Prevalence of cardiovascular risk factors in a middle-income country and estimated cost of a treatment strategy

Survey of risk factors using an age- and sex-stratified random sample of the population of Seychelles aged 25–64 in 2004. Assessment of CVD risk and treatment modalities were in line with international guidelines. Costs are expressed as US$ per capita per year.1255 persons took part in the survey (participation rate of 80.2%). Prevalence of main risk factors was: 39.6% for high blood pressure (≥140/90 mmHg or treatment) of which 59% were under treatment; 24.2% for high cholesterol (≥6.2 mmol/l); 20.8% for low HDL-cholesterol (<1.0 mmol/l); 9.3% for diabetes (fasting glucose ≥7.0 mmol/l); 17.5% for smoking; 25.1% for obesity (body mass index ≥30 kg/m2) and 22.1% for the metabolic syndrome. Overall, 43% had HBP, high cholesterol or diabetes and substantially increased CVD risk. The cost for medications needed to treat all high-risk individuals amounted to US $45.6, i.e. $11.2 for high blood pressure, $3.8 for diabetes, and $30.6 for dyslipidemia (using generic drugs except for hypercholesterolemia). Cost for minimal follow-up medical care and laboratory tests amounted to $22.6.High prevalence of major risk factors was found in a rapidly developing country and costs for treatment needed to reduce risk factors in all high-risk individuals exceeded resources generally available in low or middle income countries. Our findings emphasize the need for affordable cost-effective treatment strategies and the critical importance of population strategies aimed at reducing risk factors in the entire population.Cardiovascular diseases (CVD) have become a leading cause of mortality and morbidity in developing countries and rates are expected to rise further over the next few decades [1-4]. In particular, it has been estimated that high blood pressure (HBP) accounts for as much as 5.0% of the total mortality in middle-income countries, tobacco for 4.0%, high cholesterol for 2.1% and obesity for 2.7% [5].The increasing burden of CVD has important economic implications. CVD occurs typi