RE: [ProCOR] New report: CVD affecting younger populations in dev eloping countries
Cardiovascular Disease (and Other Chronic Diseases)in Developing
Countries--cost-effective approaches
Expert bodies have highlighted the growing global epidemic of chronic
diseases-obesity, diabetes, and cardiovascular diseases.(1-6) These groups,
though seemingly disparate in their priorities and approach, are united in
recognizing the threats posed to health and economic development in the
developing world.
The 2002 World Health Report,(7) Reducing Risks, Promoting Healthy Life
underscored these threats, and a new report, A Race Against Time-the
Challenge of Cardiovascular Disease in Developing Economies (8) links
cardiovascular diseases to development in low- and middle-income countries.
This report warns that unless steps are taken to stem the tide of risk
factors leading to cardiovascular diseases, additional economic hardships
would result especially in countries that can afford it the least.
One recent response to these pandemics of chronic noncommunicable diseases
is the WHO/FAO's collective approach to tackling obesity, diabetes,
cardiovascular diseases, and cancer. (9) Their report highlights the
clustering of these diseases in an entity called the metabolic syndrome. The
two key lifestyle risk factors (in addition to smoking) that underpin these
diseases are major shifts in diet and physical activity patterns.
Epidemiologists refer to the former as the "nutrition transition." (10-12)
A recent JAMA commentary (13) questioned whether the new buzz phrase
"metabolic syndrome" is really new, or simply a repackaging of familiar
cardiovascular disease risk factors. In their view, the metabolic syndrome
terminology reflects a new desire to take risk factors more seriously.
Cardiologists, diabetologists, and public health specialists increasingly
approach this syndrome from their own vantage points. As we deliberate risk
factors for chronic diseases, so must we accelerate efforts towards workable
strategies, especially in resource-poor countries.
Bendich and Dickelbaum (14) in their book, Primary and Secondary Preventive
Nutrition, emphasized approaches that simultaneously address the cluster of
diseases linked to the metabolic syndrome. Not only can this simplify public
health nutrition messages, but also provide logical and cost-effective
approaches to global health. Common risk factors demand common solutions.
The historical medical divide that prescribes separate interventions for
cardiovascular diseases, obesity, and diabetes can partition scarce
resources, enfeeble prevention efforts, and diminish outcomes. While such
policies may be excused in developed economies, resource-poor
countries-which now bear the brunt of the chronic disease burden-can
ill-afford disjointed approaches to prevention. It is neither logical nor
cost-effective.
As modernization, urbanization, globalization, and unhealthy lifestyles
coalesce to spawn growing global pandemics, so must we urgently synergize
prevention strategies. In this vein, A Race Against Time-the Challenge of
Cardiovascular Disease in Developing Economies could not be more timely.
B. E. Bulwer, M.D., ProCOR
2004 Fellow, Lown Fellowship in Cardiovascular Disease in the Developing
World
___________________________________________________________________________
References:
1.Murray CJL, Lopez AD. Quantifying the burden of disease and injury
attributable to ten major risk factors. In: Murray CJL, Lopez AD, eds. The
global burden of disease: a comprehensive assessment of mortality and
disability from diseases, injuries, and risk factors in 1990 and projected
to 2020. Cambridge (MA): Harvard University Press; 1996:295-324.
2.International Diabetes Federation. The rising global pandemic. Press
release, August 15, 2000; IDF website,
http://www.idf.org/home/index.cfm?node=1055 .
3.International Diabetes Federation. Global experts warn of new
diabetes threat. Press release, August 17, 2000; IDF website,
http://www.idf.org/home/index.cfm?node=1055 .
4.Obesity: Preventing and Managing the Global Epidemic Report of a WHO
Consultation Technical Report Series, 2000, Geneva, WHO/NUT/NCD. (English)
ISBN 92 4 120894 5.
5.International Association for the Study of Obesity (IOTF). IOTF
experts call on governments to support WHO global strategy. Media, April 26,
2004. http://www.iotf.org/.
6.Diet, physical activity and health. The fifty-fifth world health
assembly, WHA55.23. Agenda item 13.11 18 May 2002. Available from:
http://www.who.int/gb/EB_WHA/PDF/WHA55/ewha5523.pdf .
7.The World Health Report 2002-Reducing risks, promoting healthy life.
Geneva: World Health Organization; 2002. http://www.who.int/whr/2002/en/ .
Accessed August 22, 2003.
