Understanding the rise of cardiometabolic diseases in low- and middle-income countries

Miranda, J. Jaime; Barrientos‐Gutiérrez, Tonatiuh; Corvalán, Camila; Hyder, Adnan A.; Lazo-Porras, María; Oni, Tolu; Wells, Jonathan C. K.

doi:10.1038/s41591-019-0644-7

Cited by 230 publications

(203 citation statements)

References 196 publications

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“…Women are more likely to die from CVD because of late presentation and differences in symptomatology (9). The burden of premature deaths from complications of pregnancy such as preeclampsia, preterm birth and SGA babies and CVD later in life, fall disproportionately upon Low-and Middle-Income Countries (LMICs) (10,11). Women in rural areas of LMICs are further disadvantaged due to limitations in healthcare access and infrastructure, issues of poverty, and educational and sociocultural barriers in accessing timely care as well as engaging with ongoing treatment (12,13).…”

Section: Introductionmentioning

confidence: 99%

Cardiometabolic Risk Factors in Pregnancy and Implications for Long-Term Health: Identifying the Research Priorities for Low-Resource Settings

Nagraj

Kennedy

Norton

et al. 2020

Front. Cardiovasc. Med.

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Cardiometabolic disorders (CMDs), including ischemic heart disease, stroke and type 2 diabetes are the leading causes of mortality and morbidity in women worldwide. The burden of CMDs falls disproportionately on low and middle-income countries (LMICs), placing substantial demands on already pressured health systems. Cardiometabolic disorders may present up to a decade earlier in some LMIC settings, and are associated with high-case fatality rates. Early identification and ongoing postpartum follow-up of women with pregnancy complications such as hypertensive disorders of pregnancy (HDPs), and gestational diabetes mellitus (GDM) may offer opportunities for prevention, or help delay onset of CMDs. This mini-review paper presents an overview of the key challenges faced in the early identification, referral and management of pregnant women at increased risk of CMDs, in low-resource settings worldwide. Evidence-based strategies, including novel diagnostics, technology and innovations for early detection, screening and management for pregnant women at high-risk of CMDs are presented. The review highlights the key research priorities for addressing cardiometabolic risk in pregnancy in low-resource settings.

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Section: Introductionmentioning

confidence: 99%

Cardiometabolic Risk Factors in Pregnancy and Implications for Long-Term Health: Identifying the Research Priorities for Low-Resource Settings

Nagraj

Kennedy

Norton

et al. 2020

Front. Cardiovasc. Med.

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“…High overweight and obesity rates are strongly linked to a high prevalence of non-communicable diseases (NCDs), which are now among the leading causes of death in many regions of the world (Shekar and Popkin 2020). The prevalence of NCDs has increased sharply in many LMICs in the last few decades, while declining somewhat in high-income countries (Miranda et al 2019). The overall annual cost of overweight and obesity in LMICs is projected to reach about USD 7 trillion in the next 15 years (Shekar and Popkin 2020).…”

Section: Introductionmentioning

confidence: 99%

Food policies and obesity in low and middle income countries

Abay¹,

Ibrahim²,

Breisinger³

2020

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Understanding the public health implication of fiscal policies is crucial to combat recently increasing overweight and obesity rates in many low-and-middle income countries (LMICs). This study examines the implication of food policies, mainly tariff rates on "unhealthy" foods, including sugar and confectionery products as well as fats and oils, and governments' subsidies on individuals' body weight outcomes. We compile several macro-and micro-level datasets that provide for several LMICs macro-level information on food policies and micro-level anthropometric data. We exploit temporal dynamics in tariff rates on "unhealthy" foods and governments' spending on subsidies to estimate fixed effects models characterizing the evolution of body weight outcomes. We find that temporal dynamics in tariff rates on unhealthy and energy-dense foods are significantly and negatively associated with body weight. Conditional on several observable and time-invariant unobservable factors, a decrease in tariff rates on sugar and confectionary foods or fats and oils is associated with an increase in overweight and obesity rates. On the other hand, an increase in subsidy rates, as a share of government expenditure, is significantly associated with higher overweight and obesity rates. Interestingly, we find that the implications of these food policies are more pronounced among poorer individuals. This is intuitive because relatively poorer households are more likely to spend a larger share of their income on food consumption or unhealthy foods, and these types of households are beneficiaries of government subsidies in many LMICs. These findings have important implications for informing public health policies in LMICs, which are experiencing an unprecedented rise in overweight and obesity rates.

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“…However, in the past recent decades, CVD mortality declined in high-income countries whereas increased in low-and middleincome countries. The reasons contributing to this discrepancy area varied and are affected by environmental, social, and commercial determinants of health [2]. With the improvement of preventing, diagnosis and treatment of cardiovascular risk factors, the CVD mortality began to fall in developed countries [2].…”

Section: Introductionmentioning

confidence: 99%

“…The reasons contributing to this discrepancy area varied and are affected by environmental, social, and commercial determinants of health [2]. With the improvement of preventing, diagnosis and treatment of cardiovascular risk factors, the CVD mortality began to fall in developed countries [2]. Nevertheless, in recent years, as metabolic disorder like obesity, hypertension, diabetes, and dyslipidemia became prevalent in rural China, the CVD mortality increased synchronously [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Gender discrepancy in the predictive effect of metabolic syndrome and its components on newly onset cardiovascular disease in elderly from rural China

Guo

et al. 2020

Preprint

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Background To evaluate the possible predictive effect of metabolic syndrome (MetS) and its components on cardiovascular disease (CVD) in a longitudinal analysis according to different criteria of MetS among rural Chinese elderly. Method A population-based sample of 2486 rural elderly Chinese residents aged ≥ 60 years at baseline were followed up from 2012–2013 to 2015–2017. CVD included stroke, coronary heart disease (CHD) diagnosed by clinicians were self-reported and were confirmed by medical records. MetS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and the international Diabetes Federation (IDF) criterion respectively. Result Hazard ratio adjusting for CHD, Stroke and CVD in those with MetS using NCEP ATP III criteria in female were 1.27 (95%CI 0.73, 2.21), 1.54 (95%CI 0.99, 2.40) and 1.45 (95%CI 1.00, 2.10); 1.33 (95%CI 0.77, 2.32), 1.44 (95%CI 0.92, 2.25) and 1.36 (95%CI 0.94, 1.97) with the AHA/NHLBI criteria; and 1.10 (95%CI 0.89,1.36), 1.62 (95%CI 1.03, 2.55) and 1.36 (95%CI 0.93, 1.97) with IDF criteria. Besides, abdominal obesity using the AHA/NHLBI criteria was significantly associated with the incidence of stroke (HR: 1.60; 95%CI 1.01, 2.52). However, among rural male elderly, neither MetS nor its components were capable of predicting newly onset CVD. Conclusion MetS is significantly associated with high incidence of CVD among rural female elderly only, and the incidence of CVD was evident only when MetS was defined using NCEP ATP III criterion. In order to reduce CVD among elderly in rural China, effective strategies to prevent, diagnose, and treating MetS should be made in time, especially among female.

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Understanding the rise of cardiometabolic diseases in low- and middle-income countries

Cited by 230 publications

References 196 publications

Cardiometabolic Risk Factors in Pregnancy and Implications for Long-Term Health: Identifying the Research Priorities for Low-Resource Settings

Cardiometabolic Risk Factors in Pregnancy and Implications for Long-Term Health: Identifying the Research Priorities for Low-Resource Settings

Food policies and obesity in low and middle income countries

Gender discrepancy in the predictive effect of metabolic syndrome and its components on newly onset cardiovascular disease in elderly from rural China

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