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Zhang Y, Tong G, Ma N, Chen S, Kong Y, Rahmartani LD, Aheto JMK, Kanyike AM, Fan P, Ashfikur Rahman M, Mkopi A, Kim R, Karoli P, Niyi JL, Zemene MA, Zhang L, Cheng F, Lu C, Subramanian SV, Geldsetzer P, Qiu Y, Li Z. Associations between education and ideal cardiovascular health metrics across 36 low- and middle-income countries. BMC Med 2025; 23:204. [PMID: 40189520 PMCID: PMC11974039 DOI: 10.1186/s12916-025-04032-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2024] [Accepted: 03/24/2025] [Indexed: 04/09/2025] Open
Abstract
BACKGROUND The relationship between education and cardiovascular health (CVH) metrics in low- and middle-income countries (LMICs) remains unclear. This study explores the associations between education and ideal cardiovascular health score (CVHS), as well as seven CVH metrics. METHODS This cross-sectional study extracted data from the STEPwise approach to surveillance surveys in 36 LMICs between 2010 and 2020. We assessed CVHS using the sum score in seven metrics defined by American Heart Association: (1) ≥ 150 min/week of moderate, or 75 min/week of vigorous activity, or an equivalent combination; (2) BMI < 25 kg/m2 for non-Asians (< 23 kg/m2 for Asians); (3) fruit and vegetable intake ≥ 4.5 servings per day; (4) nonsmoking; (5) blood pressure < 120/80 mmHg (untreated); (6) total cholesterol < 200 mg/dL (untreated); and (7) fasting blood glucose < 100 mg/dL (untreated). The ideal CVHS score ranged from 5 to 7. We disaggregated prevalence of ideal CVHS and seven metrics by education, and constructed Poisson regression models to adjust for other socioeconomic factors. RESULTS Among 81,327 adult participants, the overall ideal CVHS prevalence for the studied countries was highest among individuals with primary education (52.9%, 95% CI: 51.0-54.9), surpassing those of other education levels - 48.0% (95% CI: 44.6-51.3, P = 0.003) for those with no education and 39.1% (95% CI: 36.5-41.8, P < 0.001) for those with tertiary education. Five (ideal physical activity, BMI, blood pressure, total cholesterol, and blood glucose) in seven CVH metrics peaked among participants with primary or secondary education. For instance, the prevalence of ideal blood pressure among individuals with primary education was 34.4% (95% CI: 32.7-36.1), higher than the prevalence in other education levels, ranging from 28.6% to 32.3%. These patterns were concentrated in low-income countries and lower-middle-income countries, while in upper-middle-income countries, the prevalence of ideal CVHS increased with higher education levels, ranging from 15.4% for individuals with no education to 33.1% for those with tertiary education. CONCLUSIONS In LMICs, the association between education and ideal CVHS, along with several CVH metrics, exhibited un inverted U-shape, which may be closely related to the different stages of epidemiologic transition.
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Affiliation(s)
- Yi Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Guangyu Tong
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Ning Ma
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Shaoru Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yuhao Kong
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Lhuri Dwianti Rahmartani
- Department of Epidemiology, Faculty of Public Health, Universitas Indonesia, Depok, Jawa Barat, Indonesia
| | - Justice Moses K Aheto
- Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK
| | - Andrew Marvin Kanyike
- Faculty of Health Sciences, Busitema University, Mbale, Uganda
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
| | - Pengyang Fan
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Md Ashfikur Rahman
- Development Studies Discipline, Khulna University, Khulna, 9208, Bangladesh
| | | | - Rockli Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- Division of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Peter Karoli
- National Institute for Medical Research, Dar Es Salaam, Tanzania
| | - John Lapah Niyi
- Ghana Health Service, Gushegu Municipal Health Directorate, Gushegu, Ghana
| | - Melkamu Aderajew Zemene
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Lin Zhang
- The School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Suzhou Industrial Park Monash Research Institute of Science and Technology, Monash University, Melbourne, Australia
| | - Feng Cheng
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Chunling Lu
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Division of Global Health Equity, Brigham & Women's Hospital, Boston, MA, USA
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, USA
- Harvard Center for Population & Development Studies, Cambridge, MA, USA
| | - Pascal Geldsetzer
- Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA, USA
| | - Yue Qiu
- Institute for Hospital Management, Tsinghua University, Beijing, China.
| | - Zhihui Li
- Vanke School of Public Health, Tsinghua University, Beijing, China.
