Risk of cardiovascular disease in a traditional African population with a high infectious load: a population-based study.
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.


RESULTS
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
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.
Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands. j.j.e.koopman@lumc.nl
Jacob J E
JJ
Koopman
David
D
van Bodegom
J Wouter
JW
Jukema
Rudi G J
RG
Westendorp
D000368:Aged; D044383:Black People / Q000706:statistics & numerical data; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D003141:Communicable Diseases / Q000150:complications*; D050171:Dyslipidemias / Q000150:complications; D004562:Electrocardiography; D005260:Female; D005869:Ghana / Q000453:epidemiology; D005947:Glucose / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000150:complications; D007249:Inflammation / Q000150:complications*; D050356:Lipid Metabolism; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D009765:Obesity / Q000150:complications; D016491:Peripheral Vascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data
D005947:Glucose