8.A race against time: The challenge of cardiovascular disease in
developing economies. Trustees of Columbia University in the City of New
York, 2004. ISBN 0-9754336-0-1. Available at www.earthinstitute.columbia.edu
9.Diet, nutrition and the prevention of chronic diseases. Report of
the joint WHO/FAO expert consultation. WHO Technical Report Series, No. 916
(TRS 916). Available at WHO website
http://www.who.int/dietphysicalactivity/publications/trs916/kit/en ]=
10.Popkin BM. The nutrition transition and obesity in the developing
world. J Nutr. 2001;13:871S-873S.
11.Popkin BM. The nutrition transition and its health implications in
lower-income countries. Public Health Nutr. 1998;1:5-21.
12.Popkin BM, Horton S, Kim S, Mahal A, Shuigao J. Trends in diet,
nutritional status, and diet-related noncommunicable diseases in China and
India: the economic costs of the nutrition transition. Nutr Rev.
2001;59:379-90.
13.Mitka M. Metabolic syndrome recasts old cardiac, diabetes risk
factors as a "new"entity. JAMA. 2004 May 5;291(17):2062-3.
14.Bendich A, Deckelbaum R. Preventive nutrition throughout the life
cycle-a cost-effective approach to improved health. In: Bendich A,
Deckelbaum R,eds. Primary and secondary preventive nutrition. Totowa (NJ):
Humana Press Inc.2001:427-441.
-----Original Message-----
From: procor-bounces@healthnet.org
[mailto:procor-bounces@healthnet.org]On Behalf Of Coleman, Catherine
Sent: Tuesday, May 04, 2004 10:53 AM
To: 'procor@healthnet.org'
Subject: [ProCOR] New report: CVD affecting younger populations in
developing countries
Greetings from ProCOR,
An important new report entitled A Race Against Time, which examines the
challenge of cardiovascular disease in developing economies, suggests that
heart disease and stroke are causing hundreds of thousands of deaths each
year in young people-a far great number than previously estimated--and is
having a profound effect on the work force in developing countries.
The report was released by Columbia University's Earth Institute last week.
It studies five countries: Brazil, South Africa, the Russian
republic of Tatarstan, India, and China. The researchers combined population
estimates for the five countries with current death rates and workforce data
to calculate the future effects of CVD both on society and on the workforce.
While cardiovascular diseases (CVD) are often portrayed in the West as
diseases of affluent and older people, CVD mortality rates among working age
people in India, South Africa, and Brazil are one-and-a-half to two times
that of the United States.
The report suggests that the rate of cardiovascular disease is higher in
developing countries because treatment is often unavailable, and lifestyle
programs that have improved health in the US over the past several decades,
such as diet and exercise awareness, anti-smoking campaigns, and tobacco
taxes, do not exist in most developing countries.
In India, of the 5 million people who die of CVD each year, 28% are aged
less than 65. In South Africa, despite the predominance of HIV/AIDS, the
proportion of deaths occurring among people aged 35-44 due to chronic
disease, mainly CVD, is 12% for men and 17.2% for women. In Tatarstan, CVD
death rates among young men have increased by 70% in 20 years.
The impact of heart disease and stroke is particularly devastating in
rapidly developing societies because they affect national economies. In
2020, the less developed nations will have 500 million people aged over 65
years. By 2040 there will be a billion people of this age in these countries
who will be most at risk for CVD. The report estimates that at least 21
million years of future productive life are lost because of CVD each year
and that this number will increase to 34 million years of life lost by 2020.
The report notes that effective and inexpensive treatment for blood pressure
and cholesterol can have an immediate positive effect on health, as will
support for quitting smoking and encouraging healthier lifestyles.
The report, A Race against Time, is available in pdf format at
www.earth.columbia.edu/images/raceagainsttime_FINAL_0410404.pdf.
If you would like to receive an excerpt of the report in a plain text email,
please send your request to me at ccoleman@procor.org and specify which of
the following chapters you would like to receive.
A. Introduction / Originals and rationale of the report
B. The global significance of CVD/ What are the global data?
C. CVD status and projections in 5 developing countries
D. The macroeconomic and economic consequences of CVD
E. Intervention strategies to reduce the impact of CVD
F. From analysis to action
G. Conclusions
H. Acknowledgments
I. References
Catherine Coleman
Editor-in-Chief, ProCOR www.procor.org
Lown Cardiovascular Research Foundation
21 Longwood Avenue, Brookline, MA 02446-5239
t/617-732-1318 x3332 f/617-734-5763
ccoleman@procor.org
_____________________________________________________________________
To reply or contribute to ProCOR's Global Dialogue:
ProCOR (www.procor.org) is a program of the Lown Cardiovascular
Research Foundation. ProCOR's email discussion is administered by
SATELLIFE (www.healthnet.org), The Global Health Information Network.
