ABSTRACT
Resumen: ANTECEDENTES: Estudios previos han encontrado variabilidad en la prevalencia del síndrome metabólico según diferentes definiciones. OBJETIVO: Determinar el grado de concordancia entre diferentes definiciones en una cohorte colombiana de base poblacional. MATERIAL Y MÉTODO: Estudio de cohorte prospectivo realizado en pacientes con edades comprendidas entre 15 y 64 años. Se realizó medición estandarizada de los diferentes factores de riesgo cardiovascular en 2001, 2007 y 2013. Se realizó un análisis univariado para describir la distribución de los factores de riesgo cardiovascular según las definiciones de síndrome metabólico propuestas por la Organización Mundial de la Salud (OMS), el Adult Panel Treatment III (ATPIII) y la Federación Internacional de Diabetes (IDF). El análisis de concordancia se realizó de acuerdo con el índice de concordancia Kappa. RESULTADOS: En 2001 se incluyeron 243 participantes. El 67% eran mujeres. La edad promedio fue de 36 años. La prevalencia del síndrome metabólico según las definiciones de la OMS, ATPIII e IDF fue de 5.2, 7 y 11.3% en 2001, 11.8, 9.5 y 17% en 2007 y 24, 17.3 y 29% en 2013, respectivamente. Se documentó un grado de acuerdo moderado entre las diferentes definiciones. CONCLUSIÓN: Existe variabilidad en la prevalencia del síndrome metabólico según cada una de las diferentes definiciones utilizadas, es mayor cuando se utiliza la definición propuesta por la IDF, probablemente debido al punto de corte utilizado para definir la obesidad.
Abstract: BACKGROUND: Previous studies have found variability in the prevalence of metabolic syndrome according different definitions. OBJECTIVE: To determine the degree of agreement between different definitions in a Colombian population-based cohort. MATERIAL AND METHOD: A prospective cohort conducted in patients aged between 15 to 64 years. Standardized measurements of cardiovascular risk factors were made in 2001, 2007 and 2013. Univariate analysis was performed to describe the distribution of these cardiovascular risk factors according to metabolic syndrome definition proposed by World Health Organization (WHO), Adult Panel Treatment III (ATPIII) and International Diabetes Federation (IDF). Concordance analysis was performed according to the Kappa concordance index. RESULTS: In 2001, 2432 participants were included, 67% were women. The average age was 36 years. The prevalence of metabolic syndrome according to the WHO, AT- PIII and IDF definitions was 5.2%, 7%, and 11.3% in 2001, 11.8%, 9.5% and 17% in 2007 and 24%, 17.3% and 29% in 2013, respectively. There evidence of moderate agreement between definitions. CONCLUSION: There is variability in the prevalence of metabolic síndrome according to each of the different definitions used being higher when using the definition proposed by the IDF, probably due to the cut-off point used to define obesity.
ABSTRACT
Nonsteroidal anti-inflammatory drugs are known to increase blood pressure and blunt the effect of antihypertensive drugs. Surprisingly, it has been suggested recently that aspirin lowers blood pressure and could be used for preventing hypertension. This review summarizes published data on the effects of aspirin on blood pressure. Trials suggesting that aspirin administered at bedtime lowers blood pressure are uncontrolled, unmasked, and potentially biased. They also conflict with cohort studies showing an 18% increase in the risk of hypertension among aspirin users. Fortunately, short-term use of aspirin does not seem to interfere with antihypertensive drugs. Regardless of its effect on blood pressure, low-dose aspirin effectively prevents cardiovascular events in patients with and without hypertension, but its benefits should be carefully weighed against a potential increase in the risk of adverse effects such as gastric bleeding and hemorrhagic stroke, as well as a small increase in the risk of hypertension.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Antihypertensive Agents/therapeutic use , Aspirin/therapeutic use , Hypertension/drug therapy , Platelet Aggregation Inhibitors/therapeutic use , Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Antihypertensive Agents/pharmacology , Aspirin/pharmacology , Blood Pressure/drug effects , Evidence-Based Medicine , Humans , Platelet Aggregation Inhibitors/pharmacology , Risk , Risk FactorsABSTRACT
BACKGROUND: Although cardiovascular diseases are the main cause of death in the region, there are few data on the prevalence of cardiovascular risk factors in Latin American. We studied the distribution and impact of cardiovascular risk factors in Bucaramanga, Colombia. METHODS: We conducted a cross-sectional study in a random sample of 2989 subjects 15-64 years old. Population attributable risks were estimated from Framingham risk scores. RESULTS: Smoking prevalence was 16.2% (men 26.3%; women 10.5%). Hypertension prevalence was 9.9% in women and 8.8% in men, but reached 50% in those 60-64 years old. After adjustment for body mass index, men were more likely to be hypertensive, but only if under 40 years old. Obesity was more frequent in women (15.7%) than in men (8.7%), even after age-adjustment. About 46% of the participants were overweight or obese. Women also had higher prevalence of high total cholesterol (19.7 versus 15.7%) and high low-density lipoprotein-cholesterol (23.9 versus 19.5%), but lower prevalence of low high-density lipoprotein (HDL)-cholesterol (22.2 versus 37.6%). Only low-HDL prevalence was significantly different after body mass index and age-adjustment. The prevalence of diabetes was similar in men and women (4%), but age and body mass index-adjusted impaired fasting glucose prevalence was 60% higher in women. Population attributable risks were larger and similar for high total cholesterol, hypertension, and large waist-to-hip ratio (19%). CONCLUSIONS: Women had higher prevalence of all risk factors with the exception of smoking and low-HDL. Reduction in cholesterol levels, blood pressure and obesity is a priority to control the ongoing epidemic of cardiovascular diseases in this population.
