AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 40 Submission ID: 1397 Introduction Cardiovascular diseases (CVD) remain the leading cause of global mortality and morbidity, with nearly 80% of global CVD related deaths occur in low- and middle-income countries (LMICs). In 2010, the American Heart Association (AHA) expanded the focus of addressing existing CVD risk factors, to rather focus on strategies that would directly promote cardiovascular health (CVH) of individuals. Ideal CVH were based on 7 health behaviours and factors that, when optimal, were associated with greater CVD-free survival and higher quality of life. The 7 CVH components, better known as Life’s Simple 7, included dietary quality, physical activity, cigarette smoking, body mass index (BMI), fasting blood glucose, total cholesterol, and blood pressure (BP) measurements. Each metric was defined as either poor, intermediate or ideal, with ideal CVH having all 7 metrics at an ideal level. Previous studies showed that ideal CVH strongly associated with lower risk of CVD and all-cause mortality in young, middle-aged, and older adults. The prevalence of ideal CVH in adults is generally quite low worldwide, although most studies come from high-income countries. Moreover, how the prevalence of CVH and its pattern during adulthood varies across high and LMICs have not yet been explored. Understanding similarities and specificities of different countries might help tailor public policies to encourage better CVH. Nationally representative surveys from countries with distinct characteristics are a good opportunity for exploiting the gaps described. As such, harmonisation of individual-level data from these surveys is a challenge to be addressed. The harmonisation would also permit the study of variables that may be potential determinants of achieving ideal CVH in adulthood across and within countries. We aimed to 1) compare prevalence of ideal CVH across five high- to low-income countries using nationally representative surveys, (2) to compare country CVH trends during adulthood, and (3) to identify the factors that may be associated with CVH prevalence and trends across these five countries. To address these aims we harmonised cross-sectional data from the World Health Organisation (WHO) STEPwise approach to surveillance (STEPS) program, (Bangladesh and Ethiopia), the United States (US) National Health and Nutrition Examination Surveys (NHANES), Health Survey for England (HSE) and the National Health Survey for Brazil (PNS-Brazil). Methods We compared CVH variables from five nationally representative population surveys (aged 18 - 65 plus years) from STEPS Bangladesh (2018), STEPS Ethiopia (2015), NHANES (pre-pandemic data; 2017-2020), HSE (2016) and Brazil-PNS (2013). Surveys were examined for primarily of the 8 CVH metrics (healthy sleep, diet, physical activity, cigarette smoking, BMI, fasting blood glucose, total cholesterol, and BP measurements). To investigate whether harmonisation of each variable across the countries were possible, we defined each variable according to the AHA guidelines as either ideal, intermediate, or poor health. Each variable was converted to a CVH score using cut-points based on the AHA criteria. The scores ranged from ideal (2 points), intermediate (1 point), or poor (0 point) CVH. Participant characteristics was described by country with continuous variables reported as means and standard deviation, or median and interquartile range as appropriate. The CVH metrics patterns in each country and across country was examined. We performed weighted analysis to retain representativeness of the survey data. The CVH score was examined over age per country. Weighted prevalence of each CVH metric category was reported. The prevalence of CVH was described across and within the countries. Age-sex adjusted prevalence of ideal CVH was determined within and across surveys. Logistic regression was used to assess the association between ideal CVH, and participant characteristics adjusted for relevant variables. In June 2022, the AHA updated the guidelines for CVH from Life’s Simple 7 to Life’s Essential 8, which included healthy sleep and introduced a new point system for the 8 metrics. Although the AHA has updated the guidelines and point system for CVH metrics, this secondary data analysis used the previous guidelines and point-system for Life’s Simple 7. Name: Presenting Author Information Article Category Abstract Title DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa bridget.vermeulen@wits.ac.za English Abstract Population Sciences Comparison of cardiovascular health profiles across population surveys from five high- to low-income countries Author Affiliation: Email: Dr Bridget Vermeulen ORAL PRESENTATION
RkJQdWJsaXNoZXIy NDIzNzc=