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Cardiovascular risk assessment in the resource limited setting of Western Honduras: An epidemiological perspective
Eleazar Enrique Montalvan Sanchez1, Samuel Alejandro Urrutia2, Aida Argentina Rodriguez1
1Western Honduras Gastric Cancer Prevention Initiative, Hospital de Occidente, Santa Rosa de Copan 41101, Honduras.
Insights
Cardiovascular disease risk factors are high in Honduras, with elevated hypertension, diabetes, and cholesterol. Risk assessment scores indicate a significant burden of cardiovascular disease in the population.
Area of Science:
- Epidemiology
- Cardiovascular Health
- Public Health in Central America
Background:
- Cardiovascular disease (CVD) epidemiology shows significant variation in Low and Middle-Income Countries.
- Honduras faces the highest rates of Ischemic Heart Disease and CVD mortality in Central America.
Purpose of the Study:
- To assess individual cardiovascular disease (CVD) risk factors in western Honduras.
- To calculate Cardiovascular Risk Assessment Scores (CVRAS) for the population.
Main Methods:
- A cross-sectional study was conducted in western Honduras.
- Cardiovascular risk was estimated using Framingham, MESA, ACC/AHA-PCEs, and ESC SCORE calculators.
Main Results:
- High prevalence of self-reported hypertension (49% men, 48% women) and elevated blood pressure readings (18% men, 30% women normal).
- Diabetes Mellitus reported in 19% of men and 22% of women; elevated LDL-C (>100 mg/dl) in 74% of participants.
- High cardiovascular risk scores were observed across multiple calculators: AHA/ACC-PCEs (62% men, 30% women), FRS (46% men, 15% women), MESA (70.6% men, 17.7% women), and ESC SCORE (32.4% men, 11.8% women).
Conclusions:
- Cardiovascular risk calculations revealed higher-than-expected rates in Honduras.
- The study highlights a significant burden of cardiovascular disease (CVD) and elevated Cardiovascular Risk Assessment Scores (CVRAS) in the studied population.
- This is the first report of its kind in Honduras, emphasizing the need for targeted public health interventions.
Abstract:
Cardiovascular Disease (CVD) epidemiology varies significantly among Low and Middle-Income Countries. Honduras is the Central American country with the highest Ischemic Heart Disease and CVD mortality rates. The aim of this study was to assess the individual CVD risk factors and calculate Cardiovascular Risk Assessment Scores (CVRAS) from the population. Methods: A cross-sectional study in western Honduras. Estimation of CV risk was performed using Framingham, MESA, ACC/AHA-PCEs and ESC SCORE calculators. Results: 38% were male. For men and women respectively; 49% and 48% had self-reported hypertension (HTN), on measured blood pressure only 18% and 30% had normal readings. Diabetes Mellitus was reported in 19% and 22%. Tobacco use was 14% and 3%. Self-reported regular exercise was 39.9% and 25%. Obesity was diagnosed in 24% and 24%. Lipid profile; total cholesterol was ≥200 mg/dl in 63% of subjects. LDL-C was elevated (>100 mg/dl) in 74% of participants, 9% had LDL-C levels higher than 190 mg/dl. Triglycerides were high (>160 mg/dl) in 60%, of these subjects 22% were taking lipid-lowering medications. 52% reported family-history of CVD. The risk calculation for men and women respectively for each CVRAS were; AHA/ACC-PCEs high risk (score ≥ 7.5%) in 62% and 30%, FRS high risk (score ≥ 20%) 46% and 15%, MESA high risk (Score ≥ 7.5%) in 70.6% and 17.7%, ESC SCORE high risk (score ≥ 5% in 32.4% and 11.8%). Conclusions: CV risk calculations revealed higher than rates than expected with consequently reflected on higher than estimated CVRAS. This represents the first report of its kind in Honduras.
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