PREVALENCE OF CORONARY HEART-DISEASE INDICATED BY ELECTROCARDIOGRAM ABNORMALITIES AND RISK-FACTORS IN DEVELOPING-COUNTRIES

A cross-sectional population survey was carried out in 15 population g roups (ethnicity includes Melanesian, Polynesian, Micronesian, Asian I ndian and Chinese) in 9 developing countries: Fiji, Nauru, Kiribati, C ook Island, Niue, Western Samoa, New Caledonia, Mauritius and China (B eijing) in 1978-1987. The total sample included 4594 men and 4988 wome n aged 35-59 years. The aim of study is to report the prevalence of co ronary heart disease (CHD) as indicated by ECG Minnesota coding, and r isk factor levels and to describe the individual and ecological relati onship between CHD prevalence and CHD risk factors among different eth nic groups in developing countries. Mauritians had the highest prevale nce of CHD of these countries. Total serum cholesterol concentration a nd the prevalence of CHD were higher in Mauritius Chinese than in Beij ing Chinese. Mean total cholesterol was lower than or equal to 5.2 mmo l/l (200 mg/dl) in all population groups, except in Mauritians. Hypert ensive subjects in most populations had a low cholesterol concentratio n. The prevalence of hypertension varied from 7 to 35% and mean body m ass index (BMI) from 22.9 to 37.0 kg/m(2). Smoking was more common in men (36-82%) than women (0.8-65%). Multiple logistic regression analys is using individuals as a unit of analysis showed that cholesterol and systolic blood pressure were significant independent predictors of CH D prevalence. When fasting or 2 hr post-load blood glucose was include d in the model total cholesterol was no longer significant in men but remained significant in women. Ecological analysis using populations a s units of analysis showed that the combination of several CHD risk fa ctors could explain about 90% of the interpopulations variance of the CHD prevalence in women. The best models were those where 2 hr post-lo ad glucose was included. Our study has demonstrated that the total cho lesterol concentration of the population was consistent with the preva lence of CHD in the population. A considerable proportion of the varia tion in CHD prevalence across populations in developing countries can be explained by well-known risk factors. These data support the concep t that retaining traditional balanced dietary habits and limiting salt intake together with avoiding smoking use are important activities fo r the prevention of cardiovascular disease (CVD) in developing countri es.