Contribution of modifiable risk factors for hypertension and type-2 diabetes in Peruvian resource-limited settings.
Contribution of modifiable risk factors for hypertension and type-2 diabetes in Peruvian resource-limited settings.
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DOI：
10.1136/jech-2015-205988
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发表时间：
2016-01
影响因子：
6.3
通讯作者：
CRONICAS Cohort Study Group
中科院分区：
文献类型：
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作者：
Bernabé-Ortiz A;Carrillo-Larco RM;Gilman RH;Checkley W;Smeeth L;Miranda JJ;CRONICAS Cohort Study Group
必须了解当地非传染性疾病的负担，包括国家内部的异质性。本研究的目的是在秘鲁不同的地理环境中评估高血压和2型糖尿病的概况，强调对可改变的风险因素的评估。对CRONICAS队列研究基线评估进行了分析。心脏代谢结局为血压类别（高血压、高血压前期、正常）和糖代谢紊乱状态（糖尿病、糖尿病前期、正常）。暴露是研究环境和六个可改变的因素（吸烟，饮酒，休闲时间和交通相关的体力活动水平，看电视，水果/蔬菜摄入量和肥胖）。Poisson回归模型用于报告患病率（PR）。还估计了人群归因风险（PAR）。分析了来自3238名参与者的数据，其中48.3%为男性，平均年龄45.3岁。 WHO标准化（WHO人群）高血压前期和高血压的患病率分别为24%和16%，而糖尿病前期和2型糖尿病的患病率分别为18%和6%。结果因研究环境而异（p <0.001）。多变量模型显示，高血压在每日吸烟者（PR 1.76）、重度饮酒者（PR 1.61）和肥胖者（PR 2.06）中较高，而只有肥胖者（PR 2.26）增加糖尿病患病率。PAR显示肥胖是高血压（15.7%）和2型糖尿病（23.9%）的重要决定因素。在秘鲁，高血压和糖尿病的发病率和危险因素存在明显的异质性。高血压前期和糖尿病前期在各种环境中非常普遍。我们的研究结果强调，需要了解心脏代谢疾病的流行病学，以适当实施干预措施，以应对非传染性疾病的负担。
It is important to understand the local burden of non-communicable diseases including within-country heterogeneity. The aim of this study was to characterise hypertension and type-2 diabetes profiles across different Peruvian geographical settings emphasising the assessment of modifiable risk factors. Analysis of the CRONICAS Cohort Study baseline assessment was conducted. Cardiometabolic outcomes were blood pressure categories (hypertension, prehypertension, normal) and glucose metabolism disorder status (diabetes, prediabetes, normal). Exposures were study setting and six modifiable factors (smoking, alcohol drinking, leisure time and transport-related physical activity levels, TV watching, fruit/vegetables intake and obesity). Poisson regression models were used to report prevalence ratios (PR). Population attributable risks (PAR) were also estimated. Data from 3238 participants, 48.3% male, mean age 45.3 years, were analysed. Age-standardised (WHO population) prevalence of prehypertension and hypertension was 24% and 16%, whereas for prediabetes and type-2 diabetes it was 18% and 6%, respectively. Outcomes varied according to study setting (p<0.001). In multivariable model, hypertension was higher among daily smokers (PR 1.76), heavy alcohol drinkers (PR 1.61) and the obese (PR 2.06); whereas only obesity (PR 2.26) increased the prevalence of diabetes. PAR showed that obesity was an important determinant for hypertension (15.7%) and type-2 diabetes (23.9%). There is an evident heterogeneity in the prevalence of and risk factors for hypertension and diabetes within Peru. Prehypertension and prediabetes are highly prevalent across settings. Our results emphasise the need of understanding the epidemiology of cardiometabolic conditions to appropriately implement interventions to tackle the burden of non-communicable diseases.