Spectrum of prevalent cardiovascular diseases in urban Port-au-Prince, Haiti: a population-based cross-sectional study.

Autor:	Yan LD; Center for Global Health, Weill Cornell Medicine, NYC, NY, USA.; Division of General Internal Medicine, Weill Cornell Medicine, NYC, NY, USA., Sufra R; Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti., St Sauveur R; Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti., Jean-Pierre MC; Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti., Apollon A; Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti., Malebranche R; Collège Haïtien de Cardiologie, Port-au-Prince, Haiti.; Department of Medicine and Pharmacology, Université d'État d'Haïti, Port-au-Prince, Haiti., Théard M; Collège Haïtien de Cardiologie, Port-au-Prince, Haiti., Pierre G; Collège Haïtien de Cardiologie, Port-au-Prince, Haiti., Dévieux J; Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA., Lau J; Division of General Internal Medicine, Weill Cornell Medicine, NYC, NY, USA., Mourra N; Center for Global Health, Weill Cornell Medicine, NYC, NY, USA.; Division of General Internal Medicine, Weill Cornell Medicine, NYC, NY, USA., Roberts NLS; Division of General Internal Medicine, Weill Cornell Medicine, NYC, NY, USA., Rasul R; City University of New York Institute for Implementation Science in Population Health, New York, NY, USA., Nash D; City University of New York Institute for Implementation Science in Population Health, New York, NY, USA., Pirmohamed AM; Division of Cardiology, Weill Cornell Medicine, NYC, NY, USA., Devereux RB; Division of Cardiology, Weill Cornell Medicine, NYC, NY, USA., Lee MH; Center for Global Health, Weill Cornell Medicine, NYC, NY, USA., Kwan GF; Division of Cardiology, Boston University School of Medicine, Boston, MA, USA., Safford MM; Division of General Internal Medicine, Weill Cornell Medicine, NYC, NY, USA., Adrien L; Director General, Ministry of Public Health and Population, Haiti., Alfred JP; Director of Studies and Programming, Ministry of Public Health and Population, Haiti., Deschamps M; Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti., Severe P; Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti., Fitzgerald DW; Center for Global Health, Weill Cornell Medicine, NYC, NY, USA., Pape JW; Center for Global Health, Weill Cornell Medicine, NYC, NY, USA.; Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti., Rouzier V; Center for Global Health, Weill Cornell Medicine, NYC, NY, USA.; Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti., McNairy ML; Center for Global Health, Weill Cornell Medicine, NYC, NY, USA.; Division of General Internal Medicine, Weill Cornell Medicine, NYC, NY, USA.
Jazyk:	angličtina
Zdroj:	Lancet regional health. Americas [Lancet Reg Health Am] 2024 Apr 04; Vol. 33, pp. 100729. Date of Electronic Publication: 2024 Apr 04 (Print Publication: 2024).
DOI:	10.1016/j.lana.2024.100729
Abstrakt:	Background: Eighty percent of global cardiovascular disease (CVD) is projected to occur in low- and middle -income countries (LMICs), yet local epidemiological data are scarce. We provide the first population-based, adjudicated CVD prevalence estimates in Port-au-Prince, Haiti to describe the spectrum of heart disease and investigate associated risk factors. Methods: Demographic, medical history, clinical, imaging and laboratory data were collected among adults recruited using multistage random sampling from 2019 to 2021. Prevalent CVD (heart failure, stroke, ischemic disease) were adjudicated using epidemiological criteria similar to international cohorts. Multivariable Poisson regressions assessed relationships between risk factors and prevalent CVD. Findings: Among 3003 participants, median age was 40 years, 58.1% were female, 70.2% reported income <1 USD/day, and all identified as Black Haitian. CVD age-adjusted prevalence was 14.7% (95% CI 13.3%, 16.5%), including heart failure (11.9% [95% CI 10.5%, 13.5%]), stroke (2.4% [95% CI 1.9%, 3.3%]), angina (2.1% [95% CI 1.6%, 2.9%]), myocardial infarction (1.0% [95% CI 0.6%, 1.8%]), and transient ischemic attack (0.4% [95% CI 0.2%, 1.0%]). Among participants with heart failure, median age was 57 years and 68.5% of cases were among women. The most common subtype was heart failure with preserved ejection fraction (80.4%). Heart failure was associated with hypertension, obesity, chronic kidney disease, depression, and stress. Interpretation: Early-onset heart failure prevalence is alarmingly high in urban Haiti and challenge modelling assumptions that ischemic heart disease and stroke dominate CVDs in LMICs. These data underscore the importance of local population-based epidemiologic data within LMICs to expedite the selection and implementation of evidence-based cardiovascular health policies targeting each country's spectrum of heart disease. Funding: This study was funded by NIH grants R01HL143788, D43TW011972, and K24HL163393, clinicaltrials.govNCT03892265. Competing Interests: RS, RSS, MJP, YM, AA, JD, MHL, MMS, MD, PS, JWP, VR, MLM report a grant R01HL143788. RS, RSS, JWP, MLM report a grant D43TW011972. MLM reports a grant K24HL163393. DWF reports grants K24AI098627, D43TW011826, U19AI162568, P30AI168433. JD reports grant R34MH133481. DN reports grants U01AI096299, R01MH125735, P30MH043520, R01MH117793, R34MH126809, R01AI179420, R21AI147933, RF1MH132360, R21AI177008, COVID research grant from Pfizer, and has received consulting fees from Gilead and Abbvie. GFK reports grants K23HL140133, and R21TW012165. MMS reports grant R01HL165452. JWP reports grants UM1AI069421 and D43TW011295. (© 2024 The Author(s).)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu