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Risk factors associated with myocardial infarction in Africa: the INTERHEART Africa study.
Circulation. 2005 Dec 06; 112(23):3554-61.Circ

Abstract

BACKGROUND

Cardiovascular disease (CVD) is rising in low-income countries. However, the impact of modifiable CVD risk factors on myocardial infarction (MI) has not been studied in sub-Saharan Africa (SSA). Therefore, we conducted a case-control study among patients with acute MI (AMI) in SSA to explore its association with known CVD risk factors.

METHODS AND RESULTS

First-time AMI patients (n=578) were matched to 785 controls by age and sex in 9 SSA countries, with South Africa contributing approximately 80% of the participants. The relationships between risk factors and AMI were investigated in the African population and in 3 ethnic subgroups (black, colored, and European/other Africans) and compared with those found in the overall INTERHEART study. Relationships between common CVD risk factors and AMI were found to be similar to those in the overall INTERHEART study. Modeling of 5 risk factors (smoking history, diabetes history, hypertension history, abdominal obesity, and ratio of apolipoprotein B to apolipoprotein A-1) provided a population attributable risk of 89.2% for AMI. The risk for AMI increased with higher income and education in the black African group in contrast to findings in the other African groups. A history of hypertension revealed higher MI risk in the black African group than in the overall INTERHEART group.

CONCLUSIONS

Known CVD risk factors account for approximately 90% of MI observed in African populations, which is consistent with the overall INTERHEART study. Contrasting gradients found in socioeconomic class, risk factor patterns, and AMI risk in the ethnic groups suggest that they are at different stages of the epidemiological transition.

Authors+Show Affiliations

Chronic Diseases of Lifestyle Unit, Medical Research Council, Tygerberg, South Africa.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16330696

Citation

Steyn, Krisela, et al. "Risk Factors Associated With Myocardial Infarction in Africa: the INTERHEART Africa Study." Circulation, vol. 112, no. 23, 2005, pp. 3554-61.
Steyn K, Sliwa K, Hawken S, et al. Risk factors associated with myocardial infarction in Africa: the INTERHEART Africa study. Circulation. 2005;112(23):3554-61.
Steyn, K., Sliwa, K., Hawken, S., Commerford, P., Onen, C., Damasceno, A., Ounpuu, S., & Yusuf, S. (2005). Risk factors associated with myocardial infarction in Africa: the INTERHEART Africa study. Circulation, 112(23), 3554-61.
Steyn K, et al. Risk Factors Associated With Myocardial Infarction in Africa: the INTERHEART Africa Study. Circulation. 2005 Dec 6;112(23):3554-61. PubMed PMID: 16330696.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors associated with myocardial infarction in Africa: the INTERHEART Africa study. AU - Steyn,Krisela, AU - Sliwa,Karen, AU - Hawken,Steven, AU - Commerford,Patrick, AU - Onen,Churchill, AU - Damasceno,Albertino, AU - Ounpuu,Stephanie, AU - Yusuf,Salim, AU - ,, PY - 2005/12/7/pubmed PY - 2006/2/24/medline PY - 2005/12/7/entrez SP - 3554 EP - 61 JF - Circulation JO - Circulation VL - 112 IS - 23 N2 - BACKGROUND: Cardiovascular disease (CVD) is rising in low-income countries. However, the impact of modifiable CVD risk factors on myocardial infarction (MI) has not been studied in sub-Saharan Africa (SSA). Therefore, we conducted a case-control study among patients with acute MI (AMI) in SSA to explore its association with known CVD risk factors. METHODS AND RESULTS: First-time AMI patients (n=578) were matched to 785 controls by age and sex in 9 SSA countries, with South Africa contributing approximately 80% of the participants. The relationships between risk factors and AMI were investigated in the African population and in 3 ethnic subgroups (black, colored, and European/other Africans) and compared with those found in the overall INTERHEART study. Relationships between common CVD risk factors and AMI were found to be similar to those in the overall INTERHEART study. Modeling of 5 risk factors (smoking history, diabetes history, hypertension history, abdominal obesity, and ratio of apolipoprotein B to apolipoprotein A-1) provided a population attributable risk of 89.2% for AMI. The risk for AMI increased with higher income and education in the black African group in contrast to findings in the other African groups. A history of hypertension revealed higher MI risk in the black African group than in the overall INTERHEART group. CONCLUSIONS: Known CVD risk factors account for approximately 90% of MI observed in African populations, which is consistent with the overall INTERHEART study. Contrasting gradients found in socioeconomic class, risk factor patterns, and AMI risk in the ethnic groups suggest that they are at different stages of the epidemiological transition. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/16330696/Risk_factors_associated_with_myocardial_infarction_in_Africa:_the_INTERHEART_Africa_study_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.105.563452?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -