Risk of cardiovascular disease according to blood pressure categories in an argentinian cohort.

BACKGROUND: Hypertension is a recognized strong risk factor for cardiovascular disease. However, no data was available in our country to quantify the relationship between blood pressure and cardiovascular event. OBJECTIVE: to quantify the risk of cardiovascular events according to blood pressure categories. METHODS: A prospective epidemiological study was conducted in 1526 inhabitants from Rauch City, (Buenos Aires, Argentina) between 1997 and 2012. Subjects were classified into one of these blood-pressure categories: 1-optimal, 2-normal, 3-high-normal, 4-grade 1 hypertension, 5-grade 2 hypertension and 6-grade 3 hypertension. The first CVD event, including unstable angina pectoris, fatal and non-fatal myocardial infarction, myocardial revascularization, and fatal or non-fatal stroke, was defined as the primary endpoint. Multivariable Cox proportional-hazards regression models were used to estimate the relative risk (HR) of CVD according to base-line blood-pressure categories. RESULTS: In 2012, 1124 individuals (73.7% of the baseline sample), 719 women and 405 men (in 1997, aged 45±16 and 46±16 respectively) or their relatives in case of death, could be surveyed again in order to obtain information concerning incident CVD events. Cardiovascular event rates and HR values increased in a stepwise manner across the blood pressure categories (p for trend across categories <0.001 in both sex); however, in subjects aged ≥55 years a j-curve phenomenon was observed, showing the lowest incidence in the high-normal category. In all categories CVD events rates were higher for men. CONCLUSION: This study quantified relationships between BP and CVD starting from high-normal blood pressure in Argentina.

Insulin resistance: The linchpin between prediabetes and cardiovascular disease.

The aim of this study was to test the hypothesis that cardiovascular disease occurs to the greatest extent in persons with prediabetes mellitus who are also insulin resistant. In 2003, 664 non-diabetic women (n = 457) and men (n = 207), aged 52 ± 16 and 53 ± 15 years, were surveyed during a programme for cardiovascular disease prevention. Fasting plasma glucose concentrations defined participants as having normal fasting plasma glucose (fasting plasma glucose <5.6 mmol/L) or prediabetes mellitus (fasting plasma glucose ⩾ 5.6 and <7.0 mmol/L). The tertile of prediabetes mellitus subjects with the highest fasting plasma insulin concentration was classified as insulin resistant. Baseline cardiovascular disease risk factors were accentuated in prediabetes mellitus versus normal fasting glucose, particularly in prediabetes mellitus/insulin resistant. In 2012, 86% of the sample were surveyed again, and the crude incidence for cardiovascular disease was higher in subjects with prediabetes mellitus versus normal fasting glucose (13.7 vs 6.0/100 persons/10 years; age- and sex-adjusted hazard ratio = 1.88, p = 0.052). In prediabetes mellitus, the crude incidences were 22.9 versus 9.6/100 persons/10 years in insulin resistant versus non-insulin resistant persons (age- and sex-adjusted hazard ratio = 2.36, p = 0.040). In conclusion, cardiovascular disease risk was accentuated in prediabetes mellitus/insulin resistant individuals, with a relative risk approximately twice as high compared to prediabetes mellitus/non-insulin resistant subjects.

Use of the plasma triglyceride/high-density lipoprotein cholesterol ratio to identify cardiovascular disease in hypertensive subjects.

This analysis evaluated the hypothesis that the plasma triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) concentration ratio can help identify patients with essential hypertension who are insulin-resistant, with the cardiovascular disease (CVD) risk profile associated with that defect. Data from a community-based study developed between 2003 and 2012 were used to compare CVD risk factors and outcome. Plasma TG/HDL-C cut-points of 2.5 (women) and 3.5 (men) subdivided normotensive (n = 574) and hypertensive (n = 373) subjects into "high" and "low" risk groups. Metabolic syndrome criteria (MetS) were also used to identify "high" and "low" risk groups. The baseline cardio-metabolic profile was significantly more adverse in 2003 in "high" risk subgroups, irrespective of BP classification or definition of risk (TG/HDL-C ratio vs. MetS criteria). Crude incidence of combined CVD events increased across risk groups, ranging from 1.9 in normotensive-low TG/HDL-C subjects to 19.9 in hypertensive-high TG/HDL-C ratio individuals (P for trends <.001). Adjusted hazard ratios for CVD events also increased with both hypertension and TG/HDL-C. Comparable findings were seen when CVD outcome was predicted by MetS criteria. The TG/HDL-C concentration ratio and the MetS criteria identify to a comparable degree hypertensive subjects who are at greatest cardio-metabolic risk and develop significantly more CVD.

