A review of cardiovascular diseases in developing countries

ABSTRACT

This review examines the possible association in undeveloped and developing communities between 'development' and blood pressure, coronary heart disease and rheumatic heart disease. Previous studies have shown that hypertension is rare and coronary heart disease almost unknown in many of the more isolated and less developed communities, whilst rheumatic heart disease is relatively common. Consideration is given to the possibility that development in such communities may lead to a higher incidence of hypertension and coronary heart disease and to a reduction in the amount of rheumatic heart disease. Epidemiological methods for separating environmental and genetic causes are discussed. Some more recent studies in genetically different 'primitive' groups are reviewed, and then methods are discussed for the control of the genetic component, based on the examination of one genetic group living at different levels of development, either at the same time or at different times. The advantages of using migrant studies are outlined and some examples are given. The evidence appears to favour the hypothesis that development is associated with a greater incidence of hypertension and coronary heart disease, but there is little to suggest that the incidence of rheumatic heart disease is decreasing with development (AU)