The Global Epidemiological Transition in Cardiovascular Diseases: Unrecognised Impact of Endemic Infections on Peripheral Artery Disease

Agius, Paul A.; Cutts, Julia C; Song, Peige; Rudan, Igor; Rudan, Diana; Aboyans, Victor; McDermott, Mary McGrae; Criqui, Michael H.; Fowkes, F. G. R.; Fowkes, Freya J. I.

doi:10.1007/s44197-022-00049-1

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…Preliminary ecological evidence shows an association between PAD prevalence and country‐level burdens of endemic infectious diseases like HIV, tuberculosis, and malaria. 40 Historically, rural South Africa has had a high infectious disease burden, including HIV. Approximately 23% of the HAALSI population is HIV‐positive with South Africa having one of the highest HIV burdens globally.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of and Risk Factors for Peripheral Artery Disease in Rural South Africa: A Cross‐Sectional Analysis of the HAALSI Cohort

Beidelman,

Rosenberg,

Wade

et al. 2024

JAHA

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Background The burden of peripheral artery disease (PAD) is increasing in low‐ and middle‐income countries. Existing literature from sub‐Saharan Africa is limited and lacks population‐representative estimates. We estimated the burden and risk factor profile of PAD for a rural South African population. Methods and Results We used data from 1883 participants from a rural, low‐income cohort of South African adults aged 40 to 69 years with available ankle‐brachial index measurements. We defined clinical PAD as ankle‐brachial index ≤0.90 or >1.40, and borderline PAD as ankle‐brachial index >0.90 and ≤1.00. We compared the distribution of sociodemographic variables, biomarkers, and comorbidities across PAD classifications. To identify associated factors, we calculated unadjusted and age‐sex‐adjusted prevalence ratios (PRs) with log‐binomial models. Overall, 6.6% (95% CI, 5.6–7.7) of the sample met the diagnostic criteria for clinical PAD, while 44.7% (95% CI, 42.4–47.0) met the diagnostic criteria for borderline PAD. Age (PR: 1.9 [95% CI, 1.2–3.1] for ages 50–59 years compared with 40–49 years; PR: 2.5 [95% CI, 1.5–4.0] for ages 60–69 years compared with 40–49 years); diagnosed hypertension (PR: 1.53 [95% CI, 1.08–2.17]); and C‐reactive protein (PR: 1.08 [95% CI, 1.03–1.12]) were associated with increased prevalence of clinical PAD. All other examined factors were not significantly associated with clinical PAD. Conclusions We found high PAD prevalence for younger age groups compared with previous research and a lack of statistical evidence for the influence of traditional risk factors for this rural, low‐income population. Future research should focus on identifying the underlying risk factors for PAD in this setting. South African policymakers and clinicians should consider expanded screening for early PAD detection in rural areas.

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Section: Discussionmentioning

confidence: 99%

Prevalence of and Risk Factors for Peripheral Artery Disease in Rural South Africa: A Cross‐Sectional Analysis of the HAALSI Cohort

Beidelman,

Rosenberg,

Wade

et al. 2024

JAHA

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“…Alternative potential risk factors for PAD in this population include endemic infectious diseases, chronic stress, and air pollution. Preliminary ecological evidence shows an association between PAD prevalence and country-level burdens of endemic infectious diseases like HIV, tuberculosis, and malaria 40 . Historically, rural South Africa has had a high infectious disease burden, including HIV.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of and risk factors for peripheral artery disease in rural South Africa: A cross-sectional analysis of the HAALSI cohort