Do differences in waist circumference modify the relationships among body mass index, insulin resistance, and related cardiometabolic risk factors in apparently healthy women?

OBJECTIVE: The aims of the study were to (1) compare the cardiometabolic risk profile between insulin-resistant and non-insulin-resistant women within similar body mass indexes (BMIs) and waist circumference (WC) groupings and (2) test the hypothesis that measurements of BMI are not inferior to WC in identifying insulin resistance. METHODS: The sample consisted of 899 women without known cardiovascular disease or diabetes. BMI was used to divide participants in normal (<25.0 kg/m(2)), overweight (≥25-29.9 kg/m(2)), and obese (≥30.0 kg/m(2)) subgroups, and waist circumference ≥88 cm was used to identify women with or without abdominal obesity. The 25% of the population with highest fasting insulin concentrations was classified as insulin resistant. BMI, WC, blood pressure, and fasting plasma glucose, insulin, triglyceride, and high-density lipoprotein cholesterol concentrations were compared using analysis of covariance (ANCOVA). The relationships between obesity and insulin resistance were analyzed using univariate, multivariate, and logistic regression. RESULTS: Triglyceride and glucose concentrations were higher and high-density lipoprotein cholesterol concentrations lower in the insulin-resistant group in each BMI category, as was the case when comparing by abdominal obesity. In the univariate analysis, correlations between obesity and the individual cardiometabolic risk factor were significant but weak. In multivariate analysis including both indices, only body mass independently predicted insulin resistance. CONCLUSION: Insulin-resistant women were at greater cardiometabolic risk, irrespective of adiposity category. Obesity contributed to a modest variability in insulin resistance, and abdominal obesity does not add to the ability of BMI to predict insulin resistance.

Blood pressure response to a community-based program and long-term cardiovascular outcome.

BACKGROUND: The significance in terms of the cardiovascular outcome of different patterns of blood pressure (BP) response to community-based activities has not been previously studied. The aim of our study was to evaluate the relationship between changes of BP observed during a community-based program and long-term rate of cardiovascular disease (CVD) events. METHODS: A program focused on the prevention of CVDs was implemented in a small city in Argentina over a 6-year period (1997-2003). The program was evaluated using a cohort of 1,526 randomly selected individuals. The population's mean systolic BP (SBP) decreased approximately 5mm Hg, but BP changes were heterogeneous. Eight years after the intervention had stopped, 1,124 individuals of the cohort were surveyed to evaluate incident CVD events. The sample was divided into 3 SBP change categories during the intervention: decrease (< -5mm Hg), no change (-5 to 5mm Hg) and increase (> 5mm Hg). Cox models were used to estimate the hazard ratio (HR) of CVD events for each category adjusted for age, sex, and baseline BP. RESULTS: At the end of the intervention, individuals who had increased their SBP showed an adjusted HR for CVD that was double those whose SBP levels decreased or did not change. An inverse relationship between baseline SBP and ΔSBP was observed: individuals with an increase in BP during the intervention had lower SBP at the beginning of the study. CONCLUSIONS: BP increase during the community-based program was an independent predictor of CVD events.

Identification of cardiometabolic risk: visceral adiposity index versus triglyceride/HDL cholesterol ratio.

