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.

Pubmed ID: 34957436

Pubmed Central ID: PMC8669782

Journal: Lancet regional health. Americas

Publication Date: Dec. 1, 2021

Authors: Ezzati M, Danaei G, Fuchs SC, Fuchs FD, Moreira LB, Gregg EW, Mill JG, Aguilar-Salinas CA, Di Cesare M, Rojas-Martinez R, Pereira AC, Cooper JA, Carrillo-Larco RM, Hambleton IR, Hennis A, Irazola V, Stern D, Ferreccio C, Lotufo P, Perel P, Miranda JJ, Alvarez-Váz R, Amadio MB, Baccino C, Bambs C, Bastos JL, Beckles G, Bernabe-Ortiz A, Bloch KV, Blümel JE, Boggia JG, Borges PK, Bravo M, Brenes-Camacho G, Carbajal HA, Ceballos BH, Colpani V, Cortes S, Cunha RS, d'Orsi E, Dow WH, Espeche WG, Gomez-Velasco D, Gonzalez-Villalpando C, Gonzalez-Villalpando ME, Gonzalez-Chica DA, Grazioli G, Guerra RO, Gutierrez L, Herkenhoff FL, Huidobro A, Koch E, Lajous M, Lima-Costa MF, Lopez-Ridaura R, Manrique-Espinoza BS, Marques LP, Ono LM, Muñoz OM, Oppermann K, Peixoto SV, Peres KG, Peres MA, Rodriguez NI, Rosero-Bixby L, Rubinstein A, Ruiz-Morales A, Salazar MR, Salinas-Rodriguez A, Sanchez RA, Smeeth L, Spritzer PM, Tartaglione F, Tartaglione J, Bernardo CD, Rascon MSC, Cortes-Valencia A, Gimeno SG, Horimoto AR, Maciel AC, Paiva KM, Ramírez-Palacios P, Rech CR, Rivera-Paredez B, Salmerón J, Silva NA, Silva TL, Velázquez-Cruz R

Cite As: Cohorts Consortium of Latin America and the Caribbean (CC-LAC). 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. Lancet Reg Health Am 2021 Dec;4:None.

Studies:

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 unknown. 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 100,000 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 estimated from cohorts in high-income countries. FUNDING: Wellcome Trust (214185/Z/18/Z).