Abstract
AIM: Despite the high likelihood of comorbidity from shared risk factors, the cardiovascular disease (CVD) risk, based on the combined presence of key risk factors, in people with diabetes mellitus is poorly understood. Thus, this study quantifies the composite CVD risk and its association with sociodemographic factors in people living with diabetes mellitus in Africa. METHODS: Using the WHO STEPwise approach to noncommunicable diseases risk factor Surveillance (STEPS) data and generalized linear mixed models, we analyzed CVD risk in 4738 nonpregnant adults with diabetes in Africa. The composite CVD risk was measured with the STEPS-CARDIO index, which includes smoking, overweight/obesity, hypertension, physical activity, and diet. RESULTS: The mean STEPS-CARDIO score ranged from 2 to 3.22, signifying that, on average, people with diabetes in the included countries had a medium risk of developing CVD. Higher CVD risk was observed with increasing age [odds ratio (OR): 1.03, 95% confidence interval (CI): 1.02-1.04], and among women compared with men (OR: 1.20, 95% CI: 1.05-1.38). Other factors - education, marital status, occupation, and household size - were also generally associated with elevated CVD risk, but being a student (compared to being employed) was associated with lower risk (OR: 0.51, 95% CI: 0.31-0.86). Additional analyses suggested that this protective association was partly age-driven, as most students were younger than 30 years. CONCLUSION: Findings highlight gendered and social differences in CVD risk among people with diabetes mellitus in Africa, underscoring the need for tailored preventive interventions.