DSpace Repository

Endemic Cardiovascular Diseases of the Poorest Billion

Show simple item record

dc.contributor.author Kwan, Gene-F.
dc.contributor.author Mayosi, Bongani-M.
dc.contributor.author Mocumbi, Ana-O.
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Ezzati, Majid
dc.contributor.author Jain, Yogesh
dc.contributor.author Robles, Gisela
dc.contributor.author Benjamin, Emelia-J.
dc.contributor.author Subramanian, S. V.
dc.contributor.author Bukhman, Gene
dc.date.accessioned 2019-02-06T14:45:36Z
dc.date.available 2019-02-06T14:45:36Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/5095
dc.description.abstract The poorest billion people are distributed throughout the world, though most are concentrated in rural sub-Saharan Africa and South Asia. Cardiovascular disease (CVD) data can be sparse in low- and middle-income countries beyond urban centers. Despite this urban bias, CVD registries from the poorest countries have long revealed a predominance of nonatherosclerotic stroke, hypertensive heart disease, nonischemic and Chagas cardiomyopathies, rheumatic heart disease, and congenital heart anomalies, among others. Ischemic heart disease has been relatively uncommon. Here, we summarize what is known about the epidemiology of CVDs among the world's poorest people and evaluate the relevance of global targets for CVD control in this population. We assessed both primary data sources, and the 2013 Global Burden of Disease Study modeled estimates in the world's 16 poorest countries where 62% of the population are among the poorest billion. We found that ischemic heart disease accounted for only 12% of the combined CVD and congenital heart anomaly disability-adjusted life years (DALYs) in the poorest countries, compared with 51% of DALYs in high-income countries. We found that as little as 53% of the combined CVD and congenital heart anomaly burden (1629/3049 DALYs per 100 000) was attributed to behavioral or metabolic risk factors in the poorest countries (eg, in Niger, 82% of the population among the poorest billion) compared with 85% of the combined CVD and congenital heart anomaly burden (4439/5199 DALYs) in high-income countries. Further, of the combined CVD and congenital heart anomaly burden, 34% was accrued in people under age 30 years in the poorest countries, while only 3% is accrued under age 30 years in high-income countries. We conclude although the current global targets for noncommunicable disease and CVD control will help diminish premature CVD death in the poorest populations, they are not sufficient. Specifically, the current framework (1) excludes deaths of people <30 years of age and deaths attributable to congenital heart anomalies, and (2) emphasizes interventions to prevent and treat conditions attributed to behavioral and metabolic risks factors. We recommend a complementary strategy for the poorest populations that targets premature death at younger ages, addresses environmental and infectious risks, and introduces broader integrated health system interventions, including cardiac surgery for congenital and rheumatic heart disease. en_US
dc.language.iso eng
dc.publisher Wolters Kluwer Health
dc.relation.ispartofseries Circulation
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject cardiomyopathies en_US
dc.subject cardiovascular diseases en_US
dc.subject Cardiovascular Diseases/economics/epidemiology en_US
dc.subject congenital heart disease en_US
dc.subject Endemic Diseases en_US
dc.subject epidemiology en_US
dc.subject Female en_US
dc.subject global health en_US
dc.subject Global Health en_US
dc.subject health equity en_US
dc.subject Health Status Disparities en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject poverty en_US
dc.subject Poverty en_US
dc.subject rheumatic heart disease en_US
dc.subject Risk Factors en_US
dc.title Endemic Cardiovascular Diseases of the Poorest Billion en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1161/CIRCULATIONAHA.116.008731
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.04
dc.relation.issn 1524-4539


Files in this item

Files Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record

info:eu-repo/semantics/restrictedAccess Except where otherwise noted, this item's license is described as info:eu-repo/semantics/restrictedAccess

Search DSpace


Browse

My Account

Statistics