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Oguta JO, Breeze P, Wambiya E, Akoth C, Mbuthia G, Otieno P, Ombiro O, Kisaka Y, Mbau L, Onyango E, Gathecha G, Dodd PRJ. Prevalence and Determinants of Ideal Cardiovascular Health in Kenya: A Cross-Sectional Study Using Data From the 2015 Kenya STEPwise Survey. Glob Heart 2024; 19:79. [PMID: 39464743 PMCID: PMC11505031 DOI: 10.5334/gh.1363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 09/21/2024] [Indexed: 10/29/2024] Open
Abstract
Background Kenya is experiencing a rising burden of cardiovascular diseases (CVDs) due to epidemiological and demographic shifts, along with increasing risk factors. Ideal cardiovascular health (iCVH), defined by the American Heart Association (AHA), encompasses eight metrics to evaluate cardiovascular well-being. This study assessed the prevalence and determinants of iCVH in Kenya. Methods Data from the 2015 Kenya STEPwise survey on non-communicable disease risk factors, including 4,500 adults aged 18-69, were analysed. iCVH was assessed using 2022 AHA criteria based on seven factors: nicotine exposure, physical activity, diet, BMI, blood pressure, glucose, and lipid levels. A cardiovascular health (CVH) CVH score of ≥80% classified individuals as having iCVH. Multivariable binary and ordinal logistic regression identified factors associated with iCVH. Results The mean CVH score in Kenya was 78.6% (95% CI: 77.9,79.2%), higher in females (79.3%), rural areas (79.5%), and non-drinkers (79.6%) than in males (77.9%), urban residents (77.0%), and alcohol drinkers (75.4%), respectively. The prevalence of iCVH (CVH score ≥80%) was 45.6%, while 6.4% had poor CVH (CVH score <50%). Only 1.2% achieved the maximum CVH score. iCVH prevalence declined with age and was lower among married individuals (43.7%), alcohol drinkers (32.3%), and urban residents (39.7%). Older adults had 50-80% lower odds of iCVH compared to those under 30 years. Alcohol users (AOR 0.5; p < 0.001) and urban residents (AOR 0.6; p < 0.001) were less likely to have iCVH. Residents of Nairobi and Central regions had 40-60% lower odds of iCVH compared to those in Rift Valley. The Kalenjin (AOR 0.5; p = 0.027) and Turkana (AOR 0.3; p = 0.002) ethnic groups had lower odds of iCVH compared to the Kisii. Conclusion Less than half of Kenyan adults have iCVH, with poorer CVH status among older adults, urban residents, and alcohol users. Targeted public health interventions could mitigate the CVD burden and enhance health outcomes in Kenya.
