Several factors increase the risk of heart attack, such as high blood sugar (hyperglycemia), obesity, abnormal cholesterol levels, high blood pressure (hypertension), and smoking. A study conducted in Brazil and reported in an article published in the journal PLOS ONE measured the impact of these factors. The researchers analyzed data for the Brazilian population collected between 2005 and 2017, determining the number of deaths attributed to each risk factor. The aim of the study was to contribute to the development of more effective strategies to reduce the incidence of cardiovascular diseases, which have long been the leading causes of death in Brazil.
The study, which was supported by FAPESP, quantified the impact of each factor associated with death from cardiovascular disease. Hyperglycemia correlated five to 10 times more than other factors.
The dataset came from government sources such as the Ministry of Health, the Ministry of Social Development, and IBGE, the national statistics bureau, as well as foreign sources such as the Global Health Data Exchange (GHDx) and the University of Washington’s Institute for Health Metrics and Evaluation (IHME).
Previous research established an equation to calculate the number of deaths prevented or deferred by changes in risk factors. Based on this, the researchers calculated the “premature” mortality rate compared with average life expectancy, concluding that some 5,000 people would not have died from cardiovascular disease in the period analyzed if the incidence of diabetes had been lower. On the other hand, at least 17,000 deaths were avoided by a reduction in smoking during the 12 years in question.
According to the authors, the findings provide evidence that strategies to reduce smoking were key to reduce mortality from cardiovascular disease.
Differences between men and women were also significant for the scientists, who note that sex-specific disparities reiterated the findings of other studies showing diabetes and hyperglycemia to be more significant risk factors for women than men.
Socioeconomic impact
Cardiovascular disease mortality and incidence fell 21% and 8% respectively between 2005 and 2017 in Brazil, owing mainly to improved access to basic healthcare as well as the reduction in smoking. This finding took into account the importance of hypertension, which is frequently associated with heart disease. Nevertheless, the contribution of hyperglycemia was seven times that of hypertension, possibly because access to the universal health service and better primary care coverage raised the control of hypertension in the overall population to a higher level.
This analysis was corroborated by the finding that the association between hyperglycemia and cardiovascular disease mortality was independent of socioeconomic status and access to healthcare. The researchers inserted covariables into the models analyzed, to adjust for household income, government cash transfer programs such as Bolsa Família, gross domestic product (GDP per capita), the number of physicians per 1,000 inhabitants and primary care coverage.
To help combat cardiovascular disease, health policy should aim directly to reduce the prevalence of hyperglycemia, via nutritional education, restrictions on foods and beverages with added sugar, or improved access to novel classes of drugs that reduce the risk of fatal heart attack faced by diabetics, he said. (NR/Newswise)
