Risk Factors for Myocardial Infarction in Latin America

Abstract

You don’t get to choose how you’re going to die, or when. You can only choose how you’re going to live now. 1 — —Joan Baez Eat less at dinner and you will live to 99.1 — —Ancient Chinese proverb During the past 30 years, developing countries have undergone major changes that have been paralleled by a dramatic increase in mortality and morbidity from coronary heart disease. Changes in lifestyle that have been associated with economic growth and urbanization, coupled with reductions in morbidity and mortality from communicable disease and childbirth, have resulted in the sobering statistic that 80% of the global burden from cardiovascular disease now occurs in developing countries.2,3⇓ Indeed, it is estimated that unless current trends are halted, more than 1 billion people will die from cardiovascular disease in the first half of the 21st century—the majority coming from developing countries, with most of the life-years lost occurring in middle age.1 Two studies4,5⇓ in this issue of Circulation yield valuable insight into the risk factors for myocardial infarction in Latin America and provide a challenge for the development of effective preventive strategies. Articles pp 1067 and 1075 Lanas and coauthors4 report a case-control study involving 1237 cases of first acute myocardial infarction from the 6 Latin American countries of Argentina, Brazil, Colombia, Chile, Guatemala, and Mexico, which were part of the larger INTERHEART study involving 15 152 cases of first acute myocardial infarction in 52 countries worldwide. Their work identifies risk factors for acute myocardial infarction in Latin America and provides important information about the population-attributable risk (PAR) in this region. Whereas the 9 risk factors for coronary heart disease—abnormal lipid levels, smoking, hypertension, diabetes, abdominal obesity, psychosocial stress, regular physical activity, and consumption of fruits, vegetables, and alcohol—account for …