Prevalence and Clustering of Cardiovascular Disease Risk Factors among Adults Along the Lancang-Mekong River: A Cross-Sectional Study from Low- and Middle-Income Countries

Glob Heart. 2024 Apr 17;19(1):35. doi: 10.5334/gh.1319. eCollection 2024.

Abstract

Background: Progress in cardiovascular health is increasingly concentrated in high-income countries, while the burden of cardiovascular disease (CVD) is high in low- and middle-income countries, a clear health inequity that must be urgently addressed.

Objective: This study aims to evaluate the prevalence and clustering of CVD risk factors in the three Lancang-Mekong regions.

Methods: We conducted a population-based cross-sectional survey from January 2021 to March 2023 in China, Laos, and Cambodia. We compared the prevalence and clustering of CVD risk factors-including hypertension, dyslipidemia, diabetes mellitus, overweight/obesity, current smoking status, current drinking status, inadequate vegetable and fruit intake, and insufficient physical activity-across the three regions, further stratifying the data by gender and age. Multivariate logistic regression models were performed to explore factors influencing the aggregation of CVD risk factors (≥2, ≥3, ≥4).

Results: A total of 11,005 adults were included in the study. Hypertension emerged as the primary metabolic risk factor in Laos (36.8%) and Cambodia (23.5%), whereas overweight/obesity was the primary risk factor in China (37.6%). In terms of behavioral risk factors, participants in all three regions showed insufficient vegetable and fruit intake. The prevalence of individuals without CVD risk factors was 10% in China, 1.9% in Laos, and 5.2% in Cambodia. Meanwhile, the prevalence of two or more risk factors was 64.6% in China, 79.2% in Laos, and 76.0% in Cambodia. Multivariate logistic regression models revealed that the propensity for CVD risk factors clustering was higher in men and increased with age in all three countries.

Conclusions: CVD risk factors and multiple clustering are pressing health threats among adults in low- and middle-income areas along the Lancang-Mekong River Basin. This study highlights the urgent need for proactive tailored strategies to control CVD risk factors.

Keywords: Cardiovascular disease risk factors; Low and middle-income countries; Prevention.

MeSH terms

  • Adult
  • Cardiovascular Diseases* / epidemiology
  • China / epidemiology
  • Cluster Analysis
  • Cross-Sectional Studies
  • Developing Countries
  • Humans
  • Hypertension* / epidemiology
  • Male
  • Obesity / epidemiology
  • Overweight / epidemiology
  • Prevalence
  • Risk Factors
  • Rivers

Grants and funding

The study was supported by the National Key Project of Research and Development Plan during the fourteenth Five-year Plan Period (Grant number: 2022YFC2503400); Major science and technology special plan project of Yunnan Province (Grant number: 202302 AA310045); Yunnan Province Science and Technology Department (Grant numbers: 202103 AF140002; 202103 AC100004 and 202301 AY070001-045).