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Cardiovascular Disease in the Caribbean: Risk Factor Trends, Care and Outcomes Still Far From Expectations
1Caribbean Centre for Health Systems Research and Development, Faculty of Medical Sciences, University of West Indies, St Augustine Campus, Couva, TTO.
Insights
Cardiovascular disease (CVD) care in the Caribbean shows improvements but lags behind high-income nations. Addressing social determinants like diet and lifestyle is crucial for better CVD outcomes and reduced mortality.
Area of Science:
- Public Health
- Cardiology
- Epidemiology
Background:
- Cardiovascular diseases (CVD) pose a significant public health challenge in the Caribbean.
- While improvements in cardiovascular care exist, they fall short of expectations.
Purpose of the Study:
- To analyze the epidemiology and risk factors of CVD in the Caribbean.
- To identify gaps in cardiovascular care compared to high-income countries.
- To evaluate patient outcomes, including quality of life and mortality.
Main Methods:
- A systematic review of peer-reviewed articles on CVD in the Caribbean from 1959 to 2022.
- Data extraction and classification based on epidemiological profile, risk factors, management, and outcomes.
- Analysis of 36 selected studies from various Caribbean nations.
Main Results:
- High prevalence of CVD risk factors, including those linked to social determinants like fast food consumption and sedentary lifestyles.
- Suboptimal cardiovascular care, poor patient compliance, and high inpatient mortality rates were observed.
- Significant disparities exist when compared to high-income countries.
Conclusions:
- Greater efforts are needed to enhance cardiovascular care across all stages in the Caribbean.
- Addressing social and environmental factors is essential for mitigating CVD risks.
- Improving care quality and patient compliance is vital to reduce mortality.
Abstract:
Cardiovascular diseases (CVD) are a major public health concern in the Caribbean. Cardiovascular care in the Caribbean revealed encouraging improvements but still less than expectations. This study aims to gain insight into CVD and identify gaps in cardiovascular care in the Caribbean compared to high-income countries. More specifically, this review reports on the epidemiology, CVD risk factors, management practices, and patient outcomes (quality of life (QOL) and mortality). A systematic review of peer-reviewed articles was conducted to assess the CVD of individuals in the Caribbean from 1959 to 2022.Using multiple search engines and keywords, a systematic review of relevant peer-reviewed CVD articles was conducted using the necessary inclusion and exclusion criteria. Relevant data of studies were classified by title, publication year, location, type and size of samples, and results. Further analysis grouped patients by epidemiological profile, CVD risk, management, and selected outcomes (quality of life and inpatient mortality). From the initial review of 1,553 articles, 36 were analyzed from Trinidad and Tobago (20), Barbados (4), Jamaica (7), along with the Bahamas (2), British Virgin Islands (1), Bonaire (1), and one article from a Caribbean study. The social environment of fast food, sedentary jobs, and stress determinants are postulated to be precursors for an increase in CV risks. CVD in the Caribbean reveals a high prevalence of CV risks, suboptimal care, poor compliance, and high inpatient mortality compared with high-income countries. Greater efforts are required to improve CVD care at all stages, including in the social environment.
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