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Affiliation(s)
- James Odhiambo Oguta
- Sheffield Centre for Health and Related Research, Division of Population Health, School of Medicine and Population Health, University of Sheffield. Sheffield, S1 4DA, United Kingdom
| | - Penny Breeze
- Sheffield Centre for Health and Related Research, Division of Population Health, School of Medicine and Population Health, University of Sheffield. Sheffield, S1 4DA, United Kingdom
| | - Elvis Wambiya
- Sheffield Centre for Health and Related Research, Division of Population Health, School of Medicine and Population Health, University of Sheffield. Sheffield, S1 4DA, United Kingdom
| | - Catherine Akoth
- Sheffield Centre for Health and Related Research, Division of Population Health, School of Medicine and Population Health, University of Sheffield. Sheffield, S1 4DA, United Kingdom
| | - Grace Mbuthia
- School of Nursing, College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, P.O. Box 62000-0200 Nairobi, Kenya
| | - Peter Otieno
- African Population and Health Research Center P.O. Box: 10787-00100, Nairobi, Kenya
| | | | - Yvette Kisaka
- Non-Communicable Diseases Division, Ministry of Health, Afya House, Cathedral Road, Nairobi, Kenya
| | | | - Elizabeth Onyango
- Non-Communicable Diseases Division, Ministry of Health, Afya House, Cathedral Road, Nairobi, Kenya
| | - Gladwell Gathecha
- Non-Communicable Diseases Division, Ministry of Health, Afya House, Cathedral Road, Nairobi, Kenya
| | - Pete R. J. Dodd
- Sheffield Centre for Health and Related Research, Division of Population Health, School of Medicine and Population Health, University of Sheffield. Sheffield, S1 4DA, United Kingdom
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Blake AL, Bennett NR, McKenzie JA, Tulloch-Reid MK, Govia I, McFarlane SR, Walters R, Francis DK, Wilks RJ, Williams DR, Younger-Coleman NO, Ferguson TS. Social support and ideal cardiovascular health in urban Jamaica: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003466. [PMID: 39078827 PMCID: PMC11288424 DOI: 10.1371/journal.pgph.0003466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 06/19/2024] [Indexed: 08/02/2024]
Abstract
Recent studies have suggested that high levels of social support can encourage better health behaviours and result in improved cardiovascular health. In this study we evaluated the association between social support and ideal cardiovascular health among urban Jamaicans. We conducted a cross-sectional study among urban residents in Jamaica's south-east health region. Socio-demographic data and information on cigarette smoking, physical activity, dietary practices, blood pressure, body size, cholesterol, and glucose, were collected by trained personnel. The outcome variable, ideal cardiovascular health, was defined as having optimal levels of ≥5 of these characteristics (ICH-5) according to the American Heart Association definitions. Social support exposure variables included number of friends (network size), number of friends willing to provide loans (instrumental support) and number of friends providing advice (informational support). Principal component analysis was used to create a social support score using these three variables. Survey-weighted logistic regression models were used to evaluate the association between ICH-5 and social support score. Analyses included 841 participants (279 males, 562 females) with mean age of 47.6 ± 18.42 years. ICH-5 prevalence was 26.6% (95%CI 22.3, 31.0) with no significant sex difference (male 27.5%, female 25.7%). In sex-specific, multivariable logistic regression models, social support score, was inversely associated with ICH-5 among males (OR 0.67 [95%CI 0.51, 0.89], p = 0.006) but directly associated among females (OR 1.26 [95%CI 1.04, 1.53], p = 0.020) after adjusting for age and community SES. Living in poorer communities was also significantly associated with higher odds of ICH-5 among males, while living communities with high property value was associated with higher odds of ICH among females. In this study, higher level of social support was associated with better cardiovascular health among women, but poorer cardiovascular health among men in urban Jamaica. Further research should explore these associations and identify appropriate interventions to promote cardiovascular health.
