Multiple risk factor interventions for primary prevention of cardiovascular disease in low- and middle-income countries
Key result
Multiple risk factor interventions did not significantly reduce the incidence of combined fatal and non-fatal cardiovascular events compared to no intervention (RR 0.57, 95% CI 0.11 to 3.07).
Why the study?
Do multiple risk factor interventions reduce combined fatal and non-fatal cardiovascular disease events in populations in low- and middle-income countries?
Population
Participants in low- and middle-income countries, including healthy individuals and those with varying risks…
Comparison
Multiple risk factor interventions aiming to… vs Control group.
Design
Meta-analysis
Follow-up
at least 6 months
Authors
Discussion
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Implication
Insufficient evidence supports multiple risk factor interventions for cardiovascular events in LMICs; leaves open effects on hard endpoints.
Study Design
Type
Systematic Review (n=7,310)
Structured PICO
Do multiple risk factor interventions reduce combined fatal and non-fatal cardiovascular disease events in populations in low- and middle-income countries?
P
Population
Participants in low- and middle-income countries (LMICs), including healthy individuals and those with varying risks of CVD (e.g., hypertension, type 2 diabetes) from 13 RCTs.
I
Intervention
Multiple risk factor interventions (health promotion for behaviour change with or without pharmacological treatments) aiming to alter more than one cardiovascular risk factor for at least six months.
C
Comparator
Control group (not explicitly detailed, likely usual care or no intervention).
O
Outcome
Combined fatal and non-fatal cardiovascular disease events.composite
Main Result
Effect estimate: RR 0.57 (95% CI 0.11 to 3.07)
Absolute Event Rate: 1.8% vs 3.2%
In LMICs, multiple risk factor interventions may improve surrogate markers like blood pressure and BMI, but there is currently insufficient evidence to determine their effect on hard cardiovascular events or mortality.
Limitations
- Small sample sizes and wide confidence intervals for the effect estimate
- High or unclear risk of bias in included studies
- Considerable heterogeneity between trials
- Short follow-up periods
- Small sample sizes
- Risk of bias in included trials
- Imprecise results for CVD outcomes due to wide confidence intervals
Cite This Study
Uthman et al. (2015) conducted a systematic review in Primary prevention of cardiovascular disease (n=7,310). Multiple risk factor interventions vs. No intervention was evaluated on Combined fatal and non-fatal cardiovascular disease events (RR 0.57, 95% CI 0.11 to 3.07). Multiple risk factor interventions did not significantly reduce the incidence of combined fatal and non-fatal cardiovascular events compared to no intervention (RR 0.57, 95% CI 0.11 to 3.07).