Cardiovascular risk factors in developing countries: A review of clinico-epidemiological evidence

Background: Cardiovascular disorders (CVD) are due to a constellation of modifiable and non-modifiable risk factors - some known and others unknown. Such risk factors are reported to vary across ethnicities. CVD will likely become a major public health and clinical problem in Asia such that by the year 2020 Asia will have more individuals with CVD than any other region. However, the current evidence on variations in cardiovascular risk factors both from a clinical and an epidemiological perspective with special reference to developing country settings is limited. In this context, we set out to review the existing evidence and to summarize the findings. Methods: We did not carry out a systematic review but pursued a similar structure. We abstracted the most appropriate published literature from electronic databases, namely, PubMed, Embase and the Cochrane Library applying specific search terms. We searched grey literature and followed up bibliographic references. Results: Ethnicity is emerging as an independent risk factor contributing to the rising epidemic of CVD in developing countries. Furthermore, increasing rates of urbanization have led to striking changes in lifestyle patterns resulting in decreasing physical activity, increasing weight and, consequently, increasing rates of diabetes, hypertension and dyslipidemia in urban Asians. Conclusions: Variations in selected cardiovascular risk factors in developing countries were identified. Prediction tools and risk assessments need to be population-specific and sensitive to ethnic minorities. This summary of evidence could help to shift priorities to populations for targeted cardiovascular prevention and control measures where resources are limited.