02926nas a2200337 4500000000100000008004100001100001100042700001400053700001300067700001400080700001000094700001900104700001100123700001000134700001500144700001400159700001500173700001800188700001300206700002200219700001100241700001000252700001200262700001500274245014400289250001500433300001000448490000700458520209600465020002702561 2016 d1 aYan L.1 aTandon N.1 aGupta R.1 aXavier D.1 aWu Y.1 aPrabhakaran D.1 aAli M.1 aLi X.1 aIrazola V.1 aLevitt N.1 aMiranda J.1 aRubinstein A.1 aSteyn K.1 aCarrillo-Larco R.1 aCui C.1 aXu X.1 aAlam D.1 aGaziano T.00aPrevalence of Pragmatically Defined High CV Risk and its Correlates in LMIC: A Report From 10 LMIC Areas in Africa, Asia, and South America a2016/04/23 a27-360 v113 a
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.
a2211-8179 (Electronic)