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Risk Factor - The Global Perspective

Whilc the risk of Cardio-vascular diseases has been found to be variable in different ethnic groups with the highest prevalence in the South Asian countries, a recent study has brought out certain facts which shall have iliiiiiensc hearing on tlic preventive aspect of heart care. The INTERHEAIU study is one of the largest case-control studics evuluatit~g risk factors for coronary heart discasc. The goal of thc study was to cv;lluatc tlic association oi' risk l:ictors for myocardial inl':~rcticjn(MI) globally, as uvell ;IS in each region arid among Lhc cJin'ere1lt ethnic g ~ . o ~ ~ Thc ps.

yoi~ulntion utlributahlc risk (PAR) i.e., the relativc risk assocjntcd with :1 given fllclnr in thc context ol' tlic previilence of the co~~tlition within a populatic~n was also C ~ ~ I ~ C L I ~ ; M;~tchirig ILC~.I'irst-MI patients to a !icl:tlll~y ~'01111-01 by agc ;1i cai\ch sile,

INTERHEART included 14820 healthy control subjects and 15 152 first-MI patients. Approximately 25 per cent of subjects included were from Europe, 25 per cent were from China, 20 per cent were from South Asia, and 13 per cent were from the Middle East, while 12 per cent were from South America and 5 per cent were from Africa. Demographic as well as other information about lifestyle, health\ history, psychosocial factors, and use of medication were collected by questionnaire. Height, weight, waist-to-hip circumference, blood pressure, and heart rate were measured using standard methods, and a 20-11 non-fasting blood sample was collected from every subject.

INTERHEART has identified nine risk factors strongly associated with an increased risk of acute MT; more than 90 per cent of the global risk for acute MI is predicted by these nine traditional risk factors. Investigators reporl that regardless of ethnicity, region, or gender, an abnormal ApoB/ApoA- 1 ratio and current smoking were the two strongest predictors of acute MI risk - which taken together predict 66 per cent of global heart disease. Diabetes, Hypertension, abdominal obesity, psychosocial vLuiables such as stress and depression, exercise, diet, and alcohol intake were the other variables that predicted risk of acute MI.This study convincingly showed that 90 per cent of the global risk is preventable and the impact of these risk factors was the same in evely ethnic group and in every region in the world. That nieans preventive messages can be simple and the same strategy adj~zsted for economic and cultural circumstances in every part of the world can be used.

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