Self-reported prevalence of heart attacks and strokes in Jamaica: a cross-sectional study. The Jamaica Health and Lifestyle Survey 2007–2008

Trevor S Ferguson¹, Novie OM Younger¹, Nadia D Morgan², Marshall K Tulloch-Reid¹, Shelly R McFarlane¹, Damian K Francis¹, Andriene Grant³, Eva Lewis-Fuller³, Rainford J Wilks^1
1Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston, Jamaica; ²Department of Internal Medicine, SUNY Downstate Medical Center, Brooklyn, New York, NY, USA; ³Ministry of Health, Kingston, Jamaica

Purpose: Although heart attacks and strokes are among the three leading causes of death in Jamaica, their prevalence among Jamaican adults is not known. This study aims to estimate the prevalence of these conditions and their association with known cardiovascular disease (CVD) risk factors, including age, hypertension, diabetes, overweight/obesity, and hypercholesterolemia.
Participants and methods: A national survey of 2848 Jamaicans aged 15–74 years was performed between 2007 and 2008. An interviewer-administered questionnaire was used to collect data on demographic characteristics, educational achievement, medication history, and social habits, including smoking and alcohol use. Participants were specifically asked whether they had been diagnosed with a heart attack or stroke. Blood pressure, anthropometry, fasting glucose, and total cholesterol were measured by the trained interviewers. Heart attack and stoke prevalence estimates were adjusted for the complex survey design and the age and sex distribution of the Jamaican population.
Results: The estimated prevalence of heart attacks was 0.7% (95% confidence interval [CI] 0.4%–1.2%) (0.9% for men; 0.4% for women) and of strokes was 1.4% (CI 1.0%–1.9%) (1.2% for men; 1.5% for women) with no significant sex differences. The prevalence of reported heart attacks increased with age and was more common in those with hypercholesterolemia. The prevalence of strokes was highest among people aged 55–74 years; those with primary education only; those with hypertension, diabetes, or hypercholesterolemia; former smokers; and former drinkers. In multivariable logistic regression models adjusted for age, sex, and body mass index (BMI), reported heart attacks were higher in men, older participants, and those with secondary education and lower in current drinkers. In similar models, strokes were positively associated with diabetes, hypercholesterolemia, and past alcohol use, after adjusting for age, sex, and BMI.
Conclusion: The overall prevalence of self-reported heart attacks and strokes is low in Jamaica but higher among people with CVD risk factors.

Keywords: heart attack, stroke, Jamaica, cardiovascular disease