Review

 

Prevalence of cardiovascular risk factors in Latin America: a review of the published evidence 2010-2015

 

Prevalencia de factores de riesgo cardiovascular en América Latina: una revisión de la evidencia publicada de 2010 a 2015

 

Javier Pereira-Rodríguez,*^,** Devi Peñaranda-Florez,**^,*** Anyerly Reyes-Saenz,** Karla Caceres-Arevalo,** Yair Cañizarez-Pérez**

 

* Physiotherapist, Specialist in Cardiopulmonary Rehabilitation.
** University of Santander, headquarters Cúcuta. Physiotherapy Department, Faculty of Health. Cúcuta, Colombia.
*** Physiotherapist, Specialist in Neurorehabilitation.

 

Correspondence to:
Javier Pereira-Rodriguez
Faculty of Health. University of Santander, headquarters Cúcuta
Address: Avenue 8E #4-105 Quinta Oriental, Cúcuta, 540001, Colombia.
Phone: (037) 3102858873
E-mail: jepr87@hotmail.com

 

Recibido: 27/07/2015
Aceptado: 18/08/2015

 

ABSTRACT

Introduction: There are certain variables that help us to determine the probability of an individual developing cardiovascular disease, those variables are called risk factors. The more risk factors a person has, the more likely of cardiovascular disease. Objectives: To determine prevalence of cardiovascular risk factors in Latin America. Material and methods: A literature review published during the period 2010-2015, with the participation of Latin American countries, of which items were selected in English and Spanish data bases recognized worldwide as PubMed, OMIM, SCIELO, EBSCO and magazines cardiology and public health of each Latin American country. Results: Identified 3,645 articles of which 45 were selected; after examine and evaluate the methodological framework of the 45 articles, the information of these variable allowed did add up the sample of the articles (n = 7,192,262) for conclude than latin american have a higher prevalence of overweight/obesity, physical inactivity, smoking and alcohol intake. Conclusions: In the Latin American population there is a high prevalence of cardiovascular risk factors without significant differences by gender.

Key words: Smoking, obesity, cardiovascular risk factor, Latin America.

 

RESUMEN

Introducción: Existen ciertas variables que nos ayudan a determinar la probabilidad de desarrollo de enfermedades cardiovasculares; estas variables son llamados factores de riesgo. Cuanto más factores de riesgo tenga una persona, mayores probabilidades tendrá de padecer una enfermedad cardiovascular. Objectivos: Determinar la prevalencia de los factores de riesgo cardiovascular en Latinoamérica. Material y métodos: Una revisión bibliográfica de publicaciones durante el periodo 2010-2015, con la participación de paises de Latinoámerica, los cuales fueron seleccionados en inglés y español de bases de datos reconocidas a nivel mundial como PubMed, OMIM, SCIELO, EBSCO y revistas de cardiología y salud pública de cada país latinoamericano. Resultados: Se identificaron 3,645 artículos, de los cuales 45 fueron seleccionados; después de examinar y evaluar el marco metodológico de los 45 artículos, la información de estas variables permitió sumar la muestra de los artículos (n = 7,192,262) para concluir que los latinoamericanos tienen una alta prevalencia de sobrepeso/obesidad, sedentarismo, tabaquismo y alcoholismo. Conclusiones: En la población latinoamericana hay una alta prevalencia de los factores de riesgo cardiovascular sin diferencias significativas por género.

Palabras clave: Tabaquismo, obesidad, factor de riesgo cardiovascular, Latinoamérica.

 

INTRODUCTION

Cardiovascular diseases (CVD) are leading cause of death worldwide. They are associated with both physical and mental disabilities, as well as significant economic costs.¹ It is estimated that about 23.3 million people will die from CVD in 2030, mainly from heart disease and cerebrovascular accidents, and is expected to remain the leading cause of death. Most can be prevented by acting on CVD risk factors such as consumption of snuff, diet, overweight and obesity, physical inactivity, and controlling arterial hypertension (HTA), diabetes mellitus (DM), and dyslipidemia.²

