TY - JOUR
T1 - Contribution of modifiable risk factors for hypertension and type-2 diabetes in Peruvian resource-limited settings
AU - CRONICAS Cohort Study Group
AU - Bernabé-Ortiz, Antonio
AU - Carrillo-Larco, Rodrigo M.
AU - Gilman, Robert H.
AU - Checkley, William
AU - Smeeth, Liam
AU - Miranda, J. Jaime
AU - Casas, Juan P.
AU - Smith, George Davey
AU - Ebrahim, Shah
AU - García, Héctor H.
AU - Huicho, Luis
AU - Málaga, Germán
AU - Montori, Víctor M.
AU - Diette, Gregory B.
AU - León-Velarde, Fabiola
AU - Rivera, María
AU - Wise, Robert A.
AU - Sacksteder, Katherine
N1 - Funding Information:
The authors are indebted to all participants who kindly agreed to participate in the study. Special thanks to all field teams for their commitment and hard work, especially to Lilia Cabrera, Rosa Salirrosas, Viterbo Aybar, Sergio Mimbela and David Danz, for their leadership in each of the study sites, as well as Marco Varela for data coordination. This project has been funded in whole with Federal funds from the US National Heart, Lung and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract Number HHSN268200900033C. WC was further supported by a Pathway to Independence Award (R00HL096955) from the National Heart, Lung and Blood Institute. Liam Smeeth is a Senior Clinical Fellow and AB-O is a Research Training Fellow in Public Health and Tropical Medicine (103994/Z/14/Z), both funded by the Wellcome Trust.
PY - 2015/8/6
Y1 - 2015/8/6
N2 - Background It is important to understand the local burden of non-communicable diseases including withincountry heterogeneity. The aim of this study was to characterise hypertension and type-2 diabetes profiles across different Peruvian geographical settings emphasising the assessment of modifiable risk factors. Methods Analysis of the CRONICAS Cohort Study baseline assessment was conducted. Cardiometabolic outcomes were blood pressure categories (hypertension, prehypertension, normal) and glucose metabolism disorder status (diabetes, prediabetes, normal). Exposures were study setting and six modifiable factors (smoking, alcohol drinking, leisure time and transportrelated physical activity levels, TV watching, fruit/ vegetables intake and obesity). Poisson regression models were used to report prevalence ratios (PR). Population attributable risks (PAR) were also estimated. Results Data from 3238 participants, 48.3% male, mean age 45.3 years, were analysed. Age-standardised (WHO population) prevalence of prehypertension and hypertension was 24% and 16%, whereas for prediabetes and type-2 diabetes it was 18% and 6%, respectively. Outcomes varied according to study setting (p < 0.001). In multivariable model, hypertension was higher among daily smokers (PR 1.76), heavy alcohol drinkers (PR 1.61) and the obese (PR 2.06); whereas only obesity (PR 2.26) increased the prevalence of diabetes. PAR showed that obesity was an important determinant for hypertension (15.7%) and type-2 diabetes (23.9%). Conclusions There is an evident heterogeneity in the prevalence of and risk factors for hypertension and diabetes within Peru. Prehypertension and prediabetes are highly prevalent across settings. Our results emphasise the need of understanding the epidemiology of cardiometabolic conditions to appropriately implement interventions to tackle the burden of non-communicable diseases.
AB - Background It is important to understand the local burden of non-communicable diseases including withincountry heterogeneity. The aim of this study was to characterise hypertension and type-2 diabetes profiles across different Peruvian geographical settings emphasising the assessment of modifiable risk factors. Methods Analysis of the CRONICAS Cohort Study baseline assessment was conducted. Cardiometabolic outcomes were blood pressure categories (hypertension, prehypertension, normal) and glucose metabolism disorder status (diabetes, prediabetes, normal). Exposures were study setting and six modifiable factors (smoking, alcohol drinking, leisure time and transportrelated physical activity levels, TV watching, fruit/ vegetables intake and obesity). Poisson regression models were used to report prevalence ratios (PR). Population attributable risks (PAR) were also estimated. Results Data from 3238 participants, 48.3% male, mean age 45.3 years, were analysed. Age-standardised (WHO population) prevalence of prehypertension and hypertension was 24% and 16%, whereas for prediabetes and type-2 diabetes it was 18% and 6%, respectively. Outcomes varied according to study setting (p < 0.001). In multivariable model, hypertension was higher among daily smokers (PR 1.76), heavy alcohol drinkers (PR 1.61) and the obese (PR 2.06); whereas only obesity (PR 2.26) increased the prevalence of diabetes. PAR showed that obesity was an important determinant for hypertension (15.7%) and type-2 diabetes (23.9%). Conclusions There is an evident heterogeneity in the prevalence of and risk factors for hypertension and diabetes within Peru. Prehypertension and prediabetes are highly prevalent across settings. Our results emphasise the need of understanding the epidemiology of cardiometabolic conditions to appropriately implement interventions to tackle the burden of non-communicable diseases.
UR - http://www.scopus.com/inward/record.url?scp=84958104558&partnerID=8YFLogxK
U2 - 10.1136/jech-2015-205988
DO - 10.1136/jech-2015-205988
M3 - Artículo
C2 - 26248550
AN - SCOPUS:84958104558
SN - 0143-005X
VL - 70
SP - 49
EP - 55
JO - Journal of Epidemiology and Community Health
JF - Journal of Epidemiology and Community Health
IS - 1
ER -
