The social transition of risk factors for cardiovascular disease in the African region: evidence from three cross-sectional surveys in the Seychelles.
OBJECTIVES
To examine the association between socioeconomic status (SES) and several cardiovascular disease risk factors (CVRFs) and to assess whether this association has changed over a 15-year observation period.


METHODS
Three independent population-based surveys of CVRFs were conducted in representative samples of all adults aged 25-64 years in the Seychelles, a small island state located east to Kenya, in 1989 (N=1081), 1994 (N=1067) and 2004 (N=1255).


RESULTS
Among men, current smoking and heavy drinking were more prevalent in the low versus the high SES group, and obesity was less prevalent. The socioeconomic gradient in diabetes reversed over the study period from lower prevalence in the low versus the high SES group to higher prevalence in the low SES group. Hypercholesterolemia was less prevalent in the low versus the high SES group in 1989 but the prevalence was similar in the two groups in 2004. Hypertension showed no consistent socioeconomic pattern. Among women, the SES gradient in smoking tended to reverse over time from lower prevalence in the low SES group to lower prevalence in the high SES group. Obesity and diabetes were more common in the low versus the high SES group over the study period. Heavy drinking, hypertension and hypercholesterolemia were not socially patterned among women.


CONCLUSION
The prevalence of several CVRFs was higher in low versus high SES groups in a rapidly developing country in the African region, and an increase of the burden of these CVRFs in the most disadvantaged groups of the population was observed over the 15 years study period.
['Stringhini|Silvia|S|', 'Viswanathan|Bharathi|B|', 'Gédéon|Jude|J|', 'Paccaud|Fred|F|', 'Bovet|Pascal|P|']
D000328:Adult D000428:Alcohol Drinking D002318:Cardiovascular Diseases D003430:Cross-Sectional Studies D003906:Developing Countries D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009765:Obesity D012307:Risk Factors D012750:Seychelles D012907:Smoking D012923:Social Class
Survey Africa Cardiovascular risk factors Low and middle income countries Social determinants Trends