The more risk factors a person presents, the higher the chances are for developing heart disease. Cardiovascular risk factors (CRF) are divided into 2: modifiable and non-modifiable (Table I). Some risk factors can be changed, treated, or modified and others not. But the control of as many risk factors through changes in lifestyle and/or medication, can significantly reduce cardiovascular risk. According to two epidemiological studies and the INTERSTROKE INTERHEART, it seems clear that the main risk factors associated with the presentation of acute myocardial infarction are obesity, dyslipidemia, smoking, and arterial hypertension.³

 

 

Cardiovascular diseases were the direct cause of over 4 million deaths in Europe in 2002. 1.9 million in the European Union, accounting for 43% of all deaths of any age in men and 55% in women.⁴ For this reason, it is best to avoid or reduce that probability,⁵ but it should not be considered as the sole cause, whether as one element among multiple causes that affect cardiovascular health. It is therefore important to know the incidence, morbidity and mortality of cardiovascular diseases.

Studies of noncommunicable diseases in Latin America have largely focused on urban populations and upper middle income countries.⁶ Previous research demonstrates many established cardiovascular disease risk factors in Latin America: aging, hypertension, diabetes/insulin resistance, obesity, dyslipidemia, inactivity, poor diet, and tobacco smoking.^6,7 Men generally show lower levels of awareness, treatment and control of cardiovascular risk factors⁸ and smoke more⁹ while women are more obese.¹⁰

 

MATERIALS AND METHODS

A review of studies on hypertension, smoking, alcohol intake, overweight and obesity, high cholesterol, physical inactivity and diabetes in Latin America was performed.

Inclusion criteria for selecting articles were: a) studies published during the period 2010-2015; b) the study should have evaluated Latin American countries (Argentina, Bolivia, Brazil, Chile, Costa Rica, Colombia, Cuba, Ecuador, El Salvador, Honduras, Guatemala, Mexico, Nicaragua, Panama, Paraguay, Peru, Puerto Rico, Venezuela, Uruguay, Dominican Republic); c) study population should be over 18 years old; e) study population of at least 500 participants; d) articles published in English or Spanish; f) data for each risk factor should have been divided by gender.

Data bases (PubMed, OMIM, SCIELO, EBSCO) and Cardiology and Public Health journals of each Latin American country were used for selection of articles. Search words included: Risk Factors in Latin America, Latin America, Cardiovascular Risk Factors. This search yielded 3,645 results related items CFR in Latin America, of which 2,060 items were excluded in a first filter due to insufficient sample or due to the reviewed risk factors did not meet the primary objective of the investigation. In a subsequent selection filter, 45 articles met all inclusion criteria (Figure 1).

 

 

 

RESULTS

The literature search yielded 3,645 articles of which 45 studies (Table II) -summing a total population of 7,192,262 participants from different countries in Latin America- were selected. Mexico (18.54%) was the country with the highest number of publications on cardiovascular risk factors, followed by Brazil (10.50%), Argentina (9.79%), Chile (8.94%), Colombia (4.25%) and Puerto Rico (2.60%) countries with fewer publications were Nicaragua, Panama, Guatemala, Peru, Venezuela, Dominican Republic, Costa Rica, Cuba, Ecuador, Bolivia and El Salvador (Table III).

 

 

A summary of the incuded studies is included in Table III. Of those 45 scientific papers, 80% (n = 36) had a larger sample of women versus men with 20% (n = 9) of the articles reviewed.

The most frequent cardiovascular risk factor was arterial hipertension (30 art. - 66.6%), overweight/obesity (28 art. 62.2%), diabetes (25 art. - 55.55%) and smoking (24 art. - 53.3%); moreover, it is important to note that the prevalence of overweight/obesity was 53.8%, sedentarism 38.5%, alcoholism and smoking with the 31% each one, dyslipidaemics 29.4%, diabetes 25.1% at the end hypercholesterolemia and arterial hipertension with 21.6% and 14.1% respectively (Table IV).

 

DISCUSSION

The results of this study were from a sample and results obtained in the review of articles selected from the databases.

It is very important the finding of a higher prevalence of risk factors in Latin American women compared with men; like the rise in obesity in women. These data are similar to most items of risk factors aimed at determining the prevalence of obesity in women vs men.

In other studies conducted it has been reported that diabetes is associated with overweight and obesity in both men and mujeres;^11-13 In the present study, we observed the same relationship when the information of the selected items filtered.

