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      Prevalencia e interrelación de enfermedades crónicas no transmisibles y factores de riesgo cardiovascular en México: Resultados finales de la Encuesta Nacional de Salud (ENSA) 2000 Translated title: Prevalence and interrelations of noncommunicable chronic diseases and cardiovascular risk factors in Mexico: Final outcomes from the National Health Survey 2000

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          Abstract

          Propósito: Determinar la prevalencia e interrelación de enfermedades crónicas no transmisibles (ECNT), obesidad, tabaquismo y proteinuria en la población adulta (entre 20 y 69 años) de la república mexicana, así como su estratificación de acuerdo a grupos de edad, género y área geográfica. Método: En el año 2000 se realizó una encuesta nacional probabilística en 45,300 personas. El tamaño de la muestra fue calculado para abordar ENCT con una prevalencia mínima estimada de 6%. La encuesta corresponde al tipo III del método paso a paso descrito por la OMS. Los datos fueron ponderados para la distribución de población y género, de acuerdo con la encuesta nacional de población y vivienda 2000 (INEGI). Resultados: Un total de 38,377 (98.8%) sujetos fueron incluidos para el análisis. El 69.4% fueron mujeres. La edad promedio para el género masculino fue de 39.4 ± 12.9 y para el femenino de 38.6 ± 13.0 transmisibles con la encuesta nacional de salud. La prevalencia nacional promedio para hipertensión fue del 30.05%, para diabetes del 10.7%, para obesidad del 24.4%, para glucosa capilar anormal del 12.7% y para proteinuria del 9.2%. Las prevalencias de hipertensión y diabetes fueron directamente relacionadas con la edad, índice de masa corporal y perímetro de la cintura. La distribución piramidal de la población mexicana determinó que la proporción mayoritaria en las prevalencias de las ECNT se ubicaran antes de los 54 años de forma significativa (> 75%). Conclusión: ENSA 2000 demuestra el incremento notable en la prevalencia de ECNT en México y alerta sobre la necesidad urgente de estrategias nacionales que permitan contener este importante problema de salud pública. Las estrategias deben ser orientadas al abordaje conjunto de las ECNT ya que su interrelación clínica y fisiopatológica queda demostrada en ENSA 2000.

          Translated abstract

          Purpose: To determine the prevalence and interrelation of noncommunicable chronic diseases (NCCD), obesity, smoking, and proteinuria in the adult population (between 20 and 69 years of age) of Mexico, and their stratification according to age, gender, and geographical area. Method: During the year 2000, a probabilistic national survey was performed in 45,300 persons. The sample size was calculated to approach NCCD with a minimal estimated prevalence of 6%. The survey corresponds to type III of the step-by-step method described by WHO. Data were weighted for the distribution of the population and gender, according to the national survey of population and housing (National Institute of Statistics and Geography, INEGI). Results: A total of 38,377 (98.8%) of individuals were included in the analysis; 69.4% were women. Average age for men was 39.4 ± 12.9 and for women 38.6 ± 13.0. National average prevalence for hypertension was 30.05%, for diabetes of 10.7%, for obesity of 24.4%, for abnormal capillary glucose of 12.7%, and for proteinuria of 9.2%. Prevalence for hypertension and diabetes were directly related with age, body mass index, and waist perimeter. The pyramidal distribution of the Mexican population determined that the greatest proportion of prevalence of NCCD was given by those under 54 years of age with a statistical significance (>75%). Conclusion: ENSA 2000 demonstrates the marked increase in NCCD prevalence in the Mexican population and alerts on the urgent need of national strategies to restrain this important public health problem. Strategies must be oriented towards an integrated approach of the NCCD, since their clinical and physiopathological interrelation is clearly demonstrated through ENSA 2000. (Arch Cardiol Mex 2003; 73:62-77)

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          Most cited references58

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          Applied Logistic Regression

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            Awareness, treatment, and control of hypertension in Canada.

