Applicability of Framingham risk equations for studying a low-income mexican population / Aplicabilidad del puntaje de Framingham en población mexicana de nivel socioeconómico bajo

Objective. To compare the predicted risk of coronary heart disease (CHD) and incident myocardial infarction (MI) using Framingham score equations with the observed rate of MI in Mexican subjects. Material and Methods. Longitudinal study that included 1 667 men and women aged 35 to 64 years without MI at baseline. Incident MI was defined by electrocardiogram or death certificate. The predicted risk of fatal MI, non-fatal MI, and both was calculated using Framingham score equations. Predicted to observed risk ratio of MI was estimated. Results. There were 34 incident MI cases and 24 MI deaths (median follow-up 6.2 years). The score equations overestimated the prediction of incident MI and CHD death (ratio 2.27, 95% CI, 1.19-3.34) and incident MI (ratio 2.36, 95% CI, 1.07-3.65) in men. Conclusions. The Framingham score overestimated incident MI and CHD death risk in men; however, other studies are needed to confirm our results for recalibrating the score for Mexican subjects.

Objetivo. Comparar el riesgo predicho y observado de enfermedad coronaria (EC) e infarto al miocardio (IM) usando ecuaciones del puntaje de Framingham en individuos mexicanos. Material y métodos. Estudio longitudinal de 1 667 hombres y mujeres de entre 35 a 64 años de edad y sin IM en la medición basal. IM se definió por electrocardiograma o certificado de defunción. Se estimó el riesgo predicho y la razón del riesgo predicho y observado de IM. Resultados. Durante el seguimiento (mediana de 6.2 años) hubo 34 casos y 24 defunciones por IM. El puntaje sobreestimó la predicciónde IM y muerte por EC (razón 2.27, IC 95% 1.19-3.34) e IM incidente (razón 2.36, IC 95% 1.07-3.65) en hombres. Conclusiones. En este estudio, el puntaje de Framingham sobreestimó el riesgo de IM y muerte por IM en hombres; sin embargo, estos resultados necesitan ser confirmados por otros estudios, para la posterior recalibración del puntaje en población mexicana.

Seven-year incidence and progression of obesity. Characterization of body fat pattern evolution in low-income Mexico City urban population.

BACKGROUND: There are no prospective data regarding the natural history of obesity in Mexico. The objective of this research was to investigate the incidence and progression of obesity in a low-income sector of Mexico City and to characterize evolution of body fat pattern distribution. METHODS: We carried out a population-based, prospective survey. Total on-site population was 15,532 persons; we determined as eligible all 35 to 64-year-old men and nonpregnant women for a total of 3,505. We interviewed at baseline 3,319 (94.7%) individuals and examined 2,282 (65.1%). At follow-up approximately 7 years later, we interviewed 1,764 (77.3%) subjects and examined 1,594 (69.9%). Measurements for all participants included height, weight, body mass index (BMI), waist-hip circumference, and subscapular and triceps skinfold thickness. Overweight was defined as BMI > or = 25 and < or = 29.9 kg/m2, while grade 1 obesity was BMI >or = 30 and < or = 34.9 kg/m2, grade 2 was > or = 35 and < or = 39.9, and grade 3, > or = 40 kg/m2. RESULTS: At baseline, prevalence of overweight was 48.6%, and grade 1 obesity, 22.7%, grade 2, 5.1%, and grade 3 obesity was 1.4%; at follow-up, these were 45.2, 25.8, 6.6, and 2.3%, respectively. At baseline, mean BMI in women was 29.1 +/- 0.16 kg/m2 and in men, 27.3 +/- 0.15 kg/m2; at follow-up, it reached 29.4 +/- 0.17 kg/m2 in women and 27.4 +/- 0.16 kg/m2 in men. Waist circumference increased from mean of 99.7 +/- 0.44 cm in women to 101.2 +/- 0.42 cm; in men, mean waist circumference rose from 95.2 +/- 0.38 to 96.7 +/- 0.39 cm. CONCLUSIONS: The obesity epidemic in this population possesses serious proportions that increase risk for severe metabolic consequences. There is a need for intervention.