Modern medical services, a double-edged sword manages symptoms, but accumulates genetic background of cardiovascular diseases : a cross populational analysis of 217 countries

Background and Aims: Through reduced natural selection, measured with Biological State Index (Ibs), modern medicine enables most people to survive well beyond the reproductive lifespan leading to deleterious gene accumulation in population. This study explored the role of reduced natural selection in increasing cardiovascular disease (CVD) incidence worldwide. Methods: Country-specific estimates of CVD incidence and the index of reduced natural selection were captured for analysis of their correlation. Aging, affluence, obesity prevalence, and urbanization were considered as the potential confounders in the analyses. Results: Worldwide, Ibs was significantly correlated with CVD incidence in the bivariate correlation analyses. This relationship remains when the contributing effects from aging, affluence, obesity prevalence, and urbanization are removed in partial correlation model. Multiple linear regression (enter) shows that Ibs is a significant predictor of CVD incidence. Stepwise multiple linear regression selects Ibs as the variable having the second greatest influence on CVD incidence after ageing. Ibs showed a significantly greater correlation with CVD incidence in low- and middle-income countries (LMICs) than in high-income countries. Conclusion: Worldwide, through reducing natural selection, the side effects of healthcare services may have been partially contributing to the increase of CVD incidence worldwide with special regard to LMICs.