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Affiliation(s)
- Alphanso L. Blake
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
- School of Clinical Medicine and Research, The Faculty of Medical Sciences, The University of the West Indies, Nassau, The Bahamas
| | - Nadia R. Bennett
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Joette A. McKenzie
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Marshall K. Tulloch-Reid
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Ishtar Govia
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Shelly R. McFarlane
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Renee Walters
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Damian K. Francis
- School of Health and Human Performance, Georgia College and State University, Milledgeville, Georgia, United States of America
| | - Rainford J. Wilks
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Novie O. Younger-Coleman
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Trevor S. Ferguson
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
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Pengpid S, Peltzer K. Prevalence and Correlates of Cardiovascular Health Status among Adults in Afghanistan: Results of a National Survey in 2018. Int J Prev Med 2023; 14:29. [PMID: 37351042 PMCID: PMC10284193 DOI: 10.4103/ijpvm.ijpvm_252_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 05/31/2022] [Indexed: 06/24/2023] Open
Abstract
Background The aim of the study was to assess the prevalence and correlates of cardiovascular health (CVH) status among adults in Afghanistan. Methods In a national cross-sectional household survey 3,447 adults completed CVH measurements in Afghanistan. Criteria for ideal CVH (ICVH) were physical activity, healthy diet, non-smoking, fasting blood glucose (<100 mg/dL), body mass index (<25 kg/m2), total cholesterol (<200 mg/dL), and blood pressure (<120/<80 mmHg). Results More than one-third (34.3%) of participants had 5-7 ICVH, 45.7% 3-4 ICVH, and 20% had 0-2 ICVH. In adjusted logistic regression analysis, secondary or more education (AOR: 1.80, 95% CI: 1.22-2.66) was positively associated, and older age (45-69 years) (AOR: 0.33, 95% CI: 0.26-0.42), and urban residence (AOR: 0.67, 95% CI: 0.51-0.88) were inversely associated with 5-7 ICVH. Conclusions The prevalence of ICVH was low in Afghan adults. Population measures may be used to improve CVH targeting identified associated factors.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Ngwasiri C, Samadoulougou S, Cissé K, Aminde L, Kirakoya-Samadoulougou F. Changes in ideal cardiovascular health among Malawian adults from 2009 to 2017. Sci Rep 2022; 12:21937. [PMID: 36536000 PMCID: PMC9763343 DOI: 10.1038/s41598-022-26340-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Ideal Cardiovascular Health (CVH) is a concept defined by the American Heart Association (AHA) as part of its 2020 Impact Goals. Until now, changes in ideal CVH have been poorly evaluated in Sub-Saharan African populations. We aimed to investigate changes in the prevalence of ideal CVH and its components in a population of Malawian adults. Secondary analysis was done on cross-sectional data from 2009 to 2017, obtained from the Malawi STEPS surveys which included 5730 participants aged 25-64 years. CVH metrics categorized into "ideal (6-7 ideal metrics)", "intermediate (3-5 ideal metrics)" and "poor (0-2 ideal metrics)" were computed using blood pressure, body mass index (BMI), fasting glycaemia, fruit and vegetable intake, physical activity, smoking, and total cholesterol. Sampling weights were used to account for the sampling design, and all estimates were standardised by age and sex using the direct method. The mean participant age across both periods was 40.1 ± 12.4 years. The prevalence of meeting ≥ 6 ideal CVH metrics increased substantially from 9.4% in 2009 to 33.3% in 2017, whereas having ≤ 2 ideal CVH metrics decreased from 7.6% to 0.5% over this time. For the individual metrics, desirable levels of smoking, fruit and vegetable intake, physical activity, blood pressure (BP), total cholesterol and fasting glucose all increased during the study period whilst achievable levels of BMI (< 25 kg/m2) declined. From 2009 to 2017, the mean number of ideal CVH metrics was higher in women compared to men (from 2.1% to 5.1% vs 2.0% to 5.0%). However, poor levels of smoking and fruit and vegetable intake were higher in men compared to women (from 27.9% to 23.6% vs. 7.4%% to 1.9% , and from 33.7% to 42.9% vs 30.8% to 34.6%, respectively). Also, whilst achievable levels of BMI rose in men (from 84.4% to 86.2%) the proportion reduced in women (from 72.1% to 67.5% ). Overall, CVH improved in Malawian adults from 2009 to 2017 and was highest in women. However, the prevalence of poor fruit and vegetable intake, and poor smoking remained high in men whilst optimal levels of BMI was declined in women. To improve this situation, individual and population-based strategies that address body mass, smoking and fruit and vegetable intake are warranted for maximal health gains in stemming the development of cardiovascular events.
