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Circulation. 2013 Apr 9;127(14):1493-502, 1502e1-8. doi: 10.1161/CIRCULATIONAHA.113.001470. Epub 2013 Mar 12.

The global cardiovascular risk transition: associations of four metabolic risk factors with national income, urbanization, and Western diet in 1980 and 2008.

Collaborators (321)

Aamodt G, Aamodt G, Abdeen Z, Abdella NA, Rahim HF, Addo J, Aekplakorn W, Afifi MM, Agabiti-Rosei E, Aguilar Salinas CA, Agyemang C, Ali MM, Al-Nsour M, Al-Nuaim AR, Ambady R, Aro P, Azizi F, Barbagallo CM, Barbieri MA, Barceló A, Barreto SM, Barros H, Bautista LE, Benetos A, Bjerregaard P, Björkelund C, Bo S, Bobak M, Bonora E, Bontha BV, Botana MA, Bovet P, Breckenkamp J, Breteler MM, Broda G, Brown IJ, Bursztyn M, Cabrera de León A, Campos H, Cappuccio FP, Capuano V, Casiglia E, Castellano M, Castetbon K, Cea L, Chang CJ, Chaouki N, Chatterji S, Chen Z, Chen CJ, Choi JS, Chua L, Cífková R, Cobiac LJ, Cooper RS, Corsi AM, Costanza MC, Craig CL, Dankner RS, Dastgiri S, Delgado E, Dinc G, Doi Y, Dong GH, Dorsi E, Dragano N, Drewnowski A, Eggertsen W, Elliott P, Engeland A, Erem C, Esteghamati A, Fall CH, Fan JG, Ferreccio C, Fezeu L, Firmo JO, Florez HJ, Fornés NS, Fowkes FG, Franceschini G, Frisk F, Fuchs FD, Fuller EL, Getz L, Giampaoli S, Gómez LF, Gomez-Zumaquero JM, Graff-Iversen S, Grant JF, Guerrero Carvajal R, Gulliford MC, Gupta R, Gupta PC, Gureje O, Hansen TW, Hata J, He J, Heim N, Heinrich J, Hemmingsson T, Hennis A, Herman WH, Herrera VM, Ho S, Holdsworth M, Hollman Frisman G, Hopman WM, Hussain A, Husseini A, Ibrahim M, Ikeda N, Jacobsen BK, Jaddou HY, Jafar TH, Janghorbani M, Jasienska G, Joffres MR, Jonas JB, Kadiki OA, Kalter-Leibovici O, Kamadjeu RM, Karalis I, Kastarinen MJ, Katz J, Keinan-Boker L, Kelly P, Khalilzadeh O, Khang YH, Kiechl S, Kim KW, Kiyohara Y, Kobayashi J, Krause MP, Kubínová R, Kurjata P, Kusuma YS, Lam TH, Langhammer A, Lawes CM, Le C, Lee J, Lévy-Marchal C, Li Y, Li Y, Lim S, Lim TO, Lin X, Lin CC, Lin X, Lin HH, Lind L, Lissner L, Liu X, Lopez-Jaramillo P, Lorbeer R, Lorbeer R, Ma G, Ma S, Macià F, MacLean DR, Maggi S, Magliano DJ, Makdisse M, Mancia G, Mannami T, Marques-Vidal P, Mbanya JC, McFarlane-Anderson N, Miccoli R, Miettola J, Minh HV, Miquel JF, Miranda J, Mohamed MK, Mohan V, Mohanna S, Mokdad A, Mollentze WF, Morales DD, Morgan K, Muiesan LM, Muntoni S, Nabipour I, Nakagami T, Nangia V, Nemesure B, Neovius M, Nerhus KA, Nervi F, Neuhauser H, Nguyen M, Ninomiya T, Noale M, Oh SW, Ohkubo T, Olivieri O, Önal AE, Onat A, Oróstegui M, Ouedraogo H, Pan WH, Panagiotakos DB, Panza F, Park Y, Passos VM, Pednekar MS, Peres MA, Pérez C, Pérez-Fernández R, Pichardo R, Phua HP, Pistelli F, Plans P, Polakowska M, Poulter N, Prabhakaran D, Qiao Q, Rafiei M, Raitakari OT, Ramos LR, Rampal S, Rampal L, Rasmussen F, Reddy KK, Redon J, Revilla L, Reyes-García V, Roaeid RB, Rodriguez-Artalejo F, Rojas-Martinez R, Ronkainen K, Rosero-Bixby L, Roth GA, Sachdev HS, Sánchez JR, Sanisoglu SY, Sans S, Sarraf-Zadegan N, Scazufca M, Schaan BD, Schapochnik N, Schelleman H, Schneider IJ, Schooling C, Schwarz B, Sekuri C, Sereday MS, Serra-Majem L, Shaw J, Shera AS, Shi Z, Shiri R, Shu XO, Silva DA, Silva E, Simons LA, Smith M, Söderberg S, Soebardi S, Solfrizzi V, Sonestedt E, Soysal A, Stattin P, Stein AD, Stergiou GS, Stessman J, Sudo A, Suka M, Sundh V, Sundquist K, Sundström J, Swai AB, Tai E, Tambs K, Tesfaye F, Thomas GN, Thorogood M, Tilvis RS, Tobias M, Torheim LE, Trenkwalder P, Tuomilehto JO, Tur JA, Tzourio C, Uhernik AI, Ukoli FA, Unwin N, Vander Hoorn S, Vanderpump MP, Varo JJ, Veierød B, Velásquez-Meléndez G, Verschuren M, Viet L, Villalpando S, Vioque J, Vollenweider P, Volpato S, Wang N, Wang YX, Ward M, Waspadji S, Welin LX, Wilhelmsen L, Willeit J, Woodward M, Xavier AJ, Xu F, Xu L, Yamamoto A, Yang G, Yang X, Yeh LC, Yoon JS, You Q, Yu Z, Zhang J, Zhang L, Zheng W, Zhou M.

Author information

1
Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA.

Abstract

BACKGROUND:

It is commonly assumed that cardiovascular disease risk factors are associated with affluence and Westernization. We investigated the associations of body mass index (BMI), fasting plasma glucose, systolic blood pressure, and serum total cholesterol with national income, Western diet, and, for BMI, urbanization in 1980 and 2008.

METHODS AND RESULTS:

Country-level risk factor estimates for 199 countries between 1980 and 2008 were from a previous systematic analysis of population-based data. We analyzed the associations between risk factors and per capita national income, a measure of Western diet, and, for BMI, the percentage of the population living in urban areas. In 1980, there was a positive association between national income and population mean BMI, systolic blood pressure, and total cholesterol. By 2008, the slope of the association between national income and systolic blood pressure became negative for women and zero for men. Total cholesterol was associated with national income and Western diet in both 1980 and 2008. In 1980, BMI rose with national income and then flattened at ≈Int$7000; by 2008, the relationship resembled an inverted U for women, peaking at middle-income levels. BMI had a positive relationship with the percentage of urban population in both 1980 and 2008. Fasting plasma glucose had weaker associations with these country macro characteristics, but it was positively associated with BMI.

CONCLUSIONS:

The changing associations of metabolic risk factors with macroeconomic variables indicate that there will be a global pandemic of hyperglycemia and diabetes mellitus, together with high blood pressure in low-income countries, unless effective lifestyle and pharmacological interventions are implemented.

PMID:
23481623
PMCID:
PMC4181853
DOI:
10.1161/CIRCULATIONAHA.113.001470
[Indexed for MEDLINE]
Free PMC Article
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