The CARMELA study of 2011 (Multiple Cardiovascular Risk Factor Evaluation in Latin America)¹³ undertaken in Mexico City, Bogota and Santiago de Chile yielded similar results regarding risk factors such as abdominal obesity and metabolic syndrome citing a higher prevalence of women compared with men.

The INTERHEART¹⁴ study was of greater magnitude due to realized 52 countries on five continents, with more than 29,000 individuals between cases and controls, which showed that factors most common risk (smoking, dyslipidemia, hypertension, diabetes, central obesity, stress, moderate alcohol intake, regular physical activity and intake of fruits and vegetables) accounted for 90% of the risk attributable to men and 94% of the risk for women.

Snuff consumption, alcohol intake, physical inactivity, obesity, overweight, high cholesterol and diabetes were the most studied in the FRC reviewed articles. The results of this study are similar or different to those reported in previous years on cardiovascular risk factors;¹⁵ hence the importance of updating the epidemiology of cardiovascular risk factors that affect men and women in Latin America; to develop recommendations and strategies to reduce the incidence of these risk factors in the future.

 

CONCLUSIONS

In the Latin American population there is a high prevalence of cardiovascular risk factors, which each day increase their prevalence in the population without age or gender discrimination; the investigations revised in this article shows its high prevalence and equality between men and women. Moreover, it is important to note that overweight/obesity, physical inactivity, smoking and alcohol consumption are the 4 main CRF affecting the population Latin American without significant differences by gender.

These findings highlight the importance of healthy lifestyles and performing exercises regularly during the week, in particular a low calorie diet and consistent exercise program, for enhance caloric expenditure and prevention of cardiovascular diseases. It requires further research to consolidate about the effects and Alterations in cardiovascular risk factors in Latin American population and how exercise can reverse These abnormalities And Also That the exercise and Its recommendations gonna be promoted by health professionals.

 

ACKNOWLEDGEMENTS

Especially to the University of Santander and its teachers who brought their expertise and collaboration to the article, and the students Ana Judith García Rubio, Diana Carolina Moreno Romero, Hector Mancilla Andrés Echeverry, Jeimy Esteffany Mancipe Cruz.

 

REFERENCIAS

1. Sánchez R, Ayala M, Baglivio H, Velásquez C, Burlando G, Kohlmann O, Jimenez J. On behalf of the Latin American Expert Group. Latin American guidelines of hypertension. J Hipertens. 2009; 27: 905-922.         [ Links ]

2. World Health Organization. Cardiovascular diseases [Internet]. 2015 [updated January 2015]. Available from: http://www.who.int/topics/cardiovascular_diseases/en/        [ Links ]

3. López-Jaramillo P, López J. Lecciones aprendidas de dos grandes estudios epidemiológicos de enfermedades cardio-cerebro-vasculares en las que ha participado Colombia. Rev Col Cardiol. 2010; 17 (5): 195-199.         [ Links ]

4. Maroto J, De Pablo C, Rehabilitación Cardiovascular. Madrid: Ed. Medica Panamericana. Chapter 1, Cardiac rehabilitation; p.3.         [ Links ]

5. Ilarraza H, Alvarez M, Mendoza, B. Rehabilitación Cardiaca y Prevención Secundaria. Libro 5 Ciudad de Mexico: Intersistemas Editores; 2004.         [ Links ]

6. Chan JM, Rimm EB, Colditz GA et al. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care. 1994; 17: 961-969.         [ Links ]

7. Acota-Cázares B, Escobedo-de la Peña J. High burden of cardiovascular disease risk factors in Mexico: An epidemic of ischemic heart disease that may be on its way? Am Heart J. 2010; 160 (2): 230-236.         [ Links ]

8. Goldhaber-Fiebert JD, Goldhaber-Fiebert SN, Andorsky DJ. Male involvement in cardiovascular preventive healthcare in two rural Costa Rican communities. Prev Med. 2005; 40 (6): 690-695.         [ Links ]

9. Champagne BM, Sebrie EM, Schargrodsky H, Pramparo P, Boissonnet C, Wilson E. Tobacco smoking in seven Latin American cities: the CARMELA study. Tobacco Control. 2010; 19 (6): 457-462.         [ Links ]

