1
|
Montalvan-Sanchez EE, Rodriguez-Murillo A, Carrasco-Stoval T, Carrera K, Beas R, Giron R, Jerez-Moreno V, Soriano-Turcios RA, Reyes-Guerra O, Torres K, Izquierdo-Veraza D, Torres T, Beran AA, Montalvan-Sanchez D, Norwood DA. Prevalence of Obesity and Metabolic Syndrome in the High Cardiovascular Risk Setting of Rural Western Honduras. Ethn Dis 2023; 33:124-129. [PMID: 38845737 PMCID: PMC11145726 DOI: 10.18865/ed.33.2-3.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Objective To determine the prevalence of obesity and metabolic syndrome (MS) in the population older than 45 years in rural Western Honduras and contribute to the limited literature on MS in Central America. Methods Descriptive cross-sectional study conducted in the District of Copan. The study includes 382 men and women aged 45 to 75 years. With proper consent, anthropometric parameters, blood pressure, blood sugar, and lipid profile were evaluated. MS was diagnosed by using the National Cholesterol Education Program Criteria - Adult Panel Treatment III (NCEP-ATP III). Data were stored in REDCap (Research Electronic Data Capture) and analyzed with STATA14. Results Data were collected on 382 patients; of these, 38% were male and 62% female. The prevalence of obesity was 24.1% for both sexes. The prevalence of MS was 64.9%. Prevalence in males and females was 54% and 71%, respectively. Notable parameters were elevated triglycerides (71%), low High-density lipoprotein cholesterol (HDL-C) (63.4%), and abdominal obesity (56.8%). In men, the distribution of MS was more homogeneous, with a mean result of 80% amongst all ages. Conclusions The overall prevalence of obesity and MS is severely underestimated in rural Honduras. The most remarkable parameter for MS was high triglycerides (71%). Sixty-nine percent of the population has above-normal Body Mass Index (BMI). Public health efforts to control comorbidities and tackle risk factors in this population should take utmost priority.
Collapse
Affiliation(s)
- Eleazar E. Montalvan-Sanchez
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
- Western Honduras Gastric Cancer Prevention Initiative, Hospital de Occidente, Santa Rosa de Copan, Honduras
| | - Aida Rodriguez-Murillo
- Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
- Western Honduras Gastric Cancer Prevention Initiative, Hospital de Occidente, Santa Rosa de Copan, Honduras
| | - Tiffani Carrasco-Stoval
- Western Honduras Gastric Cancer Prevention Initiative, Hospital de Occidente, Santa Rosa de Copan, Honduras
| | - Keila Carrera
- Unidad de Gastroenterologia, Hospital Manuel Nuñez Tovar, Monagas, Venezuela
| | - Renato Beas
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Roberto Giron
- Universidad Evangélica de El Salvador, San Salvador, El Salvador
| | | | | | | | - Karla Torres
- Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | | | - Tatiana Torres
- Division of Gastroenterology and Hepatology, The University of Alabama at Birmingham, Birmingham, AL
| | - Azizullah A. Beran
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | | | - Dalton A. Norwood
- Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
- Western Honduras Gastric Cancer Prevention Initiative, Hospital de Occidente, Santa Rosa de Copan, Honduras
- Division of Preventive Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL
| |
Collapse
|
2
|
Moreira NCDV, Mdala I, Hussain A, Bhowmik B, Siddiquee T, Fernandes VO, Montenegro RM, Meyer HE. Cardiovascular Risk, Obesity, and Sociodemographic Indicators in a Brazilian Population. Front Public Health 2021; 9:725009. [PMID: 34917567 PMCID: PMC8669243 DOI: 10.3389/fpubh.2021.725009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/26/2021] [Indexed: 01/10/2023] Open
Abstract
Background and Aims: Cardiovascular diseases (CVDs) are the leading cause of death globally and in Brazil. Evidence suggests that the risk of CVDs differs by race/ethnicity. Scarce information exists about the association between CVD risk, obesity indicators and sociodemographic characteristics in the Brazilian population. Objectives: We aimed to assess the CVD risk following the Framingham risk score in relation to the population's sociodemographic profile. Further, we examined the association between anthropometric markers and risk of CVDs. Methods: A total of 701 subjects aged ≥20 years from North-eastern Brazil were recruited randomly to participate in a population-based, cross-sectional survey. Age-adjusted data for CVD risk, sociodemographic characteristics, and anthropometric indices were assessed, and their relationships examined. Results: High CVD risk (Framingham risk score ≥10%) was observed in 18.9% of the population. Males (31.9 vs. 12.5%) and older subjects (age ≥45 years: 68.9% vs. age <45 years: 4.2%) had significantly higher risk of CVDs, whereas those employed in manual labor showed lower risk (7.6 vs. 21.7%). Central obesity measures like waist-to-hip ratio and waist-to-height ratio were more strongly associated with predicted CVD risk than body mass index. Conclusions: Our population had a high risk of CVDs using the Framingham risk score. Cost-effective strategies for screening, prevention and treatment of CVDs may likely reduce disease burden and health expenditure in Brazil. Central obesity measures were strongly associated with predicted CVD risk and might be useful in the clinical assessment of patients. Follow-up studies are warranted to validate our findings.
