Cardiovascular Disease Among Urban Malaysians Health And Social Care Essay

Cardiovascular Disease Among Urban Malaysians Health And Social Care Essay Results from INTERHEART global case-control study (Yusuf et al. 2004, Anand et al. 2008) concluded that the following nine potentially modifiable risk factors account for over 90% of the risk of an acute myocardial infarction (in order of highest to lowest population attributable risk for Southeast Asian and Japanese subgroup): dyslipidemia, abdominal obesity, hypertension, smoking, regular physical activity, regular alcohol consumption, psychosocial factors, diabetes mellitus, daily fruit and vegetable consumption. There are six established major risk factors for coronary heart disease: adverse diet, above-optimal levels of serum total cholesterol and blood pressure, overweight/obesity, diabetes mellitus and cigarette smoking (Stamler 2005). Urbanization Urban areas are defined as gazetted areas and their adjoining built-up areas with a combined population of 10 000 persons or more at the time of the consensus (Mahari et al. 2009). The fraction of rural population in Malaysia was 4 0.4 % in 2000 and an estimated 38.4 % in 2007, compared to Switzerland with 26.6 % in 2007 (UN Demographic Yearbook 2009). The rapid urbanization of the world brings significant changes to lifestyles. Nowadays more than 50% of the world’s population is already living in urban areas, and and estimated 70% by 2050 (WHO 2010). Epidemiology of cardiovascular disease risk factors A major trend in developing countries is the epidemiological transition from communicable causes of death to non-communicable causes. Projections by Mathers et Loncar (2006) estimate that globally the proportions of deaths due to non-communicable diseases will rise from 59% in 2002 to 69% in 2030. According to Malaysia’s statistics of death, ischaemic heart disease and cerebrovascular disease are already considered the leading causes of death in 2007 (Department of Statistics Malaysia 2009). Malaysia is strongly affected by the above mentioned health-transition. The National Health and Morbidity Su rvey (NHMS) III (2006) showed that the prevalence of obesity has more than tripled in a decade (from 4.4% in 1996 to 14.0% in 2006), the prevalence of hypertension has increased by about one third in 10 years (from 33% to 43%) and the prevalence of newly diagnosed and known diabetes has almost doubled in the same period. The prevalence of diabetes is significantly higher in urban areas, whereas the rural population is significantly more affected by hypertension and tobacco use. Studies from other areas of the developing world show divergent results. A study from Vietnam (Pham et al. 2009) confirmed the higher prevalence of hypertension in the rural population of the Mekong Delta (rural male 27%, female 16%). On the other side a higher prevalence of hypertension in urban subjects was found in the National Nutrition and Health Survey 2002 in China (Wu et al. 2008) and a systematic review in Sub-Saharan Africa (Addo et al. 2007). Concerning smoking a recent study from China (Ho et al. 2010) revealed a higher prevalence of ever-smokers among urban young women. In a semi-rural community, Chia and Srinivas (2009) found a high mean predicted coronary heart disease risk: 20-25% for men and 11-13% for women (mean age of the subjects 65.4 years(Â ±8)). Studies from Vietnam (Pham et al. 2009), Brazil and Mexico (Ford et Mokdad 2008) revealed a higher prevalence of obesity in urban areas than in rural areas. With a value of 11.6 % Malaysia has the second highest estimated comparative prevalence of diabetes mellitus in South East Asia for 2010 (with Singapore representing the highest prevalence), which is more than double of highly developed Japan (Sicree et al. 2006). Dietary imbalances in South-Asian populations are common: there is often a low intake of n-3 polyunsaturated fatty acids and fibre, and high intake of saturated fatty acids, carbohydrates and trans-isomer fatty acids (Isharwal et al. 2009, Misra et al. 2009).