Change subscription options by sending email with 'help' in subject
to, or by visiting
http://list.healthnet.org/mailman/listinfo/procor
Countries--cost-effective approaches
Expert bodies have highlighted the growing global epidemic of chronic
diseases-obesity, diabetes, and cardiovascular diseases.(1-6) These groups,
though seemingly disparate in their priorities and approach, are united in
recognizing the threats posed to health and economic development in the
developing world.
The 2002 World Health Report,(7) Reducing Risks, Promoting Healthy Life
underscored these threats, and a new report, A Race Against Time-the
Challenge of Cardiovascular Disease in Developing Economies (8) links
cardiovascular diseases to development in low- and middle-income countries.
This report warns that unless steps are taken to stem the tide of risk
factors leading to cardiovascular diseases, additional economic hardships
would result especially in countries that can afford it the least.
One recent response to these pandemics of chronic noncommunicable diseases
is the WHO/FAO's collective approach to tackling obesity, diabetes,
cardiovascular diseases, and cancer. (9) Their report highlights the
clustering of these diseases in an entity called the metabolic syndrome. The
two key lifestyle risk factors (in addition to smoking) that underpin these
diseases are major shifts in diet and physical activity patterns.
Epidemiologists refer to the former as the "nutrition transition." (10-12)
A recent JAMA commentary (13) questioned whether the new buzz phrase
"metabolic syndrome" is really new, or simply a repackaging of familiar
cardiovascular disease risk factors. In their view, the metabolic syndrome
terminology reflects a new desire to take risk factors more seriously.
Cardiologists, diabetologists, and public health specialists increasingly
approach this syndrome from their own vantage points. As we deliberate risk
factors for chronic diseases, so must we accelerate efforts towards workable
strategies, especially in resource-poor countries.
Bendich and Dickelbaum (14) in their book, Primary and Secondary Preventive
Nutrition, emphasized approaches that simultaneously address the cluster of
diseases linked to the metabolic syndrome. Not only can this simplify public
health nutrition messages, but also provide logical and cost-effective
approaches to global health. Common risk factors demand common solutions.
The historical medical divide that prescribes separate interventions for
cardiovascular diseases, obesity, and diabetes can partition scarce
resources, enfeeble prevention efforts, and diminish outcomes. While such
policies may be excused in developed economies, resource-poor
countries-which now bear the brunt of the chronic disease burden-can
ill-afford disjointed approaches to prevention. It is neither logical nor
cost-effective.
As modernization, urbanization, globalization, and unhealthy lifestyles
coalesce to spawn growing global pandemics, so must we urgently synergize
prevention strategies. In this vein, A Race Against Time-the Challenge of
Cardiovascular Disease in Developing Economies could not be more timely.
B. E. Bulwer, M.D., ProCOR
2004 Fellow, Lown Fellowship in Cardiovascular Disease in the Developing
World
___________________________________________________________________________
References:
1.Murray CJL, Lopez AD. Quantifying the burden of disease and injury
attributable to ten major risk factors. In: Murray CJL, Lopez AD, eds. The
global burden of disease: a comprehensive assessment of mortality and
disability from diseases, injuries, and risk factors in 1990 and projected
to 2020. Cambridge (MA): Harvard University Press; 1996:295-324.
2.International Diabetes Federation. The rising global pandemic. Press
release, August 15, 2000; IDF website,
http://www.idf.org/home/index.cfm?node=1055 .
3.International Diabetes Federation. Global experts warn of new
diabetes threat. Press release, August 17, 2000; IDF website,
http://www.idf.org/home/index.cfm?node=1055 .
4.Obesity: Preventing and Managing the Global Epidemic Report of a WHO
Consultation Technical Report Series, 2000, Geneva, WHO/NUT/NCD. (English)
ISBN 92 4 120894 5.
5.International Association for the Study of Obesity (IOTF). IOTF
experts call on governments to support WHO global strategy. Media, April 26,
2004. http://www.iotf.org/.
6.Diet, physical activity and health. The fifty-fifth world health
assembly, WHA55.23. Agenda item 13.11 18 May 2002. Available from:
http://www.who.int/gb/EB_WHA/PDF/WHA55/ewha5523.pdf .
7.The World Health Report 2002-Reducing risks, promoting healthy life.
Geneva: World Health Organization; 2002. http://www.who.int/whr/2002/en/ .
Accessed August 22, 2003.
8.A race against time: The challenge of cardiovascular disease in
developing economies. Trustees of Columbia University in the City of New
York, 2004. ISBN 0-9754336-0-1. Available at www.earthinstitute.columbia.edu
9.Diet, nutrition and the prevention of chronic diseases. Report of
the joint WHO/FAO expert consultation. WHO Technical Report Series, No. 916
(TRS 916). Available at WHO website
http://www.who.int/dietphysicalactivity/publications/trs916/kit/en ]=
10.Popkin BM. The nutrition transition and obesity in the developing
world. J Nutr. 2001;13:871S-873S.
