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Original Research

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:

Rodrigo M. Carrillo-Larco,

CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, PE
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J. Jaime Miranda,

CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, PE
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Xian Li,

The George Institute for Global Health at Peking University Health Science Center, Haidian District, Beijing, CN
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Chendi Cui,

Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, US
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Xiaolin Xu,

Global Heath Research Center, Duke Kunshan University, Kunshan, Jiangsu Province, CN
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Mohammed Ali,

Centre for Chronic Disease Control, Gurgaon, Haryana, IN
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Dewan S. Alam,

Centre for Control of Chronic Diseases, International Centre for Diarrheal Disease Research, Bangladesh, Mohakhali, Dhaka, BD
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Thomas A. Gaziano,

Brigham and Women’s Hospital, Harvard School of Public Health, Harvard University, Cambridge, MA; Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, MA, US
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Rajeev Gupta,

Fortis Escorts Hospital, Jaipur; Academic and Research Unit, Rajasthan University of Health Sciences, Jaipur, IN
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Vilma Irazola,

Centro de Excelencia en Salud Cardiovascular para el Cono Sur, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, AR
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Naomi S. Levitt,

Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town; Division of Diabetic Medicine and Endocrinology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, ZA
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Dorairaj Prabhakaran,

Centre for Chronic Disease Control, Gurgaon, Haryana; Public Health Foundation of India, Gurgaon, Haryana, IN
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Adolfo Rubinstein,

Centro de Excelencia en Salud Cardiovascular para el Cono Sur, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, AR
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Krisela Steyn,

Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, ZA
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Nikhil Tandon,

Centre for Chronic Disease Control, Gurgaon, Haryana, IN
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Denis Xavier,

St. John’s Medical College and Research Institute, Koramangala Post, Bangalore, IN
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Yangfeng Wu ,

The George Institute for Global Health at Peking University Health Science Center, Haidian District, Beijing; Peking University School of Public Health and Clinical Research Institute, Haidian District, Beijing, CN
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Lijing L. Yan

The George Institute for Global Health at Peking University Health Science Center, Haidian District, Beijing; Global Heath Research Center, Duke Kunshan University, Kunshan, Jiangsu Province, CN
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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.

How to Cite: Carrillo-Larco RM, Miranda JJ, Li X, Cui C, Xu X, Ali M, et al.. Prevalence of Pragmatically Defined High CV Risk and its Correlates in LMIC: A Report From 10 LMIC Areas in Africa, Asia, and South America. Global Heart. 2016;11(1):27–36. DOI: http://doi.org/10.1016/j.gheart.2015.12.004
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Published on 01 Mar 2016.
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