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Affiliation(s)
- Calypse Ngwasiri
- Clinical Research Education Networking and Consultancy (CRENC), RFMR+QFH, Yaoundé, Centre Region Cameroon ,grid.4989.c0000 0001 2348 0746Centre de Recherche en Épidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Route de Lennik 808, 1070 Belgium
| | - Sekou Samadoulougou
- grid.23856.3a0000 0004 1936 8390Centre for Research on Planning and Development, Université Laval, Quebec, QC G1V 0A6 Canada ,grid.421142.00000 0000 8521 1798Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute, Quebec, QC G1V 4G5 Canada
| | - Kadari Cissé
- grid.4989.c0000 0001 2348 0746Centre de Recherche en Épidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Route de Lennik 808, 1070 Belgium ,grid.457337.10000 0004 0564 0509Departement Biomédical et Santé Publique, Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Leopold Aminde
- grid.1022.10000 0004 0437 5432School of Medicine, Griffith University, Brisbane, Australia
| | - Fati Kirakoya-Samadoulougou
- grid.4989.c0000 0001 2348 0746Centre de Recherche en Épidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Route de Lennik 808, 1070 Belgium
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Qureshi F, Bousquet-Santos K, Okuzono SS, Tsao E, Delaney S, Guimond AJ, Boehm JK, Kubzansky LD. The social determinants of ideal cardiovascular health: A global systematic review. Ann Epidemiol 2022; 76:20-38. [PMID: 36191736 PMCID: PMC9930100 DOI: 10.1016/j.annepidem.2022.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 09/19/2022] [Accepted: 09/28/2022] [Indexed: 11/26/2022]
Abstract
This systematic review synthesizes research published from January 2010-July 2022 on the social determinants of ideal cardiovascular health (CVH) carried out around the world and compares trends in high-income countries (HICs) to those in low- and middle-income countries (LMICs). 41 studies met inclusion criteria (n = 28 HICs, n = 13 LMICs). Most were from the United States (n = 22) and cross-sectional (n = 33), and nearly all evaluated associations among adults. Among studies conducted in LMICs, nearly all were from middle-income countries and only one was carried out in low-income country. Education (n = 24) and income/wealth (n = 17) were the most frequently examined social determinants in both HICs and LMICs. Although most studies assessed ideal CVH using reliable and valid methods (n = 24), only 7 used criteria pre-defined by the American Heart Association to characterize ideal levels of each CVH metric. Despite heterogeneity in how outcome measures were derived and analyzed, consistent associations were evident between multiple markers of higher social status (i.e. greater education, income/wealth, socioeconomic status, racial/ethnic majority status) and greater levels of ideal CVH across both country contexts. Gaps in the literature include evidence from LMICs and HICs other than the United States, longitudinal research, and investigations of a wider array of social determinants beyond education and income/wealth.
