Risk factors for cardiovascular disease in the elderly in Latin America and the Caribbean

Introduction

The Latin America and Caribbean (LAC) regions are undergoing a transition from infectious to chronic non-communicable disease, together with and linked to a rapid aging of the population. Although cardiovascular disease is a principal cause of ill-health and death, few data are available among the elderly.

Materials and methods

We evaluated people aged 60 and over, living in seven urban centers in LAC: Buenos Aires, Bridgetown, Havana, Mexico City, Montevideo, Santiago, and Sao Paulo, who participated in the ‘Salud, Bienestar, y Envejecimiento’ study (SABE), conducted in 1999 and 2000. We calculated the prevalence of self-reported cardiovascular disease (CVD), and examined its association with established risk factors, using odds ratios (ORs) and their population attributable risks (PARs).

Results

The overall prevalence of CVD was 20.3% (95% CI 18.9–21.6). Rates varied across the region: lowest in Mexico City (10.0%) and Bridgetown (11.1%), intermediate in Buenos Aires (19.6%), Sao Paulo (19.8%), Montevideo (23.8%) and Havana (24.1%), and highest in Santiago (32.2%). CVD prevalence increased by 11% with every additional five-years of age, and was higher in women than men (21.2% vs. 18.9%).

Factors related to higher CVD prevalence included hypertension (odds ratio = 2.67), diabetes (OR = 1.42), obesity (OR = 1.19), and smoking (OR = 1.31), while regular exercise (OR = 0.66), adequate nutrition (OR = 0.70), and regular alcohol consumption (OR = 0.79) were related to lower CVD prevalence (p = 0.01 for BMI, p = 0.02 for alcohol consumption, and p < 0.001 for all other risk factors). Collectively, these seven modifiable risk factors accounted for 69.7% of the PAR.

Discussion

Established and modifiable risk factors underpin CVD prevalence in LAC. Public health programmes, including reliable measures of their effectiveness are needed to reduce the burden of CVD in the region.