A large proportion of cardiovascular disease events and mortality can be attributed to a small number of modifiable risk factors. This cohort study has been carried out in 21 countries where the researchers have examined 14 modifiable risk factors.
Approximately 70% of cardiovascular disease cases and deaths in the overall study population were attributed to modifiable risk factors. The modifiable risk factors are tobacco use, alcohol, diet, physical activity and sodium intake. Metabolic factors include lipids, blood pressure, diabetes and obesity. Socioeconomic factors included are education, symptoms of depression, besides household and ambient pollution.
The study highlighted the importance of addressing both
household and ambient air pollution to reduce cardiovascular disease and death.
“In the middle-income and low-income countries exposure to both forms of air
pollution is high. Ambient air pollution is primarily associated with higher
risk of cardiovascular disease, while indoor air pollution is strongly
associated with a higher risk of death.” said Dr Manmeet Kaur, Post Graduate
Institute of Medical Education and Research, Chandigarh while speaking with
India Science Wire.
“Several risk factors such as low education and indoor
and outdoor air pollution that were underappreciated in the past have turned
out to be more important than others,” said Philip Joseph, a joint lead author
of the paper.
The study included four high-income countries, twelve
middle-income countries and five low-income countries. In the study the
researchers examined associations of 14 modifiable risk factors with mortality
and cardiovascular disease of 155722 participants without a prior history of
cardiovascular disease. Out of these participants, 35,793 were from India.
“In developing countries women are more prone to
cardiovascular diseases than men, as being at home they encounter indoor
pollution more than men. The particulate matter is found to be more indoors” said
Prof V R Kutty (Health Action by People, Trivandrum).
The study also points out that among the behavioral risk
factors, tobacco had the strongest association with cardiovascular disease, followed
by physical inactivity and low-quality diet. Of the metabolic risk factors,
hypertension was strongly associated with cardiovascular disease followed by
diabetes, elevated non-HDL (High Density Lipoprotein) cholesterol and increased
waist-to-hip ratio. There were other important factors that are associated with
higher risk of cardiovascular disease like low education levels, symptoms of
depression, low grip strength and household pollution.
The study also says that in high-income countries the risk
of cardiovascular diseases is highly associated with tobacco whereas in low income
countries the risk was highest with low education levels. And the risk
associated with diabetes was highest in high-income countries and low-income
The research paper has been published in journal The
Lancet and the research was led by researchers of the Population Health
Research Institute (PHRI) of McMaster University and Hamilton Health Sciences
in Hamilton, Canada.
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