BMC Public Health (May 2021)
Body-mass index, blood pressure, diabetes and cardiovascular mortality in Cuba: prospective study of 146,556 participants
- Nurys B Armas Rojas,
- Ben Lacey,
- Monica Soni,
- Shaquille Charles,
- Jennifer Carter,
- Patricia Varona-Pérez,
- Julie Ann Burrett,
- Marcy Calderón Martínez,
- Elba Lorenzo-Vázquez,
- Sonia Bess Constantén,
- Hannah Taylor,
- Paul Sherliker,
- José Manuel Morales Rigau,
- Stephanie Ross,
- M. Sofia Massa,
- Osvaldo Jesús Hernández López,
- Nazrul Islam,
- Miguel Ángel Martínez Morales,
- Ismell Alonso Alomá,
- Fernando Achiong Estupiñan,
- Mayda Díaz González,
- Noel Rosquete Muñoz,
- Marelis Cendra Asencio,
- Oscar Díaz-Diaz,
- Ileydis Iglesias-Marichal,
- Jonathan Emberson,
- Richard Peto,
- Sarah Lewington
Affiliations
- Nurys B Armas Rojas
- National Institute of Cardiology and Cardiovascular Surgery
- Ben Lacey
- Nuffield Department of Population Health (NDPH), University of Oxford
- Monica Soni
- Nuffield Department of Population Health (NDPH), University of Oxford
- Shaquille Charles
- Nuffield Department of Population Health (NDPH), University of Oxford
- Jennifer Carter
- Nuffield Department of Population Health (NDPH), University of Oxford
- Patricia Varona-Pérez
- Institute of Hygiene, Epidemiology and Microbiology, Ministry of Public Health
- Julie Ann Burrett
- Nuffield Department of Population Health (NDPH), University of Oxford
- Marcy Calderón Martínez
- Institute of Hygiene, Epidemiology and Microbiology, Ministry of Public Health
- Elba Lorenzo-Vázquez
- Cuban Commission against Smoking, Ministry of Public Health
- Sonia Bess Constantén
- Directorate of Medical Records and Health Statistics, Ministry of Public Health
- Hannah Taylor
- Nuffield Department of Population Health (NDPH), University of Oxford
- Paul Sherliker
- Nuffield Department of Population Health (NDPH), University of Oxford
- José Manuel Morales Rigau
- Provincial Center of Hygiene, Epidemiology and Microbiology
- Stephanie Ross
- Nuffield Department of Population Health (NDPH), University of Oxford
- M. Sofia Massa
- Nuffield Department of Population Health (NDPH), University of Oxford
- Osvaldo Jesús Hernández López
- Municipal Center of Hygiene, Epidemiology and Microbiology
- Nazrul Islam
- Nuffield Department of Population Health (NDPH), University of Oxford
- Miguel Ángel Martínez Morales
- Directorate of Medical Records and Health Statistics, Ministry of Public Health
- Ismell Alonso Alomá
- Directorate of Medical Records and Health Statistics, Ministry of Public Health
- Fernando Achiong Estupiñan
- Provincial Center of Hygiene, Epidemiology and Microbiology
- Mayda Díaz González
- Municipal Center of Hygiene, Epidemiology and Microbiology
- Noel Rosquete Muñoz
- Municipal Center of Hygiene, Epidemiology and Microbiology
- Marelis Cendra Asencio
- Municipal Center of Hygiene, Epidemiology and Microbiology
- Oscar Díaz-Diaz
- National Institute of Endocrinology
- Ileydis Iglesias-Marichal
- National Institute of Endocrinology
- Jonathan Emberson
- Nuffield Department of Population Health (NDPH), University of Oxford
- Richard Peto
- Nuffield Department of Population Health (NDPH), University of Oxford
- Sarah Lewington
- Nuffield Department of Population Health (NDPH), University of Oxford
- DOI
- https://doi.org/10.1186/s12889-021-10911-9
- Journal volume & issue
-
Vol. 21,
no. 1
pp. 1 – 10
Abstract
Abstract Background Cardiovascular disease accounts for about one-third of all premature deaths (ie, age =120 mmHg), diabetes, and BMI (>=22.5 kg/m2): 20 mmHg higher usual SBP about doubled cardiovascular mortality (RR 2.02, 95%CI 1.88–2.18]), as did diabetes (2.15, 1.95–2.37), and 10 kg/m2 higher usual BMI (1.92, 1.64–2.25). RR were similar in men and in women. The association with BMI and cardiovascular mortality was almost completely attenuated following adjustment for the mediating effect of SBP. Elevated SBP (>=120 mmHg), diabetes and raised BMI (>=22.5 kg/m2) accounted for 27%, 14%, and 16% of cardiovascular deaths, respectively. Conclusions This large prospective study provides direct evidence for the effects of these major risk factors on cardiovascular mortality in Cuba. Despite comparatively low levels of these risk factors by international standards, the strength of their association with cardiovascular death means they nevertheless exert a substantial impact on premature mortality in Cuba.
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