title: Absolute cardiovascular risk in a Fiji medical zone.
abstract: BACKGROUND
  The population of Fiji has experienced emergence of non-communicable disease (NCD) and a plateau in life expectancy over the past 20 years.
  
  
  METHODS
  A mini-STEPS survey (n = 2765) was conducted in Viseisei in Western Fiji to assess NCD risk factors (RFs) in i-Taukei (Melanesians) and those of Indian descent aged 25-64 years (response 73 %). Hypertension (HT) was defined as systolic blood pressure (BP) ≥140 mmHg or diastolic BP ≥90 mmHg or on medication for HT; type 2 diabetes mellitus (T2DM) as fasting plasma glucose ≥7.0 mmol/L or on medication for T2DM; and obesity as a body mass index (kilograms/height(metres)(2)) ≥30. Data were age-adjusted to 2007 Fiji Census. Associations between RFs and ethnicity/education were investigated. Comparisons with Fiji STEPS surveys were undertaken, and the absolute risk of a cardiovascular disease (CVD) event/death in 10 years was estimated from multiple RF charts.
  
  
  RESULTS
  NCD/RFs increased with age except excessive alcohol intake and daily smoking (women) which declined. Daily smoking was higher in men 33 % (95 % confidence interval: 31-36) than women 14 % (12-116); women were more obese 40 % (37-43) than men 23 % (20-26); HT was similar in men 37 % (34-40) and women 34 % (31-36), as was T2DM in men 15 % (13-17) and women 17 % (15-19). i-Taukei men had an odds ratio (OR) of 0.41 (0.28-0.58) for T2DM compared to Indians (1.00); and i-Taukei (both sexes) had a higher OR for obesity and low fruit/vegetable intake, daily smoking, excessive alcohol intake and HT in females. Increasing education correlated with lesser smoking, but with higher obesity and lower fruit/vegetable intake. Compared to the 2011 Fiji STEPS survey, no significant differences were evident in obesity, HT or T2DM prevalences. The proportion (40-64 years) classified at high or very high risk (≥20 %) of a CVD event/death (over 10 years) based on multiple RFs was 8.3 % for men (8.1 % i-Taukei, 8.5 % Indian), and 6.7 % for women (7.9 % i-Taukei, 6.0 % Indian).
  
  
  CONCLUSIONS
  The results of the survey highlight the need for individual and community interventions to address the high levels of NCD/RFs. Evaluation of interventions is needed in order to inform NCD control policies in Fiji and other Pacific Island nations.
authors: Viseisei Sai Health Centre, Viseisei village, Ba Province, Fiji. rajat.gyaneshwar@gmail.com.|Fiji School of Medicine, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji. rajat.gyaneshwar@gmail.com.
authors: Rajat
authors: R
authors: Gyaneshwar
authors: Viseisei Sai Health Centre, Viseisei village, Ba Province, Fiji. swaran.naidu108@gmail.com.|Fiji School of Medicine, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji. swaran.naidu108@gmail.com.
authors: Swaran
authors: S
authors: Naidu
authors: Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia. magda.raban@mq.edu.au.|School of Public Health and Community Medicine (SPHCM), Faculty of Medicine, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia. magda.raban@mq.edu.au.
authors: Magdalena Z
authors: MZ
authors: Raban
authors: Viseisei Sai Health Centre, Viseisei village, Ba Province, Fiji. n_shehna@hotmail.com.
authors: Sheetal
authors: S
authors: Naidu
authors: School of Public Health and Community Medicine (SPHCM), Faculty of Medicine, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia. c.linhart@unsw.edu.au.
authors: Christine
authors: C
authors: Linhart
authors: School of Public Health and Community Medicine (SPHCM), Faculty of Medicine, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia. stephen.morrell@unsw.edu.au.
authors: Stephen
authors: S
authors: Morrell
authors: Fiji Ministry of Health, Suva, Fiji. isimeli.tukana@govnet.gov.fj.
authors: Isimeli
authors: I
authors: Tukana
authors: School of Public Health and Community Medicine (SPHCM), Faculty of Medicine, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia. r.taylor@unsw.edu.au.
authors: Richard
authors: R
authors: Taylor
mesh_terms: D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000453:epidemiology; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D005367:Fiji / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology