A Comparison of Coronary Heart Disease Incidence BetweenPolice in Urban and Rural Areas: A Study of East Java Regional Police, Indonesia

Abstract

Background: Coronary heart disease (CHD) is a serious condition with significant impacts on morbidity, mortality and healthcare costs, particularly prevalent among police officers. Police are a high-risk occupational group due to their activities. Police work is thought to be associated with high workload, occupational stress, disordered eating, lack of exercise, limited food options at work, overtime and shift work, as well as sleep disturbances which are significantly correlated with the risk of CHD. This research aims to investigate the variances in coronary heart disease (CHD) incidence and risk factors among urban and rural police officers within the East Java Regional Police, providing an assessment and strategic preventive approach for CHD. Results: A cross-sectional study enrolled 766 participants, comprising 383 urban police officers and 383 rural police officers. Data were collected during medical check-ups at the Bhayangkara State Police Hospital Surabaya in 2024, including complete physical and laboratory examinations such as initial electrocardiography, treadmill tests, total cholesterol and fasting blood sugar. CHD was assessed by ischaemic changes in ECG and/or symptoms during treadmill testing, pre-existing evidence from medical history e.g. previous cardiac events (MI, angina) angiography. The Mann-Whitney U test was performed using IBM SPSS version 26. CHD prevalence was significantly higher in urban police officers (89.7%) compared to rural police officers (10.3%) (p=0.000). Total cholesterol, as a risk factor variable, showed a significant correlation with CHD (p=0.003, p<0.05). Conclusions: Both urban and rural police officers exhibit CHD risk, with urban officers demonstrating a higher prevalence. These findings underscore the importance of implementing aggressive CHD prevention strategies, treatments, early clinical and echocardiographic follow-ups to improve outcomes.