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

由于全球流行病学、社会和经济转型，心血管疾病（CVD）已成为全球死亡的主要原因。在撒哈拉以南非洲（SSA），这些转变处于相对早期的阶段，所研究的国家处于不同阶段，经历着截然不同的轨迹。该项目的目的是在南非、加纳和坦桑尼亚的农村地区建立50岁及以上人群的队列，并在此过程中描述正在经历人口转型的非洲环境中老年人心脏代谢紊乱的变化率、原因和后果。关于老年慢性心脏代谢疾病（CMD）（如心血管疾病和糖尿病）基线水平的可靠数据在农村SSA极其有限，但了解CMD的变化率对社会和卫生政策规划至关重要。对参与者进行有效的随访，收集自我报告的健康状况、诊所和医院服务，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和心血管和代谢紊乱相关风险增加的复杂生物、行为、人口和社会经济因素。我们的长期目标是丰富加纳的INDEPTH队列研究系统。南非和坦桑尼亚，以便它们可用于规划卫生和社会服务，以确定可从简单干预措施中受益的高危个人，以降低传染性疾病的发病率和死亡率。我们的总体项目目标是建立关键传统和新型CMD风险因素的基线，评估选定风险因素的轨迹，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50岁及以上非洲人口的未来死亡率。项目二的具体目标是：

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.