Comparing cardiovascular risk factor profiles between urban and rural malaysia

Abstract

Background & Objective Cardiovascular diseases were the leading cause of NCD deaths in 2008 with over 80% occurred in low and middleincome countries1. Rapid socioeconomic development and urbanisation are a major force for this development. Our objective was to compare the cardiovascular risk factor (CVRF) profiles between urban and rural Malaysia. Design & Methods We enrolled 11,288 adults (53.4% urban) between 2007 and 2011. CVRF were obtained through questionnaires, physical examination and fasting blood tests for lipids and glucose. The study was approved by the institutional ethics committee. Results The urban population (UP) was significantly younger than the rural population (RP), (52.3 = 9.9 years vs 53.9 = 11.7 years; p < 0.001). Age-adjusted prevalence of hypertension was higher in RP (50.5% [49.2- 51.8%] vs 45.9% [44.7-47.1%]; p < 0.01). Hypercholesterolemia was more prevalent in UP with higher TC (74.7% [73.5-75.8%] vs 65.3% [63.9-66.7%]; p < 0.001) and higher LDL (69.6% [68.4-70.9%] vs 58.7% [57.3-60.2%]; p < 0.001). However, RP had higher prevalence of hypertriglyceridemia (47.0% [45.5-48.4%] vs 44.6% [43.3-46.0%]; p = 0.266) and low HDL-c (26.7% [25.4-28.0%] vs 20.6% [19.5-21.7%]; p < 0.001). UP has higher prevalence of diabetes, obesity and increased WC; (17.4% [16.5-18.4%] vs 14.3% [13.3-15.2%]; p < 0.01), (36.4% [35.1-37.7%] vs 32.1% [30.7-33.5%]; p < 0.001) and (61.9% [60.6-63.3%] vs 52.2% [50.8-53.7%]; p < 0.001) respectively. There were more current smokers in the RP compared to UP (14.7% [13.6-15.7%] vs 9.9% [9.0-10.7%]; p < 0.001). Conclusions The burden of CVRF were prevalent both in urban and rural populations in Malaysia with specific differences between them. The health delivery system needs to be streamlined to face this reality such that preventive efforts can be pursued effectively2.