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Affiliation(s)
- Farah Qureshi
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
| | - Kelb Bousquet-Santos
- Department of Biological and Health Sciences, University of Brasilia, Campus Universitario - Centro Metropolitano, Ceilandia Campus, Brasilia, FD, Brazil
| | - Sakurako S Okuzono
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Elaine Tsao
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Scott Delaney
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Anne-Josee Guimond
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Julia K Boehm
- Department of Psychology, Chapman University, Orange, CA
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA
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Pengpid S, Peltzer K. National Cross-Sectional Data on Ideal Cardiovascular Health Among Adults in Mongolia in 2019. Glob Heart 2022; 17:34. [PMID: 35837357 PMCID: PMC9165669 DOI: 10.5334/gh.1122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/09/2022] [Indexed: 11/20/2022] Open
Abstract
Background The study aimed to estimate the prevalence, distribution, and correlates of ideal cardiovascular health (CVH) among individuals (20-69 years) in Mongolia. Method Cross-sectional data were analyzed from 4,516 individuals (20-69 years, mean age = 42.3 years) who participated in the Mongolia STEPS survey in 2019, who had complete measurement of CVH metrics and no history of cardiovascular disease. Ideal CVH measures included non-smoking, healthy diet, physical activity, fasting blood glucose <100 mg/dL, body mass index (<23 kg/m2), total cholesterol <200 mg/dL, and blood pressure <120/<80 mmHg). Results The prevalence of five to seven ideal CVH metrics was 27.7% in 2019. Most Mongolians had ideal total cholesterol (77.4%), ideal smoking (67.8%), ideal fasting glucose (73.8%) and ideal physical activity (66.0%), while a lower prevalence was found for ideal blood pressure (42.4%), ideal body mass index (31.4%), and ideal healthy diet (1.8%). The prevalence of poor smoking, poor fruit/vegetable intake, poor fasting glucose, poor blood pressure, and poor total cholesterol was higher in men than in women, while poor physical activity was higher in women than in men, and poor BMI did not differ by sex. In the adjusted logistic regression analysis, older age, male sex, and belonging to the Khalkh ethnic group were negatively associated, and a higher number of adult household members was positively associated with meeting the ideal 5-7 CVH metrics. Conclusions The proportion of meeting 5-7 ideal CVH metrics was moderate among adults in Mongolia. Primary and secondary prevention programmes should be strengthened to improve CVH in Mongolia, considering identified associated factors.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, TH
- Department of Research Administration and Development, University of Limpopo, Polokwane, ZA
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, TW
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Pengpid S, Peltzer K. Prevalence and associated factors of ideal cardiovascular health: A cross-sectional national population-based study of adults in the Marshall Islands. POPULATION MEDICINE 2022. [DOI: 10.18332/popmed/148425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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9
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Pengpid S, Peltzer K. National trends in ideal cardiovascular health among adults in Bhutan from three cross-sectional surveys in 2007, 2014, and 2019. Sci Rep 2022; 12:5660. [PMID: 35383251 PMCID: PMC8983656 DOI: 10.1038/s41598-022-09688-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/21/2022] [Indexed: 11/29/2022] Open
Abstract
The study aimed to estimate the prevalence, distribution, and correlates of ideal cardiovascular health (CVH) among individuals (20–69 years) across three cross-sectional surveys in 2007, 2014 and 2019 in Bhutan. Cross-sectional data were analysed from 9712 individuals (20–69 years, mean age = 37.6 years) who participated in the 2007, 2014 or 2019 Bhutan STEPS surveys, had complete measurement of CVH metrics, and had no history of a cardiovascular disease in 2014 and 2019. Ideal CVH measures included non-smoking, healthy diet, physical activity, body mass index (< 23 kg/m2), blood pressure < 120/ < 80 mmHg, total cholesterol < 200 mg/dL, and fasting blood glucose < 100 mg/dL). The prevalence of five to seven ideal CVH metrics increased from 11.6% in 2007 to 37.9% in 2019. Trend analyses showed that ideal physical activity, ideal total cholesterol, ideal blood pressure, and ideal fasting glucose increased from 2007 to 2019, while ideal fruit and vegetable intake, ideal smoking, and ideal body mass index decreased from 2007 to 2019. Five to seven ideal CVH metrics, 0–7 ideal CVH metrics, and 0–14 poor, intermediate, and ideal CVH metrics increased from 2007 to 2019. In the adjusted logistic regression analysis, older age decreased the odds of having 5–7 ideal CVH metrics in all three study years. Male sex increased the odds, and employment decreased the odds of 5–7 ideal CVH metrics in 2007, and urban residence increased the odds of 5–7 ideal CVH metrics in 2014 and decreased the odds in 2019. The proportion of meeting 5–7 ideal CVH metrics increased in Bhutan. Primary and secondary prevention programmes must be strengthened to improve CVH in Bhutan, considering identified associated factors.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public, Health Mahidol University, Bangkok, Thailand.,Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa
| | - Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa. .,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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