Beidelman¹,

Rosenberg²,

Wade³

et al. 2023

Preprint

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Introduction. The burden of peripheral artery disease (PAD) is increasing in low- and middle-income countries. Existing literature from sub-Saharan Africa is limited and lacks population-representative estimates. We estimated the burden and risk factor profile of PAD for a rural South African population. Methods. We used data from 1,883 participants of the HAALSI cohort of South African adults aged 40-69 years with available ankle-brachial index (ABI) measurements. We defined clinical PAD as ABI ?0.90 or >1.40 and borderline PAD as ABI >0.90 & ?1.00. We compared the distribution of sociodemographic variables, biomarkers, and comorbidities across PAD classifications. To identify associated factors, we calculated unadjusted and age-sex-adjusted prevalence ratios with log-binomial models. Results. Overall, 6.6% (95% CI: 5.6-7.7) of the sample met the diagnostic criteria for clinical PAD while 44.7% (95% CI: 42.4-47.0) met the diagnostic criteria for borderline PAD. Age (PR: 1.9, 95% CI: 1.2-3.1 for ages 50-59 compared to 40-49; PR: 2.5, 95% CI: 1.5-4.0 for ages 60-69 compared to 40-49) and C-reactive protein (PR: 1.08, 95% CI: 1.03-1.12) were associated with increased prevalence of clinical PAD. All other examined factors were not associated with clinical PAD. Conclusions. We found high PAD prevalence for younger age groups compared to previous research and a lack of evidence for the influence of traditional risk factors for this rural, low-income population. Future research should focus on identifying the underlying risk factors for PAD in this setting. South African policymakers and clinicians should consider expanded screening for early PAD detection in rural areas.

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“…By the rate of prevalence, stroke, and Peripheral arterial disease are Indonesia's two most common CVDs. PAD is frequently neglected, a study of ankle-brachial index examinations in diabetes mellitus patients in Indonesia revealed that 14.5% had lower extremity PAD [20][21][22]. Another study reported that as many as 42% of chronic kidney disease patients had moderate Ankle Brachial Index (ABI) results.…”

Section: Indonesia Pattern In Global Burden Diseasementioning

confidence: 99%

The 30 Years Of Shifting In Indonesian Cardiovascular Burden -Analysis Of Global Burden Of Disease Study

Muharram,

Multazam,

Mustofa

et al. 2023

Preprint

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Importance: Cardiovascular disease (CVD) remains the leading cause of mortality and morbidity. Compared with disease burden rates in 1990, significant reductions in Disability-Adjusted Life Years (DALYs) burden rates for CVD have been recorded. However, general DALYs rates have not changed in Indonesia in the past 30 years. Thus, assessing Indonesian CVD burdens will be an essential first step in determining primary disease interventions. Objective: To determine the national and province-level burden of CVD from 1990 to 2016 in China. Design, Setting, and Participants: This research used Global Burden Disease (GBD) 2019 Institute of Health Metrics (IHME) data to analyze CVD burden trends, including mortality, morbidity, and prevalence characteristics of 12 underlying CVDs. Exposures: Residence in Indonesia Main Outcomes and Measures: Mortality, Incidence, prevalence, death, and DALYs of CVD. Results: CVD Deaths have doubled from 278 million in 1990 to 651 million in 2019. ALL CVDs recorded increased death rates, except for rheumatic heart disease (RHD) (-69%) and congenital heart disease (CHD) (-37%). Based on underlying diseases, stroke and ischemic heart disease (IHD) are still the leading causes of mortality and morbidity in Indonesia, whereas stroke and peripheral artery disease (PAD) are the most prevalent CVDs. Indonesia has the second worst CVD DALYs rates compared to ASEAN countries after Laos. At provincial levels, the highest CVD DALY rates were recorded in Bangka-Belitung, South Kalimantan, and Yogyakarta. In terms of DALYs rate changes, they were recorded in West Nusa Tenggara (24%), South Kalimantan (18%), and Central Java (11%). Regarding sex, only RHD and PAD burdens were dominated by females. Conclusions: CVD mortality, morbidity, and prevalence rates increased in Indonesia from 1990-2019. Importantly, these data could provide reference points for policymakers, such as improving risk factor prevention and health care optimization.

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The Global Epidemiological Transition in Cardiovascular Diseases: Unrecognised Impact of Endemic Infections on Peripheral Artery Disease

Cited by 4 publications

References 17 publications

Prevalence of and Risk Factors for Peripheral Artery Disease in Rural South Africa: A Cross‐Sectional Analysis of the HAALSI Cohort

Prevalence of and Risk Factors for Peripheral Artery Disease in Rural South Africa: A Cross‐Sectional Analysis of the HAALSI Cohort

Prevalence of and risk factors for peripheral artery disease in rural South Africa: A cross-sectional analysis of the HAALSI cohort

The 30 Years Of Shifting In Indonesian Cardiovascular Burden -Analysis Of Global Burden Of Disease Study

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