Current Problems in Cardiology
Volume 35, Issue 2 , Pages 72-115 , February 2010

Growing Epidemic of Coronary Heart Disease in Low- and Middle-Income Countries

References 

  1. WHO. The World Health Report 2002: Reducing Risks, Promoting Healthy Life. Geneva: World Health Organization; 2002;
  2. Leeder S, Raymond S, Greenberg H, et al. A Race Against Time: The Challenge of Cardiovascular Disease in Developing Countries. New York: Trustees of Columbia University; 2004;
  3. Olshansky SJ, Ault AB. The fourth stage of the epidemiologic transition: the age of delayed degenerative diseases. Milbank Mem Fund Q. 1986;64:355–391
  4. Omran AR. The epidemiologic transition: a theory of the epidemiology of population change. Milbank Mem Fund Q. 1971;49:509
  5. Yusuf S, Reddy S, Ounpuu S, et al. Global burden of cardiovascular diseases. Part I: General considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104:2746–2753
  6. Lopez AD, Mathers CD, Ezzati M, et al, editors. Global burden of disease and risk factors. In: DCP Project, editor, vol 552. New York, NY: World Bank and Oxford University Press, 2006.
  7. Reddy KS. Cardiovascular disease in non-Western countries. N Engl J Med. 2004;350:2438–2440
  8. World Bank. World Development Indicators. Washington, DC: World Bank; 2002;
  9. American Heart Association. Heart disease and stroke statistics (Update 2004). 2003;[cited: July 13, 2003]. Available from: http://www.americanheart.org
  10. Pestana JA, Steyn K, Leiman A, et al. The direct and indirect costs of cardiovascular disease in South Africa in 1991. S Afr Med J. 1996;86:679–684
  11. UN Office of the High Representative for the least developed countries. Landlocked Developing Countries and Small Island Developing States. http://www.un.org/special-rep/ohrlls/ldc/list.htm2009;[cited April 16, 2009].
  12. Development Data Group. World Development Indicators. In:  Bank TW editors. Washington, D.C: International Bank; 2007;p. 402
  13. World Health Report 2003: Shaping the Future. Geneva: World Health Organization; 2003;
  14. WHO. In: The Global Burden of Disease: 2004 Update. Geneva: World Health Organization; 2008;p. 160
  15. Liu L. Cardiovascular diseases in China. Biochem Cell Biol. 2007;85:157–163
  16. Zhang XH, Lu ZL, Liu L. Coronary heart disease in China. Heart. 2008;94:1126–1131
  17. Gupta R. Burden of coronary heart disease in India. Indian Heart J. 2005;57:632–638
  18. Wu Z, Yao C, Zhao D, et al. Sino-MONICA project: a collaborative study on trends and determinants in cardiovascular diseases in China. Part I: Morbidity and mortality monitoring. Circulation. 2001;103:462–468
  19. Chen ZM, Jiang LX, Chen YP, et al. Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: Randomised placebo-controlled trial. Lancet. 2005;366:1607–1621
  20. Chen ZM, Pan HC, Chen YP, et al. Early intravenous then oral metoprolol in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet. 2005;366:1622–1632
  21. Tognoni G, Franzosi M, Latini R, et al. Oral captopril versus placebo among 13,634 patients with suspected acute myocardial infarction: interim report from the Chinese cardiac study (CCS-1). Lancet. 1995;345:686–687
  22. Liu L. Long-term mortality in patients with myocardial infarction: impact of early treatment with captopril for 4 weeks. Chin Med J [Engl]. 2001;114:115–118
  23. Ye P, Lu ZL, Du BM, et al. Effect of xuezhikang on cardiovascular events and mortality in elderly patients with a history of myocardial infarction: a subgroup analysis of elderly subjects from the China coronary secondary prevention study. J Am Geriatr Soc. 2007;55:1015–1022
  24. Zhao SP, Lu ZL, Du BM, et al. Xuezhikang, an extract of cholestin, reduces cardiovascular events in type 2 diabetes patients with coronary heart disease: subgroup analysis of patients with type 2 diabetes from China coronary secondary prevention study (CCSPS). J Cardiovasc Pharmacol. 2007;49:81–84
  25. La Vecchia C, Levi F, Lucchini F, et al. Trends in mortality from major diseases in Europe, 1980-1993. Eur J Epidemiol. 1998;14:1–8
