Diabetes
Composite risk of cardiovascular disease comorbidity in people living with diabetes in Africa Divine-Favour Chichenim Ofili* Divine-Favour Chichenim Ofili Regina Idu Ejemot-Nwadiaro Stephen Chukwuma Ogbodo Henshaw Okoroiwu Ugochinyere Vivian Ukah
Aim: Diabetes mellitus (DM) and cardiovascular diseases (CVD) share similar risk factors, thereby increasing the likelihood of comorbidity. However, the risk of CVD, based on the interaction of key risk factors, among people living with DM is poorly understood. Thus, this study quantified the composite CVD risk and its association with socio-demographic characteristics in people living with DM in Africa.
Methods: Using data from the World Health Organization STEPwise approach to non-communicable diseases risk factor Surveillance (STEPS), and generalized linear mixed models for clustered ordinal responses, we assessed the association between CVD risk and socio-demographic characteristics in non-pregnant African adults living with diabetes. CVD risk was measured using a composite score (STEPS-CARDIO index) of five key CVD risk factors – smoking, overweight/obesity, hypertension, physical activity, and diet.
Results: In this sample of 4738 individuals, most respondents were at medium risk of developing CVD (country level mean STEPS-CARDIO score ranged from 2 to 3·22). Older age was significantly associated with higher CVD risk (OR, 1.03; 95% CI, 1.02-1.04), and this was consistent for both sexes, and women had 1.20 times higher CVD risk than men (OR, 1.20; 95% CI, 1.05-1.38). Although education, marital status, occupation, and household size, were generally positively associated with CVD risk, being a student (OR, 0.51; 95% CI, 0.31-0.86) or religious education graduate (OR, 0.97; 95% CI, 0.68-1.37) was protective; the latter presented an increased CVD risk for men.
Conclusion: The findings highlight gendered and social differences in CVD risk among people with DM in Africa. Tailored preventive interventions are therefore required to address the specific needs, and significantly reduce the CVD risk, of populations living with diabetes in Africa.
Keywords: Diabetes, Cardiovascular Diseases, CVD risk, DM-CVD comorbidity, Africa, Risk stratification, STEPS-CARDIO index
