Abstract 17368: Burden of Cardiovascular Diseases in Haiti: Implications for Low-Income Countries

Abstract

Introduction: Although 80% of global cardiovascular disease (CVD) burden occurs in low- and middle-income countries, data from Black populations in these settings are scarce. We estimated the baseline prevalence of CVD using data from the population-based Haiti Cardiovascular Disease Cohort. Methods: Among urban Haitian adults ≥18 years, we collected data on demographics, health behaviors, psychosocial measures, anthropometrics and clinical exams including imaging and laboratory data at enrollment from 2019-2021. Prevalent cases of CVD were adjudicated using approaches guided by US and international cohorts. Multivariable Poisson regressions assessed relationships between risk factors and prevalent CVD. Results: Among 3,003 participants, median age was 40 years, 58.1% were female, and 70.2% reported income of <$1/day. The most common risk factors were elevated blood pressure (30.4% hypertension, 23.0% prehypertension) and obesity (17.2%). Age-adjusted prevalence of CVD was 14.7% (95%CI 13.3%, 16.5%). Heart failure was the predominant disease with an adjusted prevalence of 11.9% (95%CI 10.5%, 13.5%), followed by stroke (2.4% [95%CI 1.9%, 3.3%]), angina (2.1% [95%CI 1.6%, 2.9%]), MI (1.0% [95%CI 0.6%, 1.8%]), and TIA (0.4% [95%CI 0.2%, 1.0%]). Of all heart failure, 80% had preserved ejection fraction, with a median age of 57 years. Heart failure was associated in a dose-response relationship with hypertension, and with obesity, diabetes, chronic kidney disease, depression, and stress. Conclusions: The burden of CVD in urban Haiti is primarily early-onset heart failure, with low prevalence of ischemic heart disease, challenging current global assumptions. These findings highlightunderscore the urgent need for local population-based epidemiologic data on cardiovascular disease and risk factors to inform health policy, planning and promotion.