Abstract
BackgroundA significant number of cardiovascular disease (CVD)-related deaths occur in developing countries. An increasing prevalence of CVD is associated with a change in the macro-economy of these countries. In this post hoc analysis, CVD risk factor (CVDRF) prevalence is evaluated across countries based on national income in the Africa and Middle East Region (AfME).MethodsData from the Africa Middle East Cardiovascular Epidemiological (ACE) study were used; a cross-sectional study in 14 AfME countries (94 clinics) from July 2011–April 2012, which evaluated CVDRF prevalence in stable adult outpatients. World Bank definitions were used to classify countries as low-income (LI), lower-middle-income (LMI), upper-middle-income (UMI) or high-income (HI) countries. Four thousand three hundred seventy-eight subjects were recruited where 260 (6%), 1324 (30%), 1509 (35%) and 1285 (29%) were from LI, LMI, UMI, and HI countries, respectively.ResultsOf all the CVDRFs evaluated, almost two-thirds of the study population across the national income groups had abdominal obesity and dyslipidemia. Countries in the HI category were associated with a higher prevalence of diabetes (32%), obesity (44%) and smoking (16%). UMI and HI countries were associated with higher clustering of CVDRFs where at least one-third of subjects having four or more CVDRFs. Lower income countries had lower blood pressure control rates and lower percentages of outpatients achieving LDL-cholesterol targets.ConclusionThe burden of CVDRFs in stable outpatients is high across the national income categories in the AfME region, with HI countries showing a higher prevalence of CVDRFs. The high burden in lower income countries is associated with sub-optimal control of dyslipidemia and hypertension. Lowering the CVDRF burden would need specific public health actions in line with positive changes in the macro-economy of these countries.Trial registrationThe ACE trial is registered under NCT01243138.
Highlights
A significant number of cardiovascular disease (CVD)-related deaths occur in developing countries
We evaluate the prevalence of major CVD risk factor (CVDRF) – namely dyslipidemia, hypertension, obesity, diabetes mellitus and smoking – according to national income level
In conclusion, CVDRFs are widely prevalent across the national income spectrum in the Africa and Middle East region
Summary
A significant number of cardiovascular disease (CVD)-related deaths occur in developing countries. An increasing prevalence of CVD is associated with a change in the macro-economy of these countries. In this post hoc analysis, CVD risk factor (CVDRF) prevalence is evaluated across countries based on national income in the Africa and Middle East Region (AfME). More than 60% of CVD, chronic kidney disease (CKD), and diabetes deaths in the developing world are attributable to preventable cardiometabolic risk factors, hypertension, dyslipidemia, obesity, and diabetes mellitus, and nearly half occur prematurely in relatively young adults [2, 4]. We evaluate the prevalence of major CVDRFs – namely dyslipidemia, hypertension, obesity, diabetes mellitus and smoking – according to national income level
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