Prevalence of Pragmatically Defined High CV Risk and its Correlates in LMIC: A Report From 10 LMIC Areas in Africa, Asia, and South America.


Journal Article

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.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.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.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.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.

Full Text

Duke Authors

Cited Authors

  • Carrillo-Larco, RM; Miranda, JJ; Li, X; Cui, C; Xu, X; Ali, M; Alam, DS; Gaziano, TA; Gupta, R; Irazola, V; Levitt, NS; Prabhakaran, D; Rubinstein, A; Steyn, K; Tandon, N; Xavier, D; Wu, Y; Yan, LL

Published Date

  • March 2016

Published In

Volume / Issue

  • 11 / 1

Start / End Page

  • 27 - 36

PubMed ID

  • 27102020

Pubmed Central ID

  • 27102020

Electronic International Standard Serial Number (EISSN)

  • 2211-8179

International Standard Serial Number (ISSN)

  • 2211-8160

Digital Object Identifier (DOI)

  • 10.1016/j.gheart.2015.12.004


  • eng