  26. Kesteloot H, Sans S, Kromhout D. Dynamics of cardiovascular and all-cause mortality in Western and Eastern Europe between 1970 and 2000. Eur Heart J. 2006;27:107–113
  27. Mirzaei M, Truswell AS, Taylor R, et al. Coronary heart disease (CHD) epidemics: not all the same. Heart. 2009;95:740–746
  28. Xu K, Evans DB, Kawabata K, et al. Household catastrophic health expenditure: a multicountry analysis. Lancet. 2003;362:111–117
  29. Ganova-Iolovska M, Kalinov K, Geraedts M. Quality of care of patients with acute myocardial infarction in Bulgaria: a cross-sectional study. BMC Health Serv Res. 2009;9:15
  30. Gurjeva OS, Bukhman G, Murphy S, et al. Treatment and outcomes of eastern Europeans with coronary syndromes in opus-TIMI 16. Int J Cardiol. 2005;100:101–107
  31. Eastaugh JL, Calvert MJ, Freemantle N. Highlighting the need for better patient care in stable angina: results of the international angina treatment patterns (ATP) survey in 7074 patients. Fam Pract. 2005;22:43–50
  32. Nabipour I, Amiri M, Imami SR, et al. The metabolic syndrome and nonfatal ischemic heart disease; a population-based study. Int J Cardiol. 2007;118:48–53
  33. Health, nutrition and population statistics. World Bank Economic Indicators 2007. http://go.worldbank.org/N2N84RDV00[cited 2009 3/27]
  34. Azambuja MI, Foppa M, Maranhão MF, et al. Economic burden of severe cardiovascular diseases in Brazil: an estimate based on secondary data. Arq Bras Cardiol. 2008;91:148–155163-71
  35. Regional Core Health Data Initiative. http://www.paho.org/English/SHA/coredata/tabulator/newTabulator.htm2004;[cited 2009 4/1]
  36. Balbinotto Neto G, Silva EN. The costs of cardiovascular disease in Brazil: a brief economic comment. Arq Bras Cardiology. 2008;91:198–199217-8
  37. Laurenti R, Buchalla CM, Caratin Vde S. Ischemic heart disease (Hospitalization, length of stay and expenses in Brazil from 1993 to 1997). Arq Bras Cardiology. 2000;74:483–492
  38. Curioni C, Cunha CB, Veras RP, et al. The decline in mortality from circulatory diseases in Brazil. Rev Panam Salud Publ. 2009;25:9–15
  39. Rodriguez T, Malvezzi M, Chatenoud L, et al. Trends in mortality from coronary heart and cerebrovascular diseases in the Americas: 1970-2000. Heart. 2006;92:453–460
  40. The PURSUIT Trial Investigators. Inhibition of platelet glycoprotein IIb/IIIa with eptifibatide in patients with acute coronary syndromes. The PURSUIT Trial Investigators. Platelet glycoprotein IIb/IIIa in unstable angina: receptor suppression using Integrilin therapy. N Engl J Med. 1998;339:436–443
  41. Akkerhuis KM, Deckers JW, Boersma E, et al. Geographic variability in outcomes within an international trial of glycoprotein IIb/IIIa inhibition in patients with acute coronary syndromes (Results from PURSUIT). Eur Heart J. 2000;21:371–381
  42. Mendis S, Abegunde D, Yusuf S, et al. WHO study on Prevention of REcurrences of Myocardial Infarction and StrokE (WHO-PREMISE). Bull World Health Organ. 2005;83:820–829
  43. Mansur AP, Mattar AP, Tsubo CE, et al. Prescription and adherence to statins of patients with coronary artery disease and hypercholesterolemia. Arq Bras Cardiol. 2001;76:111–118
  44. Garcia-Castillo A, Jerjes-Sánchez C, Martínez Bermúdez P, et al. Mexican registry of acute coronary syndromes. Arch Cardiol Mex. 2005;75(suppl 1):S6–S32
  45. Murray CJ, Lopez AD. Mortality by cause for eight regions of the world: global burden of disease study. Lancet. 1997;349:1269–1276
  46. Al-Nozha MM, Arafah MR, Al-Mazrou YY, et al. Coronary artery disease in Saudi Arabia. Saudi Med J. 2004;25:1165–1171
  47. Nsour M, Mahfoud Z, Kanaan MN, et al. Prevalence and predictors of nonfatal myocardial infarction in Jordan. East Mediterr Health J. 2008;14:818–830
  48. Romdhane BH, Bougatef S, Skhiri H, et al. The first Tunisian cardiovascular diseases register: processes and results. Rev Epidemiol Sante Publique. 2004;52:558–564
