Key result
Hypertension was the leading vascular risk factor in Indonesia, accounting for 20% to 25% of all coronary heart disease and 36% to 42% of all strokes across both sexes.
Observational (n=722,330)
Yes
A substantial proportion of cardiovascular disease in Indonesia is attributable to modifiable risk factors, particularly hypertension and smoking in men, emphasizing the need for targeted population-based prevention strategies.
May guide hypertension control priorities in Indonesia; leaves open causal validation in prospective cohorts.
BACKGROUND: In Indonesia, coronary heart disease (CHD) and stroke are estimated to cause more than 470 000 deaths annually. In order to inform primary prevention policies, we estimated the sex- and age-specific burden of CHD and stroke attributable to five major and modifiable vascular risk factors: cigarette smoking, hypertension, diabetes, elevated total cholesterol, and excess body weight. METHODS: Population attributable risks for CHD and stroke attributable to these risk factors individually were calculated using summary statistics obtained for prevalence of each risk factor specific to sex and to two age categories (<55 and ≥55 years) from a national survey in Indonesia. Age- and sex-specific relative risks for CHD and stroke associated with each of the five risk factors were derived from prospective data from the Asia-Pacific region. RESULTS: Hypertension was the leading vascular risk factor, explaining 20%-25% of all CHD and 36%-42% of all strokes in both sexes and approximately one-third of all CHD and half of all strokes across younger and older age groups alike. Smoking in men explained a substantial proportion of vascular events (25% of CHD and 17% of strokes). However, given that these risk factors are likely to be strongly correlated, these population attributable risk proportions are likely to be overestimates and require verification from future studies that are able to take into account correlation between risk factors. CONCLUSIONS: Implementation of effective population-based prevention strategies aimed at reducing levels of major cardiovascular risk factors, especially blood pressure, total cholesterol, and smoking prevalence among men, could reduce the growing burden of CVD in the Indonesian population.
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Hussain et al. (2016) conducted an observational in Cardiovascular disease (Coronary heart disease and stroke) (n=722,330). Major modifiable vascular risk factors (hypertension, smoking, elevated cholesterol, excess body weight, diabetes) vs. Unexposed individuals was evaluated on Population attributable risk (PAR) for coronary heart disease and stroke. Hypertension was the leading vascular risk factor in Indonesia, accounting for 20% to 25% of all coronary heart disease and 36% to 42% of all strokes across both sexes.