Impact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: an individual-level pooled analysis of 31 cohort studies
Abstract
Background: Estimates of the burden of cardio-metabolic risk factors in Latin America and the Caribbean (LAC) rely on relative risks (RRs) from non-LAC countries. Whether these RRs apply to LAC remains unknown. Methods: We pooled LAC cohorts. We estimated RRs per unit of exposure to body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC) and non-HDL cholesterol on fatal (31 cohorts, n=168,287) and non-fatal (13 cohorts, n=27,554) cardiovascular diseases, adjusting for regression dilution bias. We used these RRs and national data on mean risk factor levels to estimate the number of cardiovascular deaths attributable to non-optimal levels of each risk factor. Results: Our RRs for SBP, FPG and TC were like those observed in cohorts conducted in high-income countries; however, for BMI, our RRs were consistently smaller in people below 75 years of age. Across risk factors, we observed smaller RRs among older ages. Non-optimal SBP was responsible for the largest number of attributable cardiovascular deaths ranging from 38 per 100,000 women and 54 men in Peru, to 261 (Dominica, women) and 282 (Guyana, men). For non-HDL cholesterol, the lowest attributable rate was for women in Peru (21) and men in Guatemala (25), and the largest in men (158) and women (142) from Guyana. Interpretation: RRs for BMI from studies conducted in high-income countries may overestimate disease burden metrics in LAC; conversely, RRs for SBP, FPG and TC from LAC cohorts are similar to those estimated from cohorts in high-income countries. Funding: Wellcome Trust (214185/Z/18/Z).
Related
- Factors associated with significant fibrosis and MASH in a diabetic Caribbean population of the French West Indies
- Physical activity moderates the deleterious relationship between cardiovascular disease, or its risk factors, and quality of life: Findings from two population-based cohort studies in Southern Brazil and South Australia
- Plasma proteomics identifies an endoplasmic reticulum stress-associated molecular signature across cardiovascular-kidney-metabolic syndrome stages
- Sodium bicarbonate therapy in severe metabolic acidemia: an individual patient data meta-analysis of the BICAR-ICU and BICAR-ICU2 trials
- Metabolic health and cardiovascular risk among Cameroonian adults with and without obesity
BibTeX
@article{carrillolarco2026impact,
title = {{Impact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: an individual-level pooled analysis of 31 cohort studies}},
author = {Rodrigo M. Carrillo-Larco and Dalia Stern and Ian R. Hambleton and Anselm Hennis and Mariachiara Di Cesare and Paulo Lotufo and Catterina Ferreccio and Vilma Irazola and Pablo Perel and Edward W Gregg and J. Jaime Miranda and Majid Ezzati and Goodarz Danaei and Carlos A Aguilar-Salinas and Ramón Alvarez-Váz and Marselle B Amadio and Cecilia Baccino and Claudia Bambs and João Luiz Bastos and Gloria Beckles and Antonio Bernabe-Ortiz and Carla Do Bernardo and Katia V. Bloch and Juan E. Blümel and Jose G. Boggia and Pollyanna K. Borges and Miguel Bravo and Gilbert Brenes-Camacho and Horacio A Carbajal and Maria S. Castillo Rascon and Blanca H. Ceballos and Veronica Colpani and Jackie A Cooper and Sandra Cortes and Adrian Cortes-Valencia and Roberto S Cunha and Eleonora D’orsi and William H Dow and Walter G Espeche and Flavio D. Fuchs and Sandra C. Fuchs and Suely Ga Gimeno and Donaji Gomez-Velasco and David A Gonzalez-Chica and Clicerio Gonzalez-Villalpando and María-Elena Gonzalez-Villalpando and Gonzalo Grazioli and Ricardo O. Guerra and Laura Gutierrez and Fernando L Herkenhoff and Andrea Rvr Horimoto and Andrea Huidobro and Elard Koch and Martin Lajous and Maria Fernanda Lima-Costa and Ruy Lopez-Ridaura and Alvaro Cc Maciel and Betty S Manrique-Espinoza and Larissa P Marques and Jose G Mill},
