Academic journal article Iranian Journal of Public Health

Risk Factors of Cardiovascular Disease and Their Related Socio-Economical, Environmental and Health Behavioral Factors: Focused on Low-Middle Income Countries- A Narrative Review Article

Academic journal article Iranian Journal of Public Health

Risk Factors of Cardiovascular Disease and Their Related Socio-Economical, Environmental and Health Behavioral Factors: Focused on Low-Middle Income Countries- A Narrative Review Article

Article excerpt

Introduction

Cardiovascular disease (CVD) is becoming a leading cause of morbidity, mortality, and disability in the world. It is becoming a large global burden. Approximately one-third of all global deaths and 10% of total DALY losses were attributed to CVD (1).For the past few decades, the majority of cardiovascular disease occurred in industrialized, higher-income countries. However, the absolute burden of cardiovascular disease has been greater in developing countries. Developing countries now experience a much greater burden of cardiovascular disease than developed countries do, so will bear the greatest burden of cardiovascular disease in the future (2).

The relationship between CVD and risk factors such as high blood pressure, cholesterol, obesity, smoking, diabetes, and physical inactivity have been well known. In order to decrease the burden of disease associated with CVD, risk factors for CVD have been extensively studied in developed countries. Poorolajal estimated of NCDs risk factors in Iran (3), but to our knowledge, few studies focused on factors related to CVD risk factors in low-middle income countries. Furthermore, due to industrialization, globalization, urbanization, and population ageing, there are also a number of underlying determinants of CVD, or "the related factors of risk factors". Therefore, more and more studies have documented social determinants such as economic situation, cultural change, health behavior, and lifestyle in high-income countries. However, previous studies rarely focused on these circumstances in low- and middle-income countries. And another problem is that, although the association between CVD and diabetes and health risk factors like diet, smoking, alcohol, physical inactivity and socioeconomic status has been studied within countries (4),few studies have assessed the cross-country association of CVD risk factors with national macroeconomic variables. Due to increasing urbanization and industrialization, risk factors are no more focused at individual level but are related to environmental, social and economic factors.

Therefore, our study's aim is to identify factors related to CVD risk factors encompassing various factors, like education, health environment, health behaviors, and government policy in low-middleincome countries that have not been studied previously. We did an ecological study to identify population-level patterns and dynamics with national macroeconomic variables.

Methods

Design and data sources

In order to address these research aims, we used an ecological study design using data from lowmiddle-income countries. The prevalence of obesity, insufficient activity, systolic blood pressure, and fasting blood glucose are risk factors of cardiovascular disease, which were evaluated in relation to national indicators of the economic, education, transportation environment, health behavior, and policy. Aggregate country-level data were assembled from several databases (Table 1) including WHO (5), The World bank (6) databases, and published articles. Initially, we collected data for all low- and middle-income countries in the study, but, later, countries with missing data of any of the indicators were excluded, leaving 47 countries for analysis. At first, we choose GINI as one of the independent variables, but classification into low, middle and high income countries' according to GINI was not available, so we excluded high income countries according to GNI, World bank database of 2012 (7).

Dependent variables

In our study, the dependent variables included obesity prevalence, insufficient activity, blood pressure, and blood glucose. Each of the dependent variables was gender-specific. Obesity variables were self-reported prevalence rates of obesity (i.e. percentage of population with BMI≥30 kg/m2) derived from national surveys. As Table 1 shows, insufficiently active individuals were defined as attaining less than 5 times 30 minutes of moderate activity per week or less than 3 times 20 minutes of vigorous activity per week, or equivalent. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.