Cardiovascular-Risk-Factor Burden and CV Events: Paradoxical Findings Across Low- and High-Income Countries — Physician’s First Watch
Cardiovascular-Risk-Factor Burden and CV Events: Paradoxical Findings Across Low- and High-Income Countries
By Harlan M. Krumholz, MD, SM
Low-income countries have the lowest cardiovascular-risk-factor burden — but, paradoxically, the highest incidence of major cardiovascular events — according to a New England Journal of Medicine study.
Researchers studied cardiovascular-risk-factor burden, incident cardiovascular disease, and death in more than 150,000 adult residents of 17 high-, middle-, and low-income countries.
The mean cardiovascular-risk-factor burden was highest in high-income countries and lowest in low-income countries. For primary prevention, the use of antiplatelet drugs was highest in high-income countries and lowest in low-income countries. A similar pattern was observed for beta-blockers, renin-angiotensin system blockers, and statins. Cardiovascular and overall death rates were highest in low-income countries and lowest in high-income countries. The case-fatality rate was 17% in low-income countries and 7% in high-income countries.
These results suggest that improved healthcare delivery and access to high-quality care in low- and middle-income countries could save many lives.
Dr. Krumholz is editor-in-chief of NEJM Journal Watch Cardiology, from which this story was adapted.