journal = {The Lancet Regional Health - Americas},
year = {2026},
month = oct,
doi = {10.1016/j.lana.2021.100068},
url = {https://hal.science/hal-05791959v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Impact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: an individual-level pooled analysis of 31 cohort studies
AU - Rodrigo M. Carrillo-Larco
AU - Dalia Stern
AU - Ian R. Hambleton
AU - Anselm Hennis
AU - Mariachiara Di Cesare
AU - Paulo Lotufo
AU - Catterina Ferreccio
AU - Vilma Irazola
AU - Pablo Perel
AU - Edward W Gregg
AU - J. Jaime Miranda
AU - Majid Ezzati
AU - Goodarz Danaei
AU - Carlos A Aguilar-Salinas
AU - Ramón Alvarez-Váz
AU - Marselle B Amadio
AU - Cecilia Baccino
AU - Claudia Bambs
AU - João Luiz Bastos
AU - Gloria Beckles
AU - Antonio Bernabe-Ortiz
AU - Carla Do Bernardo
AU - Katia V. Bloch
AU - Juan E. Blümel
AU - Jose G. Boggia
AU - Pollyanna K. Borges
AU - Miguel Bravo
AU - Gilbert Brenes-Camacho
AU - Horacio A Carbajal
AU - Maria S. Castillo Rascon
AU - Blanca H. Ceballos
AU - Veronica Colpani
AU - Jackie A Cooper
AU - Sandra Cortes
AU - Adrian Cortes-Valencia
AU - Roberto S Cunha
AU - Eleonora D’orsi
AU - William H Dow
AU - Walter G Espeche
AU - Flavio D. Fuchs
AU - Sandra C. Fuchs
AU - Suely Ga Gimeno
AU - Donaji Gomez-Velasco
AU - David A Gonzalez-Chica
AU - Clicerio Gonzalez-Villalpando
AU - María-Elena Gonzalez-Villalpando
AU - Gonzalo Grazioli
AU - Ricardo O. Guerra
AU - Laura Gutierrez
AU - Fernando L Herkenhoff
AU - Andrea Rvr Horimoto
AU - Andrea Huidobro
AU - Elard Koch
AU - Martin Lajous
AU - Maria Fernanda Lima-Costa
AU - Ruy Lopez-Ridaura
AU - Alvaro Cc Maciel
AU - Betty S Manrique-Espinoza
AU - Larissa P Marques
AU - Jose G Mill
PY - 2026
DA - 2026/10/11
JO - The Lancet Regional Health - Americas
DO - 10.1016/j.lana.2021.100068
UR - https://hal.science/hal-05791959v1
AB - Background: Estimates of the burden of cardio-metabolic risk factors in Latin America and the Caribbean (LAC) rely on relative risks (RRs) from non-LAC countries. Whether these RRs apply to LAC remains unknown. Methods: We pooled LAC cohorts. We estimated RRs per unit of exposure to body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC) and non-HDL cholesterol on fatal (31 cohorts, n=168,287) and non-fatal (13 cohorts, n=27,554) cardiovascular diseases, adjusting for regression dilution bias. We used these RRs and national data on mean risk factor levels to estimate the number of cardiovascular deaths attributable to non-optimal levels of each risk factor. Results: Our RRs for SBP, FPG and TC were like those observed in cohorts conducted in high-income countries; however, for BMI, our RRs were consistently smaller in people below 75 years of age. Across risk factors, we observed smaller RRs among older ages. Non-optimal SBP was responsible for the largest number of attributable cardiovascular deaths ranging from 38 per 100,000 women and 54 men in Peru, to 261 (Dominica, women) and 282 (Guyana, men). For non-HDL cholesterol, the lowest attributable rate was for women in Peru (21) and men in Guatemala (25), and the largest in men (158) and women (142) from Guyana. Interpretation: RRs for BMI from studies conducted in high-income countries may overestimate disease burden metrics in LAC; conversely, RRs for SBP, FPG and TC from LAC cohorts are similar to those estimated from cohorts in high-income countries. Funding: Wellcome Trust (214185/Z/18/Z).
SN - 2667-193X
ER -