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Risk of cardiovascular disease in a traditional African population with a high infectious load: a population-based
Jacob J E Koopman1, David van Bodegom, J Wouter Jukema
1Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands. j.j.e.koopman@lumc.nl
Insights
Inflammation alone does not cause cardiovascular disease. Lifestyle factors are essential for cardiovascular disease development, even in populations with high inflammation.
Area of Science:
- Cardiovascular research
- Inflammation and disease
- Epidemiology
Background:
- Investigating the origins of cardiovascular disease (CVD), contrasting inflammatory versus lifestyle factors.
- Assessing CVD risk factors and disease prevalence in an African population with high inflammation.
- Comparing findings with established data from American and European populations.
Purpose of the Study:
- To determine if inflammation is the sole driver of cardiovascular disease.
- To evaluate the interplay between inflammation, lifestyle, and CVD in a specific population.
- To compare CVD risk and prevalence between an African cohort and Western societies.
Main Methods:
- Population-based study of 924 individuals aged 50+ in rural Ghana.
- Measured cardiovascular risk factors (waist circumference, BMI, blood pressure, glucose, lipids, inflammation markers).
- Assessed cardiovascular disease using electrocardiography (myocardial infarction) and ankle-arm index (peripheral arterial disease).
Main Results:
- Ghanaians exhibited more pro-inflammatory profiles but fewer traditional CVD risk factors (obesity, hypertension, dysglycaemia, dyslipidaemia) than Western populations.
- Prevalence of myocardial infarction was 1.2% and peripheral arterial disease was 2.8% in the Ghanaian cohort.
- Despite higher inflammation, CVD prevalence was lower in this African population compared to Western societies.
Conclusions:
- Inflammatory processes alone are insufficient for the pathogenesis of cardiovascular disease.
- Additional factors, likely related to lifestyle, are necessary for CVD development.
- Findings challenge the sole inflammatory hypothesis of cardiovascular disease and highlight the role of lifestyle.
Background:
To test the inflammatory origin of cardiovascular disease, as opposed to its origin in western lifestyle. Population-based assessment of the prevalences of cardiovascular risk factors and cardiovascular disease in an inflammation-prone African population, including electrocardiography and ankle-arm index measurement. Comparison with known prevalences in American and European societies.
Methodology/Principal Findings:
Traditional population in rural Ghana, characterised by adverse environmental conditions and a high infectious load. Population-based sample of 924 individuals aged 50 years and older. Median values for cardiovascular risk factors, including waist circumference, BMI, blood pressure, and markers of glucose and lipid metabolism and inflammation. Prevalence of myocardial infarction detected by electrocardiography and prevalence of peripheral arterial disease detected by ankle-arm index. When compared to western societies, we found the Ghanaians to have more proinflammatory profiles and less cardiovascular risk factors, including obesity, dysglycaemia, dyslipidaemia, and hypertension. Prevalences of cardiovascular disease were also lower. Definite myocardial infarction was present in 1.2% (95%CI: 0.6 to 2.4%). Peripheral arterial disease was present in 2.8% (95%CI: 1.9 to 4.1%).
Conclusions/Significance:
Taken together, our data indicate that for the pathogenesis of cardiovascular disease inflammatory processes alone do not suffice and additional factors, probably lifestyle-related, are mandatory.
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