TY - JOUR
T1 - The global cardiovascular risk transition: associations of four metabolic risk factors with national income, urbanization, and Western diet in 1980 and 2008
AU - Danaei, Goodarz
AU - Singh, Gitanjali M.
AU - Paciorek, Christopher J.
AU - Lin, John K.
AU - Cowan, Melanie J.
AU - Finucane, Mariel M.
AU - Farzadfar, Farshad
AU - Stevens, Gretchen A.
AU - Riley, Leanne M.
AU - Lu, Yuan
AU - Rao, Mayuree
AU - Ezzati, Majid
AU - AUTHOR GROUP
AU - Aamodt, Geir
AU - Abdeen, Ziad
AU - Abdella, Nabila A.
AU - Rahim, Hanan F. Abdul
AU - Addo, Juliet
AU - Aekplakorn, Wichai
AU - Afifi, Mustafa M.
AU - Agabiti-Rosei, Enrico
AU - Aguilar Salinas, Carlos A.
AU - Agyemang, Charles
AU - Ali, Mohamed M.
AU - Al-Nsour, Mohannad
AU - Al-Nuaim, Abdul R.
AU - Ambady, Ramachandran
AU - Aro, Pertti
AU - Azizi, Fereidoun
AU - Barbagallo, Carlo M.
AU - Barbieri, Marco Antonio M.
AU - Barceló, Alberto
AU - Barreto, Sandhi M.
AU - Barros, Henrique
AU - Bautista, Leonelo E.
AU - Benetos, Athanase
AU - Bjerregaard, Peter
AU - Björkelund, Cecilia
AU - Bo, Simona
AU - Bobak, Martin
AU - Bonora, Enzo
AU - Bontha, Babu V.
AU - Botana, Manuel A.
AU - Bovet, Pascal
AU - Breckenkamp, Juergen
AU - Breteler, Monique M.
AU - Broda, Grazyna
AU - Brown, Ian J.
AU - Bursztyn, Michael
AU - Cabrera de León, Antonio
AU - Campos, Hannia
PY - 2013
Y1 - 2013
N2 - It is commonly assumed that cardiovascular disease risk factors are associated with affluence and Westernization. We investigated the associations of body mass index (BMI), fasting plasma glucose, systolic blood pressure, and serum total cholesterol with national income, Western diet, and, for BMI, urbanization in 1980 and 2008. Country-level risk factor estimates for 199 countries between 1980 and 2008 were from a previous systematic analysis of population-based data. We analyzed the associations between risk factors and per capita national income, a measure of Western diet, and, for BMI, the percentage of the population living in urban areas. In 1980, there was a positive association between national income and population mean BMI, systolic blood pressure, and total cholesterol. By 2008, the slope of the association between national income and systolic blood pressure became negative for women and zero for men. Total cholesterol was associated with national income and Western diet in both 1980 and 2008. In 1980, BMI rose with national income and then flattened at ≈Int$7000; by 2008, the relationship resembled an inverted U for women, peaking at middle-income levels. BMI had a positive relationship with the percentage of urban population in both 1980 and 2008. Fasting plasma glucose had weaker associations with these country macro characteristics, but it was positively associated with BMI. The changing associations of metabolic risk factors with macroeconomic variables indicate that there will be a global pandemic of hyperglycemia and diabetes mellitus, together with high blood pressure in low-income countries, unless effective lifestyle and pharmacological interventions are implemented
AB - It is commonly assumed that cardiovascular disease risk factors are associated with affluence and Westernization. We investigated the associations of body mass index (BMI), fasting plasma glucose, systolic blood pressure, and serum total cholesterol with national income, Western diet, and, for BMI, urbanization in 1980 and 2008. Country-level risk factor estimates for 199 countries between 1980 and 2008 were from a previous systematic analysis of population-based data. We analyzed the associations between risk factors and per capita national income, a measure of Western diet, and, for BMI, the percentage of the population living in urban areas. In 1980, there was a positive association between national income and population mean BMI, systolic blood pressure, and total cholesterol. By 2008, the slope of the association between national income and systolic blood pressure became negative for women and zero for men. Total cholesterol was associated with national income and Western diet in both 1980 and 2008. In 1980, BMI rose with national income and then flattened at ≈Int$7000; by 2008, the relationship resembled an inverted U for women, peaking at middle-income levels. BMI had a positive relationship with the percentage of urban population in both 1980 and 2008. Fasting plasma glucose had weaker associations with these country macro characteristics, but it was positively associated with BMI. The changing associations of metabolic risk factors with macroeconomic variables indicate that there will be a global pandemic of hyperglycemia and diabetes mellitus, together with high blood pressure in low-income countries, unless effective lifestyle and pharmacological interventions are implemented
U2 - https://doi.org/10.1161/CIRCULATIONAHA.113.001470
DO - https://doi.org/10.1161/CIRCULATIONAHA.113.001470
M3 - Article
C2 - 23481623
SN - 0009-7322
VL - 127
SP - 1493-502, 1502e1-8
JO - Circulation
JF - Circulation
IS - 14
ER -