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Raal FJ, Alsheikh-Ali AA, Omar MI, et al. Cardiovascular risk factor burden in Africa and the Middle East across country income categories: a post hoc analysis of the cross-sectional Africa Middle East Cardiovascular Epidemiological (ACE) study. Arch Public Health. 2018;76:15doi: 10.1186/s13690-018-0257-5.
Raal, F. J., Alsheikh-Ali, A. A., Omar, M. I., Rashed, W., Hamoui, O., Kane, A., Alami, M., Abreu, P., & Mashhoud, W. M. (2018). Cardiovascular risk factor burden in Africa and the Middle East across country income categories: a post hoc analysis of the cross-sectional Africa Middle East Cardiovascular Epidemiological (ACE) study. Archives of public health = Archives belges de sante publique, 7615. https://doi.org/10.1186/s13690-018-0257-5
Raal, Frederick J, et al. "Cardiovascular risk factor burden in Africa and the Middle East across country income categories: a post hoc analysis of the cross-sectional Africa Middle East Cardiovascular Epidemiological (ACE) study." Archives of public health = Archives belges de sante publique vol. 76 (2018): 15. doi: https://doi.org/10.1186/s13690-018-0257-5
Raal FJ, Alsheikh-Ali AA, Omar MI, Rashed W, Hamoui O, Kane A, Alami M, Abreu P, Mashhoud WM. Cardiovascular risk factor burden in Africa and the Middle East across country income categories: a post hoc analysis of the cross-sectional Africa Middle East Cardiovascular Epidemiological (ACE) study. Arch Public Health. 2018 Feb 12;76:15. doi: 10.1186/s13690-018-0257-5. eCollection 2018. PMID: 29449941; PMCID: PMC5812200.
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Arch Public Health. 2018 Feb 12;76:15. doi: 10.1186/s13690-018-0257-5. eCollection 2018.

Cardiovascular risk factor burden in Africa and the Middle East across country income categories: a post hoc analysis of the cross-sectional Africa Middle East Cardiovascular Epidemiological (ACE) study.

Archives of public health = Archives belges de sante publique

Frederick J Raal, Alawi A Alsheikh-Ali, Mohamed I Omar, Wafa Rashed, Omar Hamoui, Abdoul Kane, Mohamed Alami, Paula Abreu, Walid M Mashhoud

Affiliations

  1. Carbohydrate & Lipid Metabolism Research Unit, Division of Endocrinology & Metabolism, Department of Medicine, Faculty of Health Sciences, Johannesburg Hospital, University of the Witwatersrand, Parktown, Johannesburg, 2193 South Africa.
  2. College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
  3. Pfizer Gulf FZ LLC, Dubai Media City, Dubai, United Arab Emirates.
  4. 4Cardiology Division, Mubarak Al-Kabeer Hospital, Kuwait City, Kuwait.
  5. Clemenceau Medical Center, Cardiovascular Diseases, Beirut, Lebanon.
  6. 6Department of Cardiology, Dakar University, Hospital General de Grand Yoff, Dakar, Senegal.
  7. Private Practice, Casablanca, Morocco.
  8. 8Pfizer Inc, New York, NY USA.
  9. Pfizer Saudi Limited, Jeddah, Saudi Arabia.

PMID: 29449941 PMCID: PMC5812200 DOI: 10.1186/s13690-018-0257-5

Abstract

BACKGROUND: A significant number of cardiovascular disease (CVD)-related deaths occur in developing countries. An increasing prevalence of CVD is associated with a change in the macro-economy of these countries. In this post hoc analysis, CVD risk factor (CVDRF) prevalence is evaluated across countries based on national income in the Africa and Middle East Region (AfME).

METHODS: Data from the Africa Middle East Cardiovascular Epidemiological (ACE) study were used; a cross-sectional study in 14 AfME countries (94 clinics) from July 2011-April 2012, which evaluated CVDRF prevalence in stable adult outpatients. World Bank definitions were used to classify countries as low-income (LI), lower-middle-income (LMI), upper-middle-income (UMI) or high-income (HI) countries. Four thousand three hundred seventy-eight subjects were recruited where 260 (6%), 1324 (30%), 1509 (35%) and 1285 (29%) were from LI, LMI, UMI, and HI countries, respectively.

RESULTS: Of all the CVDRFs evaluated, almost two-thirds of the study population across the national income groups had abdominal obesity and dyslipidemia. Countries in the HI category were associated with a higher prevalence of diabetes (32%), obesity (44%) and smoking (16%). UMI and HI countries were associated with higher clustering of CVDRFs where at least one-third of subjects having four or more CVDRFs. Lower income countries had lower blood pressure control rates and lower percentages of outpatients achieving LDL-cholesterol targets.

CONCLUSION: The burden of CVDRFs in stable outpatients is high across the national income categories in the AfME region, with HI countries showing a higher prevalence of CVDRFs. The high burden in lower income countries is associated with sub-optimal control of dyslipidemia and hypertension. Lowering the CVDRF burden would need specific public health actions in line with positive changes in the macro-economy of these countries.

TRIAL REGISTRATION: The ACE trial is registered under NCT01243138.

Keywords: Africa; Cardiovascular risk; Developing countries; Epidemiology; Middle East

Conflict of interest statement

Ethics approval was obtained from all participating centers and appropriate regulatory bodies in each country. All patients provided informed consent.Frederick J. Raal has received research grants, ho

References

  1. N Engl J Med. 2014 Aug 28;371(9):818-27 - PubMed
  2. Lancet. 2015 Jan 10;385(9963):117-71 - PubMed
  3. Lancet Glob Health. 2013 Nov;1(5):e259-81 - PubMed
  4. PLoS One. 2014 Aug 04;9(8):e102830 - PubMed
  5. Circulation. 2002 Dec 17;106(25):3143-421 - PubMed
  6. Diabetes Care. 2010 Jan;33 Suppl 1:S62-9 - PubMed
  7. Lancet. 2005 Sep 24-30;366(9491):1059-62 - PubMed
  8. Am Heart J. 2009 Jul;158(1):1-7.e1 - PubMed
  9. Eur Heart J. 2007 Oct;28(19):2375-414 - PubMed
  10. Lancet. 2015 Jul 25;386(9991):399-402 - PubMed
  11. Lancet. 2014 Jan 25;383(9914):356-67 - PubMed
  12. Circulation. 2001 Nov 27;104(22):2746-53 - PubMed
  13. Circulation. 2005 Dec 6;112(23):3536-40 - PubMed
  14. N Engl J Med. 2015 Apr 2;372(14):1333-41 - PubMed
  15. J Hypertens. 2003 Apr;21(4):707-16 - PubMed
  16. Int J Epidemiol. 2011 Dec;40(6):1652-66 - PubMed
  17. Lancet Diabetes Endocrinol. 2014 Aug;2(8):634-47 - PubMed

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