Dear all,
         In one of Dr Raphael’s recent letter, he
mentioned that only 30% of variation in area CVD could
be contributed to traditional risk factors.  Other
researches attributed quite a bit more to living
condition, eg, income.  Some people talked about that
low-income population has more risk factors.  I could
not agree with this.

        As we know, diet is one of the traditional
risk factors of CVD.  From a recent survey by WHO, in
China, the lower- and middle-income class showed a
rise of high-fat diet  (from 19% to 36.4% in the
former and from 19.1% to 51.0% in the latter).  But,
the proportion of upper-income persons who were
consuming a relatively high-fat diet (>30% of daily
energy intake) also rose from 22.8% to 66.6% between
1989 and 1993.  This figure indicates that
upper-income groups could be also in the high-risk
populations.

      Comparing the impact of CVD between developed
and developing countries, 49% of deaths in the former
and 23% of deaths in the latter but 63% of total
deaths from CVD from developing countries, more
attention should be paid in developing countries.

      Rather than traditional risk factors, I would
also like to mention the potential effect of impaired
foetal nutrition.  A recent article shows a hypothesis
that babies born ‘ small for dates’ have metabolic
adaptations which increases risk of diabetes,
hypertension and dyslipidaemia in later life.   We
also need to notice the potential reluctance of
population in emerging economies to accept CVD risk
modification diets and behaviours because of
aspirations for affluent lifestyle.

    In summary, the new century draws on a period of
challenge and opportunity for the developing countries
as they embark on their efforts to quell the emerging
epidemic of CVD.  National and international efforts
must be coordinated to recognise this epidemic and
respond without delay.



__________________________________________________
Do You Yahoo!?
Get email alerts & NEW webcam video instant messaging with Yahoo! Messenger
http://im.yahoo.com