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Differences in the association of cardiovascular risk factors with education: a comparison of Costa Rica (CRELES) and the USA (NHANES)
(J Epidemiol Community Health 2010: 64, 2009) Rehkopf, David H.; Dow, William H.; Rosero Bixby, Luis
Background Despite different levels of economic development, Costa Rica and the USA have similar mortalities among adults. However, in the USA there are substantial differences in mortality by educational attainment, and in Costa Rica there are only minor differences. This contrast motivates an examination of behavioural and biological correlates underlying this difference. Methods The authors used data on adults aged 60 and above from the Costa Rican Longevity and Healthy Ageing Study (CRELES) (n¼2827) and from the US National Health and Nutrition Examination Survey (NHANES) (n¼5607) to analyse the cross-sectional association between educational level and the following risk factors for cardiovascular disease (CVD): ever smoked, current smoker, sedentary, high saturated fat, high carbohydrates, high calorie diet, obesity, severe obesity, large waist circumference, HDL cholesterol, LDL cholesterol, triglycerides, hemoglobin A1c, fasting glucose, C-reactive protein, systolic blood pressure and BMI. Results There were significantly fewer hazardous levels of risk biomarkers at higher levels of education for more than half (10 out of 17) of the risk factors in the USA, but for less than a third of the outcomes in Costa Rica (five out of 17). Conclusions These results are consistent with the context-specific nature of educational differences in risk factors for CVD and with a non-uniform nature of association of CVD risk factors with education within countries. Our results also demonstrate that social equity in mortality is achieved without uniform equity in all risk factors.
Factores de riesgo cardiovascular y condiciones socioeconómicas y sociodemográficas en México, 2000 –2018 = Cardiovascular risk factors and socioeconomic and sociodemographic conditions inMexico, 2000 –2018
(Población y Salud en Mesoamérica, Volumen 18, no. 2, Artículo científico, enero-junio, 2021) Lozano Keymolen, Daniel; Gaxiola Robles Linares, Sergio Cuauhtémoc
Introducción:En países de ingresos altos, el nivel socioeconómico se relaciona con diferencias en la prevalencia e incidencia de los factores de riesgo cardiovascular. En países de ingresos medios como México, la evidencia es menor por lo que el objetivo del estudio fue estimar las tendencias en las prevalencias de seis de los principales factores modificables de riesgo cardiovascular; a saber,diabetes, hipertensión arterial, colesterol elevado, consumo de tabaco, consumo de alcohol y obesidad, según el nivel de condiciones socioeconómicas en el hogar y su asociación con determinados factores sociodemográficos entre personas adultas de 20 y más años en el periodo 2000-2018.Método:Los datos se obtuvieron de cuatro encuestas de salud de tipo transversal, representativas a nivel nacional. Con muestras individuales de cada encuesta,se estimaron las prevalencias de los factores de riesgo cardiovascular. Con un análisis por conglomerados se determinaron tres niveles de condiciones socioeconómicas. En cada muestra, con regresiones logísticas,se estimaron las prevalencias de cada factor de riesgo,según el nivel socioeconómico determinado por cada conglomerado ajustando por sexo, edad y escolaridad. Resultados: A diferencia de la diabetes, la hipertensión,el colesterol o la obesidad, el consumo de tabaco y de alcohol ha disminuido. La obesidad, la hipertensión arterial, el consumo de tabaco o de alcohol y el colesterol elevado mostraron diferencias entre los niveles alto y bajo de condiciones socioeconómicas en los cuatro puntos analizados, pero no la diabetes. Conclusión: Deben consolidarse programas y políticas enfocadas a la modificación, atención y tratamiento médico de los factores de riesgo cardiovascular. Introduction:In high-income countries, socioeconomic status is related to differences in the prevalence and incidence of cardiovascular risk factors. In middle-income countries like Mexico, the evidence is less so the objective of the study wasto estimate the trends in the prevalences of sixof the main modifiable cardiovascular risk factors: diabetes, hypertension,high cholesterol, tobacco use, alcohol use, and obesity, according tothe levelofsocioeconomic conditions at homeamong adults 20 years of age and overin the period 2000-2018. Method:The data were obtained from four nationally representative cross-sectional health surveys. With individual samples from each survey, the prevalences of cardiovascular risk factors were estimated. With a cluster analysis, three levels of socioeconomic conditions were determined. In each sample, with logistic regressions, the prevalences of each risk factor were estimated according to the socioeconomic level determined by each cluster, adjusting for sex, age, and education.Results:Unlike diabetes, hypertension, cholesterol or obesity, tobacco and alcohol consumption have decreased. Obesity, arterial hypertension, tobacco or alcohol consumption and high cholesterol showed differences between the high and low levels of socioeconomic conditions in the four points analyzed, but not diabetes. Conclusion:Programs and policies focused on the modification, care and medical treatment of cardiovascular risk factors should be consolidated.
