Overview of Cardiovascular Disease Risk Factors in Adults in São Paulo, Brazil: Prevalence and Associated Factors in 2008 and 2015

Abstract Background Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in Brazil. Objective To provide population-based data on prevalence and factors associated with CVD risk factors. Methods Individuals aged ≥20 years from two editions of the cross-sectional Health Survey of São Paulo focusing on Nutrition (ISA-Nutrition), performed in Sao Paulo city in 2008 (n=590) and 2015 (n=610), were evaluated for: obesity, central obesity, waist/height ratio, high blood pressure (HBP), dyslipidemia, diabetes, and number of CVD risk factors ≥3. Prevalence was estimated according to complex survey procedures. Factors associated with cardiovascular risk factors were assessed using logistic regression, with statistical significance of p<0.05. Results Obesity and older age were associated with higher odds of all cardiovascular risk factors investigated, except for dyslipidemia. HBP was positively associated with being Black/Brown and negatively associated with being physicaly active in leisure time. Women were more likely to have increased adiposity indicators and three or more cardiovascular risk factors than men. Those with higher education had lower chances of having diabetes, HBP and dyslipidemia, and those with higher income had higher chances of having three or more risk factors. Former smokers had higher odds of diabetes, obesity, and high waist/height ratio, and smokers had higher odds of high non-HDL cholesterol levels. From 2008 to 2015, there was an increase (p<0.001) in the prevalence of diabetes (6.9% to 17.3%), HBP (31.9% to 41.8%), dyslipidemia (51.3% to 67.6%), and number of CVD risk factors ≥3 (18.9% to 34.1%). Conclusion This study shows increasing prevalence of CVD risk factors in adult population in Sao Paulo and may support the definition of target groups and priority actions on CVD prevention and treatment.

The burden of abdominal obesity with physical inactivity on health expenditure in Brazil

The purpose of this study was to analyze the association between the clustering of physical inactivity with abdominal obesity and public health care expenditure in Brazilian adults. The sample was composed of 963 patients of both genders, randomly selected in the Brazilian Public Health care System during 2010. Entire health care expenditures during the last year were computed and stratified into: medical consultations, medication dispensing, laboratory tests and overall expenditure. Waist circumference was used to diagnose abdominal obesity and physical activity was assessed by previously validated questionnaire. Sedentary and abdominally obese patients (OR= 3.01 [OR95%CI= 1.81-4.99]) had higher likelihood be inserted in the group of higher expenditures than only abdominally obese patients (OR= 1.66 [OR95%CI= 1.07-2.59]). There is a synergic effect between abdominal obesity and physical inactivity on overall health care expenditures.

O objetivo deste estudo foi analisar a associação entre a agregação de inatividade física com a obesidade abdominal e despesas de saúde pública em adultos brasileiros. A amostra foi composta de 963 pacientes de ambos os sexos, selecionados aleatoriamente no Sistema Único de Saúde em 2010. Gastos com saúde durante o último ano foram computados e estratificados em: consultas médicas, distribuição de medicamentos, exames laboratoriais e gasto total. A circunferência da cintura foi usada para diagnosticar a obesidade abdominal e atividade física foi avaliada através de um questionário previamente validado. Pacientes sedentários e com obesidade abdominal (OR = 3.01 [IC95% = 1.81-4.99]) apresentaram maior probabilidade de ser inserido no grupo de despesas mais elevadas do que apenas os pacientes com obesidade abdominal (OR= 1.66 [IC95%= 1.07-2.59]). Existe um efeito sinérgico entre a obesidade abdominal e sedentarismo em despesas totais de saúde.

El objetivo de este estudio fue analizar la asociación entre la agregación de la inactividad física con la obesidad abdominal y el gasto público en salud en adultos brasileños. La muestra consistió en 963 pacientes de ambos sexos, seleccionados al azar en el Sistema de la Salud en 2010. El gasto en salud en el último año se calcula y se estratificó en: consultas médicas, medicamentos, exámenes de laboratorio y el gasto total. Circunferencia de la cintura se utiliza para diagnosticar la obesidad abdominal y la actividad física se evaluó mediante un cuestionario previamente validado. Pacientes sedentarios y con obesidad abdominal (OR= 3,01 [IC95%= 1,81-4,99]) tenían más probabilidades de ser incluido en el grupo de los mayores gastos que sólo los pacientes con obesidad abdominal (OR= 1,66 [IC95%= 1,07-2,59]). Existe un efecto sinérgico entre la obesidad abdominal y la inactividad física en el gasto total en salud.