Affiliations 

  • 1 Research Department, Instituto Universitario Hospital Italiano de Buenos Aires, Argentina. Electronic address: luis.garegnani@hospitalitaliano.org.ar
  • 2 Research Department, Instituto Universitario Hospital Italiano de Buenos Aires, Argentina; Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
  • 3 Research Department, Instituto Universitario Hospital Italiano de Buenos Aires, Argentina
  • 4 Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  • 5 Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 6 Faculty of Medicine, Eduardo Mondlane University, Mozambique; Research Unit of the Department of Medicine, Maputo Central Hospital, Mozambique
  • 7 Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurugram, Haryana, India
  • 8 SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  • 9 Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
  • 10 Public Health Department, Instituto Universitario Hospital Italiano de Buenos Aires, Argentina
Prev Med, 2023 Jul;172:107534.
PMID: 37146731 DOI: 10.1016/j.ypmed.2023.107534

Abstract

BACKGROUND: In 2010 the American Heart Association defined the concept of ideal cardiovascular health to renew the focus on primordial prevention for cardiovascular disease. Evidence primarily from high-income countries suggests ideal CVH prevalence is low and decreases with age, with vulnerable populations differentially affected. We aimed to identify and characterize the evidence relevant to CVH metrics in low- and middle-income countries (LMICs).

METHODS: We followed the Joanna Briggs Institute guideline for the conduct of this scoping review. We searched MEDLINE, Embase, LILACS and study registers from inception to 14 March 2022. We included cross-sectional and cohort studies in populations representing a geographically-defined unit (urban or rural) in LMICs, and with data on CVH metrics i.e. all health or clinical factors (cholesterol, blood pressure, glycemia and body mass index) and at least one health behavior (smoking, diet or physical activity). We report findings following the PRISMA-Scr extension for scoping reviews.

RESULTS: We included 251 studies; 85% were cross-sectional. Most studies (70.9%) came from just ten countries. Only 6.8% included children younger than 12 years old. Only 34.7% reported seven metrics; 25.1%, six. Health behaviors were mostly self-reported; 45.0% of studies assessed diet, 58.6% physical activity, and 90.0% smoking status.

CONCLUSIONS: We identified a substantial and heterogeneous body of research presenting CVH metrics in LMICs. Few studies assessed all components of CVH, especially in children and in low-income settings. This review will facilitate the design of future studies to bridge the evidence gap. This scoping review protocol was previously registered on OSF: https://osf.io/sajnh.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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