. 2016 Mar;11(1):27-36.

doi: 10.1016/j.gheart.2015.12.004.

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-Larco¹, J Jaime Miranda², Xian Li³, Chendi Cui⁴, Xiaolin Xu⁵, Mohammed Ali⁶, Dewan S Alam⁷, Thomas A Gaziano⁸, Rajeev Gupta⁹, Vilma Irazola¹⁰, Naomi S Levitt¹¹, Dorairaj Prabhakaran¹², Adolfo Rubinstein¹⁰, Krisela Steyn¹³, Nikhil Tandon⁶, Denis Xavier¹⁴, Yangfeng Wu¹⁵, Lijing L Yan¹⁶

Affiliations

¹ CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
² CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
³ The George Institute for Global Health at Peking University Health Science Center, Haidian District, Beijing, China.
⁴ Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
⁵ Global Heath Research Center, Duke Kunshan University, Kunshan, Jiangsu Province, China.
⁶ Centre for Chronic Disease Control, Gurgaon, Haryana, India.
⁷ Centre for Control of Chronic Diseases, International Centre for Diarrheal Disease Research, Bangladesh, Mohakhali, Dhaka, Bangladesh.
⁸ Brigham and Women's Hospital, Harvard School of Public Health, Harvard University, Cambridge, MA, USA; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA.
⁹ Fortis Escorts Hospital, Jaipur, India; Academic and Research Unit, Rajasthan University of Health Sciences, Jaipur, India.
¹⁰ Centro de Excelencia en Salud Cardiovascular para el Cono Sur, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
¹¹ Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Division of Diabetic Medicine and Endocrinology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
¹² Centre for Chronic Disease Control, Gurgaon, Haryana, India; Public Health Foundation of India, Gurgaon, Haryana, India.
¹³ Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
¹⁴ St. John's Medical College and Research Institute, Koramangala Post, Bangalore, India.
¹⁵ The George Institute for Global Health at Peking University Health Science Center, Haidian District, Beijing, China; Peking University School of Public Health and Clinical Research Institute, Haidian District, Beijing, China. Electronic address: ywu@george.org.cn.
¹⁶ The George Institute for Global Health at Peking University Health Science Center, Haidian District, Beijing, China; Global Heath Research Center, Duke Kunshan University, Kunshan, Jiangsu Province, China. Electronic address: lijing.yan@duke.edu.

PMID: 27102020
PMCID: PMC4843819
DOI: 10.1016/j.gheart.2015.12.004

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 et al. Glob Heart. 2016 Mar.

. 2016 Mar;11(1):27-36.

doi: 10.1016/j.gheart.2015.12.004.

Authors

Affiliations

¹ CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
² CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
³ The George Institute for Global Health at Peking University Health Science Center, Haidian District, Beijing, China.
⁴ Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
⁵ Global Heath Research Center, Duke Kunshan University, Kunshan, Jiangsu Province, China.
⁶ Centre for Chronic Disease Control, Gurgaon, Haryana, India.
⁷ Centre for Control of Chronic Diseases, International Centre for Diarrheal Disease Research, Bangladesh, Mohakhali, Dhaka, Bangladesh.
⁸ Brigham and Women's Hospital, Harvard School of Public Health, Harvard University, Cambridge, MA, USA; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA.
⁹ Fortis Escorts Hospital, Jaipur, India; Academic and Research Unit, Rajasthan University of Health Sciences, Jaipur, India.
¹⁰ Centro de Excelencia en Salud Cardiovascular para el Cono Sur, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
¹¹ Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Division of Diabetic Medicine and Endocrinology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
¹² Centre for Chronic Disease Control, Gurgaon, Haryana, India; Public Health Foundation of India, Gurgaon, Haryana, India.
¹³ Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
¹⁴ St. John's Medical College and Research Institute, Koramangala Post, Bangalore, India.
¹⁵ The George Institute for Global Health at Peking University Health Science Center, Haidian District, Beijing, China; Peking University School of Public Health and Clinical Research Institute, Haidian District, Beijing, China. Electronic address: ywu@george.org.cn.
¹⁶ The George Institute for Global Health at Peking University Health Science Center, Haidian District, Beijing, China; Global Heath Research Center, Duke Kunshan University, Kunshan, Jiangsu Province, China. Electronic address: lijing.yan@duke.edu.

PMID: 27102020
PMCID: PMC4843819
DOI: 10.1016/j.gheart.2015.12.004

Abstract

Background: 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.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: The authors report no relationships that could be construed as a conflict of interest.

Figures

**Figure 1. Age-Standardized Prevalence of High Cardiovascular Risk by Gender, Age Group, and Study Site**
Numbers above the study site represent the overall and sex-specific age-standardized prevalence of high cardiovascular risk and 95% CI.

See this image and copyright information in PMC

Cited by

Sex differences in non-communicable disease prevalence in China: a cross-sectional analysis of the China Health and Retirement Longitudinal Study in 2011.
Liu Y, Liu G, Wu H, Jian W, Wild SH, Gasevic D. Liu Y, et al. BMJ Open. 2017 Dec 14;7(12):e017450. doi: 10.1136/bmjopen-2017-017450. BMJ Open. 2017. PMID: 29247088 Free PMC article.
Cardiovascular risk factor reduction by community health workers in rural India: A cluster randomized trial.
Joshi R, Agrawal T, Fathima F, Usha T, Thomas T, Misquith D, Kalantri S, Chidambaram N, Raj T, Singamani A, Hegde S, Xavier D, Devereaux PJ, Pais P, Gupta R, Yusuf S. Joshi R, et al. Am Heart J. 2019 Oct;216:9-19. doi: 10.1016/j.ahj.2019.06.007. Epub 2019 Jun 19. Am Heart J. 2019. PMID: 31377568 Free PMC article. Clinical Trial.
Rheumatic heart disease knowledge and associated factors among nurses working in cardiac centers at public and private hospitals of Addis Ababa: cross sectional study.
Techane T, Legesse B, Ayalew Y, Hailu A. Techane T, et al. BMC Nurs. 2022 May 27;21(1):130. doi: 10.1186/s12912-022-00910-5. BMC Nurs. 2022. PMID: 35619104 Free PMC article.
Capsule Commentary on Chiu et al. BMI Trajectories as a Harbinger of Pre-Diabetes or Underdiagnosed Diabetes: An 18-Year Retrospective Cohort Study in Taiwan.
Ruchi R. Ruchi R. J Gen Intern Med. 2016 Oct;31(10):1216. doi: 10.1007/s11606-016-3777-0. J Gen Intern Med. 2016. PMID: 27400926 Free PMC article. No abstract available.

References

1. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2095–128. - PMC - PubMed
1. Murray CJ, Lopez AD. Measuring the global burden of disease. N Engl J Med. 2013;369(5):448–57. - PubMed
1. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117–71. - PMC - PubMed
1. World Health Organization - WHO. Noncommunnicable Diseases. Available http://www.who.int/mediacentre/factsheets/fs355/en/
1. Yusuf S, Rangarajan S, Teo K, Islam S, Li W, Liu L, et al. Cardiovascular risk and events in 17 low-, middle-, and high-income countries. N Engl J Med. 2014;371(9):818–27. - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Medical
- MedlinePlus Health Information
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Miscellaneous

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Related information

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Miscellaneous