Summary
The occurrence of cardiovascular diseases (CVD) and related risk factors was evaluated in Seychelles, a middle level income country, as accumulating evidence supports increasing rates of CVD in developing countries, CVD mortality was obtained from vital statistics for two periods, 1984–5 and 1991–3, CVD morbidity was estimated by retrospective review of discharge diagnoses for all admissions to medical wards in 1990–1992. Levels of CVD risk factors in the population were assessed in 1989 through a population-based survey. In 1991–93, standardized mortality rates were in males and females respectively, 80.9 and 38.8 for cerebrovascular disease and 92.9 and 47.0 for ischemic heart disease. CVD accounted for 25.2% of all admissions to medical wards. Among the general population aged 35–63, 30% had high blood pressure, 52% of males smoked, and 28% of females were obese. These findings substantiate the current health fransition to CVD in Seychelles. More generally, epidemiologic data on CVD mortality, morbidity, and related risk factors, as well as similarindicators for other chronic diseases, should more consistently appear in national and international reports of human development to help emphasize, in the health policy making scene, the current transition to chronic diseases in developing countries and the subsequent need for appropriate control and prevention programs.
Zusammenfassung
Während zwei Perioden wurden in den Seychellen Daten über Herz kreislaufkrankheiten (HKK) erhoben. Die Mortalitätsdaten stammen von den Mortalitätsstatistiken. Morbiditätsdaten Wurden mittels einer retrospektiven Studie der Spitalaustrittsdiagnosen erfasst. Den Risikofaktoren für HKK wurde in einer Bevölkerungserhebung nachgegangen. 1991 bis 1993 betrugen die standardisierten Mortalitätsraten für zerebrovaskuläre Krankheiten 80,9 (Männer) und 38,8 (Frauen), für die koronare Herzkrankheit 92,9 (Männer) und 47,0 (Frauen). HKK machten 25,2% aller Spitaleinweisungen aus. In der 35 bis 64 jährigen Bevölkerung wiesen 30% eine Hypertonie auf; 52% der Männer waren Raucher und 28% der Frauen waren übergewichtig. Aus den erhobenen. Daten geht hervor, dass sich den Seychellen ein Übergang zur HKK absoielt. Generell sollte dieser epidemiologische Übergang zu chronischen Krankheiten, wie man sie in den Entwicklungsländern sieht, vermehrt in Betracht gezogen werden, wenn auf nationaler und internationaler Ebene die Gesundheitspolitik entschieden wird.
Résumé
L'apparition des maladies cardio-vasculaires (MCV) et leurs facteurs de risque ont été évalués aux Seychelles, pays à niveau de revenu intermédiaire entre les pays en voie de développement (PVD) et les pays industrialisés. En effet, des éléments de plus en plus nombreux attestent d'une augmentation de l'incidence des MCV dans certains pays en développement. La mortalité par maladies cardio-vasculaires a été mesurée à partir des statistiques vitales pour les periodes 1984–85 et 1991–93. La morbídité a été estimée rétrospectivement sur la base des lettres de sorties de toutes les admissions des hôpitaux de 1990–92. Le niveau des facteurs de risque dans la population a été évalué en 1989 dans le cadre d'une étude spécifique. Durant la période 1991–93, les taux de mortalité standardisés étaient de 80.9 et 38.8 pour les maladies cérébrovasculaires et de 92.9 et 47.0 pour les MCV chez les hommes et les femmes respectivement. Les MCV représentaient 25.2% des admissions hospitalières. Pour les facteurs de risque dans la population générále de 35–64 ans, on comptait 30% d'hypertension artérielle, 52% de fumeurs chez les hommes, alors que 28% des femmes etaient obèses Ces chiffres vont dans le sens d'une situation dite de transition pour les MCV aux Seychelles. Plus généralement les données épidémiologìques concemant la mortalité, la morbidité et les facteurs de risques cardiovasculaires ainsi que des éléments concernant les autres maladies chroniques, devraient apparaitre plus systermatiquement dans les rapports statistiques nationaux et internationaux. On pourrait de cette façon mieux mettre en évidence la transition épidémiologique vers les maladies chroniques dans les PVD et défendre la nécessité d'en tenir compte dans les politiques de santé ainsi que dans les programmes de prevention.
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Pascal Bovet for the Investigators of the Seychelles Heart Study. The epidemiologic transition to chronic diseases in developing countries: Cardiovascular mortality, morbidity, and risk factors in Seychelles (Indian Ocean). Soz Präventivmed 40, 35–43 (1995). https://doi.org/10.1007/BF01615660
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DOI: https://doi.org/10.1007/BF01615660