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Cardiovascular risk is lower in rural areas and at high altitudes (≥2,500 m.a.s.l.). Urbanization modifies the altitude-cardiovascular risk association, showing a greater effect in urban settings.

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Area of Science:

  • Cardiology
  • Public Health
  • Environmental Epidemiology

Background:

  • Limited data exists on how urbanization and altitude influence combined cardiovascular (CV) risk.
  • Assessing these factors is crucial for understanding population health disparities.

Purpose of the Study:

  • To evaluate the association between urbanization, altitude, and absolute CV risk in Peru.
  • To determine if urbanization and altitude independently affect CV risk.

Main Methods:

  • A pooled analysis of Peruvian Demographic Health Surveys (2014-2020) was performed.
  • Included were 80,409 subjects aged 40-74 years.
  • 10-year predicted absolute CV risk was calculated using the WHO non-laboratory method.

Main Results:

  • Lower CV risk was associated with rurality (PR=0.89) and high altitudes (PR=0.68 for ≥3,500 m.a.s.l.).
  • Urbanization acted as an effect modifier, with a more pronounced association in urban areas.
  • 7.8% of the population had a predicted CV risk of ≥10%.

Conclusions:

  • Rural living and high-altitude environments (≥2,500 m.a.s.l.) are linked to reduced predicted cardiovascular risk.
  • These findings highlight the importance of considering environmental and geographical factors in CV risk assessment.