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Cardiovascular risk and events in 17 low-, middle-, and high-income countries

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dc.contributor.authorYusuf, Salimspa
dc.contributor.authorRangarajan, Sumathyspa
dc.contributor.authorTeo, Koonspa
dc.contributor.authorIslam, Shofiqulspa
dc.contributor.authorLi, Weispa
dc.contributor.authorLiu, Lishengspa
dc.contributor.authorBo, Jianspa
dc.contributor.authorLou, Qinglinspa
dc.contributor.authorLu, Fanghongspa
dc.contributor.authorLiu, Tianluspa
dc.contributor.authorYu, Liuspa
dc.contributor.authorZhang, Shiyingspa
dc.contributor.authorMony, Premspa
dc.contributor.authorSwaminathan, Sumathispa
dc.contributor.authorMohan, Viswanathanspa
dc.contributor.authorGupta, Rajeevspa
dc.contributor.authorKumar, Rajeshspa
dc.contributor.authorVijayakumar, Krishnapillaispa
dc.contributor.authorLear, Scott A.spa
dc.contributor.authorAnand, Sonia S.spa
dc.contributor.authorWielgosz, Andreasspa
dc.contributor.authorDiaz, Rafaelspa
dc.contributor.authorAvezum, Alvarospa
dc.contributor.authorLopez-Jaramillo, Patriciospa
dc.contributor.authorLanas, Fernandospa
dc.contributor.authorYusoff, Khalidspa
dc.contributor.authorIsmail, Noorhassimspa
dc.contributor.authorIqbal, Romainaspa
dc.contributor.authorRahman, Omarspa
dc.contributor.authorRosengren, Annikaspa
dc.contributor.authorYusufali, Afzalhusseinspa
dc.contributor.authorKelishadi, Royaspa
dc.contributor.authorKruger, Annamariespa
dc.contributor.authorPuoane, Thandispa
dc.contributor.authorSzuba, Andrzejspa
dc.contributor.authorChifamba, Jephatspa
dc.contributor.authorOguz, Aytekinspa
dc.contributor.authorMcQueen, Matthew J.spa
dc.contributor.authorMcKee, Martinspa
dc.contributor.authorDagenais, Gillesspa
dc.contributor.authorThe PURE (Prospective Urban Rural Epidemiology) Study investigatorseng
dc.date.accessioned2019-08-08T13:34:37Zspa
dc.date.available2019-08-08T13:34:37Zspa
dc.date.issued2014-08-28spa
dc.description10 p.spa
dc.description.abstractBACKGROUND More than 80% of deaths from cardiovascular disease are estimated to occur in low-income and middle-income countries, but the reasons are unknown. METHODS We enrolled 156,424 persons from 628 urban and rural communities in 17 countries (3 high-income, 10 middle-income, and 4 low-income countries) and assessed their cardiovascular risk using the INTERHEART Risk Score, a validated score for quantifying risk-factor burden without the use of laboratory testing (with higher scores indicating greater risk-factor burden). Participants were followed for incident cardiovascular disease and death for a mean of 4.1 years. RESULTS The mean INTERHEART Risk Score was highest in high-income countries, intermediate in middle-income countries, and lowest in low-income countries (P<0.001). However, the rates of major cardiovascular events (death from cardiovascular causes, myocardial infarction, stroke, or heart failure) were lower in high-income countries than in middle- and low-income countries (3.99 events per 1000 person-years vs. 5.38 and 6.43 events per 1000 person-years, respectively; P<0.001). Case fatality rates were also lowest in high-income countries (6.5%, 15.9%, and 17.3% in high-, middle-, and low-income countries, respectively; P=0.01). Urban communities had a higher risk-factor burden than rural communities but lower rates of cardiovascular events (4.83 vs. 6.25 events per 1000 person-years, P<0.001) and case fatality rates (13.52% vs. 17.25%, P<0.001). The use of preventive medications and revascularization procedures was significantly more common in high-income countries than in middle- or low-income countries (P<0.001). CONCLUSIONS Although the risk-factor burden was lowest in low-income countries, the rates of major cardiovascular disease and death were substantially higher in low-income countries than in high-income countries. The high burden of risk factors in high-income countries may have been mitigated by better control of risk factors and more frequent use of proven pharmacologic therapies and revascularization. (Funded by the Population Health Research Institute and others.)eng
dc.format.mimetypeapplication/pdfspa
dc.identifier.doi10.1056/NEJMoa1311890spa
dc.identifier.isbn1533-4406spa
dc.identifier.issn0028-4793spa
dc.identifier.urihttps://repositorio.udes.edu.co/handle/001/3542spa
dc.language.isoengspa
dc.relation.ispartofNew England Journal of Medicineeng
dc.rightsDerechos Reservados - The Authors, New England Journal of Medicine, 2014spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial 4.0 Internacional (CC BY-NC 4.0)spa
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/spa
dc.sourcehttps://www.researchgate.net/publication/267509668_Cardiovascular_Risk_and_Events_in_17_Low-_Middle-_and_High-Income_Countries/link/5720bd2508aead26e7210970/downloadeng
dc.subject.proposalCardiovasculareng
dc.subject.proposalRiskeng
dc.subject.proposalEventseng
dc.titleCardiovascular risk and events in 17 low-, middle-, and high-income countrieseng
dc.typeArtículo de revistaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_6501spa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/articlespa
dc.type.redcolhttp://purl.org/redcol/resource_type/ARTspa
dc.type.versioninfo:eu-repo/semantics/publishedVersionspa
dspace.entity.typePublication
oaire.accessrightshttp://purl.org/coar/access_right/c_abf2spa
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85spa
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