title: Cardiovascular risk surveillance to develop a nationwide health promotion strategy: the grenada heart project.
abstract: OBJECTIVE
  The Grenada Heart Project aims to study the clinical, biological, and psychosocial determinants of the cardiovascular health in Grenada in order to develop and implement a nationwide cardiovascular health promotion program.
  
  
  METHODS
  We recruited 2,827 adults randomly selected from the national electronic voter list. The main outcome measures were self-reported cardiovascular disease and behavioral risk factors, anthropometric measures, blood pressure, point-of-care testing for glucose and lipids, and ankle-brachial index. Risk factors were also compared with the U.S. National Health and Nutritional Survey data.
  
  
  RESULTS
  Prevalence of cardiovascular disease risk factors were: overweight and obesity-57.7% of the population, physical inactivity-23.4%, diabetes-13.3%, hypertension-29.7%, hypercholesterolemia-8.6%, and smoking-7%. Subjects who were physically active had a significantly lower 10-year Framingham risk score (p<0.001). Compared with the U.S. National Health and Nutrition Survey data, Grenadian women had higher rates of adiposity, diabetes, hypertension, and elevated low-density lipoprotein cholesterol, whereas Grenadian men had a higher rate of diabetes, a similar rate of hypertension, and lower rates of the other risk factors. Prevalence of peripheral arterial disease was 7.6%; stroke and coronary heart disease were equally prevalent at ∼2%.
  
  
  CONCLUSIONS
  This randomly selected adult sample in Grenada reveals prevalence rates of obesity, hypertension, and diabetes significantly exceeding those seen in the United States. The contrasting, paradoxically low levels of prevalent cardiovascular disease support the concept that Grenada is experiencing an obesity-related "risk transition." These data form the basis for the implementation of a pilot intervention program based on the Institute of Medicine recommendations and may serve as a model for other low- and middle-income countries.
authors.affiliation: Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Sameer
authors.initials: S
authors.lastname: Bansilal
authors.affiliation: Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Vedanthan
authors.affiliation: George Institute, University of Sydney, Sydney, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Woodward
authors.affiliation: Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Rupa
authors.initials: R
authors.lastname: Iyengar
authors.affiliation: Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Hunn
authors.affiliation: Grenada Heart Project, St. George's, Grenada.
authors.forename: Marcelle
authors.initials: M
authors.lastname: Lewis
authors.affiliation: MIS Statistical Consultants LLC, Baltimore, MD, USA.
authors.forename: Lesley
authors.initials: L
authors.lastname: Francis
authors.affiliation: Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Charney
authors.affiliation: Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Claire
authors.initials: C
authors.lastname: Graves
authors.affiliation: Mount Sinai School of Medicine, New York, NY, USA; University of Toronto, Toronto, Canada.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Farkouh
authors.affiliation: Mount Sinai School of Medicine, New York, NY, USA; Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain.
authors.forename: Valentin
authors.initials: V
authors.lastname: Fuster