10. Kabagambe EK, Baylin A, Campos H. Nonfatal acute myocardial infarction in Costa Rica: modifiable risk factors, population-attributable risks, and adherence to dietary guidelines. Circulation. 2007; 115 (9): 1075-1081.         [ Links ]

11. Schargrodsky H, Hernandez-Hernandez R, Champagne BM et al. CARMELA: assessment of cardiovascular risk in seven Latin American cities. Am J Med. 2008; 121 (1): 58-65.         [ Links ]

12. Colditz GA, Willett WC, Rotnitzky A et al. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med. 1995; 122: 481-486.         [ Links ]

13. Pramparo P, Boissonnet C, Schargrodsky H. Evaluación del riesgo cardiovascular en siete ciudades de Latinoamérica: las principales conclusiones del estudio CARMELA y de los subestudios. Revista Argentina de Cardiología. 2011; 79 (4): 337-382.         [ Links ]

14. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F et al. INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004; 364 (9438): 937-952.         [ Links ]

15. Deen D. Metabolic syndrome: time for action. Am Fam Physi. 2004; 69: 2875-2882.         [ Links ]

16. González M, Dennis R, Devia J et al. Factores de riesgo cardiovascular y de enfermedades crónicas en población caficultora. Rev Salud Pública. 2012; 14 (3): 390-403.         [ Links ]

17. Valencia M, Aguilar O, Rodriguez A. Caracterización de los pacientes en una consulta de hipertensión arterial de un municipio de Risaralda, Colombia, 2005-2012. Rev Med Risaralda. 2012; 18 (2): 122-128.         [ Links ]

18. Ruiz A, Aschner P, Puerta M, Cristancho R. Estudio IDEA (International Day for Evaluation of Abdominal Obesity): prevalencia de obesidad abdominal y factores de riesgo asociados en atención primaria en Colombia. Biomédica. 2012; 32: 610-616.         [ Links ]

19. Sanchez L, Barbosa J, Arias S. Morbilidad cardiovascular por autoreporte y su asociación con factores biopsicosociales, Tolima, Colombia. Rev Fac Nac Salud Pública. 2014; 32 (1): 80-87.         [ Links ]

20. Rosselli D, Ospina J, Rueda J. Estudio MULATA: muestra latinoamericana de pacientes con tensión arterial elevada. Rev Med Risaralda. 2013; 19 (2):114-119.         [ Links ]

21. Manrique F, Ospina J, Herrera G. Prevalencia de hipertrofia ventricular izquierda en pacientes hipertensos. Acta Med Colomb. 2014; 39: 244-249.         [ Links ]

22. Alvarado C, Jaramillo M, Matijasevic E, Rendón I et al. Estudio poblacional de factores de riesgo cardiovascular relacionados con el estilo de vida, hallazgos electrocardiográficos y medicación actual de pacientes valorados por el servicio de Cardiología. Rev Colomb Cardiol. 2012; 19: 61-71.         [ Links ]

23. Hidalgo A, Tovar J. Factores de riesgo cardiovascular en participantes de un programa masivo de actividad física. Investigaciones Andina 2014; 16 (28): 949-962.         [ Links ]

24. Ureña A, Corona C, Osuna M, Jimenez S. Prevalencia de hipertensión arterial, sobrepeso y obesidad en poblaciones urbanas del estado de Sinaloa, México. Rev Mex Cardiol. 2012; 23 (1): 7-11.         [ Links ]

25. Campos I, Hernandez L, Rojas R, Pedroza A, Medina C, Barquera S. Hipertensión arterial: prevalencia, diagnóstico oportuno, control y tendencias en adultos mexicanos. Salud Publica Mex. 2013; 55 (Suppl 2): S144-S150.         [ Links ]

26. Guerrero C, Muños J, Saenz B, Reynales L. Consumo de tabaco, mortalidad y política fiscal en México. Salud Publica Mex. 2013; 55 (Suppl 2): S276-S281.         [ Links ]

27. Campos I, Gonzales A, Barquera S. Factores de riesgo cardiovascular asociados a obesidad y descontrol glucémico en adultos con diabetes mellitus. Rev Med Hosp Gen Méx. 2012; 75 (1): 14-23.         [ Links ]

