Cardiovascular risk factor levels in urban and rural Thailand--The International Collaborative Study of Cardiovascular Disease in Asia (InterASIA).

BACKGROUND Vascular mortality is increasing in economically developing countries but reliable data about the determinants of cardiovascular disease are few. The International Collaborative Study of Cardiovascular Disease in Asia (InterASIA) was designed to obtain precise estimates of cardiovascular risk factor levels in the adult population of Thailand. DESIGN A complex sample survey. METHODS Data from a structured questionnaire, brief physical examination and a blood sample were collected from 5305 individuals aged 35 years or older (response rate 68%). Mean risk factor levels were calculated for eight groups defined by age and sex in 18 representative urban and rural areas of Thailand. Population risk factor levels were calculated by applying sampling weights derived from the 2000 Thai Census and allowing for the complex sampling design. RESULTS The estimated mean (standard error) population blood pressure was 120/76 (0.7/0.5) mmHg, mean serum total cholesterol was 5.2 (0.06) mmol/l, mean body mass index was 24 (0.2) kg/m2, mean fasting plasma glucose was 5.6 (0.06) mmol/l, the proportion with diabetes 9.6 (1)% and the proportion of current smokers was 25 (3)%. There were estimated to be 5.1 (0.5) million individuals with high blood pressure, 4.4 (0.4) million with high total cholesterol, 8.9 (0.8) million overweight or obese, 2.4 (0.2) million with diabetes and 6.2 (0.9) million current smokers. Mean levels of all major risk factors, except smoking, were worse in urban compared with rural areas. However, except for total cholesterol, the absolute numbers of individuals with abnormal risk factor levels were highest in rural areas. CONCLUSION Absolute levels of cardiovascular risk factors in Thailand are high. Effective risk factor control strategies that target both rural and urban areas of Thailand have the potential to avert much premature cardiovascular disease.

[1]  M. Woodward,et al.  Twelve-year changes in vascular risk factors and their associations with mortality in a cohort of 3499 Thais: the Electricity Generating Authority of Thailand Study. , 2003, International journal of epidemiology.

[2]  B. Hughes,et al.  Thailand: winning battles, but the war's far from over , 2000, Tobacco control.

[3]  A. Dobson,et al.  Estimation of contribution of changes in classic risk factors to trends in coronary-event rates across the WHO MONICA Project populations , 2000, The Lancet.

[4]  H. Iso,et al.  Trends of cardiovascular risk factors and diseases in Japan: implications for primordial prevention. , 1999, Preventive medicine.

[5]  Bruce Neal,et al.  1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension. Guidelines Subcommittee. , 1999, Journal of hypertension.

[6]  T. Yipintsoi,et al.  Prevalence of coronary heart disease and major cardiovascular risk factors in Thailand. , 1998, International journal of epidemiology.

[7]  P. Wood,et al.  National Cholesterol Education Program recommendations for measurement of high-density lipoprotein cholesterol: executive summary. The National Cholesterol Education Program Working Group on Lipoprotein Measurement. , 1995, Clinical chemistry.

[8]  P Whelton,et al.  Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population. Data from the health examination surveys, 1960 to 1991. , 1995, Hypertension.

[9]  D. Gordon,et al.  Declining serum total cholesterol levels among US adults. The National Health and Nutrition Examination Surveys. , 1993, JAMA.

[10]  C. Sitthi-amorn,et al.  The prevalence and risk factors of hypertension in Klong Toey slum and Klong Toey government apartment houses. , 1989, International journal of epidemiology.

[11]  S. J. Smith,et al.  The Centers for Disease Control-National Heart, Lung and Blood Institute Lipid Standardization Program. An approach to accurate and precise lipid measurements. , 1989, Clinics in laboratory medicine.

[12]  E. Frohlich.  Classification of resistant hypertension. , 1988, Hypertension.

[13]  G S Rautela,et al.  Automated enzymic measurement of total cholesterol in serum. , 1978, Clinical chemistry.