Collapse
Affiliation(s)
- Nayla Cristina do Vale Moreira
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo (UiO), Oslo, Norway.,Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Fortaleza, Brazil.,Faculty of Health Sciences, NORD University, Bodø, Norway
| | - Ibrahimu Mdala
- Department of General Practice, Institute of Health and Society, University of Oslo (UiO), Oslo, Norway
| | - Akhtar Hussain
- Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Fortaleza, Brazil.,Faculty of Health Sciences, NORD University, Bodø, Norway.,Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh.,International Diabetes Federation, Brussels, Belgium
| | - Bishwajit Bhowmik
- Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | - Tasnima Siddiquee
- Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | | | - Renan M Montenegro
- Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Fortaleza, Brazil
| | - Haakon E Meyer
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo (UiO), Oslo, Norway.,Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
3
|
Malta DC, Pinheiro PC, Azeredo RT, Santos FM, Ribeiro ALP, Brant LCC. Prevalence of high risk for cardiovascular disease among the Brazilian adult population, according to different risk calculators: a comparative study. CIENCIA & SAUDE COLETIVA 2021; 26:1221-1231. [PMID: 33886752 DOI: 10.1590/1413-81232021264.01592021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/18/2021] [Indexed: 11/22/2022] Open
Abstract
This study compares the proportion of the Brazilian adult population classified as being at high risk of cardiovascular disease (CVD) based on six different CVD risk calculators in order to assess the agreement across different tools. A cross-sectional study was conducted using laboratory data from the National Health Survey (NHS). The prevalence rates of high 10-year risk of CVD among individuals aged between 45 and 64 years were as follows: Brazilian Society of Cardiology (BSC) global risk score (GRS) - 38.1%; American College of Cardiology/American Heart Association (ACC/AHA) score - 44.1%; Framingham Heart Study/GRS - 19.4%; European Society of Cardiology SCORE - 14.6%; World Health Organization/International Society of Hypertension (WHO/ISH) score - 3.1%; and Lim et al. - 2.5%. The CVD calculators showed poor agreement for the identification of high-risk individuals and a high level of agreement for the identification of low/moderate risk individuals, except for the ACC/AHA risk score. The findings show that the proportion of individuals classified as eligible for preventive drug therapy varies from tool to tool, which could lead to the misinterpretation of risk, poor cost-effectiveness of therapy and difficulty implementing public policies.
Collapse
Affiliation(s)
- Deborah Carvalho Malta
- Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Pedro Cisalpino Pinheiro
- Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Renato Teixeira Azeredo
- Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Filipe Malta Santos
- Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Antonio Luiz Pinho Ribeiro
- Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Luisa Campos Caldeira Brant
- Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| |
Collapse
|
4
|
Avilés-Santa ML, Monroig-Rivera A, Soto-Soto A, Lindberg NM. Current State of Diabetes Mellitus Prevalence, Awareness, Treatment, and Control in Latin America: Challenges and Innovative Solutions to Improve Health Outcomes Across the Continent. Curr Diab Rep 2020; 20:62. [PMID: 33037442 PMCID: PMC7546937 DOI: 10.1007/s11892-020-01341-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/10/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Latin America is the scenario of great inequalities where about 32 million human beings live with diabetes. Through this review, we aimed at describing the current state of the prevalence, awareness, treatment, and control of diabetes mellitus and completion of selected guidelines of care across Latin America and identify opportunities to advance research that promotes better health outcomes. RECENT FINDINGS The prevalence of diabetes mellitus has been consistently increasing across the region, with some variation: higher prevalence in Mexico, Haiti, and Puerto Rico and lower in Colombia, Ecuador, Dominican Republic, Peru, and Uruguay. Prevalence assessment methods vary, and potentially underestimating the real number of persons with diabetes. Diabetes unawareness varies widely, with up to 50% of persons with diabetes who do not know they may have the disease. Glycemic, blood pressure, and LDL-C control and completion of guidelines to prevent microvascular complications are not consistently assessed across studies, and the achievement of control goals is suboptimal. On the other hand, multiple interventions, point-of-care/rapid assessment tools, and alternative models of health care delivery have been proposed and tested throughout Latin America. The prevalence of diabetes mellitus continues to rise across Latin America, and the number of those with the disease may be underestimated. However, some local governments are embedding more comprehensive diabetes assessments in their local national surveys. Clinicians and public health advocates in the region have proposed and initiated various multi-level interventions to address this enormous challenge in the region.
