ABSTRACT
Cardiovascular disease, including coronary artery disease (CAD) and stroke, is the leading cause of death worldwide (WHO, 2011). Over 80% of cardiovascular disease deaths take place in low-and middle-income countries and occur almost equally in men and women. According to INTERHEART, modifi able risk factors are implicated in almost all CAD mortality (Yusuf et al., 2004). INTERHEART was a standardized case-control study of acute myocardial infarction (MI) carried out in 52 countries and including every inhabited continent. The study compared 15,152 post-MI cases with 14,820 age-and sex-matched control participants in terms of self-reported smoking, hypertension, diabetes, psychosocial factors, physical activity, dietary patterns, and consumption of alcohol as well as measurements of adiposity and apolipoproteins. The investigators found that the above nine potentially modifi able risk factors accounted for more than 90% of the population attributable risk for an acute initial MI. These risks held for men and women, across geographic regions and for all racial and ethnic groups. It is important to note that daily consumption of fruits or vegetables, moderate or strenuous exercise, and moderate consumption of alcohol were found to be protective.
