CARDIOMETABOLIC DISEASE & RISK FACTORS AMONG OLDER ADULTS IN SUB-SAHARAN AFRICA

项目2：撒哈拉以南非洲老年人的心脏代谢性疾病和危险因素由于全球流行病学、社会和经济转型，心血管疾病已成为全球主要的死亡原因。这些转变在撒哈拉以南非洲(SSA)处于相对较早的阶段，所研究的国家处于不同阶段，并且经历了截然不同的轨迹。该项目的目的是在南非、加纳和坦桑尼亚农村地区建立50岁及以上人群队列，并以此确定在人口结构转型的非洲背景下，老年人心脏代谢紊乱的发生率、原因和后果的变化特征。关于老年人慢性心脏代谢疾病(CMD)基线水平的可靠数据，如心血管疾病和糖尿病，在农村地区极其有限，但了解CMD的变化速度对于社会和卫生政策规划至关重要。对参与者进行有效的跟踪，收集自我报告的健康状况、临床和医院服务，以及已建立的生物标志物和口头尸检，将有助于全面了解导致死亡增加的复杂生物、行为、人口和社会经济因素以及心血管和代谢疾病的相关风险。我们的长期目标是丰富加纳、南非和坦桑尼亚的INDEPTH队列研究系统，以便它们可以用于规划医疗和社会服务，以确定哪些高危个人可以从简单的干预措施中受益，以降低CMD的发病率和死亡率。我们的总体项目目标是建立关键的传统和新的CMD风险因素的基线，评估选定的风险因素的轨迹，并测试在包括艾滋病毒/艾滋病在内的传染病突出的不同环境中，容易识别和可修改的风险因素是否可以预测非洲50岁及以上人口的未来死亡率。项目2的具体目标是： 1.比较3个SSA社区的风险因素和晚期CMD的基线患病率 2.建立传统和新的CMD危险因素的变化轨迹和模式，并建立CVD 3.建立模型，评估艾滋病毒不同流行地区的传统和新型生物风险因素、社会和环境风险因素与心血管疾病死亡率之间的关系。

Project 2: Cardiometabolic Disease and Risk Factors Among Older Adults in Sub-Saharan Africa Cardiovascular disease (CVD) has become the leading cause of death globally as a result of epidemiologic, social, and economic transitions globally. These transitions are at a relatively early stage in Sub-Saharan Africa (SSA), with the countries under study at different stages and experiencing contrasting trajectories. The purpose of this project is to establish cohorts of persons aged 50 and over in rural South Africa, Ghana, and Tanzania and, in doing so, characterize the changing rates, causes, and consequences of cardiometabolic disorders among older people in African settings undergoing demographic transition. Reliable data on baseline levels of chronic cardiometabolic disease (CMD) such as CVD and diabetes in older ages are extremely limited in rural SSA but understanding the rate of change in CMD is critical for social and health policy planning. Effective follow-up of participants and collection of self-reported health status and clinic and hospital services as well as established biomarkers and verbal autopsies will lead to a comprehensive understanding of the complex biologic, behavioral, demographic, and socioeconomic factors causing increasing death and associated risk from cardiovascular and metabolic disorders. Our long term goal is to enrich the INDEPTH cohort studies systems in Ghana,.South Africa and Tanzania so they can be used to plan health and social services to identify high risk individuals who can benefit from simple interventions to reduce CMD morbidity and mortality. Our overall project objective is to establish a baseline of key traditional and novel CMD risk factors, assess trajectories of select risk factors, and test whether easily identified and modifiable risk factors predict future mortality in African populations 50 and over in diverse settings where infectious disease including HIV/AIDS is prominent. The specific aims of Project 2 are: 1. To compare baseline prevalence of risk factors and advanced CMD across 3 SSA communifies 2. To establish trajectories and patterns of change in traditional and novel CMD risk factors and established CVD 3. To develop models to assess the association between traditional and novel biologic risk factors, social and environmental risk factors, and CVD mortality in areas of differential HIV prevalence.