Collapse
Affiliation(s)
- M Larissa Avilés-Santa
- Division of Extramural Scientific Programs, Clinical and Health Services Research at the National Institute on Minority Health and Health Disparities, Bethesda, MD, USA.
| | | | | | | |
Collapse
|
5
|
Belaunzaran-Zamudio PF, Caro-Vega Y, Giganti MJ, Castilho JL, Crabtree-Ramirez BE, Shepherd BE, Mejía F, Cesar C, Moreira RC, Wolff M, Pape JW, Padgett D, McGowan CC, Sierra-Madero JG. Frequency of non-communicable diseases in people 50 years of age and older receiving HIV care in Latin America. PLoS One 2020; 15:e0233965. [PMID: 32555607 PMCID: PMC7299309 DOI: 10.1371/journal.pone.0233965] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 05/15/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND A growing population of older adults with HIV will increase demands on HIV-related healthcare. Nearly a quarter of people receiving care for HIV in Latin America are currently 50 years or older, yet little is known about the frequency of comorbidities in this population. We estimated the prevalence and incidence of non-communicable diseases (NCDs) among people 50 years of age or older (≥50yo) receiving HIV care during 2000-2015 in six centers affiliated with the Caribbean, Central and South American network for HIV epidemiology (CCASAnet). METHODS We estimated the annual prevalence, and overall prevalence and incidence of cardiovascular diseases, diabetes, hypertension, dyslipidemia, psychiatric disorders, chronic liver and renal diseases, and non-AIDS-defining cancers, and multimorbidity (more than one NCD) of people ≥50yo receiving care for HIV. Analyses were performed according to age at enrollment into HIV care (<50yo and ≥50yo). RESULTS We included 3,415 patients ≥50yo, of whom 1,487(43%) were enrolled at age ≥50 years. The annual prevalence of NCDs increased from 32% to 68% and multimorbidity from 30% to 40% during 2000-2015. At the last registered visit, 53% of patients enrolled <50yo and 50% of those enrolled ≥50yo had at least one NCD. Most common NCDs at the last visit in each age-group at enrollment were dyslipidemia (36% in <50yo and 28% in ≥50yo), hypertension (17% and 18%), psychiatric disorders (15% and 10%), and diabetes (11% and 12%). CONCLUSIONS The prevalence of NCDs and multimorbidity in people ≥50 years receiving care for HIV in CCASAnet centers in Latin America increased substantially in the last 15 years. Our results make evident the need of planning for provision of complex, primary care for aging adults living with HIV.
Collapse
Affiliation(s)
- Pablo F. Belaunzaran-Zamudio
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Yanink Caro-Vega
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Mark J. Giganti
- Department of Biostatistics, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Jessica L. Castilho
- Department of Medicine, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Brenda E. Crabtree-Ramirez
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Bryan E. Shepherd
- Department of Biostatistics, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Fernando Mejía
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Rodrigo C. Moreira
- Fundacão Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil
| | - Marcelo Wolff
- Department of Infectious Diseases, Fundación Arriarán, Santiago de Chile, Chile
| | | | - Denis Padgett
- Instituto Hondureño de Seguridad Social, Tegucigalpa, Honduras
| | - Catherine C. McGowan
- Department of Medicine, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Juan G. Sierra-Madero
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | |
Collapse
|
6
|
Scheenstra B, van 't Hof A, Spreeuwenberg M, Linz D. From calculating cardiovascular risk factors in Honduras towards a universal cardiovascular risk model. IJC HEART & VASCULATURE 2020; 27:100485. [PMID: 32310239 PMCID: PMC7154309 DOI: 10.1016/j.ijcha.2020.100485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 02/16/2020] [Indexed: 12/04/2022]
Affiliation(s)
- Bart Scheenstra
- Department of Cardiology. Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Arnoud van 't Hof
- Department of Cardiology. Maastricht University Medical Centre, Maastricht, the Netherlands
- Department of Cardiology, Zuyderland Medical Centre, Heerlen, the Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands
| | - Marieke Spreeuwenberg
- Department of Health Services Research, CAPHRI, Maastricht University, Maastricht, the Netherlands
| | - Dominik Linz
- Department of Cardiology. Maastricht University Medical Centre, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands
- Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| |
Collapse
|