  49. Ghaffar A, Reddy KS, Singhi M. Burden of non-communicable diseases in South Asia. BMJ. 2004;328:807–810
  50. Mohan V, Deepa R, Rani SS, et al. Prevalence of coronary artery disease and its relationship to lipids in a selected population in South India: the Chennai Urban population study (CUPS Number 5). J Am Coll Cardiol. 2001;38:682–687
  51. Ahmad N, Bhopal R. Is coronary heart disease rising in India? (A Systematic Review Based on ECG Defined Coronary Heart Disease). Heart. 2005;91:719–725
  52. Ajay VS, Gupta R, Panniyammakkal J. National Cardiovascular Disease Database (Delhi Ministry of Health and Family Welfare, Government of India). Geneva: World Health Organization; 2002;
  53. Jafar TH, Qadri Z, Chaturvedi N. Coronary artery disease epidemic in Pakistan: more electrocardiographic evidence of ischaemia in women than in men. Heart. 2008;94:408–413
  54. Goyal A, Yusuf S. The burden of cardiovascular disease in the Indian subcontinent. Indian J Med Res. 2006;124:235–244
  55. Joshi R, Chow CK, Raju PK, et al. Fatal and nonfatal cardiovascular disease and the use of therapies for secondary prevention in a rural region of India. Circulation. 2009;119:1950–1955
  56. World Bank. World Development Indicators. http://siteresources.worldbank.org/DATASTATISTICS/Resources/reg_wdi.pdf2008;[cited: April 16, 2009]
  57. Measuring the Global Burden of Disease and Risk Factors, 1990-2001. In:  Lopez AD,  Mathers CD,  Ezzati M, et al. editor. Global Burden of Disease and Risk Factors. New York: Oxford University Press; 2006;
  58. Gaziano TA, Opie LH, Weinstein MC. Cardiovascular disease prevention with a multidrug regimen in the developing world: a cost-effectiveness analysis. Lancet. 2006;368:679–686
  59. Mensah GA. Ischaemic heart disease in Africa. Heart. 2008;94:836–843
  60. World Health Organization. Integrated management of cardiovascular risk: report of a WHO meeting, Geneva, 9-12 July 2002. In:  Bengoa R,  Yach D editor. Cardiovascular Disease Program. New York: World Health Organization; 2002;
  61. Palacios R, Alonso I, Hidalgo A, et al. Peripheral arterial disease in HIV patients older than 50 years of age. AIDS Res Hum Retrovir. 2008;24:1043–1046
  62. Mauss S, Berger F, Schmutz G, et al. Lipoprotein(a) in patients initiating antiretroviral therapy. HIV Med. 2008;9:415–420
  63. Grover SA, Coupal L, Gilmore N, et al. Impact of dyslipidemia associated with highly active antiretroviral therapy (HAART) on cardiovascular risk and life expectancy. Am J Cardiol. 2005;95:586–591
  64. Thun M, da Costa V, Silva E. Introduction and overview of global tobacco surveillance. Tobacco Control Country Profiles. Geneva: World Health Organization; 2003;
  65. Shafey O, Eriksen M, Ross H, et al. The Tobacco Atlas. 3rd edition. Atlanta, GA: American Cancer Society; 2009;
  66. WHO. Report on the Global Tobacco Epidemic, 2008: The MPOWER Package. Geneva: World Health Organization; 2008;
  67. Parish S, Collins R, Peto R, et al. Cigarette smoking, tar yields, and non-fatal myocardial infarction: 14,000 cases and 32,000 controls in the United Kingdom. The international studies of infarct survival (ISIS) collaborators. BMJ. 1995;311:471–477
  68. Teo KK, Ounpuu S, Hawken S, et al. Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: a case-control study. Lancet. 2006;368:647–658
  69. Ezzati M, Henley SJ, Thun MJ, et al. Role of smoking in global and regional cardiovascular mortality. Circulation. 2005;112:489–497
  70. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364:937–952
  71. Barnoya J, Glantz SA. Cardiovascular effects of second hand smoke: Nearly as large as smoking. Circulation. 2005;111:2684–2698
  72. Sargent RP, Shepard RM, Glantz SA. Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study. BMJ. 2004;328:977–980
  73. Pell JP, Haw S, Cobbe S, et al. Smoke-free legislation and hospitalizations for acute coronary syndrome. N Engl J Med. 2008;359:482–491
  74. Lawes CM, Vander Hoorn S, Rodgers A. Global burden of blood-pressure-related disease, 2001. Lancet. 2008;371:1513–1518