11.Popkin BM. The nutrition transition and its health implications in
lower-income countries. Public Health Nutr. 1998;1:5-21.
12.Popkin BM, Horton S, Kim S, Mahal A, Shuigao J. Trends in diet,
nutritional status, and diet-related noncommunicable diseases in China and
India: the economic costs of the nutrition transition. Nutr Rev.
2001;59:379-90.
13.Mitka M. Metabolic syndrome recasts old cardiac, diabetes risk
factors as a "new"entity. JAMA. 2004 May 5;291(17):2062-3.
14.Bendich A, Deckelbaum R. Preventive nutrition throughout the life
cycle-a cost-effective approach to improved health. In: Bendich A,
Deckelbaum R,eds. Primary and secondary preventive nutrition. Totowa (NJ):
Humana Press Inc.2001:427-441.
-----Original Message-----
From: procor-bounces@healthnet.org
[mailto:procor-bounces@healthnet.org]On Behalf Of Coleman, Catherine
Sent: Tuesday, May 04, 2004 10:53 AM
To: 'procor@healthnet.org'
Subject: [ProCOR] New report: CVD affecting younger populations in
developing countries
Greetings from ProCOR,
An important new report entitled A Race Against Time, which examines the
challenge of cardiovascular disease in developing economies, suggests that
heart disease and stroke are causing hundreds of thousands of deaths each
year in young people-a far great number than previously estimated--and is
having a profound effect on the work force in developing countries.
The report was released by Columbia University's Earth Institute last week.
It studies five countries: Brazil, South Africa, the Russian
republic of Tatarstan, India, and China. The researchers combined population
estimates for the five countries with current death rates and workforce data
to calculate the future effects of CVD both on society and on the workforce.
While cardiovascular diseases (CVD) are often portrayed in the West as
diseases of affluent and older people, CVD mortality rates among working age
people in India, South Africa, and Brazil are one-and-a-half to two times
that of the United States.
The report suggests that the rate of cardiovascular disease is higher in
developing countries because treatment is often unavailable, and lifestyle
programs that have improved health in the US over the past several decades,
such as diet and exercise awareness, anti-smoking campaigns, and tobacco
taxes, do not exist in most developing countries.
In India, of the 5 million people who die of CVD each year, 28% are aged
less than 65. In South Africa, despite the predominance of HIV/AIDS, the
proportion of deaths occurring among people aged 35-44 due to chronic
disease, mainly CVD, is 12% for men and 17.2% for women. In Tatarstan, CVD
death rates among young men have increased by 70% in 20 years.
The impact of heart disease and stroke is particularly devastating in
rapidly developing societies because they affect national economies. In
2020, the less developed nations will have 500 million people aged over 65
years. By 2040 there will be a billion people of this age in these countries
who will be most at risk for CVD. The report estimates that at least 21
million years of future productive life are lost because of CVD each year
and that this number will increase to 34 million years of life lost by 2020.
The report notes that effective and inexpensive treatment for blood pressure
and cholesterol can have an immediate positive effect on health, as will
support for quitting smoking and encouraging healthier lifestyles.
The report, A Race against Time, is available in pdf format at
www.earth.columbia.edu/images/raceagainsttime_FINAL_0410404.pdf.
If you would like to receive an excerpt of the report in a plain text email,
please send your request to me at ccoleman@procor.org and specify which of
the following chapters you would like to receive.
A. Introduction / Originals and rationale of the report
B. The global significance of CVD/ What are the global data?
C. CVD status and projections in 5 developing countries
D. The macroeconomic and economic consequences of CVD
E. Intervention strategies to reduce the impact of CVD
F. From analysis to action
G. Conclusions
H. Acknowledgments
I. References
Catherine Coleman
Editor-in-Chief, ProCOR www.procor.org
Lown Cardiovascular Research Foundation
21 Longwood Avenue, Brookline, MA 02446-5239
t/617-732-1318 x3332 f/617-734-5763
ccoleman@procor.org
_____________________________________________________________________
To reply or contribute to ProCOR's Global Dialogue:
ProCOR (www.procor.org) is a program of the Lown Cardiovascular
Research Foundation. ProCOR's email discussion is administered by
SATELLIFE (www.healthnet.org), The Global Health Information Network.
Change subscription options by sending email with 'help' in subject
to
http://list.healthnet.org/mailman/listinfo/procor
Reply to this message
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