Are Health Behaviors and Risk Factors for Altherosclerotic Cardiovascular Disease Interrelated Among Older Filipinos in Underserved Communities?

Introduction: Moving individuals toward ideal cardiovascular health through adoption of healthy lifestyle behaviors is critically important for prevention of atherosclerotic cardiovascular disease (ASCVD) and other important health conditions. However, associations between health behaviors and risks for ASCVD is poorly understood among older adults (≥ 60 years) living in rural areas in the Philippines. Likewise, their access to healthcare and health-seeking practices are unknown. Purpose: To 1) compare risk profiles of Filipinos at low- vs. moderate to high-risk for ASCVD; and 2)examine the relationships befiveen demographic variables, risk profiles, and health behaviors. Methods: A convenient sample of 427 Filipinos (≥ 60 years old) were recruited to participate in this comparative, cross-sectional study. Data on sociodemographic characteristics, risk profiles, and health behaviors (e.g., dietary patterns, physical activity, smoking status,and alcohol use)were collected. Results: Of the 427 participants (mean age was 69.2± 6.7 years, primarily women [65%], married [52.8%]), 319 (75%) were at low-risk and 108 (25%) were at moderate to high-risk for ASCVD. Those at moderate to high-risk were more likely to have cardiometabolic diseases(e.g., hypertension, hyperlipidemia, diabetes, and obesity, all p's < .001).Health behaviors did not differ between the two groups except for consumption of≥ 5 servings of fruit which was higher in the low-risk group. Conclusion: Findings showed that there is highly consistent and convergent evidence that older Filipinos living in rural areas are at high risk for ASCVD and other health conditions. Much of this is attributable to the suboptimal implementation of prevention strategies, uncontrolled ASCVD risk factors, and poor access to effective and equitable healthcare services commonly observed in low-income countries. Clinicians, researchers, policy makers, and other stakeholders need to address these issues to improve primary and secondary prevention and disease management in this population.