Clara Eugenia Pérez

Cardiovascular risk factors and metabolic syndrome in a population of young students from the National University of Colombia

OBJECTIVE To estimate prevalence and distribution of cardiovascular risk factors and Metabolic Syndrome (MS) in young individuals admitted to the National University of Colombia in Bogotá. METHODS An analytic cross-sectional study was conducted in a sample of 249 individuals of both genders aged 15 to 20 years. A questionnaire was personally administered to collect demographic, socioeconomic, smoking, perinatal, and womens health data. Anthropometric measurements, blood pressure, and a fasting blood sample were taken. Prevalence of MS was determined and compared using criteria from several qualified institutions. RESULTS We found a high prevalence of smoking (18.9%), arterial prehypertension (14.1%) and overweight (11.2%), 9.2% of study participants had prediabetes, and the most frequent dyslipidemia was low HDL cholesterol (13.3%). Alcoholic beverage consumption was declared by 60.6% of study terol and plasma triglyceride levels. Gestational age at birth was inversely associated with presence of low HDL cholesterol levels and high blood pressure. Prevalence of the MS varied markedly according to the definition employed: 9.2% using REGODCI (Research Group on Diabetes and Chronic Illnesses) criteria, 2% using IDF (International Diabetes Federation) criteria, and 2.4% using AHA (American Heart Association) criteria. CONCLUSION The encountered prevalence of modifiable cardiovascular risk factors justifies promotion of therapeutic lifestyle changes among this age group in Colombia. Further harmonization of MS criteria in young individuals is needed.

Valoración del riesgo cardiovascular global y prevalencia de dislipemias según los criterios del NCEP-ATP III en una población adulta de Bogotá, Colombia

Antecedentes Las enfermedades cardiovasculares son la principal causa de muerte en Colombia y en el mundo. Sin embargo, no se dispone de suficiente documentacion sobre la prevalencia y la distribucion de los factores de riesgo cardiovascular en la poblacion colombiana. Ningun studio ha determinado la prevalencia de las dislipemias y el syndrome metabolico de acuerdo con los criterios del NCEP-ATP III en Colombia. Objetivo Valorar el riesgo cardiovascular global y determinar la prevalencia de las dislipemias y los factores de riesgo cardiovascular en una muestra de adultos no hospitalizados residentes en Bogota, Colombia. Metodos Se estudio a 364 individuos adultos. Mediante una encuesta supervisada se indagaron la edad, los antecedentes familiares de enfermedad cardiovascular y el habito de fumar. Se determinaron la talla, el peso, el perimetro de la cintura, el perimetro de la cadera y la presion arterial por metodos estandarizados. En muestras de sangre tomadas el mismo dia se determinaron la glucemia en ayuno y el perfil lipidico minimo. Se calculo el riesgo cardiovascular global a 10 anos mediante las tablas de Framingham, y se clasifico a cada paciente en una categoria de riesgo de acuerdo con los criterios de ILIB-Latinoamerica (riesgo latente, intermedio o alto). La prevalencia de sindrome metabolico tambien se calculo de acuerdo con los criterios de ILIB-Latinoamerica. Se considero que era dislipemico todo individuo que no se encontrara en las metas trazadas para su categoria de riesgo segun el NCEP-ATP III. Resultados Se encontro una alta prevalencia de sobrepeso (37,3%), obesidad (9,6%), obesidad central (39,2%) y sindrome metabolico (28%). La hipertension arterial y la obesidad se asociaron con modificaciones significativas en el perfil de lipidos, especialmente con incrementos en los trigliceridos y descensos en el colesterol ligado a lipoproteinas de alta densidad (cHDL). El tabaquismo en ambos sexos y la obesidad central entre las mujeres se asociaron con valores mas bajos de cHDL. El riesgo cardiovascular global promedio a 10 anos fue del 3,89% (un 7,25% en varones y un 1,97% en mujeres). La prevalencia general de dislipemias fue del 66,7% (un 52% en el grupo de riesgo latente, un 88,8% en el de riesgo intermedio y un 100% en el de riesgo alto). En el grupo de riesgo latente predomino el cHDL bajo aislado, y en el de riesgo alto, la dislipemia combinada.

Reduction of global cardiovascular risk with nutritional versus nutritional plus physical activity intervention in Colombian adults

Background Cardiovascular disease is a major cause of morbidity/mortality in non-developed countries. Reports of the effects of non-pharmacological interventions on global cardiovascular risk in Latin American adults, however, are scarce. Objective To compare the change in global cardiovascular risk induced by a tailored, Adult Treatment Panel-III compliant nutrition program versus the same program with addition of supervised, regular physical activity in Colombian adults. Design The study was a randomized, controlled trial. Methods Seventy-five Colombian patients aged 40–70 years and with Framingham-estimated global cardiovascular risk of 1% or higher were randomly assigned to a nutritional intervention program or a combined nutritional intervention-physical exercise program for 16 weeks. Patients underwent medical and anthropometric evaluation, bioelectrical impedance, lipid profile and Framingham global cardiovascular risk determination at baseline and at the end of follow-up. Results The groups were comparable at baseline; 21 persons in the nutritional intervention program group and 27 in the nutritional intervention-physical exercise program group completed the follow-up. Global cardiovascular risk modification (mean ± SE) was −2.04 ± 1.1 absolute percentage points (relative reduction 19.6%) in the nutritional intervention-physical exercise program group, compared with 0.23 ± 0.9 (relative increase 2.8%) in the nutritional intervention program group. Mean difference in global cardiovascular risk modification between groups reached borderline statistical significance in ANCOVA (P = 0.054). Reductions in systolic and diastolic blood pressure, waist circumference and low-density lipoprotein cholesterol were similar, but the nutritional intervention-physical exercise program group achieved significantly greater improvements in body weight, body mass index, percentage body fat and high-density lipoprotein cholesterol. Conclusions Our data suggest that a structured nutritional intervention-physical exercise program is more efficacious than a nutritional intervention program in the reduction of global cardiovascular risk and cardiovascular risk factors, in only 16 weeks.