BACKGROUND: Cardiovascular disease is the leading cause of death in Argentina and the U.S. Argentina is 92% urban, with cardiovascular disease risk factor levels approximating the U.S. METHODS: The Coronary Heart Disease (CHD) Policy Model is a national-scale computer model of CHD and stroke. Risk factor data were obtained from the Cardiovascular Risk Factor Multiple Evaluation in Latin America Study (2003-04), Argentina National Risk Factor Survey (2005) and U.S. national surveys. Proportions of cardiovascular events over 2005-2015 attributable to risk factors were simulated by setting risk factors to optimal exposure levels [systolic blood pressure (SBP) 115 mm Hg, low-density lipoprotein cholesterol (LDL) 2.00 mmol/l (78 mg/dl), high-density lipoprotein cholesterol (HDL) 1.03 mmol/l (60 mg/dl), absence of diabetes, and smoking]. Cardiovascular disease attributable to body mass index (BMI) >21 kg/m² was assumed mediated through SBP, LDL, HDL, and diabetes. RESULTS: Cardiovascular disease attributable to major risk factors was similar between Argentina and the U.S., except for elevated SBP in men (CHD 8% points higher in Argentine men, 6% higher for stroke). CHD attributable to BMI >21 kg/m² was substantially higher in the U.S. (men 10-11% points higher; women CHD 13-14% higher). CONCLUSIONS: Projected cardiovascular disease attributable to major risk factors appeared similar in Argentina and the U.S., though elevated BMI may be responsible for more of U.S. cardiovascular disease. A highly urbanized middle-income nation can have cardiovascular disease rates and risk factor levels comparable to a high income nation, but fewer resources for fighting the epidemic.
BACKGROUND:Cardiovascular disease is the leading cause of death in Argentina and the U.S. Argentina is 92% urban, with cardiovascular disease risk factor levels approximating the U.S. METHODS: The Coronary Heart Disease (CHD) Policy Model is a national-scale computer model of CHD and stroke. Risk factor data were obtained from the Cardiovascular Risk Factor Multiple Evaluation in Latin America Study (2003-04), Argentina National Risk Factor Survey (2005) and U.S. national surveys. Proportions of cardiovascular events over 2005-2015 attributable to risk factors were simulated by setting risk factors to optimal exposure levels [systolic blood pressure (SBP) 115 mm Hg, low-density lipoprotein cholesterol (LDL) 2.00 mmol/l (78 mg/dl), high-density lipoprotein cholesterol (HDL) 1.03 mmol/l (60 mg/dl), absence of diabetes, and smoking]. Cardiovascular disease attributable to body mass index (BMI) >21 kg/m² was assumed mediated through SBP, LDL, HDL, and diabetes. RESULTS:Cardiovascular disease attributable to major risk factors was similar between Argentina and the U.S., except for elevated SBP in men (CHD 8% points higher in Argentinemen, 6% higher for stroke). CHD attributable to BMI >21 kg/m² was substantially higher in the U.S. (men 10-11% points higher; women CHD 13-14% higher). CONCLUSIONS: Projected cardiovascular disease attributable to major risk factors appeared similar in Argentina and the U.S., though elevated BMI may be responsible for more of U.S. cardiovascular disease. A highly urbanized middle-income nation can have cardiovascular disease rates and risk factor levels comparable to a high income nation, but fewer resources for fighting the epidemic.
Authors: Majid Ezzati; Stephen Vander Hoorn; Anthony Rodgers; Alan D Lopez; Colin D Mathers; Christopher J L Murray Journal: Lancet Date: 2003-07-26 Impact factor: 79.321
Authors: R Cooper; J Cutler; P Desvigne-Nickens; S P Fortmann; L Friedman; R Havlik; G Hogelin; J Marler; P McGovern; G Morosco; L Mosca; T Pearson; J Stamler; D Stryer; T Thom Journal: Circulation Date: 2000-12-19 Impact factor: 29.690
Authors: Kirsten Bibbins-Domingo; Glenn M Chertow; Pamela G Coxson; Andrew Moran; James M Lightwood; Mark J Pletcher; Lee Goldman Journal: N Engl J Med Date: 2010-01-20 Impact factor: 91.245
Authors: Honorio Silva; Rafael Hernandez-Hernandez; Raul Vinueza; Manuel Velasco; Carlos Pablo Boissonnet; Jorge Escobedo; H Elif Silva; Palmira Pramparo; Elinor Wilson Journal: Am J Ther Date: 2010 Mar-Apr Impact factor: 2.688
Authors: Andrea L C Schneider; Andreea M Rawlings; A Richey Sharrett; Alvaro Alonso; Thomas H Mosley; Ron C Hoogeveen; Christie M Ballantyne; Rebecca F Gottesman; Elizabeth Selvin Journal: Eur Heart J Date: 2014-03-30 Impact factor: 29.983
Authors: Oscar H Del Brutto; Chuanhui Dong; Tatjana Rundek; Mitchell S V Elkind; Victor J Del Brutto; Ralph L Sacco Journal: J Community Health Date: 2013-08
Authors: Chad E Darling; Javier A Sala Mercado; Walter Quiroga-Castro; Gabriel F Tecco; Felix R Zelaya; Eduardo C Conci; Jose P Sala; Craig S Smith; Alan D Michelson; Peter Whittaker; Robert D Welch; Karin Przyklenk Journal: BMJ Open Date: 2014-01-17 Impact factor: 2.692