Prevalence of a healthy lifestyle among individuals with cardiovascular disease in high-, middle- and low-income countries: The Prospective Urban Rural Epidemiology (PURE) study

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dc.contributor.authorTeo, Koon
dc.contributor.authorLear, Scott
dc.contributor.authorIslam, Shofiqul
dc.contributor.authorMony, Prem
dc.contributor.authorDehghan, Mahshid
dc.contributor.authorLi, Wei
dc.contributor.authorRosengren, Annika
dc.contributor.authorLopez-Jaramillo, Patricio
dc.contributor.authorDiaz, Rafael
dc.contributor.authorOliveira, Gustavo
dc.contributor.authorMiskan, Maizatullifah
dc.contributor.authorRangarajan, Sumathy
dc.contributor.authorIqbal, Romaina
dc.contributor.authorIlow, Rafal
dc.contributor.authorPuoane, Thandi
dc.contributor.authorBahonar, Ahmad
dc.contributor.authorGulec, Sadi
dc.contributor.authorDarwish, Ebtihal A.
dc.contributor.authorLanas, Fernando
dc.contributor.authorVijaykumar, Krishnapillai
dc.contributor.authorRahman, Omar
dc.contributor.authorChifamba, Jephat
dc.contributor.authorHou, Yan
dc.contributor.authorLi, Ning
dc.contributor.authorYusuf, Salim
dc.date.accessioned2017-04-04T10:11:14Z
dc.date.available2017-04-04T10:11:14Z
dc.date.issued2013
dc.description.abstractImportance: Little is known about adoption of healthy lifestyle behaviors among individuals with a coronary heart disease (CHD) or stroke event in communities across a range of countries worldwide. Objective: To examine the prevalence of avoidance or cessation of smoking, eating a healthy diet, and undertaking regular physical activities by individuals with a CHD or stroke event. Design, Setting, and Participants Prospective Urban Rural Epidemiology (PURE) was a large, prospective cohort study that used an epidemiological survey of 153 996 adults, aged 35 to 70 years, from 628 urban and rural communities in 3 high-income countries (HIC), 7 upper-middle-income countries (UMIC), 3 lower-middle-income countries (LMIC), and 4 low-income countries (LIC), who were enrolled between January 2003 and December 2009. Main Outcome: Measures smoking status (current, former, never), level of exercise (low, 600 metabolic equivalent task [MET]-min/wk; moderate, 600-3000 MET-min/wk; high, 3000 MET-min/wk), and diet (classified by the Food Frequency Questionnaire and defined using the Alternative Healthy Eating Index). Results: Among 7519 individuals with self-reported CHD (past event: median, 5.0 [interquartile range {IQR}, 2.0-10.0] years ago) or stroke (past event: median, 4.0 [IQR, 2.0-8.0] years ago), 18.5% (95% CI, 17.6%-19.4%) continued to smoke; only 35.1% (95% CI, 29.6%-41.0%) undertook high levels of work- or leisure related physical activity, and 39.0% (95% CI, 30.0%-48.7%) had healthy diets; 14.3% (95% CI, 11.7%-17.3%) did not undertake any of the 3 healthy lifestyle behaviors and 4.3% (95% CI, 3.1%-5.8%) had all 3. Overall, 52.5% (95% CI, 50.7%-54.3%) quit smoking (by income country classification: 74.9% [95% CI, 71.1%-78.6%] in HIC; 56.5% [95% CI, 53.4%-58.6%] in UMIC; 42.6% [95% CI, 39.6%-45.6%] in LMIC; and 38.1% [95% CI, 33.1%-43.2%] in LIC). Levels of physical activity increased with increasing country income but this trend was not statistically significant. The lowest prevalence of eating healthy diets was in LIC (25.8%; 95% CI, 13.0%-44.8%) compared with LMIC (43.2%; 95% CI, 30.0%- 57.4%), UMIC (45.1%, 95% CI, 30.9%-60.1%), and HIC (43.4%, 95% CI, 21.0%- 68.7%). Conclusion and Relevance: Among a sample of patients with a CHD or stroke event from countries with varying income levels, the prevalence of healthy lifestyle behaviors was low, with even lower levels in poorer countries.en_US
dc.description.accreditationISIen_US
dc.identifier.citationTeo, K. et al. (2013). Prevalence of a healthy lifestyle among individuals with cardiovascular disease in high-, middle- and low-income countries: The Prospective Urban Rural Epidemiology (PURE) study. JAMA, 309(15): 1613 - 1621en_US
dc.identifier.issn0098-7484
dc.identifier.urihttp://hdl.handle.net/10566/2723
dc.identifier.urihttp://dx.doi.org/10.1001/jama.2013.3519
dc.language.isoenen_US
dc.privacy.showsubmitterFALSE
dc.publisherAmerican Medical Associationen_US
dc.rightsAll JAMA articles reporting original research are made freely available 6 months after publication (see Public Access), subject to certain conditions. Authors who submit their manuscripts to an approved public repository...must indicate that the content may not be made available to the public sooner than 6 months after publication in the journal. If authors adhere to these requirements, they may submit the final accepted version of the manuscript or a published copy of the article to the repository, if and only if the repository ensures that the deposited manuscript will not be made available to the public during the 6-month embargo following publication in the journal.
dc.status.ispeerreviewedTRUE
dc.subjectHealthy lifestyleen_US
dc.subjectCardiovascular diseaseen_US
dc.subjectCommunitiesen_US
dc.titlePrevalence of a healthy lifestyle among individuals with cardiovascular disease in high-, middle- and low-income countries: The Prospective Urban Rural Epidemiology (PURE) studyen_US
dc.typeArticleen_US

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