BACKGROUND: The plasma concentration ratio of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) can identify cardiometabolic risk and cardiovascular disease. The visceral adiposity index is a sex-specific index, in which measurements of body mass index and waist circumference are combined with TG and HDL-C concentrations. The current analysis was initiated to see if the visceral adiposity index would improve the ability of the TG/HDL-C to identify increased cardiometabolic risk and outcome. METHODS: Cardiometabolic data were obtained in 2003 from 926 apparently healthy individuals, 796 of whom were evaluated in 2012 for evidence of incident cardiovascular disease. The relationship between TG/HDL-C and values for visceral adiposity index was evaluated by Pearson's correlation coefficient. The relative risks for first cardiovascular event between individuals above and below the TG/HDL-C sex-specific cut points, and in the top quartile of visceral adiposity index versus the remaining 3 quartiles, were estimated using Cox proportional hazard models. RESULTS: TG/HDL-C concentration and visceral adiposity index were highly correlated (r = 0.99) in both men and women. Although more men (133 vs121) and women (73 vs 59) were identified as being at "high risk" by an elevated TG/HDL-C ratio, the individual cardiometabolic risk factors were essentially identical with either index used. However, the hazard ratio of developing cardiovascular disease was significantly increased in individuals with an elevated TG/HDL-C, whereas it was not the case when the visceral adiposity index was used to define "high risk." CONCLUSION: The visceral adiposity index does not identify individuals with an adverse cardiometabolic profile any better than the TG/HDL-C.

Comparison of the abilities of the plasma triglyceride/high-density lipoprotein cholesterol ratio and the metabolic syndrome to identify insulin resistance.

This study compares the ability of an elevated triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio, using sex-specific cut-points, to identify insulin-resistant individuals within a population without known cardiac disease or diabetes with that obtained using the diagnostic criteria of the metabolic syndrome (MetS). Measurements were made of waist circumference (WC), systolic and diastolic blood pressure, fasting plasma glucose, fasting plasma insulin (FPI), plasma TG and plasma HDL-C concentrations in 1102 women and 464 men. These data were used to classify subjects as being insulin resistant (FPI concentration in the upper quartile) and having the MetS or an elevated TG/HDL-C ratio (>2.5 and >3.5 for women and men, respectively). The sensitivity and specificity with which the two indices identified insulin-resistant subjects were similar (43% and 81% for TG/HDL-C ratio and 45% and 82% for MetS), as the number of individuals was found with either an elevated TG/HDL-C ratio (n = 386) or the MetS (n = 384). Eighty-one per cent of the individuals were identified concordantly. Cardio-metabolic risk profiles in 'low-risk' individuals identified by a low TG/HDL-C ratio were comparable to those who did not have the MetS, and this was also the case when comparing 'high-risk' groups identified by having the MetS or an elevated TG/HDL-C ratio. These findings suggest that TG/HDL-C concentration ratio is as adequate as MetS diagnosis to identify insulin-resistant subjects.

Relation among the plasma triglyceride/high-density lipoprotein cholesterol concentration ratio, insulin resistance, and associated cardio-metabolic risk factors in men and women.

Results of recent studies using the ratio of plasma triglyceride (TG) to high-density lipoprotein (HDL) cholesterol concentration to identify insulin-resistant patients at increased cardiometabolic risk have emphasized that the cut point used for this purpose will vary with race. Because TG and HDL cholesterol concentrations vary with gender, this analysis was initiated to define gender-specific plasma TG/HDL cholesterol concentration ratios that best identified high-risk subjects among women (n = 1,102) and men (n = 464) of primarily European ancestry. Insulin resistance was defined as the 25% of the population with the highest values for fasting plasma insulin concentration and homeostasis model assessment of insulin resistance. Using TG/HDL concentration ratios >2.5 in women and >3.5 in men identified subgroups of men and women that were comparable in terms of insulin resistance and associated cardiometabolic risk, with significantly higher values for fasting plasma insulin, homeostasis model assessment of insulin resistance, blood pressure, body mass index, waist circumference, and glucose and TG concentrations and lower HDL cholesterol concentrations than in women and men below these cut points. The sensitivity and specificity of these gender-specific cut points to identify insulin-resistant subjects were about 40% and about 80%, respectively. In conclusion, the plasma TG/HDL cholesterol concentration ratio that identifies patients who are insulin resistant and at significantly greater cardiometabolic risk varies between men and women.

