Background: Cardiovascular diseases (CVDs) are the leading cause of disability and death in Vietnam and the world. Modifiable behavioral and metabolic risk factors largely drive this burden, but their combined impact on the Vietnamese populations remains unclear. Understanding these contributions is important for developing effective prevention and health policies. Hypothesis: To estimate the number and proportion of CVDs cases and deaths attributable to five behavior and metabolic-related risk factors in Vietnam in 2023. Methods: Population attributable fractions (PAFs) were calculated to determine the relationship between CVDs and well-established behavioral (smoking, second-hand smoking, alcohol consumption, physical inactivity) and metabolic (BMI, waist circumference-WC, blood pressure, glucose, cholesterol) risk factors. This study synthesized data on risk factor prevalence from the nationally representative Vietnamese surveys (WHO-STEPS), relative risks from available meta-analyses where possible, and CVDs morbidity and mortality figures from the Global Burden of Disease Study 2023. Results: An estimated 90.4% of CVDs cases in men (154,966 cases) and 62.4% in women (83,861 cases) were attributable to combined metabolic and behavioral risks when WC represents adiposity. The proportions of CVDs deaths attributable to these risk factors were 96.6% in men (62,473 deaths) and 39.6% in women (11,960 deaths). In men, the leading causes were tobacco smoking (34.4%) and hypertension (27.6%) for new cases, and hypertension (31.3%) and smoking (25.6%) for deaths; second-hand smoke and WC also contributed. In women, second-hand smoke (24.9%) and hypertension (17.9%) made up the highest proportion of new cases, while hypertension (17.4%) and WC (10.5%) accounted for the highest proportion of CVDs deaths. For adiposity, using BMI yielded lower combined PAFs compared to WC by 6.5-10.2% for new cases and 1.6-6.5% for deaths. Conclusion: Most CVDs burden is preventable. Tobacco exposure and hypertension are the leading causes, with second-hand smoke notably impacting women. For adiposity, WC captures CVDs risk better than BMI, especially among men. Prioritizing blood pressure control, tobacco reduction, and central adiposity could avert most cases and deaths.
Duong et al. (Tue,) studied this question.