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^&para ; ; Dewan S. Alam^# ; Thomas A. Gaziano^&lowast ; &lowast ; ; ^&dagger ; &dagger ; ; Rajeev Gupta^&Dagger ; &Dagger ; ; ^§ ; § ; ; Vilma Irazola^‖‖ ; Naomi S. Levitt^&para ; &para ; ; ^## ; Dorairaj Prabhakaran^&para ; ; ^&lowast ; &lowast ; &lowast ; ; Adolfo Rubinstein^‖‖ ; Krisela Steyn^&para ; &para ; ; Nikhil Tandon^&para ; ; 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

para0015">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

para0020">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

para0025">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

para0030">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.