Ideal Cardiovascular Health in a Nationally Representative Population-Based Sample of Adults in Malawi

Background: , healthy diet, and physical activity) and three health factors (total cholesterol <200 mg/dL, blood pressure <120/<80 mmHg, and fasting blood glucose <100 mg/dL). Objective: This study aimed to determine the prevalence, distribution, and correlates of ICH among adults in Malawi. Methods: National cross-sectional survey data of 3,441 persons aged 18-69 years with complete ICH measurements in Malawi in 2017 were analysed. Results: Almost one in ten (7.4%) of respondents had 0-2 ICH metric), 21.2% 3-4 ICH metrics, and 71.5% 5-7 ICH metrics). Only 3.3% had all seven ICH metrics, 15.3% had intermediate ICH (≥1 metric in the intermediate category and none in the poor category), and 81.5% poor ICH (≥1 metric in poor category). In adjusted logistic regression analysis, older age (50-69 years) (Adjusted Odds Ratio-AOR: 0.25, 95% Confidence Interval-CI: 0.17-0.36) and urban residence (AOR: 0.56, 95% CI: 0.40-0.78) were negatively associated with meeting 5-7 ICH metrics. In addition, in unadjusted analysis, higher education was positively associated with meeting 5-7 ICH metrics. Conclusion: The proportion of meeting 5-7 ICH metrics was high in Malawian adults. Both high-risk and population-wide intervention programmes targeting older adults and urban residents should be implemented in aiding to improve cardiovascular health in Malawi. Highlights: The proportion of meeting 5-7 ideal cardiovascular health (ICH) metrics was 71.5% in Malawian adults (18-69 years, median age 32 years).In a sub-group analysis (45-69 years, median age 55 years), 55.9% had 5-7 ideal ICH metrics.ICH was lower with increasing age and among urban residents.