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Body-mass index, blood pressure, diabetes and cardiovascular mortality in Cuba: prospective study of 146,556 participants

Armas Rojas NB 1 , Lacey B 2 , Soni M 2 , Charles S 2 , Carter J 2 , Varona-Pérez P 3 Show all authors , Burrett JA 2 , Martínez MC 3 , Lorenzo-Vázquez E 4 , Constantén SB 5 , Taylor H 2 , Sherliker P 2 , Rigau JMM 6 , Ross S 2 , Massa MS 2 , López OJH 7 , Islam N 2 , Morales MÁM 5 , Alomá IA 5 , Estupiñan FA 6 , González MD 8 , Muñoz NR 9 , Asencio MC 9 , Díaz-Diaz O 10 , Iglesias-Marichal I 10 , Emberson J 2 , Peto R 2 , Lewington S 11

Affiliations 

  • 1 National Institute of Cardiology and Cardiovascular Surgery, Havana, Cuba. Cuba.Prospective.Study@ndph.ox.ac.uk
  • 2 Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
  • 3 Institute of Hygiene, Epidemiology and Microbiology, Ministry of Public Health, Havana, Cuba
  • 4 Cuban Commission against Smoking, Ministry of Public Health, Havana, Cuba
  • 5 Directorate of Medical Records and Health Statistics, Ministry of Public Health, Havana, Cuba
  • 6 Provincial Center of Hygiene, Epidemiology and Microbiology, Matanzas, Cuba
  • 7 Municipal Center of Hygiene, Epidemiology and Microbiology, Jagüey Grande, Matanzas, Cuba
  • 8 Municipal Center of Hygiene, Epidemiology and Microbiology, Colón, Matanzas, Cuba
  • 9 Municipal Center of Hygiene, Epidemiology and Microbiology, Camagüey, Cuba
  • 10 National Institute of Endocrinology, Havana, Cuba
  • 11 Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK. sarah.lewington@ndph.ox.ac.uk
BMC Public Health, 2021 05 27;21(1):963.
PMID: 34039286 DOI: 10.1186/s12889-021-10911-9

Abstract

BACKGROUND: Cardiovascular disease accounts for about one-third of all premature deaths (ie, age =120 mmHg), diabetes, and BMI (>=22.5 kg/m2): 20 mmHg higher usual SBP about doubled cardiovascular mortality (RR 2.02, 95%CI 1.88-2.18]), as did diabetes (2.15, 1.95-2.37), and 10 kg/m2 higher usual BMI (1.92, 1.64-2.25). RR were similar in men and in women. The association with BMI and cardiovascular mortality was almost completely attenuated following adjustment for the mediating effect of SBP. Elevated SBP (>=120 mmHg), diabetes and raised BMI (>=22.5 kg/m2) accounted for 27%, 14%, and 16% of cardiovascular deaths, respectively.

CONCLUSIONS: This large prospective study provides direct evidence for the effects of these major risk factors on cardiovascular mortality in Cuba. Despite comparatively low levels of these risk factors by international standards, the strength of their association with cardiovascular death means they nevertheless exert a substantial impact on premature mortality in Cuba.

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

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