Prevalence of Pragmatically Defined High CV Risk and its Correlates in LMIC: A Report From 10 LMIC Areas in Africa, Asia, and South America

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• 作者：Rodrigo M. Carrillo-Larco^&lowast ; ; J. Jaime Miranda^&lowast ; ; ^&dagger ; ; Xian Li^&Dagger ; ; Chendi Cui^§ ; ; Xiaolin Xu^‖ ; Mohammed Ali^¶ ; ; Dewan S. Alam^# ; Thomas A. Gaziano^&lowast ; &lowast ; ; ^&dagger ; &dagger ; ; Rajeev Gupta^&Dagger ; &Dagger ; ; ^§ ; § ; ; Vilma Irazola^‖‖ ; Naomi S. Levitt^¶ ; ¶ ; ; ^## ; Dorairaj Prabhakaran^¶ ; ; ^&lowast ; &lowast ; &lowast ; ; Adolfo Rubinstein^‖‖ ; Krisela Steyn^¶ ; ¶ ; ; Nikhil Tandon^¶ ; ; Denis Xavier^&dagger ; &dagger ; &dagger ; ; Yangfeng Wu^&Dagger ; ; ^&Dagger ; &Dagger ; &Dagger ; ; ^{ywu@george.org.cn" class="auth_mail" title="E-mail the corresponding author} ; Lijing L. Yan^&Dagger ; ; ^‖ ; ^{lijing.yan@duke.edu" class="auth_mail" title="E-mail the corresponding author}
• 刊名：Global Heart
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：11
• 期：1
• 页码：27-36
• 全文大小：365 K

文摘

Currently available tools for assessing high cardiovascular risk (HCR) often require measurements not available in resource-limited settings in low- and middle-income countries (LMIC). There is a need to assess HCR using a pragmatic evidence-based approach.

Objectives

This study sought to report the prevalence of HCR in 10 LMIC areas in Africa, Asia, and South America and to investigate the profiles and correlates of HCR.

Methods

Cross-sectional analysis using data from the National Heart, Lung, and Blood Institute—UnitedHealth Group Centers of Excellence. HCR was defined as history of heart disease/heart attack, history of stroke, older age (≥50 years for men and ≥60 for women) with history of diabetes, or older age with systolic blood pressure ≥160 mm Hg. Prevalence estimates were standardized to the World Health Organization's World Standard Population.

Results

A total of 37,067 subjects ages ≥35 years were included; 53.7% were women and mean age was 53.5 ± 12.1 years. The overall age-standardized prevalence of HCR was 15.4% (95% confidence interval: 15.0% to 15.7%), ranging from 8.3% (India, Bangalore) to 23.4% (Bangladesh). Among men, the prevalence was 1.7% for the younger age group (35 to 49 years) and 29.1% for the older group (≥50); among women, 3.8% for the younger group (35 to 59 years) and 40.7% for the older group (≥60). Among the older group, measured systolic blood pressure ≥160 mm Hg (with or without other conditions) was the most common criterion for having HCR, followed by diabetes. The proportion of having met more than 1 criterion was nearly 20%. Age, education, and body mass index were significantly associated with HCR. Cross-site differences existed and were attenuated after adjusting for age, sex, education, smoking, and body mass index.

Conclusions

The prevalence of HCR in 10 LMIC areas was generally high. This study provides a starting point to define targeted populations that may benefit from interventions combining both primary and secondary prevention strategies.