Relationships among insulin resistance, obesity, diagnosis of the metabolic syndrome and cardio-metabolic risk.

The aim of this study is to test the hypotheses that: 1) diagnosing the metabolic syndrome does not effectively identify insulin-resistant (IR) individuals; and 2) waist circumference (WC) is no better than body mass index (BMI) in predicting insulin resistance or the components of the metabolic syndrome (MetS). Measurements of BMI, WC, blood pressure, and fasting plasma glucose, insulin (FPI), triglycerides (TG), and HDL-cholesterol (HDL-C) concentrations were made in 1,300 adults, without known cardiovascular disease (CVD) or drug treatment of hypertension or diabetes. Receiver operating characteristic curves were used to determine the ability of the MetS, and its components, to identify IR individuals. In addition, comparisons were made of CVD risk factors following division of the population into quartiles of FPI concentrations, and univariate and multiple regression analysis used to compare the ability of WC, BMI, and FPI as predictors of MetS components. The MetS was no more effective in identifying IR individuals than several individual components (sensitivity~40%), and IR individuals not identified were at significantly increased CVD risk. FPI concentration was the best predictor of an abnormal glucose, TG, and HDL-C, whereas the adiposity indices were better predictors of abnormal blood pressure. The relationship between BMI and WC with the MetS and its components seemed comparable.

Alanine-aminotransferase: an early marker for insulin resistance?

In a population-based sample, after excluding alcohol consumption, hepatotoxic drugs and hepatitis B and C infected, we investigated if alanine-aminotransferase (ALT) was associated with metabolic syndrome and insulin resistance, and if this association was caused by non-alcoholic fatty liver disease (NAFLD). The sample (432 female and 119 male) was divided into two ALT thresholds corresponding to the 50th and 75th percentiles (P) (female > or = 15 and > or = 19 U/L; male > or = 17 and > or = 23 U/I, respectively). Blood pressure, body mass index, waist circumference, cholesterol, HDL cholesterol (HDLc), triglyceride (TG), TG/HDLc ratio, glycemia and homeostasis model assessment of insulin resistance (HOMA-IR) were compared between those above and below each ALT threshold. Female placed above the 50th P of ALT had higher levels of TG/HDLc ratio (p=0.029), glycemia (p=0.028), and homeostasis model assessment of insulin resistance, (p=0.045), and above the 75th P had higher SBP (p=0.036), DBP (p=0.018), TG (p=0.024), TG/HDLc ratio (p=0.028), glycemia (p=0.004) and HOMA-IR (p=0.0014). Male placed above the 50th P of ALT had higher BMI (p=0.017) and TG/HDLc ratio (p=0.048), and above the 75th P had lower values of HDLc (p=0.042). Only 16.5% of women and 14.5% of men, above the 75th P of ALT, showed an increase in liver brightness in the echography. This work shows in woman an early association of ALT with TG/HDLc ratio and HOMA-IR. Since the last two are independent predictors of cardiovascular risk, attention should be drawn to ALT values near the upper limit of the normal range even in the absence of NAFLD and obesity.

Alanine-aminotransferase: an early marker for insulin resistance? / Alanino-aminotransferasa: un marcador temprano de resistencia a la insulina?