  75. Martiniuk AL, Lee CM, Lawes CM, et al. Hypertension: its prevalence and population-attributable fraction for mortality from cardiovascular disease in the Asia-Pacific region. J Hypertens. 2007;25:73–79
  76. Ezzati M, Vander Hoorn S, Lopez AD, et al. Comparative quantification of mortality and burden of disease attributable to selected risk factors. In:  Lopez AD,  Ezzati M,  Jamieson DT, et al. editor. Global Burden of Disease and Risk Factors. New York: Oxford University Press; 2006;p. 241–396
  77. Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab. 2008;93(suppl 1):S9–S30
  78. Popkin BM, Gordon-Larsen P. The nutrition transition: Worldwide obesity dynamics and their determinants. Int J Obes Relat Metab Disord. 2004;28(suppl 3):S2–S9
  79. Kelly T, Yang W, Chen CS, et al. Global burden of obesity in 2005 and projections to 2030. Int J Obes. 2008;32:1431–1437
  80. Raymond SU, Leeder S, Greenberg HM. Obesity and cardiovascular disease in developing countries: a growing problem and an economic threat. Curr Opin Clin Nutr Metab Care. 2006;9:111–116
  81. Monteiro CA, Moura EC, Conde WL, et al. Socioeconomic status and obesity in adult populations of developing countries: a review. Bull World Health Organ. 2004;82:940–946
  82. Mendez MA, Monteiro CA, Popkin BM. Overweight exceeds underweight among women in most developing countries. Am J Clin Nutr. 2005;81:714–721
  83. Poskitt EM. Countries in transition: Underweight to obesity non-stop?. Ann Trop Paediatr. 2009;29:1–11
  84. Seale C. Changing patterns of death and dying. Soc Sci Med. 2000;51:917–930
  85. Speed of population aging in selected countries. http://www.prb.org/Home/Publications/GraphicsBank/Aging.aspx2009;[cited 2009 4/15]
  86. The demographic transition. http://www.unfpa.org/swp/1998/pressumary2.htm1998;[cited 2009 4/15]
  87. Fact sheet. Diabetes 2008 [cited 2009 4/20]. Available from: http://www.who.int/mediacentre/factsheets/fs312/en/.
  88. Hossain P, Kawar B, El Nahas M. Obesity and diabetes in the developing world—A growing challenge. N Engl J Med. 2007;356:213–215
  89. Wild S, Roglic G, Green A, et al. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047–1053
  90. Haslam DW, James WP. Obesity. Lancet. 2005;366:1197–1209
  91. Suhrcke M, Nugent RA, Stuckler D, et al. Chronic Disease: An Economic Perspective. In: Oxford Health Alliance; 2006;p. 60;Available from: http://www.oxha.org/knowledge/publications/oxha-chronic-disease-an-economic-perspective.pdf/view
  92. Schieber GJ, Gottret P, Fleisher LK, et al. Financing global health: mission unaccomplished. Health Aff Millwood. 2007;26:921–934
  93. Thom T, Haase N, Rosamond W, et al. Heart disease and stroke statistics—2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006;113:e85–e151
  94. Barceló A, Aedo C, Rajpathak S, et al. The cost of diabetes in Latin America and the Caribbean. Bull World Health Organization. 2003;81:19–27
  95. Popkin BM, Horton S, Kim S, et al. Trends in diet, nutritional status, and diet-related noncommunicable diseases in China and India: the economic costs of the nutrition transition. Nutr Rev. 2001;59:379–390
  96. Gaziano T, Reddy KS, Paccaud F, et al. Cardiovascular disease. In:  Jamison D,  Measham A,  Alleyne G, et al. editor. Disease Control Priorities in Developing Countries. New York: Oxford University Press and The World Bank; 2006;p. 645–662
  97. Gaziano TA. Cardiovascular disease in the developing world and its cost-effective management. Circulation. 2005;112:3547–3553
  98. Gaziano TA, Steyn K, Cohen DJ, et al. Cost-effectiveness analysis of hypertension guidelines in South Africa: absolute risk versus blood pressure level. Circulation. 2005;112:3569–3576
  99. Assmann G, Cullen P, Schulte H. Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular Munster (PROCAM) study. [Erratum appears in Circulation 2002;105:900] Circulation. 2002;105:310–315
  100. Conroy RM, Pyörälä K, Fitzgerald AP, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J. 2003;24:987–1003
