Magnitude, Distribution and Contextual Risk Enhancing Predictors of High 10-Year Cardiovascular Risk Among Diabetic Patients in Tanzania.
ASCVD
Tanzania
cardiovascular risk
diabetes mellitus
factors
primary prevention
Journal
Patient related outcome measures
ISSN: 1179-271X
Titre abrégé: Patient Relat Outcome Meas
Pays: New Zealand
ID NLM: 101551170
Informations de publication
Date de publication:
2023
2023
Historique:
received:
26
01
2023
accepted:
20
04
2023
medline:
8
5
2023
pubmed:
8
5
2023
entrez:
8
5
2023
Statut:
epublish
Résumé
Atherosclerotic Cardiovascular Disease (ASCVD) is the leading cause of death worldwide. In Diabetics, ASCVD is associated with poor prognosis and a higher case fatality rate compared with the general population. Sub-Saharan Africa is facing an epidemiological transition with ASCVD being prevalent among young adults. To date, over 20 million people have been living with DM in Africa, Tanzania being one of the five countries in the continent reported to have a higher prevalence. This study aimed to identify an individual's 10-year ASCVD absolute risk among a diabetic cohort in Tanzania and define contextual risk enhancing factors. A prospective observational study was conducted at the Aga Khan hospital, Mwanza, for a period of 8 months. The hospital is a 42-bed district-level hospital in Tanzania. Individuals 10-year risk was calculated based on the ASCVD 2013 risk calculator by ACC/AHA. Pearson's chi-square or Fischer's exact test was used to compare categorical and continuous variables. Multivariable analysis was applied to determine contextual factors for those who had a high 10-year risk of developing ASCVD. The overall cohort included 573 patients. Majority of the individuals were found to be hypertensive (n = 371, 64.7%) and obese (n = 331, 58%) having a high 10-year absolute risk (n = 343, 60%) of suffering ASCVD. The study identified duration of Diabetes Mellitus (>10 years) (OR 8.15, 95% CI 5.25-14.42), concomitant hypertension (OR 1.82 95% CI 1.06-3.06), Diabetic Dyslipidemia (OR 1.44, 95% CI 1.08-1.92) and deranged serum creatinine (OR 1.03, 95% CI 1.02-1.03) to be the risk enhancing factors amongst our population. The study confirms the majority of diabetic individuals in the lake region of Tanzania to have a high 10-year ASCVD risk. The high prevalence of obesity, hypertension and dyslipidemia augments ASCVD risk but provides interventional targets for health-care workers to decrease these alarming projections.
Identifiants
pubmed: 37152069
doi: 10.2147/PROM.S405392
pii: 405392
pmc: PMC10162395
doi:
Types de publication
Journal Article
Langues
eng
Pagination
87-96Informations de copyright
© 2023 Kassam et al.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest in this work.
Références
Nat Rev Cardiol. 2009 Nov;6(11):712-22
pubmed: 19770848
Front Cardiovasc Med. 2022 Nov 10;9:1008335
pubmed: 36440012
Cochrane Database Syst Rev. 2021 Oct 25;10:CD013650
pubmed: 34693515
Lancet. 2012 Aug 11;380(9841):581-90
pubmed: 22607822
Crit Pathw Cardiol. 2015 Jun;14(2):74-80
pubmed: 26102017
Lancet. 2019 Jul 13;394(10193):121-130
pubmed: 31189511
Clin Epidemiol. 2016 Jun 11;8:177-84
pubmed: 27354825
N Engl J Med. 2016 Jul 28;375(4):311-22
pubmed: 27295427
J Am Coll Cardiol. 2019 Jun 25;73(24):3168-3209
pubmed: 30423391
Front Cardiovasc Med. 2022 Mar 25;9:849007
pubmed: 35402575
Circulation. 2019 Jun 18;139(25):e1082-e1143
pubmed: 30586774
Diabetes Res Clin Pract. 2022 Jan;183:109118
pubmed: 34883189
J Am Heart Assoc. 2019 Feb 19;8(4):e011295
pubmed: 30776949
Am J Prev Cardiol. 2022 Mar 15;10:100335
pubmed: 35342890
Arch Intern Med. 2011 Mar 14;171(5):404-10
pubmed: 21403036
JACC Basic Transl Sci. 2020 Jun 22;5(6):632-644
pubmed: 32613148
Atherosclerosis. 2004 Aug;175(2):361-7
pubmed: 15262193
Circulation. 2014 Jun 24;129(25 Suppl 2):S49-73
pubmed: 24222018
Ann Intern Med. 2012 Aug 21;157(4):263-75
pubmed: 22910937
Stroke. 1997 Mar;28(3):557-63
pubmed: 9056611
Diabetes Res Clin Pract. 2019 Nov;157:107843
pubmed: 31518657
Lancet. 2013 Jul 27;382(9889):339-52
pubmed: 23727170
Clin J Am Soc Nephrol. 2007 May;2(3):581-90
pubmed: 17699466
Ann Intern Med. 2015 Feb 17;162(4):266-75
pubmed: 25686167
Curr Cardiol Rev. 2020;16(4):258-265
pubmed: 31362691
Tanzan J Health Res. 2011 Dec;13(5 Suppl 1):378-86
pubmed: 26591992
J Diabetes Complications. 2021 Mar;35(3):107767
pubmed: 33168394
Tanzan J Health Res. 2011 Dec;13(5 Suppl 1):365-77
pubmed: 26591991
J Am Heart Assoc. 2022 Jul 5;11(13):e025973
pubmed: 35785971
Circulation. 2019 Sep 10;140(11):e596-e646
pubmed: 30879355
Eur Heart J. 2017 Aug 21;38(32):2459-2472
pubmed: 28444290
Lancet. 2010 Jun 26;375(9733):2215-22
pubmed: 20609967
Am J Kidney Dis. 2002 Feb;39(2 Suppl 1):S1-266
pubmed: 11904577
Lancet. 2004 Sep 11-17;364(9438):937-52
pubmed: 15364185
World J Diabetes. 2021 Jun 15;12(6):827-838
pubmed: 34168731
World J Diabetes. 2014 Aug 15;5(4):444-70
pubmed: 25126392
Lancet. 2010 Jun 26;375(9733):2254-66
pubmed: 20609971
Stroke. 2012 May;43(5):1212-7
pubmed: 22382158