In a population-based sample, after excluding alcohol consumption, hepatotoxic drugs and hepatitis Band C infected, we investigated if alanine-aminotransferase (ALT) was associated with metabolic syndrome and insulin resistance, and if this association was caused by non-alcoholic fatty liver disease (NAFLD). The sample (432 female and 119 male) was divided into two ALT thresholds corresponding to the 50th and 75th percentiles (P) (female < or = 15 and < or = 19 U/L; male < or = 17 and < or = 23 U/l, respectively). Blood pressure, body mass index, waist circumference, cholesterol, HDL cholesterol (HDLc), triglyceride (TG), TG/HDLc ratio, glycemia and homeostasis model assessment of insulin resistance (HOMA-IR) were compared between those above and below each ALT threshold. Female placed above the 50th P of ALT had higher levels of TG/HDLc ratio (p=0.029), glycemia (p=0.028), and homeostasis model assessment of insulin resistance, (p=0.045), and above the 75th P had higher SBP (p=0.036), DBP (p=0.018), TG (p=0.024), TG/HDLc ratio (p=0.028), glycemia (p=0.004) and HOMA-IR (p=0.0014). Male placed above the 50th P of ALT had higher BMI (p=0.017) and TG/HDLc ratio (p=0.048), and above the 75th P had lower values of HDLc (p=0.042). Only 16.5 percent of women and 14.5 percent of men, above the 75th P of ALT, showed an increase in liver brightness in the echography. This work shows in woman an early association of ALT with TG/HDLc ratio and HOMA-IR. Since the last two are independent predictors of cardiovascular risk, attention should be drawn to ALT values near the upper limit of the normal range even in the absence of NAFLD and obesity.(AU)

En una muestra poblacional, luego de excluir a quienes consumían alcohol y drogas hepatotóxicas y a los infectados con virus B y C de la hepatitis, investigamos si la alanino-aminotransferasa (ALT), o transaminasa glutámico pirúvica (TGP), se asociaba con el síndrome metabólico y con resistencia a la insulina y si esta asociación se explicaba por enfermedad hepática grasa no alcohólica (NAFLD). La muestra (432 mujeres y 119 varones) se dividió por los percentilos (P) 50 y 75 de la distribución de ALT (mujeres < o = 15 y < o = 19 U/l; varones < o = 17 y < o = 23 U/l, respectivamente). Las mujeres a partir del P50 de ALT tuvieron valores más altos de índice triglicéridos (TG)/HDLc (p=0.029), glucemia (p=0.028) y de la valoración del modelo homeostático de insulino-resistencia (HOMA-IR) (p=0.045); a partir del P75 tuvieron valores más altos de presión arterial sistólica (PAS) (p=0.036), presión arterial diastólica (PAD) (p=0.018), TG (p=0.024), índice TG/HDLc (p=0.028), glucemia (p=0.004) y HOMA-IR (p=0.001). Los varones a partir del P50 de ALT tuvieron valores más altos del índice de masa corporal (p=0.017) y del índice (TG/HDLc (p=0.048); a partir del P75 mostraron valores más bajos de HDLc (p=0,042). Sólo 16.5 porciento de las mujeres y 14.5 porciento de los varones, a partir del P75 de ALT, mostraron aumento del brillo hepático en la ecografía. Este trabajo muestra, en mujeres, asociación temprana de ALT con el índice TG/HDLc y el HOMA-IR. Dado que estos dos últimos son predictores independientes del riesgo cardiovascular se debería prestar atención a los valores de ALT cercanos al límite superior aun en ausencia de NAFLD y de obesidad. (AU)

Alanine-aminotransferase: an early marker for insulin resistance? / Alanino-aminotransferasa: un marcador temprano de resistencia a la insulina?

In a population-based sample, after excluding alcohol consumption, hepatotoxic drugs and hepatitis Band C infected, we investigated if alanine-aminotransferase (ALT) was associated with metabolic syndrome and insulin resistance, and if this association was caused by non-alcoholic fatty liver disease (NAFLD). The sample (432 female and 119 male) was divided into two ALT thresholds corresponding to the 50th and 75th percentiles (P) (female < or = 15 and < or = 19 U/L; male < or = 17 and < or = 23 U/l, respectively). Blood pressure, body mass index, waist circumference, cholesterol, HDL cholesterol (HDLc), triglyceride (TG), TG/HDLc ratio, glycemia and homeostasis model assessment of insulin resistance (HOMA-IR) were compared between those above and below each ALT threshold. Female placed above the 50th P of ALT had higher levels of TG/HDLc ratio (p=0.029), glycemia (p=0.028), and homeostasis model assessment of insulin resistance, (p=0.045), and above the 75th P had higher SBP (p=0.036), DBP (p=0.018), TG (p=0.024), TG/HDLc ratio (p=0.028), glycemia (p=0.004) and HOMA-IR (p=0.0014). Male placed above the 50th P of ALT had higher BMI (p=0.017) and TG/HDLc ratio (p=0.048), and above the 75th P had lower values of HDLc (p=0.042). Only 16.5 percent of women and 14.5 percent of men, above the 75th P of ALT, showed an increase in liver brightness in the echography. This work shows in woman an early association of ALT with TG/HDLc ratio and HOMA-IR. Since the last two are independent predictors of cardiovascular risk, attention should be drawn to ALT values near the upper limit of the normal range even in the absence of NAFLD and obesity.

