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).
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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).
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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.
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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.
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Nota
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