International Institute for Population Sciences
Deemed to be University (An Autonomous Organization of Ministry of Health & Family Welfare, Government of India)

Background: Chronic heart disease (CHD) and chronic lung disease (CLD) are major contributors to morbidity and mortality among ageing populations, often sharing common risk factors and biological pathways. Despite evidence of cardiopulmonary interactions, limited studies in India have examined gender-specific mediating and moderating effects of health risk factors in the CLD–CHD relationship using nationally representative data. This study estimates the prevalence of CHD and CLD among Indian adults aged ≥45 years, assesses their association, and explores the gender-specific roles of BMI, self-rated health, hypertension, diabetes, cancer, stroke, and high cholesterol. Data and Methods: We analysed cross-sectional data from 60,632 respondents in Wave 1 of the LASI (2017–2018). Weighted descriptive statistics and gender-stratified multivariable logistic regression models assessed associations between CLD and CHD, incorporating interaction terms for key health risk factors. Mediation analysis used the Karlson–Holm–Breen method to decompose total effects into direct and indirect pathways. Results: The prevalence of CHD and CLD was 3.86% and 7.29%, respectively. Females with CLD had higher odds of CHD (AOR=2.89) than males. Significant moderating effects were observed for SRH, hypertension, high BMI, diabetes, cancer, stroke, and high cholesterol, predominantly among females. Mediation analysis identified SRH as the strongest mediator, explaining 34% of the CLD–CHD association overall (52% in males, 24% in females), followed by hypertension (10%) and high cholesterol (5%). Conclusion: CHD and CLD are moderately associated with shared risk profiles, exhibiting distinct gender patterns. Integrated, gender-sensitive interventions focusing on perceived health and cardiometabolic risk management are essential.