describes her 10-year absolute cardiovascular risk category?