Ideal cardiovascular health in the WHO African Region increased from 15.58% in 2003 to 18.00% in 2022, potentially preventing 2.5 million CVD cases annually.
Contrary to Western regions, the WHO African Region demonstrates an increasing trend in ideal cardiovascular health among adults, highlighting the potential to prevent millions of CVD cases through primordial prevention.
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Abstract Background/Introduction Over 75% of cardiovascular disease (CVD) deaths globally occur in low- and middle-income countries, including Africa, where risk factors such as hypertension, obesity, smoking, and poor diets are increasing. In that context, primordial prevention aiming at preventing the onset of risk factors in the first place to promote an ideal cardiovascular health (CVH) is of utmost importance. However, research on CVH in Africa is scarce and has been largely limited to single-country studies. Therefore, a comprehensive analysis on the status and the determinants of CVH in the continent is lacking. Purpose The main objective was to provide a comprehensive picture of the distribution and determinants of CVH score in adults in the WHO African Region. The secondary objective was to estimate time trends in CVH over 20 years. Methods This is a cross-sectional analysis of pooled data from WHO STEPS Surveys (2003- 2022) in 33 countries in the WHO African Region of nonpregnant adults aged 18-69 years. CVH was assessed using the American Heart Association’s Life’s Simple 7 (LS7) score, with CVH categorized into poor (0–7), intermediate (8–11), and ideal (12–14) levels. Hierarchical multilevel models were used to identify key sociodemographic and determinants of CVH. Trends in CVH score over 20 years were estimated using a spatiotemporal Bayesian model. The Population Preventable Fraction (PPF) to quantify the number of CVD cases that could be averted through improved CVH was also estimated. Results Out of the 199,415 participants in 33 countries, the study population includes 78,446 individuals free of CVD without missing information and representing 95 million people across 22 countries and 25 surveys. The mean age was 35.4 ± 12.9 years and 49,4% were females. The weighted prevalence of poor, intermediate and ideal CVH was 15.9%, 57.9% and 26.2%, respectively. Older age, female sex, lower education, and heavy alcohol consumption were associated with lower odds of achieving intermediate or ideal CVH scores (Table 1). Country-level contextual factors, particularly higher levels of education and undernourishment, were associated with higher CVH scores. Conversely, higher levels of urbanization were associated with lower CVH scores (not shown). Spatio-temporal analysis revealed an increase in ideal CVH prevalence (15.58% in 2003 to 18.00% in 2022, p0.001) and a decline in poor CVH (31.47% to 29.77%, p0.001), with consistent trends across sexes. The PPF associated with any improvement in CVH (from poor to moderate or high, and from moderate to high CVH) would prevent 2.5 million CVD cases annually in the WHO Africa region. Conclusion This is the most extensive analysis on the distribution, determinants and time trends in CVH in the Africa region. Contrary to the western regions, the Africa region shows higher level and increasing trends in CVH in the adult population.
Agboyibor et al. (Sat,) reported a other. Ideal cardiovascular health in the WHO African Region increased from 15.58% in 2003 to 18.00% in 2022, potentially preventing 2.5 million CVD cases annually.