Cardiovascular risk surveillance to develop a nationwide health promotion strategy: The grenada heart project

Sameer Bansilal, Rajesh Vedanthan, Mark Woodward, Rupa Iyengar, Marilyn Hunn, Marcelle Lewis, Lesley Francis, Alexander Charney, Claire Graves, Michael E. Farkouh, Valentin Fuster

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The Grenada Heart Project aims to study the clinical, biological, and psychosocial determinants of the cardiovascular health in Grenada in order to develop and implement a nationwide cardiovascular health promotion program. Methods: We recruited 2,827 adults randomly selected from the national electronic voter list. The main outcome measures were self-reported cardiovascular disease and behavioral risk factors, anthropometric measures, blood pressure, point-of-care testing for glucose and lipids, and ankle-brachial index. Risk factors were also compared with the U.S. National Health and Nutritional Survey data. Results: Prevalence of cardiovascular disease risk factors were: overweight and obesity - 57.7% of the population, physical inactivity - 23.4%, diabetes - 13.3%, hypertension - 29.7%, hypercholesterolemia - 8.6%, and smoking - 7%. Subjects who were physically active had a significantly lower 10-year Framingham risk score (p < 0.001). Compared with the U.S. National Health and Nutrition Survey data, Grenadian women had higher rates of adiposity, diabetes, hypertension, and elevated low-density lipoprotein cholesterol, whereas Grenadian men had a higher rate of diabetes, a similar rate of hypertension, and lower rates of the other risk factors. Prevalence of peripheral arterial disease was 7.6%; stroke and coronary heart disease were equally prevalent at ∼2%. Conclusions: This randomly selected adult sample in Grenada reveals prevalence rates of obesity, hypertension, and diabetes significantly exceeding those seen in the United States. The contrasting, paradoxically low levels of prevalent cardiovascular disease support the concept that Grenada is experiencing an obesity-related "risk transition." These data form the basis for the implementation of a pilot intervention program based on the Institute of Medicine recommendations and may serve as a model for other low- and middle-income countries.

Original languageEnglish (US)
Pages (from-to)87-94
Number of pages8
JournalGlobal Heart
Volume7
Issue number2
DOIs
StatePublished - Jul 2012

ASJC Scopus subject areas

  • Epidemiology
  • Community and Home Care
  • Cardiology and Cardiovascular Medicine

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