Research
Risk factors for cardiovascular disease in the elderly in Latin America and the Caribbean
Abstract
Introduction: The Latin America and Caribbean (LAC) regions are undergoing a transition from infectious to chronic non-communicable disease, together with and linked to a rapid aging of the population. Although cardiovascular disease is a principal cause of ill-health and death, few data are available among the elderly.
Materials and methods: We evaluated people aged 60 and over, living in seven urban centers in LAC: Buenos Aires, Bridgetown, Havana, Mexico City, Montevideo, Santiago, and Sao Paulo, who participated in the ‘Salud, Bienestar, y Envejecimiento’ study (SABE), conducted in 1999 and 2000. We calculated the prevalence of self-reported cardiovascular disease (CVD), and examined its association with established risk factors, using odds ratios (ORs) and their population attributable risks (PARs).
Results: The overall prevalence of CVD was 20.3% (95% CI 18.9–21.6). Rates varied across the region: lowest in Mexico City (10.0%) and Bridgetown (11.1%), intermediate in Buenos Aires (19.6%), Sao Paulo (19.8%), Montevideo (23.8%) and Havana (24.1%), and highest in Santiago (32.2%). CVD prevalence increased by 11% with every additional five-years of age, and was higher in women than men (21.2% vs. 18.9%).
Factors related to higher CVD prevalence included hypertension (odds ratio = 2.67), diabetes (OR = 1.42), obesity (OR = 1.19), and smoking (OR = 1.31), while regular exercise (OR = 0.66), adequate nutrition (OR = 0.70), and regular alcohol consumption (OR = 0.79) were related to lower CVD prevalence (p = 0.01 for BMI, p = 0.02 for alcohol consumption, and p < 0.001 for all other risk factors). Collectively, these seven modifiable risk factors accounted for 69.7% of the PAR.
Discussion: Established and modifiable risk factors underpin CVD prevalence in LAC. Public health programmes, including reliable measures of their effectiveness are needed to reduce the burden of CVD in the region.