Multiple cardiometabolic risk factors in the Southern Cone of Latin America: A population-based study in Argentina, Chile, and Uruguay

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Highlights

  • Cardiovascular disease risk factors are highly prevalent in the general population in the Southern Cone of Latin America.

  • The prevalences of obesity, hypertension, dyslipidemia, and diabetes were 35.7%, 40.8%, 58.4%, and 12.4%, respectively.

  • The prevalence of metabolic syndrome was 37.4%.

  • The proportion of individuals with ≥ 3 cardiovascular risk factors was 68.3%.

Abstract

Background

Cardiovascular disease is a major cause of death, and its mortality is increasing in Latin America. However, population-based data on cardiovascular disease risk factors are sparse in these countries.

Methods

A total of 7524 men and women, aged 35 to 74 years old, were recruited between February 2010 and December 2011 from randomly selected samples in 4 cities (Bariloche and Marcos Paz, Argentina; Temuco, Chile; and Pando-Barros Blancos, Uruguay) in the Southern Cone of Latin America. Cardiovascular risk factors were measured using standard methods by trained and certified observers.

Results

Approximately 85.5% of adults ate less than five servings of fruit or vegetables per day, 35.2% engaged in low physical activity, and 29.7% currently smoked cigarettes. The prevalences of obesity, central obesity, hypertension, chronic kidney disease, dyslipidemia, diabetes, and metabolic syndrome were 35.7%, 52.9%, 40.8%, 2.0%, 58.4%, 12.4%, and 37.4%, respectively. The proportion of individuals with ≥ 3 cardiovascular risk factors, including low intake of fruit and vegetables, low physical activity, current cigarette smoking, obesity or central obesity, hypertension, chronic kidney disease, dyslipidemia, and diabetes, was 68.3%, and the proportion of individuals with ≥ 3 cardiometabolic risk factors, including obesity or central obesity, hypertension, chronic kidney disease, dyslipidemia, and diabetes, was 22.9%.

Conclusions

Cardiovascular disease risk factors are highly prevalent in the general population in the Southern Cone of Latin America. These data suggest that national efforts on the prevention, treatment, and control of cardiovascular risk factors should be a public health priority in the Southern Cone of Latin America.

Introduction

Coronary heart disease (CHD) and stroke are the leading causes of deaths worldwide, collectively killing 12.9 million people in 2010, or one in four deaths [1]. Low- and middle-income countries (LMIC) are disproportionally affected: over 80% of cardiovascular disease (CVD) deaths occur in LMIC, and almost half of CVD deaths are in people younger than 70 years in these countries [2]. It is estimated that the number of CVD deaths in Latin America will increase by more than 60% between 2000 and 2020 while CVD deaths will increase by only 5% in high-income countries during the same period [3]. In a case–control study of 1237 CHD patients and 1888 controls in South America, abdominal obesity, dyslipidemia, cigarette smoking, and hypertension were associated with high population-attributable risks of 48.5%, 40.8%, 38.4%, and 32.9%, respectively [4]. These risk factors jointly accounted for 88% of the population-attributable risk. However, population-based data on the prevalence of these risk factors are sparse in Argentina, Chile and Uruguay. Furthermore, the limited available information on CVD risk factors in these populations was predominantly from studies based on self-reported data [5], [6] or conducted in small convenience samples [7]. Self-reported CVD risk factors do not provide reliable estimates of disease burden because they are influenced by access to healthcare and other factors [8].

The CESCAS (Centro de Excelencia en Salud Cardiovascular para el Cono Sur) I study is a population-based study aimed to examine CVD and risk factors in the general population from four representative cities in the Southern Cone of Latin America [9]. Specifically, the objectives of the present analysis are to provide current and reliable data on population levels of behavioral and metabolic risk factors for CVD and to assess the distribution of multiple CVD risk factors in the general adult population in the Southern Cone of Latin America.

Section snippets

Study participants

The details of study design and sampling method of the CESCAS I study have been published earlier [9]. Briefly, 7524 women and men, aged 35 to 74 years old, were recruited between February 2010 and December 2011 from randomly selected samples in 4 small to mid-sized cities in the Southern Cone of Latin America: two cities located in Argentina (Bariloche and Marcos Paz), one in Chile (Temuco), and one in Uruguay (Pando-Barros Blancos). Marcos Paz and Pando-Barros Blancos are small cities with

Demographic and behavioral risk factors

The demographic and behavioral risk factors in the general population aged 35–74 years in the Southern Cone of Latin America are presented in Table 1. Approximately 52.3% individuals did not graduate from high school (52.4% in men and 52.2% in women), 6.0% were unemployed (5.1% in men and 6.8% in women), and 56.2% did not report to have social security or private health insurance (54.8% in men and 57.4% in women).

Approximately 85.5% of adults (89.8% men and 81.7% women) aged 35–74 years in the

Discussion

Our study indicates that behavioral and metabolic risk factors for CVD are high in the general adult population of the Southern Cone of Latin America. For example, 68.3% of individuals have three or more risk factors, including low intake of fruit and vegetables, low physical activity, current cigarette smoking, obesity or central obesity, hypertension, CKD, dyslipidemia, and diabetes. Furthermore, 77.0% of individuals are overweight or obese, 52.9% have central obesity, 40.8% have

Conflict of interest

None declared.

Acknowledgments

The authors would like to acknowledge gratefully the contribution of all CESCAS I study staff. We also acknowledge the editorial assistance of Miss Katherine Obst.

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    Acknowledgement of grant support: This work was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under contract no. 268200900029C.

    1

    This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

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