JMIR Publications

ABSTRACT

Background:

Beyond risk factor levels at a single time point, recent evidence demonstrated that risk trajectories are differentially related to cardiovascular disease (CVD) risk. However, factors associated with suboptimal control or unstable trends of CVD risk trajectories are not yet established.

Objective:

This study aims to examine factors associated with CVD risk trajectories in a semirural, multi-ethnic community-dwelling population.

Methods:

Data on sociodemographic, lifestyle, psychosocial and cardiovascular factors were measured in Wave 1 (2013) and Wave 2 (2018) of the South East Asia Community Observatory (SEACO) cohort. The 10-year CVD risk change transition was computed. Multivariable regression analyses were employed to examine the association between risk factors and changes in Framingham Risk Score (FRS) and predicted CVD risk trajectory patterns with adjustments for concurrent risk factors.

Results:

Of the 6,599 multi-ethnic community-dwelling individuals (59.9% female and 40.1% male; mean age = 55.3 ±10.6), CVD risk increased over time in 30% of the sample population while 24% remained in the high-risk trajectory pattern, which was reflected by the increased prevalence of all major CVD risk factors over the 5-year follow-up. Further analyses revealed that socioeconomic, employment and dietary habits were important determinants of elevated CVD risk over time.

Conclusions:

Our findings carry significant implications for public health, indicating that the rise in major risk factors, along with disparities in psychosocial factors, could potentially elevate the risk of CVD among individuals in an underserved setting. More population-based prevention efforts that continuously monitor CVD risk and consider any changes in risk factors among vulnerable populations should be emphasised.