  101. Ferrario M, Chiodini P, Chambless LE, et al. Prediction of coronary events in a low incidence population (Assessing accuracy of the CUORE cohort study prediction equation). Int J Epidemiol. 2005;34:413–421
  102. Wilson PW, D'Agostino RB, Levy D, et al. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97:1837–1847
  103. Folsom AR, Chambless LE, Ballantyne CM, et al. An assessment of incremental coronary risk prediction using C-reactive protein and other novel risk markers: the atherosclerosis risk in communities study. Arch Intern Med. 2006;166:1368–1373
  104. Wang TJ, Gona P, Larson MG, et al. Multiple biomarkers for the prediction of first major cardiovascular events and death. N Engl J Med. 2006;355:2631–2639
  105. Ware JH. The limitations of risk factors as prognostic tools. N Engl J Med. 2006;355:2615–2617
  106. Ridker PM, Buring JE, Rifai N, et al. Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds Risk Score. JAMA. 2007;297:611–619
  107. Lindholm LH, Mendis S. Prevention of cardiovascular disease in developing countries. Lancet. 2007;370:720–722
  108. Mendis S, Lindholm LH, Mancia G, et al. World Health Organization (WHO) and International Society of Hypertension (ISH) risk prediction charts: assessment of cardiovascular risk for prevention and control of cardiovascular disease in low and middle-income countries. J Hypertens. 2007;25:1578–1582
  109. Gaziano TA, Young CR, Fitzmaurice G, et al. Laboratory-based versus non-laboratory-based method for assessment of cardiovascular disease risk: the NHANES I follow-up study cohort. Lancet. 2008;371:923–931
  110. Jha P, Chaloupka FJ, Moore J, et al. Tobacco addiction. Disease Control Priorities in the Developing Countries. 2nd edition. New York: Oxford University Press; 2006;
  111. Mohiuddin SM, Mooss AN, Hunter CB, et al. Intensive smoking cessation intervention reduces mortality in high-risk smokers with cardiovascular disease. Chest. 2007;131:446–452
  112. Ong HT. Beta blockers in hypertension and cardiovascular disease. BMJ. 2007;334:946–949
  113. Jamison D, Breman JG, Measham AR, et al. Disease Control Priorities in Developing Countries. 2nd edition. New York: Oxford University Press and The World Bank; 2006;
  114. Dong Y. Community Health Services in China: the experience of Tianjin city. Aust Health Rev. 2001;24:176–182
  115. Yu Z, Song G, Guo Z, et al. Changes in blood pressure, body mass index, and salt consumption in a Chinese population. Prev Med. 1999;29:165–172
  116. Hodge AM, Dowse GK, Gareeboo H, et al. Incidence, increasing prevalence, and predictors of change in obesity and fat distribution over 5 years in the rapidly developing population of Mauritius. Int J Obes Relat Metab Disord J Int Assoc Study Obes. 1996;20:137–146
  117. Rossouw JE, Jooste PL, Chalton DO, et al. Community-based intervention: the coronary risk factor study (CORIS). Int J Epidemiol. 1993;22:428–438
  118. Uusitalo U, Feskens EJ, Tuomilehto J, et al. Fall in total cholesterol concentration over five years in association with changes in fatty acid composition of cooking oil in Mauritius: cross sectional survey. BMJ. 1996;313:1044–1046
  119. Zatonski WA, McMichael AJ, Powles JW. Ecological study of reasons for sharp decline in mortality from ischaemic heart disease in Poland since 1991. BMJ. 1998;316:1047–1051
  120. Zatonski WA, Willett W. Changes in dietary fat and declining coronary heart disease in Poland: population based study. BMJ. 2005;331:187–188
  121. World Health Organization, WHO. Global InfoBase. http://www.who.int/infobase
  122. Gaziano TA, Galea G, Reddy KS. Scaling up interventions for chronic disease prevention: the evidence. Lancet. 2007;370:1939–1946

 Dr. Gaziano is supported by a grant from the Fogarty International Center, NIH (Grant Number 2K01TW007141-05).

 The authors have no conflicts of interest to disclose.

PII: S0146-2806(09)00127-3

doi: 10.1016/j.cpcardiol.2009.10.002

Current Problems in Cardiology
Volume 35, Issue 2 , Pages 72-115 , February 2010