En una muestra poblacional, luego de excluir a quienes consumían alcohol y drogas hepatotóxicas y a los infectados con virus B y C de la hepatitis, investigamos si la alanino-aminotransferasa (ALT), o transaminasa glutámico pirúvica (TGP), se asociaba con el síndrome metabólico y con resistencia a la insulina y si esta asociación se explicaba por enfermedad hepática grasa no alcohólica (NAFLD). La muestra (432 mujeres y 119 varones) se dividió por los percentilos (P) 50 y 75 de la distribución de ALT (mujeres < o = 15 y < o = 19 U/l; varones < o = 17 y < o = 23 U/l, respectivamente). Las mujeres a partir del P50 de ALT tuvieron valores más altos de índice triglicéridos (TG)/HDLc (p=0.029), glucemia (p=0.028) y de la valoración del modelo homeostático de insulino-resistencia (HOMA-IR) (p=0.045); a partir del P75 tuvieron valores más altos de presión arterial sistólica (PAS) (p=0.036), presión arterial diastólica (PAD) (p=0.018), TG (p=0.024), índice TG/HDLc (p=0.028), glucemia (p=0.004) y HOMA-IR (p=0.001). Los varones a partir del P50 de ALT tuvieron valores más altos del índice de masa corporal (p=0.017) y del índice (TG/HDLc (p=0.048); a partir del P75 mostraron valores más bajos de HDLc (p=0,042). Sólo 16.5 porciento de las mujeres y 14.5 porciento de los varones, a partir del P75 de ALT, mostraron aumento del brillo hepático en la ecografía. Este trabajo muestra, en mujeres, asociación temprana de ALT con el índice TG/HDLc y el HOMA-IR. Dado que estos dos últimos son predictores independientes del riesgo cardiovascular se debería prestar atención a los valores de ALT cercanos al límite superior aun en ausencia de NAFLD y de obesidad.

Decrease of blood pressure by community-based strategies.

In a cross section study performed in Rauch in 1997 we found a high prevalence of hypertension and low levels of treatment and control. To evaluate the impact of the community-based intervention activities on blood pressure (BP), we made a cohort study in 1526 inhabitants aged between 15 and 75 years in 2003. The initial study, the advice to consult the family doctor when alterations were found, the free provision of antihypertensive drugs, the press diffusion of the study results and a healthy lifestyle were included among the intervention activities. BP was measured in the subjects' residence by especially trained nurses, considering systolic BP (SBP) and diastolic BP (DBP) as the average of three measurements in one occasion. A total of 1307 subjects (85.65%) were re-interviewed. SBP decreased from 137.98 +/- 0.57 to 132.49 +/- 0.53 mm Hg (p < 0.01) and DBP from 88.73 +/- 0.38 to 81.87 +/- 0.33 mm Hg (p < 0.01). Pressure decrease was observed in all the age groups, in both sexes and in the subgroup without receiving antihypertensive drugs. The percentage with antihypertensive drugs increased from 12.2 to 20.4 (p < 0.01). A significant relationship was observed between the percentiles of the BP changes and weight changes in subjects with and without antihypertensive drugs. Community-based intervention strategies were effective to BP control and, probably, to decrease the cardiovascular risk in a community with high prevalence of hypertension.

Decrease of blood pressure by community-based strategies.

