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

RODRIGO M. CARRILLO-LARCO; J. JAIME MIRANDA; THOMAS A. GAZIANO; VILMA IRAZOLA

Global Heart

Elsevier

Año: 2016

2211-8160

Background: Currently available tools for assessing high cardiovascular risk (HCR) often requiremeasurements 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 SouthAmerica 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 agewith systolic blood pressure 160 mm Hg. Prevalence estimates were standardized to the World HealthOrganization?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% to15.7%), 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 theyounger group (35 to 59 years) and 40.7% for the older group (60). Among the older group, measuredsystolic blood pressure R160 mm Hg (with or without other conditions) was the most common criterion forhaving 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 andwere 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 pointto define targeted populations that may benefit from interventions combining both primary and secondaryprevention strategies.