The Burden of Cardiovascular Events According to Cardiovascular Risk Profile in Adults from High-, Middle- and Low-Income Countries

Background Current strategies to prevent adverse cardiovascular outcomes focus on secondary prevention and primary prevention in high-risk groups. The proportion of events occurring in lower-risk groups globally is unknown. Methods We prospectively documented fatal or non-fatal myocardial infarction, stroke, heart failure, or any other fatal cardiovascular event stratified by history of cardiovascular disease (CVD), and by the INTERHEART and the Framingham risk score in those without prior CVD, in 189,097 adults from 26 high-, middle- and low-income countries. Results Participants mean±SD age was 51±10 years and 59% were women. We observed 14,829 outcome events affecting 8% of the cohort during a median 12.4 years follow-up. Overall, 44% of outcome events occurred in CVD-naive participants at low or intermediate INTERHEART risk…