Guzman-Vilca Wilmer Cristobal, Quispe-Villegas Gustavo A, Carrillo-Larco Rodrigo M
School of Medicine "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru.
CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
EClinicalMedicine. 2022 Oct 1;52:101688. doi: 10.1016/j.eclinm.2022.101688. eCollection 2022 Oct.
Predicted heart age (PHA) can simplify communicating the absolute cardiovascular disease (CVD) risk. Few studies have characterized PHA across multiple populations, and none has described whether people with excess PHA are eligible for preventive treatment for CVD.
Pooled analysis of 41 World Health Organization (WHO) STEPS surveys conducted in 41 countries in six world regions between 2013 and 2019. PHA was calculated as per the non-laboratory Framingham risk score in adults without history of CVD. We described the differences between chronological age and PHA, the distribution of PHA, and the proportion of people with excess PHA that were eligible for antihypertensive and lipid-lowering treatment following the WHO guidelines. Logistic regression models were fitted to assess sociodemographic and health-related variables associated with PHA excess.
94,655 individuals aged 30-74 years were included. 36% of those aged 30-34 years had a PHA of 30-34 years; 9% of those aged 60-64 years had a PHA of 60-64 years. Countries in Africa had the lowest prevalence of very high PHA (i.e., PHA exceeding chronological age in ≥5 years) and countries in Western Pacific had the highest. ≥50% of the population with PHA excess (i.e., PHA exceeding chronological age in ≥1 year) was not eligible for antihypertensive nor lipid-lowering treatment. Abdominal obesity, high total cholesterol, smoking and having diabetes were associated with higher odds of having PHA excess, whereas higher education and employment were inversely associated with excess PHA.
PHA is generally higher than chronological age in LMICs and there are regional disparities. Most people with excess PHA would not be eligible to receive preventive medication.
RMC-L is supported by a Wellcome Trust International Training Fellowship (214185/Z/18/Z).
预测心脏年龄（PHA）有助于简化心血管疾病（CVD）绝对风险的沟通。很少有研究对多个群体的PHA进行特征描述，且尚无研究描述PHA过高的人群是否符合CVD预防性治疗的条件。
对2013年至2019年间在世界六个区域的41个国家进行的41项世界卫生组织（WHO）的全球健康行为危险因素监测（STEPS）调查进行汇总分析。PHA根据无CVD病史成年人的非实验室弗明汉风险评分计算得出。我们描述了实际年龄与PHA之间的差异、PHA的分布情况，以及根据WHO指南符合抗高血压和降脂治疗条件的PHA过高人群的比例。采用逻辑回归模型评估与PHA过高相关的社会人口学和健康相关变量。
纳入了94655名年龄在30 - 74岁之间的个体。30 - 34岁人群中，36%的人的PHA为30 - 34岁；60 - 64岁人群中，9%的人的PHA为60 - 64岁。非洲国家极高PHA（即PHA超过实际年龄≥5岁）的患病率最低，西太平洋国家最高。≥50%的PHA过高人群（即PHA超过实际年龄≥1岁）不符合抗高血压或降脂治疗条件。腹型肥胖、总胆固醇高、吸烟和患有糖尿病与PHA过高的几率较高相关，而高等教育和就业与PHA过高呈负相关。
在低收入和中等收入国家，PHA通常高于实际年龄，且存在地区差异。大多数PHA过高的人不符合接受预防性药物治疗的条件。
RMC-L由惠康信托国际培训奖学金（214185/Z/18/Z）资助。
