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Int J Cardiol. 2011 Aug 4;150(3):332-7. doi: 10.1016/j.ijcard.2011.04.013. Epub 2011 May 7.

Coronary heart disease and stroke attributable to major risk factors is similar in Argentina and the United States: the Coronary Heart Disease Policy Model.

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  • 1Division of General Medicine, Columbia University Medical Center, New York, USA. aem35@columbia.edu

Abstract

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.

Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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PMID:
21550675
[PubMed - indexed for MEDLINE]
PMCID:
PMC3139755
Free PMC Article

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