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Global Variability in Angina Pectoris and Its Association With Body Mass Index and Poverty - 06/08/11

Doi : 10.1016/j.amjcard.2010.10.040 
Longjian Liu, MD, MSc, PhD a, , Jixiang Ma, PhD b, Xiaoyan Yin, MD c, Ellie Kelepouris, MD d, Howard J. Eisen, MD d
a Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania 
b Institution of Non-Communicable Disease Prevention, Shandong Center for Disease Control and Prevention, Jinan, China 
c Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 
d Department of Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania 

Corresponding author: Tel: (215) 762-1370; fax: (215) 762-1174

Riassunto

In the absence of a previous global comparison, we examined the variability in the prevalence of angina across 52 countries and its association with body weight and the poverty index using data from the World Health Organization-World Health Survey. The participants with angina were defined as those who had positive results using a Rose angina questionnaire and/or self-report of a physician diagnosis of angina. The body mass index (BMI) was determined as the weight in kilograms divided by the square of the height in meters. The poverty index (a standard score of socioeconomic status for a given country) was extracted from the United Nations' statistics. The associations of angina with the BMI and poverty index were analyzed cross-sectionally using univariate and multivariate analyses. The results showed that the total participants (n = 210,787) had an average age of 40.64 years. The prevalence of angina ranged from 2.44% in Tunisia to 23.89% in Chad. Those participants with a BMI of <18.5 kg/m2 (underweight), 25 to 29 kg/m2 (overweight), or BMI ≥30 kg/m2 (obese) had a significantly greater risk of having angina compared to those with a normal BMI (≥18.5 but <25 k/m2). The odds ratios of overweight and obese for angina remained significant in the multilevel models, in which the influence of the country-level poverty status was considered. A tendency was seen for underweight status and a poverty index >14.65% to be associated with the risk of having angina, although these associations were not statistically significant in the multilevel models. In conclusion, significant variations were found in the anginal rates across 52 countries worldwide. An increased BMI was significantly associated with the odds of having angina.

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 The reviews expressed in the present study are the authors' and do not necessarily reflect those of the WHO.
 Dr. Liu conceived and contributed the analytic study design, conducted the analysis, and drafted and finalized the paper; Drs. Ma, Yin, Kelepouris, and Eisen gave critical reviews of the analytic design and editing of the report.


© 2011  Pubblicato da Elsevier Masson SAS.
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Vol 107 - N° 5

P. 655-661 - marzo 2011 Ritorno al numero
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