In a cross section study performed in Rauch in 1997 we found a high prevalence of hypertension and low levels of treatment and control. To evaluate the impact of the community-based intervention activities on blood pressure (BP), we made a cohort study in 1526 inhabitants aged between 15 and 75 years in 2003. The initial study, the advice to consult the family doctor when alterations were found, the free provision of antihypertensive drugs, the press diffusion of the study results and a healthy lifestyle were included among the intervention activities. BP was measured in the subjects residence by especially trained nurses, considering systolic BP (SBP) and diastolic BP (DBP) as the average of three measurements in one occasion. A total of 1307 subjects (85.65

) were re-interviewed. SBP decreased from 137.98 +/- 0.57 to 132.49 +/- 0.53 mm Hg (p < 0.01) and DBP from 88.73 +/- 0.38 to 81.87 +/- 0.33 mm Hg (p < 0.01). Pressure decrease was observed in all the age groups, in both sexes and in the subgroup without receiving antihypertensive drugs. The percentage with antihypertensive drugs increased from 12.2 to 20.4 (p < 0.01). A significant relationship was observed between the percentiles of the BP changes and weight changes in subjects with and without antihypertensive drugs. Community-based intervention strategies were effective to BP control and, probably, to decrease the cardiovascular risk in a community with high prevalence of hypertension.

Variables asociadas a hipertensión arterial en una region de la Argentina / Associated variables to hypertension in a region of Argentina

We conducted a study in a random sample of 1523 inhabitants (15-75 years old) of Rauch city to determine risk factors prevalence to development hypertension and cardiovascular diseases. We measured blood pressure, weight, height, waist circumference, cholesterol and glucose levels, sodium excretion, and alcohol and tobacco consumption. We found a high prevalence of hypertension (43.20 per cent in men and 28.50 per cent in women), and obesity-overweight (54.81 per cent in men and 44.65 per cent in women), both of them augmented with aging. Only 4 per cent of hypertensive subjects were being controlled and only 32 per cent of them were aware of their condition. Men showed a marked increment of prevalence of hypertension and obesity-overweight between groups of 15-24 years and 25-34 years. Women had delayed and more gradual increments. In male and female respectively, the prevalence of hypercholesterolemia was 26.86 and 13.81, the prevalence of diabetes was 3.42 and 1.53, and the prevalence of tobacco consumption was 34.61 and 20.83. Higher BMI and waist circumference identified subjects with higher blood pressure up to 54 and 65 years, in men and women, respectively. Age and waist circumference in the whole group, and alcohol consumption in men, were independently correlated with blood pressure; sodium excretion had no correlation. High prevalence of hypertension and obesity-overweight and their association suggest that the most important primary prevention measure in this community should be to prevent obesity. Low levels of awareness indicate the need of ongoing detection programs, and low grade to control of hypertension could be modified with education programs for health providers. (Au)

Variables asociadas a hipertensión arterial en una region de la Argentina / Associated variables to hypertension in a region of Argentina

We conducted a study in a random sample of 1523 inhabitants (15-75 years old) of Rauch city to determine risk factors prevalence to development hypertension and cardiovascular diseases. We measured blood pressure, weight, height, waist circumference, cholesterol and glucose levels, sodium excretion, and alcohol and tobacco consumption. We found a high prevalence of hypertension (43.20 per cent in men and 28.50 per cent in women), and obesity-overweight (54.81 per cent in men and 44.65 per cent in women), both of them augmented with aging. Only 4 per cent of hypertensive subjects were being controlled and only 32 per cent of them were aware of their condition. Men showed a marked increment of prevalence of hypertension and obesity-overweight between groups of 15-24 years and 25-34 years. Women had delayed and more gradual increments. In male and female respectively, the prevalence of hypercholesterolemia was 26.86 and 13.81, the prevalence of diabetes was 3.42 and 1.53, and the prevalence of tobacco consumption was 34.61 and 20.83. Higher BMI and waist circumference identified subjects with higher blood pressure up to 54 and 65 years, in men and women, respectively. Age and waist circumference in the whole group, and alcohol consumption in men, were independently correlated with blood pressure; sodium excretion had no correlation. High prevalence of hypertension and obesity-overweight and their association suggest that the most important primary prevention measure in this community should be to prevent obesity. Low levels of awareness indicate the need of ongoing detection programs, and low grade to control of hypertension could be modified with education programs for health providers.