New research from Harvard T. H. Chan School of Public Health and Imperial College London shows that more people are at high risk of developing fatal cardiovascular disease (CVD) in many developing countries than in developed countries, such as the U.S.
This finding comes from a research team that developed the first global model for predicting CVD risk at a nation-by-nation level. Their paper on the new method, and its application in several countries, was published recently.
Global health officials have long warned that the “diseases of modernization,” such as CVD, have the potential to overwhelm the health and health systems of countries as they modernize and adopt more sedentary lifestyles. This study highlights the fallout of such modernization, with fatal CVD risk rates highest in the Czech Republic, China, Iran, and Mexico and lowest in South Korea, Spain, Japan, and Denmark.
In China, 33% of men and 28% of women had a fatal CVD risk of 10% or higher over a 10-year period. In Mexico the prevalence of high-risk CVD was 16% for men and 11% for women. By comparison, in countries such as Spain, Japan, and Denmark, only 5%-10% of men and women have a risk of developing a fatal CVD.
Risk of fatal CVD in the U.S. was higher, however, than in some of the other developed countries in the study. More men and women in the U.S., as compared with men and women in Denmark, South Korea, and Spain, were at 10% or higher risk of fatal CVD. In fact, the prevalence of women at high risk in the U.S. (11%) and England (10%) was more similar to Mexico (11%) than to other high-income countries examined in the study.
To develop the model, which will be available later this year at www.globorisk.org, the researchers analyzed data from more than 50,000 participants in eight existing long-term studies, which included risk factors such as blood pressure, cholesterol, diabetes, and smoking, as well as gender and age.
The researchers generated risk charts that estimated risk of fatal CVD over a span of 10 years for 11 countries in different regions of the world.
“This new tool will allow healthcare professionals around the world to make optimal clinical decisions about treatment of their patients and for health policy makers to efficiently allocate resources to CVD prevention,” said Goodarz Danaei, assistant professor of global health at Harvard Chan School and senior author of the paper.
The results emphasize the need to use the current momentum for universal health coverage to ensure that people at high risk of CVD in low- and middle-income countries receive the same basic treatments available to those in the high-income world, according to the authors. The U.S. results also demonstrate the urgent need for equitable access to primary health care as a tool for CVD prevention, the authors said.
Illustration: Harvard T. H. Chan School of Public Health.
Harvard T. H. Chan School of Public Health News Release (03/25/15)
Science Daily (03/25/15)
Abstract (The Lancet Diabetes & Endocrinology; (03/25/15))