LATIN AMERICA SHOWS DISTINCT DISEASE RISK PROFILEThe risk factors for cardiovascular disease are the same for men and women throughout the world. They include physical inactivity, overweight and obesity, poor diet and nutrition, tobacco smoking, high blood pressure, high blood cholesterol and diabetes. However, where populations are concerned, the risk factors may present themselves in different proportions. For example, a population in one country or region may have significantly different rates of physical inactivity than populations in another country or region. Understanding the differences can be crucial to preventing myocardial infarctions. The differencesLatin America is distinct in that it presents remarkably higher proportions of abdominal obesity, high blood cholesterol and hypertension, according to the results of a study published in the 6 March 2007 edition of the American Heart Association’s journal Circulation. The study analyzed data from the six Latin American countries that participated in the INTERHEART international study. In Argentina, Brazil, Chile, Colombia, Guatemala and Mexico, the population-adjusted risk for abdominal obesity was 48.6% compared to 31.2% in the 46 other countries that participated in INTERHEART. For high blood cholesterol, it was 42% compared to the other countries’ 32%. For hypertension, it was 29.1% compared to the others’ 20.8%. At 48.1%, the population-adjusted risk for tobacco smoking was about the same for both the Latin American and the non-Latin American countries. Lanas, Escobar play lead rolesThe lead author was Dr Fernando Lanas, Professor of medicine at the Universidad de la Frontera in Temuco, Chile. The study appeared in a special edition of Circulation that focused on Latin America and that was edited by Dr Edgardo Escobar, who is also Chair of the World Heart Federation’s Council on Clinical Cardiology. Another study published in the same edition revealed that the two most important risk factors for myocardial infarctions in Costa Rica were abdominal obesity and smoking. Smith encourages changeIn the accompanying editorial, Dr Sidney Smith, Jr, Chairman of the World Heart Federation’s Scientific Advisory Board, noted with “particular concern” the high rates of abdominal obesity because it can significantly increase the risk of cardiovascular disease and diabetes. “The results of these two important studies underline the need for major lifestyle and behaviorial modification in Latin America if the growing toll of coronary heart disease is to be reversed,” wrote Dr Smith. He added, “In Latin American countries and many others with developing economies, there has been a rapid shift to increased consumption of high energy-dense foods and caloric beverages, animal-source foods and caloric sweeteners added to many other foods. “Importantly, the availability and greater consumption of caloric beverages is not associated with a reduction in food intake.” Dr Smith urged Latin American countries to look at Brazil for insights into programmes that could reduce obesity, including national food and nutrition policies “to promote eating habits and lifestyles that will optimize health and nutritional patterns throughout the country.” Brazil’s policies emphasize nutritional labelling of packaged foods with recommendations on serving sizes, mandates that 70% of schools’ food budgets be spent on fresh vegetables, fruits and minimally processed foods from local producers and farmers, and strategies to increase physical activity, he wrote. Dr Smith emphasized that a significant opportunity to raise awareness about the problems identified in the studies will present itself in May 2008 when the World Heart Federation will host its next World Congress of Cardiology in Buenos Aires, Argentina. “Hopefully, such awareness will lend further support to vitally needed programmes to improve the lifestyles contributing to the epidemic of cardiovascular disease,” Dr Smith wrote. The studies and the editorial can be accessed on the Circulation web site at http://circ.ahajournals.org/. | |||||||
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