RESUMO
OBJECTIVES: To assess the frequency of carotid atherosclerosis and its relation to cardiovascular risk factors in a general elderly population of Mexico City. MATERIAL AND METHODS: B-mode ultrasonography was performed to investigate carotid atherosclerosis in 145 CUPA (a research project) participants, between July 1993 and January 1996. The outcome was then related to cardiovascular risk factors. RESULTS: Prevalence of ultrasound-detected carotid atherosclerosis was 64.8%. Intimal-medial thickening was detected in 64 subjects (44.1%) and carotid plaques in 82 (56.5%); Fifty-two subjects had both intimal-medial thickening and plaques. However, only 8 subjects had carotid plaques with severe stenosis (5.5%). There were no significant differences in the prevalence of atherosclerotic lesions (male 61.9%, female 66.0%). Carotid atherosclerosis was significantly associated with age (p < 0.0001), high blood pressure (p < 0.001), isolated systolic hypertension (p = 0.01), hypercholesterolemia (p = 0.04), and diabetes mellitus (p = 0.06). Prevalence of carotid atherosclerosis increased progressively with the number of vascular risk factors. CONCLUSIONS: There was a high prevalence of carotid atherosclerosis in this general elderly population of Mexico City, and was almost equal to that reported in developed western countries. Age, hypertension, hypercholesterolemia, and diabetes were the strongest predictors of atherosclerosis.
Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Doenças das Artérias Carótidas/diagnóstico por imagem , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Doenças das Artérias Carótidas/epidemiologia , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Sensibilidade e Especificidade , Ultrassonografia Doppler de Pulso/métodos , Ultrassonografia Doppler de Pulso/estatística & dados numéricos , População Urbana/estatística & dados numéricosRESUMO
To evaluate the information about prevalence of hypertension at a national level, several articles published either within or outside Mexico from 1933 to 1995 were reviewed. Variables about criteria and methodology were considered: the BP readings, method used, cutting points to define hypertension, year for screen. There were 30 papers out of 7 states, 16 reporting the Federal District of Mexico, 3 from Jalisco, 3 from Yucatán and 2 from Tamaulipas, there was only one referring to the State of Mexico, one to Veracruz, one to Michoacán and another referring to Mexicans in USA; as whole population there were two, one by the Instituto Mexicano del Seguro Social and another by Secretaría de Salud. A wide variation in prevalence was found (0.47 to 30.9%) mainly attributed to different sampling, measurements and reporting methodology. Few information was disclosed regarding female and elderly populations. The trend is slightly increasing, as expected accordingly to other information sources, but the problem might actually be masked by bias interference. Most of the studies performed have contributed so far to explore the gross prevalence, but may not reach scientific evidence to base evaluations of preventive interventions. The problem may not just be happening in this country. Variability may be partially controlled following the international recommendations to record arterial blood pressure, but still, there is a lack of recommendations to uniform epidemiological reports. Otherwise the values of hypertension prevalence may not be useful for hypertension surveillance.