COIMBATORE: Over the past several years, it was believed that the relentless pressures of urban life, the endless competition and deadlines, sedentary hours and city conveniences like delivery apps and elevators serve as a fertile ground for NCDs like hypertension and diabetes, making them largely an urban phenomenon.

But not anymore.

A rock solid study of over 10 years, encompassing follow up of the same individuals across rural, suburban and urban Coimbatore has found that "non-communicable diseases are not just an urban phenomenon anymore," the KMCH (Kovai Medical Center and Hospital) Research Foundation said.

Inspired by the transformational, multigenerational Framingham Heart Study, the KMCH said its study has found that suburban and rural communities in and around Coimbatore recorded the sharpest rise in new cases of high blood pressure, pushing back both urban and rural populations.

The findings challenge the widely held assumption that non-communicable diseases (NCD) are primarily an urban problem.

The results were presented at the third International Conference on Indian Rural Public Health and Non-Communicable Diseases, held in Coimbatore on Saturday and Sunday.

Founding Trustee, KMCH Research Foundation and Chairman, KMCH, Dr Nalla G Palaniswami, said: "As a young doctor, I was fascinated by the Framingham study and always dreamed if a similar study could be done in our part of the world to understand about NCDs. The idea is to create evidence locally for the people by local researchers and nurture a culture of research among busy clinicians."

That dream has unfolded into a reality and the results doubt would have a profound and far-reaching impact in the way the chronic conditions are dealt with, according to the KMCH.

Another key finding of the study is that such chronic conditions rarely occur in isolation, and abdominal obesity, raised blood pressure, abnormal glucose and lipid abnormalities frequently present together in the same individual.

Among participants who did not have high blood pressure when the study began, the proportion who developed it during follow up was 31.5 per cent in rural, 44.4 per cent in suburban and 37.0 per cent in urban communities.

The KMCH said its NCD study commenced in 2015 covering rural, suburban and urban communities in and around Coimbatore, covering close to 9,600 participant assessments across successive phases, with the most recent survey completed in 2026.

Participants first assessed in 2015 and 2016 were traced and reassessed in the latest round unlike most of the other studies on NCD in India which were one time surveys.

Explaining further, KMCH said its study found that men are progressing considerably faster in developing NCDs than women.

In urban communities, 54.8 per cent of men who were free of high blood pressure at the start developed it, against 26.0 per cent of women.

The gap was similar in suburban communities, at 52.2 per cent for men and 37.7 per cent for women, and in rural communities, at 37.0 per cent and 27.2 per cent.

In most individuals who already had manifested such a condition, it was largely not brought under control.

Among participants who had high blood pressure at the start of the study, 91.1 per cent in urban communities, 80.0 per cent in suburban and 78.7 per cent in rural communities continued to report it during the follow up.

The trend extends to blood sugar as well as those who had been diagnosed with prediabetes progressed into diabetes and people with normal glycemic levels turned prediabetic.

A key finding was that one in four rural adults already had measurable coronary disease.

Abnormalities in carotid arterial wall, early changes in the blood vessels and anemia were among the other findings in the study populations.

Among participants who had prediabetes when the study began, 51.2 per cent in urban communities and 42.2 per cent in suburban communities went on to develop diabetes, against 20.8 per cent in rural communities.

Among those whose glucose readings were normal at the start, 46.3 per cent in urban, 42.0 per cent in suburban and 35.2 per cent in rural communities moved into the prediabetes range.

These glycemic findings are based on 128 rural, 81 sub-urban and 67 urban participants.

A separate arm of the programme examined rural adults aged 35 to 65 who had no symptoms of heart disease.

Using coronary computed tomography at Kovai Medical Center and Hospital to look for calcium deposits in the coronary arteries, an established early marker of atherosclerosis, the study detected such deposits in 25.6 per cent of them.

The figure was 33.5 per cent among men and 18.5 per cent among women, and it increased with age.

In other words, roughly one in four rural adults with no complaints already had measurable coronary disease.

Early changes in the blood vessels were also recorded.

Among participants whose carotid intima media thickness was normal at the start, abnormal readings developed in 21.2 per cent of the rural group and 20.7 per cent of the suburban group.

Anemia developed in 31.3 per cent of rural, 26.3 per cent of suburban and 20.0 per cent of urban participants who were not anemic at baseline.

Such conditions, as underlined, rarely occur in isolation.

The conference, the third edition, was organised by the KMCH Research Foundation together with KMCH Institute of Health Sciences and Research, and was held at Dr NGP Conference Hall, Dr NGP Arts and Science College, Kalapatti, Coimbatore, on September 19 and 20, 2026.

Sessions were held on rural public health, cardiovascular health, diabetes and metabolic disorders, maternal, child and adolescent health, healthy ageing, nutrition and lifestyle medicine, tobacco and alcohol control, environmental and occupational health, and health systems and public health policy.

The KMCH NCD Study concludes that rather than waiting for the full manifestation of diabetes, high blood pressure or cardiovascular diseases, initiation of appropriate interventions at the borderline stage itself would help save lives.

It also finds that the differences between rural, suburban and urban communities, and between men and women, indicate that a single prevention approach applied uniformly is unlikely to work.