The social transition of risk factors for cardiovascular disease in the African region: evidence from three cross-sectional surveys in the Seychelles

Int J Cardiol. 2013 Sep 30;168(2):1201-6. doi: 10.1016/j.ijcard.2012.11.064. Epub 2012 Nov 30.


Objectives: To examine the association between socioeconomic status (SES) and several cardiovascular disease risk factors (CVRFs) and to assess whether this association has changed over a 15-year observation period.

Methods: Three independent population-based surveys of CVRFs were conducted in representative samples of all adults aged 25-64 years in the Seychelles, a small island state located east to Kenya, in 1989 (N=1081), 1994 (N=1067) and 2004 (N=1255).

Results: Among men, current smoking and heavy drinking were more prevalent in the low versus the high SES group, and obesity was less prevalent. The socioeconomic gradient in diabetes reversed over the study period from lower prevalence in the low versus the high SES group to higher prevalence in the low SES group. Hypercholesterolemia was less prevalent in the low versus the high SES group in 1989 but the prevalence was similar in the two groups in 2004. Hypertension showed no consistent socioeconomic pattern. Among women, the SES gradient in smoking tended to reverse over time from lower prevalence in the low SES group to lower prevalence in the high SES group. Obesity and diabetes were more common in the low versus the high SES group over the study period. Heavy drinking, hypertension and hypercholesterolemia were not socially patterned among women.

Conclusion: The prevalence of several CVRFs was higher in low versus high SES groups in a rapidly developing country in the African region, and an increase of the burden of these CVRFs in the most disadvantaged groups of the population was observed over the 15 years study period.

Keywords: Africa; Cardiovascular risk factors; Low and middle income countries; Social determinants; Survey; Trends.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alcohol Drinking / economics
  • Alcohol Drinking / epidemiology
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / economics*
  • Cardiovascular Diseases / epidemiology*
  • Cross-Sectional Studies / methods
  • Developing Countries / economics*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / diagnosis
  • Obesity / economics
  • Obesity / epidemiology
  • Risk Factors
  • Seychelles / epidemiology
  • Smoking / economics
  • Smoking / epidemiology
  • Social Class