Major cardiovascular risk factors in Latin America: a comparison with the United States. The Latin American consortium of studies in obesity (LASO)
(PLOS ONE, vol.8(1), 2013) Miranda Montero, Jaime J.; Herrera Galindo, Víctor Mauricio; Chirinos Medina, Julio A.; Gómez Gutiérrez, Luis Fernando; Perel, Pablo; Pichardo Estevez, Rafael; González Medina, Angel; Sánchez Abanro, José Ramón; Ferreccio, Catterina; Aguilera Sanhueza, Ximena; Silva, Eglé; Oróstegui, Myriam; Medina Lezama, Josefina; Pérez, Cynthia M.; Suárez, Erick; Ortiz Martínez, Ana Patricia; Rosero Bixby, Luis; Schapochnik, Noberto; Ortiz, Zulma; Ferrante, Daniel; Casas, Juan P.; Bautista Lorenzo, Leonelo Enrique
Limited knowledge on the prevalence and distribution of risk factors impairs the planning and implementation of cardiovascular prevention programs in the Latin American and Caribbean (LAC) region. For the last two decades cardiovascular diseases have been the main cause of death in Latin America and the Caribbean (LAC). [1] Cardiovascular mortality rates continue to increase in most LAC countries, and in those countries where rates have declined the blunting of the trend has been considerably lower than in the United Sates (US). [2]. Data on the distribution of cardiovascular risk factors in LAC region are limited, and the few studies available show significant variation in the levels of prevalence. For instance, the CARMELA study, [3] conducted in seven major urban cities from LAC, reprted markedly different hypertension levels. For instance, hypertension prevalence in Santiago (Chile), Buenos Aires (Argentina), and Barquisimeto (Venezuela), ranged from 24% to 29%, whereas in Quito (Ecuador), Bogotá (Colombia), Mexico City (Mexico), and Lima (Peru) varied from 9% to 13%. Yet, diabetes prevalence in these cities was similar to world’s estimates, around 7%. [3] Differences in rural-urban residence, socioeconomic development, and internal migration patterns could partly explain the contrasting profiles of cardiovascular risk factors, but knowledge on this regard is also very limited. This scarcity of data on the distribution of risk factors and, in turn, on their impact on incidence and mortality hampers efforts to curtail the growing epidemic of cardiovascular disease in LAC. In fact, national and regional health policies have been customarily based on estimates of the burden of risk factors and disease that rely heavily on demographic profiles. [4]. Here we reprt the distribution of cardiovascular risk factors using data from population-based studies from eight LAC countries. We also compare the distribution of cardiovascular risk factors in LAC and the US, as a way to illustrate the current stage of LAC in the process of the epidemiological transition. Insight into the specific differences in the distribution of risk factors in the LAC and US populations is important to foresee future trends in cardiovascular morbidity and mortality in the region.
Pulse blood pressure and cardiovascular mortality in a population-based cohort of elderly Costa Ricans
(Journal of Human Hypertension; Volumen 30, Número 9, 2016) Rosero Bixby, Luis; Coto Yglesias, Fernando; Dow, William H.
We studied the relationships between blood pressure (BP), pulse pressure (PP) and cardiovascular (CV) death in older adults using data from 2346 participants enrolled in the Costa Rican CRELES study, mean age 76 years (s.d. 10.2), 31% qualified as wide PP. All covariates included and analyzed were collected prospectively as part of a 4-year home-based follow-up; mortality was tracked for an additional 3 years, identifying 266 CV deaths. Longitudinal data revealed little change over time in systolic BP (SBP), a decline in diastolic BP, and widening of PP. Wide PP was associated with higher risk of CV death but only among individuals receiving antihypertensive drug therapy. Individuals with both wide PP and receiving therapy had 2.6 hazard rate of CV death relative to people with normal-PP plus not taking treatment (TRT), even adjusting for SBP. Increasing PP between visits was significantly associated to higher CV death independently of TRT status. SBP and DBP were not significantly associated to CV death when the effect of PP was controlled for. Conclusion: elderly hypertensive patients with wide or increasing PP, especially if receiving TRT, are the highest CV risk group, thus must be carefully assessed, monitored and treated with caution.

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Examinando Enfermedades crónicas por Materia "ENFERMEDADES CARDIOVASCULARES"

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