Key result
Rural Malaysian youths had a significantly higher prevalence of having at least one cardiovascular risk factor compared to urban youths (74.2% vs. 66.8%, OR 1.423).
Why the study?
Early identification of cardiovascular risk factors in youths helps determine who is at high risk for later CAD, with modernized lifestyles thought to expose both urban and rural youths equally.
Cross-Sectional (n=942)
Yes
A high proportion of Malaysian youths have at least one cardiovascular risk factor, with rural youths showing a higher prevalence of overweight/obesity and family history of hypercholesterolemia compared to urban youths.
High CRF prevalence in Malaysian youths supports screening; observational data leaves open whether urban-rural differences warrant targeted prevention.
BACKGROUND: Coronary artery disease (CAD) is one of the major causes of morbidity and mortality worldwide. Early identification of the cardiovascular risk factors (CRF) among youths assists in determining the high-risk group to develop CAD in later life. In view of the modernised lifestyle, both urban and rural residing youths are thought to be equally exposed to various CRF. This study aimed to describe the common CRF including obesity, dyslipidaemia, hypertension, smoking and family history of hypercholesterolaemia and premature CAD in youths residing in urban and rural areas in Malaysia. METHODS: We recruited 942 Malaysian subjects aged 15-24 years old [(males = 257, and urban = 555 vs. rural = 387, (mean age ± SD = 20.5 ± 2.1 years)] from the community health screening programmes organised in both rural and urban regions throughout Malaysia. Medical history and standardised anthropometric measurements were recorded. Laboratory investigations were obtained for fasting serum lipid profiles and plasma glucose levels. RESULTS: A total of 43.7% from the total study population was either obese or overweight. Youths in the rural were more overweight and obese (49.4% vs. 42.7%, p < 0.044) and have higher family history of hypercholesterolaemia (16.3% vs. 11.3%, p < 0.036) than youths in the urban areas. Low-density lipoprotein (LDL-c) (2.8 vs. 2.7 mmol/L) and total cholesterol (TC) (4.7 vs. 4.5 mmol/L) were significantly higher in urban compared to rural youths (p < 0.019 and p < 0.012). Overall, more youth in this study has CRF rather than not (Has ≥ 1 CRF = 69.9%). Significantly more rural youths have at least one CRF compared to urban youths (rural = 74.2% vs. urban = 66.8%, p = 0.016). CONCLUSION: In conclusion, our study showed that a large number of youths had at least one or more CRF. Rural youths have significantly higher BMI with higher family history of hypercholesterolaemia compared to urban youths. However, urban youths have higher LDL-c and TC levels. Other coronary risk factors are not significantly different between urban and rural youths. Rural youths have more CRF compared to urban youths. A larger longitudinal study focusing on this population is important to better understand the effect of the area of residence on CRF in youth.
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Nor et al. (2022) conducted a cross-sectional in Cardiovascular risk factors (n=942). Rural residence vs. Urban residence was evaluated on Presence of at least one cardiovascular risk factor (OR 1.423, 95% CI 1.067-1.899, p=0.016). Rural Malaysian youths had a significantly higher prevalence of having at least one cardiovascular risk factor compared to urban youths (74.2% vs. 66.8%, OR 1.423).
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