Title |
Absolute cardiovascular risk in a Fiji medical zone
|
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Published in |
BMC Public Health, February 2016
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DOI | 10.1186/s12889-016-2806-6 |
Pubmed ID | |
Authors |
Rajat Gyaneshwar, Swaran Naidu, Magdalena Z. Raban, Sheetal Naidu, Christine Linhart, Stephen Morrell, Isimeli Tukana, Richard Taylor |
Abstract |
The population of Fiji has experienced emergence of non-communicable disease (NCD) and a plateau in life expectancy over the past 20 years. A mini-STEPS survey (n = 2765) was conducted in Viseisei in Western Fiji to assess NCD risk factors (RFs) in i-Taukei (Melanesians) and those of Indian descent aged 25-64 years (response 73 %). Hypertension (HT) was defined as systolic blood pressure (BP) ≥140 mmHg or diastolic BP ≥90 mmHg or on medication for HT; type 2 diabetes mellitus (T2DM) as fasting plasma glucose ≥7.0 mmol/L or on medication for T2DM; and obesity as a body mass index (kilograms/height(metres)(2)) ≥30. Data were age-adjusted to 2007 Fiji Census. Associations between RFs and ethnicity/education were investigated. Comparisons with Fiji STEPS surveys were undertaken, and the absolute risk of a cardiovascular disease (CVD) event/death in 10 years was estimated from multiple RF charts. NCD/RFs increased with age except excessive alcohol intake and daily smoking (women) which declined. Daily smoking was higher in men 33 % (95 % confidence interval: 31-36) than women 14 % (12-116); women were more obese 40 % (37-43) than men 23 % (20-26); HT was similar in men 37 % (34-40) and women 34 % (31-36), as was T2DM in men 15 % (13-17) and women 17 % (15-19). i-Taukei men had an odds ratio (OR) of 0.41 (0.28-0.58) for T2DM compared to Indians (1.00); and i-Taukei (both sexes) had a higher OR for obesity and low fruit/vegetable intake, daily smoking, excessive alcohol intake and HT in females. Increasing education correlated with lesser smoking, but with higher obesity and lower fruit/vegetable intake. Compared to the 2011 Fiji STEPS survey, no significant differences were evident in obesity, HT or T2DM prevalences. The proportion (40-64 years) classified at high or very high risk (≥20 %) of a CVD event/death (over 10 years) based on multiple RFs was 8.3 % for men (8.1 % i-Taukei, 8.5 % Indian), and 6.7 % for women (7.9 % i-Taukei, 6.0 % Indian). The results of the survey highlight the need for individual and community interventions to address the high levels of NCD/RFs. Evaluation of interventions is needed in order to inform NCD control policies in Fiji and other Pacific Island nations. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Malaysia | 1 | 1% |
New Zealand | 1 | 1% |
Unknown | 75 | 97% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 13 | 17% |
Student > Ph. D. Student | 8 | 10% |
Student > Bachelor | 7 | 9% |
Researcher | 6 | 8% |
Student > Postgraduate | 4 | 5% |
Other | 11 | 14% |
Unknown | 28 | 36% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 22 | 29% |
Nursing and Health Professions | 8 | 10% |
Social Sciences | 4 | 5% |
Economics, Econometrics and Finance | 3 | 4% |
Agricultural and Biological Sciences | 3 | 4% |
Other | 9 | 12% |
Unknown | 28 | 36% |