Population attributable risk fraction for major cardiovascular risk factors for coronary artery disease and stroke in Palestinians living in and out camps in the Gaza Strip
Résumé
Background: Epidemiological data on cardiovascular diseases in Palestine are scarce. We aimed toestimate the attributable risk of major modifiable cardiovascular risk factors contributing to prevalentcoronary artery disease (CAD) and stroke in the Palestinian population in Gaza. More specifically, wecompared the population living in and out of camps to assess the potential influence of this specificenvironmental parameter on cardiovascular epidemiology.Methods: The prevalence of cardiovascular risk factors and their association with CAD and stroke werestudied in a cross-sectional study carried out in the Gazan community among 2240 participants, aged ≥25 years. The population attributable risk fractions (PARF) were calculated using an adjusted odds ratiofor CAD and stroke.Results: The PARF of hypertension, diabetes and low physical activity were respectively at 33.8%(95%CI, 24.8-46.1), 22.3% (95% CI,16.3-30.4) and 16.2% (95% CI,11.9-22.0) for CAD. For stroke,hypertension, diabetes and high level of triglycerides had the highest impact, with PARF reaching 54.4%(95% CI, 32.1-95.1), 39.4% (95%CI,23.9-64.9), and 30.7% (95% CI,18.6-50.6), respectively.Hypertension, diabetes, low PA, and obesity were the factors with the strongest impact on CAD andstroke in women. When comparing the PARF in a population living in camps and those living out ofcamps, hypertension and diabetes remained the risk factors with the highest PARF for CAD or stroke inpersons living in both areas with a slight difference.Conclusion: A majority of CAD and stroke cases are attributable to major cardiovascular risk factors inthe Gazan population. Interventions to reduce cardiovascular disease occurrence should primarily focuson the control of hypertension, diabetes, and obesity as preventable risk factors in this setting.