Several factors increase the risk of heart attack, such as high blood sugar, obesity, abnormal cholesterol levels, high blood pressure, 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 from the Brazilian population collected between 2005 and 2017, determining the number of deaths attributed to each risk factor. The objective 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 was five to ten times more correlated than the other factors.
The data comes from government sources such as the Department of Health, Department of Social Development and IBGE, the National Bureau of Statistics, as well as overseas sources such as the Global Health Data Exchange (GHDx) and the Institute for Health Metrics and Evaluation (IHME) from the University of Washington.
Regardless of the control used – and we tested variables, statistical models and methods of different types – diabetes was also associated with mortality from cardiovascular disease. Moreover, the association was not limited to the year analyzed but lasted up to a decade. »
Renato Gaspar, one of the authors supported by FAPESP
Gaspar carries out postdoctoral research at the Vascular Biology Laboratory of the Heart Institute (InCor) attached to the Faculty of Medicine of the University of São Paulo (FM-USP).
Previous research has established an equation to calculate the number of deaths averted or delayed by changes in risk factors. On this basis, the researchers calculated the “premature” mortality rate in relation to the average life expectancy, concluding that some 5,000 people would not have died of cardiovascular disease during the period analyzed if the incidence of diabetes had been lower. On the other hand, at least 17,000 deaths were averted by a reduction in smoking over the 12 years in question.
According to the authors, these results provide evidence that strategies aimed at reducing smoking were essential in reducing mortality from cardiovascular disease.
The differences between men and women were also important to the scientists, who note that the gender disparities reiterate findings from other studies showing that diabetes and high blood sugar are greater risk factors for women than for men. men.
Socio-economic impact
Mortality and incidence of cardiovascular diseases decreased by 21% and 8% respectively between 2005 and 2017 in Brazil, mainly due to better access to basic health care 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 greater than that of hypertension, possibly because access to universal health service and better coverage of primary care brought control of hypertension in the population. globally at a higher level.
This analysis was supported by the fact that the association between hyperglycemia and cardiovascular disease mortality was independent of socioeconomic status and access to health care. The researchers inserted covariates into the analyzed models, in order to adjust household income, government cash transfer programs such as Bolsa Família, gross domestic product (GDP per capita), number of doctors per 1,000 inhabitants and primary care coverage.
“Along with the importance of increasing income, reducing inequality and poverty, and improving access and quality of care, we need to address diabetes and high blood sugar in a specific way,” Gaspar said, noting that excessive sugar consumption and related issues are not widely discussed in Brazil. “We need a nutrition education policy. We should discuss whether to put warnings on foods high in sugar, as we already do on cigarette packs, or whether to levy an additional tax to induce manufacturers to reduce the amount of sugar in these products. Other countries are discussing this stuff and we should be doing it here.”
To help combat cardiovascular disease, health policy should aim directly at reducing the prevalence of hyperglycaemia, through nutrition education, restrictions on foods and beverages containing added sugar, or better access to new classes of drugs that reduce the risk of fatal heart attacks faced by diabetics, he said.
Source :
Foundation for research in São Paulo (FAPESP)
Journal reference:
Gaspar, R.S., et al. (2022) Analysis of the impact of modifiable risk factors on cardiovascular disease mortality in Brazil. PLOS ONE. doi.org/10.1371/journal.pone.0269549.