DALYs attributable to 10 leading risk factors by sex, adults 15–69 years, South Asia, 2004
Additional research is finding that cardiovascular risk is highest for South Asians among the world’s regions (Goyal and Yusuf 2006). A recent study of 52 countries from all over the world, including Bangladesh, India, Nepal, Pakistan, and Sri Lanka, found that South Asians were 6 years younger (53 vs59 years) than those in the rest of the world at their first heart attack, had high levels of risk factors for CVD such as diabetes and high lipids, and had low levels of protective factors such as physical activity and healthy dietary habits.
The South Asians, therefore, appearing to have a greater susceptibility to CVD, it may have an even greater impact in the future than previously appreciated (Goyal and Yusuf 2006; Ramaraj and Chellappa 2008). In terms of DALYs forgone to risk factors, Figure 1.4 (for men and women) shows very different risk profiles. However, for both sexes, most of the risk factors are related to NCDs.
The profile for women reflects the contributions to premature disability and mortality from high cholesterol (an NCD risk factor) to be similar to that of iron deficiency (an MCH issue). Among males, with the exception of unsafe sex, all the other risk factors associated with forgone DALYS are related to NCDs, including tobacco consumption and alcohol use, high cholesterol, high blood pressure, and low consumption of fruits and vegetables.
A consequence of high levels of risk factors among men, in particular tobacco and alcohol, is that stagnation in the reduction or even increase in premature adult mortality may be expected in the years ahead. These risk factors and trends are similar to the situation seen in the Russian Federation and Eastern Europe (Marquez et al. 2005).
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