Research published in journals nature human behavior Estimate the prevalence of cardiovascular disease risk factors in adults living in extreme poverty.

Study: Prevalence of cardiovascular disease risk factors in adults living in extreme poverty. Image credit: Cozine / Shutterstock

background

Adults living in extreme poverty in low- and middle-income countries are generally thought to have lower rates of cardiovascular disease and its risk factors, such as obesity, diabetes, hypertension, dyslipidemia, and smoking.

Adults living in extreme poverty typically consume low-calorie, plant-based foods and have occupations that require high-intensity physical activity. These lifestyle patterns may play a role in lowering the risk of cardiovascular disease.

Accurately estimating the prevalence of cardiovascular risk factors in this subpopulation is particularly important for guiding health policy and health care delivery. However, limited data on this issue are currently available from nationally representative surveys.

In this study, scientists identified five major health problems, including hypertension, diabetes, obesity, dyslipidemia, and smoking, among adults living below the World Bank’s International Extreme Poverty Line (income less than $1.90 per day). We estimated the prevalence of vascular disease risk factors. In the world.

research design

The scientists pooled individual-level data from 105 nationally representative household surveys across 78 countries. This equates to her 85% of the world’s population living in extreme poverty. The researchers identified this subpopulation by disaggregating individual-level data by country-specific measures of household income or wealth.

This study analyzed data from a total of 32,695,579 participants. Of all participants, 7,922,289 lived in extreme poverty (income less than $1.90 per day), 806,381 lived on $1.90 to $3.19 per day, and 806,381 lived on $3.20 to $5.49 per day. There were 748,078 people living on $5.50 or more per day, and 922,870 people living on more than $5.50 per day.

important findings

The estimated prevalence of five major cardiovascular disease risk factors in adults living in extreme poverty is hypertension 17.5%, diabetes 4.0%, current smoking 10.6%, obesity 3.1%, and dyslipidemia. was 1.4%.

Among adults earning high incomes (>$5.50/day), the prevalence of hypertension, diabetes, current smoking, obesity, and dyslipidemia was 20.8%, 7.6%, 21.1%, 14.2%, and 17, respectively. It was estimated that %.

In low-income and upper-middle-income countries, the prevalence of these risk factors among adults living in extreme poverty was not significantly lower than the prevalence among high-income groups.

Specifically, no significant differences in diabetes prevalence were observed between extremely poor adults and high-income individuals in low- and upper-middle-income countries. However, in low- and middle-income countries, a higher prevalence of diabetes was observed among high-income individuals. A similar pattern was observed for hypertension prevalence.

Similar to the prevalence of diabetes, lower prevalence of current smoking and dyslipidemia was observed across poverty levels in low-income countries, and higher prevalence across population income groups in upper-middle income countries. Observed. Variations in the prevalence of these risk factors by poverty level were found only in low- and middle-income countries.

On the other hand, the prevalence of obesity was positively correlated with the level of poverty.

Variations in prevalence due to demographic trends

When we stratified the prevalence of cardiovascular disease risk factors among poor adults by residence type, we found that urban residents had a higher prevalence of diabetes than rural residents.

Similar gender stratification revealed that men had a slightly higher prevalence of hypertension, a significantly higher prevalence of smoking, and a significantly lower prevalence of obesity compared to women.

Stratification by education revealed that smoking rates were higher among those with high school education or higher compared to those with no schooling.

Treatment of cardiovascular risk factors

Among poor adults with hypertension, approximately 15% reported taking antihypertensive medications, and 5% reported achieving control of their hypertension. Among patients with diabetes, approximately 19% reported taking hypoglycemic drugs. Only 1% of people who needed statins (cholesterol-lowering drugs) for secondary prevention of cardiovascular disease reported taking them.

We observed lower use of hypertension, antidiabetic, and statin drugs at each poverty level in low-income countries. The odds of taking these drugs were consistently lower among adults living at more extreme poverty levels in low- and middle-income countries. These patterns were less pronounced in upper-middle income countries.

Significance of research

The study found a high prevalence of cardiovascular disease risk factors among adults living in extreme poverty. This observation contradicts the current perception that the prevalence of these risk factors is low in this subpopulation, primarily due to their highly active lifestyle and low-calorie dietary habits.

This study can inform discussions about equity regarding resource allocation and the design of effective interventions.