Abstract Body (Do not enter title and authors here): Introduction: The sociodemographic context of population growth and ageing, social disparities and the high level of urbanisation in Latin America and the Caribbean (LAC) provide a unique entry point to reflect on the impact of cardiovascular diseases (CVD) on populations. Our objective was to evaluate recent trends in cardiovascular risk factors (CVRF) in LAC to inform the development of potential solutions to address CVD in LAC.

Methods: Using data from the “NCD Risk Factor Collaboration (NCD-Risc)” available for public consultation, we evaluated trends in the main CVRFs in LAC from 1990 to 2016-2020, namely: systolic blood pressure (SBP) in mmHg, total cholesterol (TC) in mmol/ml, body mass index (BMI) in average kg/m2 and prevalence of diabetes. NCD Risc compiles and harmonises data from studies representative of populations from various countries around the world. Data on the estimated prevalence of smoking in the region come from the “Global Burden of Diseases” study. Data are presented standardised by age to allow comparison of different periods, given that the age distribution of the population varied.

Results: The CVRFs that showed favourable trends in LAC in recent decades were: smoking, mean SBP and TC. The prevalence of smoking fell from 69% to 17% for men and 67.6% to 7.6% for women, reducing the CVD risk attributable to tobacco by 34%. Mean SBP fell from 130 mmHg to 129 mmHg for men and 127 mmHg to 122 mmHg for women. The mean CT reduced from 4.7 mmol/L to 4.6 mmol/L for men and 4.8 mmol/L to 4.7 mmol/L for women. Obesity and diabetes showed unfavourable trends. The average BMI increased from 23.0 kg/m2 to 26.8 kg/m2 for men and from 23.0 kg/m2 to 27.5 kg/m2 for women, with the prevalence of obesity increasing from 3% to 11% in men and from 6% to 15% in women. The prevalence of diabetes followed this pattern and increased from 5.4% to 8.8% for men and from 5.8% to 9.6% for women.

Conclusion: CVRF trends are heterogeneous and demonstrate success for policies aimed at CVRF, such as high blood pressure and smoking. However, the trends reveal that the problem in the coming decades will be the rise in obesity and its consequences, which may
reverse favourable trends in CVD mortality risk in LAC. Population and individual strategies, considering the social determinants of health, need to be planned, such as taxation of ultra-processed foods and campaigns to encourage physical activity.