28. Meaney A, Ceballos G, Gutierrez G et al. Cardiovascular risk factors in a Mexican middle-class urban population. The Lindavista Study. Baseline data. Arch Cardiol Mex. 2013; 83 (4): 249-256.         [ Links ]

29. Escobedo Jorge, Buitron Luisa, Cenobio Jesús. Diabetes en México. Estudio CARMELA. Cir Cir. 2011; 79: 424-431.         [ Links ]

30. Gonzales C, Dávila C, Zamora M et al. Risk factors associated to diabetes in Mexican population and phenotype of the individuals who will convert to diabetes. Salud Publica Mex. 2014; 56: 317-322.         [ Links ]

31. Trujillo B, Vasquez C, Almanza J et al. Frecuencia y factores de riesgo asociados a sobrepeso y obesidad en universitarios de Colima, México. Rev Salud Pública. 2010; 12 (2): 197-207.         [ Links ]

32. Escobedo J, Ramón J, Schargrodsky H, Champagne B. Prevalencia de dislipidemias en la ciudad de México y su asociación con otros factores de riesgo cardiovascular. Resultados del estudio CARMELA. Gac Med Mex. 2014; 150: 128-136.         [ Links ]

33. Rojas R, Aguilar C, Jimenez A et al. Metabolic syndrome in Mexican adults. Results from the National Health and Nutrition Survey 2006. Salud Publica Mex. 2010; 52 (Supl 1): S11-S18.         [ Links ]

34. Midory L, Santana F, Arruda M. Asociación independiente del tabaquismo a los eventos cardiacos postoperatorios y a la mortalidad a 30 días. Arq Bras Cardiol. 2010; 94 (5): 607-614.         [ Links ]

35. Lamego S, Perim M, Pires D et al. Distribución por género del ácido úrico sérico y factores de riesgo cardiovascular: estudio poblacional. Arq Bras Cardiol. 2012; 98 (1): 13-21.         [ Links ]

36. de Carvalho CA, Fonseca PC, Barbosa J et al. The association between cardiovascular risk factors and anthropometric obesity indicators in university students in São Luís in the State of Maranhão, Brazil. Cien Saude Colet. 2015; 20 (2): 479-490.         [ Links ]

37. Basei Rossa CE, Avancini CPR, Manfroi WC. Metabolic syndrome in workers in a university hospital. Rev Port Cardiol. 2012; 31 (10): 629-636.         [ Links ]

38. Gronner MF, Bosi PL, Carvalho AM, Casale G et al. Prevalence of metabolic syndrome and its association with educational inequalities among Brazilian adults: a population-based study. Braz J Med Biol Res. 2011; 44 (7): 713-719.         [ Links ]

39. Miquetichuc F, Brandão P, Gondim M, Tronco E et al. Hipertensión arterial y su correlación con algunos factores de riesgo en ciudad brasileña de pequeño tamaño. Arq Bras Cardiol. 2010; 95 (4): 502-509.         [ Links ]

40. Landea M, Salazar M, Marillet A et al. Prevalencia de tabaquismo y factores de riesgo cardiovascular en el casco urbano de una localidad rural de la Provincia de Buenos Aires. Rev Am Med Resp. 2011; 3: 110-116.         [ Links ]

41. Mariani J, Antonietti L, Tajer C et al. Diferencias de género en el tratamiento de síndromes coronario agudos: resultados del registro Epi-Cardio. Rev Argent Cardiol. 2013; 81: 307-315.         [ Links ]

42. Rubinstein A, Colantonio L, Bardach A et al. Estimación de la carga de las enfermedades cardiovasculares atribuible a factores de riesgo modificables en Argentina. Rev Panam Salud Publica. 2010; 27 (4): 237-245.         [ Links ]

43. Armas N, Noval R, Dueñas A et al. Estimación del riesgo cardiovascular mediante ta-blas de la Organización Mundial de la Salud. Área de salud "Héroes del Moncada". Rev Cubana Cardiol Cir Cardiovasc. 2014; 20 (1).         [ Links ]