            M. Joffres (1997)
            The Canadian Heart Health Surveys are cross-sectional, population-based cardiovascular disease risk factor surveys that took place in each of the 10 Canadian provinces between 1986 and 1992. Hypertension awareness, treatment, and control status are examined. Of 23,129 randomly selected, noninstitutionalized respondents aged 18 to 74 years, 85% had four blood pressure (BP) measurements taken under standardized conditions, two at home during a home interview and two at a following clinic visit. The mean of all available measurements was used to determine hypertension status. Estimates are weighted and represent population values. Only 2% of respondents had never had their BP checked, and 73% had had their BP checked in the last 12 months. A systolic or diastolic BP > or = 140/90 mm Hg was found in 22% of participants (26% of men, 18% of women), representing 4.1 million Canadians. Overall, 16% of participants were treated and controlled; 23% were treated and not controlled; 19% were not treated and not controlled; and 42% were unaware of their hypertension (47% of men and 35% of women). Among hypertensives 18 to 34 years old, 64% of men and 19% of women were unaware of their hypertension. Among treated and not controlled hypertensives 63% had a mean systolic BP > or = 150 mm Hg, and 29% a diastolic BP > or = 95 mm Hg, suggesting that an important number of Canadians treated for hypertension are still at increased risk. Despite frequent interactions with the health care system, too many Canadians are still not well controlled or are unaware of their hypertension.
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              Effects of current smoking and smoking discontinuation on renal function and proteinuria in the general population.

              Smoking may adversely affect the progression of renal diseases. However, it is unknown whether smoking affects renal function in subjects without nephropathy. In 1998, 28,409 volunteers from the general population were examined at the Institut Régional pour la Santé (IRSA). Renal function was estimated with creatinine clearance using the Cockcroft formula. Dipstick proteinuria was assessed on an overnight urine sample by a trained technician. Adjusted creatinine clearance was higher in current smokers than in former smokers and never smokers (100.6 +/- 13.6 vs. 98.8 +/- 13.9 mL/min/1.73 m2, P < 0.0001, and vs. 98.5 +/- 14.0 mL/min/1. 73 m2, P < 0.0001, respectively). This difference was predominant in men and weak in women, and was associated with the number of cigarettes smoked daily. The slope of the projected age-related decline in the creatinine clearance accelerated with age, but it was similar in current smokers, former smokers, and never smokers. Creatinine clearance was associated with a relative risk of proteinuria [for each mL/min/1.73 m2, the relative risk was 1.007 (95% CI, 1.000 to 1.015), P = 0.056, for 1+ or higher proteinuria; and 1.018 (1.004 to 1.030), P = 0.0078, for 2+ or higher proteinuria]. Current and former smokers had a marked risk of 2 or higher proteinuria [adjusted RR (95% CI), 3.26 (1.66 to 6.80), P = 0. 0009, and 2.69 (1.24 to 5.99), respectively, P = 0.013, vs. never smoking], which was independent of the daily or cumulative cigarette consumption. In the general population, smokers do not exhibit lower creatinine clearance than never smokers. In fact, creatinine clearance is slightly higher in current smokers at least in men, even when normotensive and hypertensive subjects are analyzed separately, but the difference is small, especially in women. This effect seems reversible upon smoking discontinuation. Chronic smoking results in a marked risk of irreversible proteinuria that may occur despite moderate smoking.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
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                Journal
                acm
                Archivos de cardiología de México
                Arch. Cardiol. Méx.
                Elsevier
                1405-9940
                March 2003
                : 73
                : 1
                : 62-77
                Affiliations
                [1 ] Secretaria de Salud México
                Article
                S1405-99402003000100009
                0fbb0442-4d38-4a47-9f9f-103b4bc25dd6

                http://creativecommons.org/licenses/by/4.0/

                History
                Categories
                Cardiac & Cardiovascular Systems

                Cardiovascular Medicine
                National Survey,cardiovascular risk factors,epidemiological tanscition,Encuesta Nacional,factores de riesgo cardiovascular, (hipertensión, diabetes, obesidad)

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