Impact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: an individual-level pooled analysis of 31 cohort studies

Article

Carrillo-Larco, R., Stern, D., Hambleton, I., Hennis, A., Cesare, M., Lotufo, P., Ferreccio, C., Irazola, V., Perel, P., Gregg, E., Miranda, J., Ezzati, M., Danaei, G., Carrillo-Larco, R., Stern, D., Hambleton, I., Hennis, A., Di Cesare, M., Lotufo, P., Ferreccio, C., Irazola, V., Perel, P., Gregg, E., Miranda, J., Ezzati, M., Danaei, G., Aguilar-Salinas, C., Alvarez-Váz, R., Amadio, M., Baccino, C., Bambs, C., Bastos, J., Beckles, G., Bernabe-Ortiz, A., Bernardo, C., Bloch, K., Blümel, J., Boggia, J., Borges, P., Bravo, M., Brenes-Camacho, G., Carbajal, H., Rascon, M., Ceballos, B., Colpani, V., Cooper, J., Cortes, S., Cortes-Valencia, A., Cunha, R., d'Orsi, E., Dow, W., Espeche, W., Fuchs, F., Fuchs, S., Gimeno, S., Gomez-Velasco, D., Gonzalez-Chica, D., Gonzalez-Villalpando, C., Gonzalez-Villalpando, M., Grazioli, G., Guerra, R., Gutierrez, L., Herkenhoff, F., Horimoto, A., Huidobro, A., Koch, E., Lajous, M., Lima-Costa, M., Lopez-Ridaura, R., Maciel, A., Manrique-Espinoza, B., Marques, L., Mill, J., Moreira, L., Muñoz, O., Ono, L., Oppermann, K., Paiva, K., Peixoto, S., Pereira, A., Peres, K., Peres, M., Ramírez-Palacios, P., Rech, C., Rivera-Paredez, B., Rodriguez, N., Rojas-Martinez, R., Rosero-Bixby, L., Rubinstein, A., Ruiz-Morales, A., Salazar, M., Salinas-Rodriguez, A., Salmerón, J., Sanchez, R., Silva, N., Silva, T., Smeeth, L., Spritzer, P., Tartaglione, F., Tartaglione, J. and Velázquez-Cruz, R. 2021. Impact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: an individual-level pooled analysis of 31 cohort studies. The Lancet Regional Health - Americas. 4, pp. 1-12. https://doi.org/10.1016/j.lana.2021.100068
TypeArticle
TitleImpact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: an individual-level pooled analysis of 31 cohort studies
AuthorsCarrillo-Larco, R., Stern, D., Hambleton, I., Hennis, A., Cesare, M., Lotufo, P., Ferreccio, C., Irazola, V., Perel, P., Gregg, E., Miranda, J., Ezzati, M., Danaei, G., Carrillo-Larco, R., Stern, D., Hambleton, I., Hennis, A., Di Cesare, M., Lotufo, P., Ferreccio, C., Irazola, V., Perel, P., Gregg, E., Miranda, J., Ezzati, M., Danaei, G., Aguilar-Salinas, C., Alvarez-Váz, R., Amadio, M., Baccino, C., Bambs, C., Bastos, J., Beckles, G., Bernabe-Ortiz, A., Bernardo, C., Bloch, K., Blümel, J., Boggia, J., Borges, P., Bravo, M., Brenes-Camacho, G., Carbajal, H., Rascon, M., Ceballos, B., Colpani, V., Cooper, J., Cortes, S., Cortes-Valencia, A., Cunha, R., d'Orsi, E., Dow, W., Espeche, W., Fuchs, F., Fuchs, S., Gimeno, S., Gomez-Velasco, D., Gonzalez-Chica, D., Gonzalez-Villalpando, C., Gonzalez-Villalpando, M., Grazioli, G., Guerra, R., Gutierrez, L., Herkenhoff, F., Horimoto, A., Huidobro, A., Koch, E., Lajous, M., Lima-Costa, M., Lopez-Ridaura, R., Maciel, A., Manrique-Espinoza, B., Marques, L., Mill, J., Moreira, L., Muñoz, O., Ono, L., Oppermann, K., Paiva, K., Peixoto, S., Pereira, A., Peres, K., Peres, M., Ramírez-Palacios, P., Rech, C., Rivera-Paredez, B., Rodriguez, N., Rojas-Martinez, R., Rosero-Bixby, L., Rubinstein, A., Ruiz-Morales, A., Salazar, M., Salinas-Rodriguez, A., Salmerón, J., Sanchez, R., Silva, N., Silva, T., Smeeth, L., Spritzer, P., Tartaglione, F., Tartaglione, J. and Velázquez-Cruz, R.
Abstract

Background: Estimates of the burden of cardio-metabolic risk factors in Latin America and the Caribbean (LAC) rely on relative risks (RRs) from non-LAC countries. Whether these RRs apply to LAC remains un- known.
Methods: We pooled LAC cohorts. We estimated RRs per unit of exposure to body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC) and non-HDL cholesterol on fatal (31 cohorts, n = 168,287) and non-fatal (13 cohorts, n = 27,554) cardiovascular diseases, adjusting for regression dilution bias. We used these RRs and national data on mean risk factor levels to estimate the number of cardiovascular deaths attributable to non-optimal levels of each risk factor.
Results: Our RRs for SBP, FPG and TC were like those observed in cohorts conducted in high-income countries; however, for BMI, our RRs were consistently smaller in people below 75 years of age. Across risk factors, we observed smaller RRs among older ages. Non-optimal SBP was responsible for the largest number of attributable cardiovascular deaths ranging from 38 per 10 0,0 0 0 women and 54 men in Peru, to 261 (Dominica, women) and 282 (Guyana, men). For non-HDL cholesterol, the lowest attributable rate was for women in Peru (21) and men in Guatemala (25), and the largest in men (158) and women (142) from Guyana.
Interpretation: RRs for BMI from studies conducted in high-income countries may overestimate disease burden metrics in LAC; conversely, RRs for SBP, FPG and TC from LAC cohorts are similar to those esti- mated from cohorts in high-income countries.

PublisherElsevier
JournalThe Lancet Regional Health - Americas
ISSN2667-193X
Publication dates
Online17 Sep 2021
Print31 Dec 2021
Publication process dates
Deposited24 Sep 2021
Accepted24 Aug 2021
Output statusPublished
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Copyright Statement

© 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

Digital Object Identifier (DOI)https://doi.org/10.1016/j.lana.2021.100068
LanguageEnglish
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