Cardiovascular risk status of Afro-origin populations across the spectrum of economic development: findings from the Modeling the Epidemiologic Transition Study Journal Article


Authors: Dugas, L. R.; Forrester, T. E.; Plange-Rhule, J; Bovet, P; Lambert, E. V.; Durazo-Arvizu, R. A.; Cao, G.; Cooper, R. S.; Khatib, R.; Tonino, L.; Riesen, W.; Korte, W.; Kliethermes, S.; Luke, A
Article Title: Cardiovascular risk status of Afro-origin populations across the spectrum of economic development: findings from the Modeling the Epidemiologic Transition Study
Abstract: BACKGROUND: Cardiovascular risk factors are increasing in most developing countries. To date, however, very little standardized data has been collected on the primary risk factors across the spectrum of economic development. Data are particularly sparse from Africa. METHODS: In the Modeling the Epidemiologic Transition Study (METS) we examined population-based samples of men and women, ages 25-45 of African ancestry in metropolitan Chicago, Kingston, Jamaica, rural Ghana, Cape Town, South Africa, and the Seychelles. Key measures of cardiovascular disease risk are described. RESULTS: The risk factor profile varied widely in both total summary estimates of cardiovascular risk and in the magnitude of component factors. Hypertension ranged from 7% in women from Ghana to 35% in US men. Total cholesterol was well under 200 mg/dl for all groups, with a mean of 155 mg/dl among men in Ghana, South Africa and Jamaica. Among women total cholesterol values varied relatively little by country, following between 160 and 178 mg/dl for all 5 groups. Levels of HDL-C were virtually identical in men and women from all study sites. Obesity ranged from 64% among women in the US to 2% among Ghanaian men, with a roughly corresponding trend in diabetes. Based on the Framingham risk score a clear trend toward higher total risk in association with socioeconomic development was observed among men, while among women there was considerable overlap, with the US participants having only a modestly higher risk score. CONCLUSIONS: These data provide a comprehensive estimate of cardiovascular risk across a range of countries at differing stages of social and economic development and demonstrate the heterogeneity in the character and degree of emerging cardiovascular risk. Severe hypercholesterolemia, as characteristic in the US and much of Western Europe at the onset of the coronary epidemic, is unlikely to be a feature of the cardiovascular risk profile in these countries in the foreseeable future, suggesting that stroke may remain the dominant cardiovascular event.
Keywords: Public Health; African diaspora; Human Development Index; Cardiovascular risk
Journal Title: BMC public health
Volume: 17
Issue: 1
ISSN: 1471-2458; 1471-2458
Publisher: Unknown  
Journal Place: England
Date Published: 2017
Start Page: 438
End Page: 017-4318-4
Language: eng
DOI/URL:
Notes: LR: 20170517; GR: R01 DK080763/DK/NIDDK NIH HHS/United States; JID: 100968562; OTO: NOTNLM; 2016/09/16 [received]; 2017/04/26 [accepted]; epublish