44. Nordet P, Mendis S, Duelas A et al. Total cardiovascular risk assessment and management using two prediction tools, with and without blood cholesterol. MEDICC Rev. 2013; 15 (4): 36-40.         [ Links ]

45. Marimón E, Odalys O, Caridad Maria et al. Prevalencia de factores de riesgo de enfermedades no transmisibles. Rev Ciencias Médicas. 2013; 17 (2): 2-12.         [ Links ]

46. López R, Hurtado D, López L, Acosta J et al. Una aproximación a conocer la prevalencia de hipertensión arterial, factores de riesgo cardiovascular y estilo de vida en Venezuela. Avances Cardiol. 2014; 34 (2): 128-134.         [ Links ]

47. Gabrielli L, Castro P, Corbalan R et al. Seguimiento alejado de pacientes evaluados en una Unidad de Dolor Torácico. Rev Med Chile. 2010; 138: 1117-1123.         [ Links ]

48. Ibañez L, Sanzana R, Salas C et al. Prevalencia de síndrome metabólico en individuos de etnia Mapuche residentes en zonas rurales y urbanas de Chile. Rev Med Chile. 2014; 142: 953-960.         [ Links ]

49. Arteaga A, Maiz A, Rigotti A, Cortes V. Asociación entre diabetes mellitus y patología cardiovascular en la población adulta de Chile: estudio de la Encuesta Nacional de Salud 2009-2010. Rev Med Chile. 2014; 142: 175-183.         [ Links ]

50. Kramer V, Adasme M, Bustamante J et al. Agregación de factores de riesgo cardiovascular y conciencia de enfermedad en trabajadores de un hospital universitario. Rev Med Chile. 2012; 140: 602-608.         [ Links ]

51. Arteaga A, Bustos P, Soto R et al. Actividad física y su asociación con factores de riesgo cardiovascular. Un estudio en adultos jóvenes. Rev Med Chile. 2010; 138: 1209-1216.         [ Links ]

52. Maldonado R, Madariaga A, Lopez C et al. Caracterización clínica de pacientes con Infarto Agudo al Miocardio sin lesiones coronarias significativas. Estudio GEMI 2011-2013. Rev Chil Cardiol. 2014; 33: 165-172.         [ Links ]

53. Melgar I, Garcia C, grupo cardiotesis et al. Prevalencia de factores de riesgo cardiovascular en la población de guatemala. Rev Guatem Cardiol. 2012; 22 (2): 3-19.         [ Links ]

54. Suasnavar P, Sotomora G. Dolor precordial asociado a cardiopatía isquémica en el servicio de urgencias de medicina interna del hospital roosevelt. Rev Guatem Cardiol. 2013; 23 (2): 49-52.         [ Links ]

55. Bernabe-Ortiz A, Benziger CP, Gilman R et al. Sex differences in risk factors for cardiovascular disease: The PERU MIGRANT study. PLoS ONE. 2012; 7 (4): e35127.         [ Links ]

56. Palacios C, Perez C, Guzman M et al. Association between adiposity indices and cardiometabolic risk factors among adults living in Puerto Rico. Public Health Nutr. 2011; 14 (10): 1714-1723.         [ Links ]

57. Laux TS, Bert PJ, González M et al. Prevalence of Hypertension and Associated Risk Factors in Six Nicaraguan Communities. Ethn Dis. 2012; 22 (2): 129-135.         [ Links ]

58. Mc Donald PAJ, Montenegro GJA, Cruz GCE et al. Prevalence, sociodemographic distribution, treatment and control of diabetes mellitus in Panama. Diabetol Metab Syndr. 2013; 5: 69.         [ Links ]

59. Daviglus ML, Talavera GA, Avilés-Santa ML et al. Prevalence of major cardiovascular risk factors and cardiovascular diseases among hispanic/latino individuals of diverse backgrounds in the United States. JAMA. 2012; 308 (17): 1775-1784.         [ Links ]

60. Castillo M, Calero MS, Oliveira G et al. ¿Existe diferencia en la evolución aguda y tardía en mujeres con infarto del miocárdio? Rev Ecuat Cardiologia. 2015; 1 (1).         [ Links ]

 

Nota

Este artículo puede ser consultado en versión completa en: http://www.medigraphic.com/revmexcardiol