title: Prevalence of cardiovascular risk factors in a middle-income country and estimated cost of a treatment strategy.
abstract: BACKGROUND
  We assessed the prevalence of risk factors for cardiovascular disease (CVD) in a middle-income country in rapid epidemiological transition and estimated direct costs for treating all individuals at increased cardiovascular risk, i.e. following the so-called "high risk strategy".
  
  
  METHODS
  Survey of risk factors using an age- and sex-stratified random sample of the population of Seychelles aged 25-64 in 2004. Assessment of CVD risk and treatment modalities were in line with international guidelines. Costs are expressed as USD per capita per year.
  
  
  RESULTS
  1255 persons took part in the survey (participation rate of 80.2%). Prevalence of main risk factors was: 39.6% for high blood pressure (> or =140/90 mmHg or treatment) of which 59% were under treatment; 24.2% for high cholesterol (> or =6.2 mmol/l); 20.8% for low HDL-cholesterol (<1.0 mmol/l); 9.3% for diabetes (fasting glucose > or =7.0 mmol/l); 17.5% for smoking; 25.1% for obesity (body mass index > or =30 kg/m2) and 22.1% for the metabolic syndrome. Overall, 43% had HBP, high cholesterol or diabetes and substantially increased CVD risk. The cost for medications needed to treat all high-risk individuals amounted to USD 45.6, i.e. 11.2 dollars for high blood pressure, 3.8 dollars for diabetes, and 30.6 dollars for dyslipidemia (using generic drugs except for hypercholesterolemia). Cost for minimal follow-up medical care and laboratory tests amounted to 22.6 dollars.
  
  
  CONCLUSIONS
  High prevalence of major risk factors was found in a rapidly developing country and costs for treatment needed to reduce risk factors in all high-risk individuals exceeded resources generally available in low or middle income countries. Our findings emphasize the need for affordable cost-effective treatment strategies and the critical importance of population strategies aimed at reducing risk factors in the entire population.
authors.affiliation: Ministry of Health and Social Services, Victoria, Seychelles, Switzerland. pascal.bovet@chuv.ch
authors.forename: Pascal
authors.initials: P
authors.lastname: Bovet
authors.forename: Conrad
authors.initials: C
authors.lastname: Shamlaye
authors.forename: Anne
authors.initials: A
authors.lastname: Gabriel
authors.forename: Walter
authors.initials: W
authors.lastname: Riesen
authors.forename: Fred
authors.initials: F
authors.lastname: Paccaud
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology*; D017281:Cost of Illness; D003920:Diabetes Mellitus / Q000191:economics / Q000453:epidemiology*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources; D006801:Humans; D006937:Hypercholesterolemia / Q000191:economics / Q000453:epidemiology*; D006973:Hypertension / Q000191:economics / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012750:Seychelles / Q000453:epidemiology