Abstract Body: Background: About 80% of the global burden of cardiovascular disease (CVD) is in developing countries that are also struggling with a high burden of communicable diseases. In sub-Saharan Africa (SSA), CVD is projected to be the leading cause of mortality by 2030. Yet, only a few studies have employed evidence-based CVD screening strategies, and little is known about the distribution and key drivers of cardiovascular risk in the region. In this study, we computed the absolute CVD risk score and examined the associated demographic and lifestyle risk factors in a sample of rural community-dwelling midlife and elderly Kenyans.
Methods: CVD risk factors including smoking status, alcohol use and medical history were self-reported through structured questionnaires. Physical activity objectively measured using Omron pedometers. Body mass index (BMI), waist circumference, and systolic blood pressure (SBP) were measured using CDC-BRFSS protocols. The non-lab-based Framingham algorithm was used to compute the absolute CVD risk scores. Chi-square and t-test were used to evaluate gender-specific differences (categorical and continuous variables respectively.
Results: The sample (N=102; 57.8% female; mean age 59.8±7.3 yrs) was predominantly highly active (9,737±6,357 steps/day), with a 47% prevalence of hypertension (no gender differences). Compared to men, women were younger (57.1 vs. 63.7 yrs; p<.001) with higher BMI (29.2 vs 24.8 kg/m²) and prevalence of central obesity (84.8 vs 18.6%). However, they had lower SBP (129.3 vs 138.3 mmHg; p=0.032) and did not smoke (0.0 vs 11.6%; p=.012). Overall, 34.3% of the sample was at high risk of CVD (risk score ≥20%), but women had a lower CVD risk profile compared to men (CVD risk score of 9.7 vs 28.1%; p<.001).
Conclusions: Blood pressure control and smoking could partially explain gender differences in CVD risk burden. The data also suggests that individuals with obesity may have their CVD risk mitigated by an active lifestyle and optimal blood pressure control.