Division of Population Health, Department of Medicine, Jacob's School of Medicine and Biomedical Sciences, University at Buffalo, 100 High Street, Buffalo, NY, D2-76, 14203, USA.
School of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
BMC Public Health. 2024 Aug 12;24(1):2170. doi: 10.1186/s12889-024-19688-z.
The prevalence of cardiovascular disease is burgeoning in low- and middle-income countries (LMICs). In sub-Saharan Africa, the prevalence of cardiovascular risk factors is increasing, though rates of CVD diagnosis and management remain low. Awareness of the influence of social determinants of health (SDOH) on cardiovascular outcomes is growing, however, most work focuses on high-income countries. Material needs security is a measure of SDOH that may be particularly relevant for LMICs. This study investigated the relationship between material needs security and cardiovascular risk in older adults living in South Africa.
The analysis included 5059 respondents age ≥ 40 in the Health and Aging in Africa survey, an observational cohort study administered in 2014 in Mpumalanga Province, South Africa. Linear regression models tested the association between material needs and eight cardiovascular risk factors (waist-to-hip ratio, body mass index, blood pressure, glucose, cholesterol, LDL, and triglycerides). Adjusted linear regression models controlled for sociodemographic confounders.
There were significant adjusted associations found between increased material needs security and four cardiovascular risk factors, including waist-to-hip ratio (β = 0.001; 95% CI [0.00002,0.002]), BMI (β = 0.19; 95%CI=[0.14,0.24]), glucose (β = 0.46; 95%CI=[0.02,0.90]), and triglycerides (β = 0.26; 95%CI=[0.02,0.49]).
Increased material needs security was associated with significantly increased cardiovascular risk in older adults in rural South Africa. These findings can inform the approach to treatment and management of cardiovascular disease in South Africa and similar LMICs. Future investigations should evaluate the implementation and efficacy of interventions that recognize the role of material needs security in cardiovascular risk.
心血管疾病在中低收入国家（LMICs）的发病率正在上升。在撒哈拉以南非洲，心血管危险因素的患病率正在上升，尽管心血管疾病的诊断和管理率仍然很低。人们越来越意识到社会决定因素（SDOH）对心血管结果的影响，但大多数工作都集中在高收入国家。物质需求安全是衡量 SDOH 的一个指标，对于 LMICs 可能尤为重要。本研究调查了南非老年人中物质需求安全与心血管风险之间的关系。
该分析包括在南非姆普马兰加省于 2014 年进行的观察性队列研究“非洲健康与老龄化调查”中，年龄≥40 岁的 5059 名受访者。线性回归模型检验了物质需求与 8 个心血管风险因素（腰臀比、体重指数、血压、血糖、胆固醇、低密度脂蛋白和甘油三酯）之间的关联。调整后的线性回归模型控制了社会人口统计学混杂因素。
发现物质需求安全增加与四个心血管风险因素存在显著的调整关联，包括腰臀比（β=0.001；95%CI[0.00002,0.002]）、BMI（β=0.19；95%CI[0.14,0.24]）、血糖（β=0.46；95%CI[0.02,0.90]）和甘油三酯（β=0.26；95%CI[0.02,0.49]）。
物质需求安全增加与南非农村地区老年人心血管风险显著增加相关。这些发现可以为南非和类似的 LMICs 提供治疗和管理心血管疾病的方法。未来的研究应评估承认物质需求安全在心血管风险中的作用的干预措施的实施和效果。
