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      The prevalence of chronic diseases and major disease risk factors at different ages among 150 000 men and women living in Mexico City: cross-sectional analyses of a prospective study

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          Abstract

          Background

          While most of the global burden from chronic diseases, and especially vascular diseases, is now borne by low and middle-income countries, few large-scale epidemiological studies of chronic diseases in such countries have been performed.

          Methods

          From 1998–2004, 52 584 men and 106 962 women aged ≥35 years were visited in their homes in Mexico City. Self reported diagnoses of chronic diseases and major disease risk factors were ascertained and physical measurements taken. Age- and sex-specific prevalences and means were analysed.

          Results

          After about age 50 years, diabetes was extremely common – for example, 23.8% of men and 26.9% of women aged 65–74 reported a diagnosis. By comparison, ischaemic heart disease was reported by 4.8% of men and 3.0% of women aged 65–74, a history of stroke by 2.8% and 2.3%, respectively, and a history of cancer by 1.3% and 2.1%. Cancer history was generally more common among women than men – the excess being largest in middle-age, due to breast and cervical cancer. At older ages, the gap narrowed because of an increasing prevalence of prostate cancer. 51% of men and 25% of women aged 35–54 smoked cigarettes, while 29% of men and 41% of women aged 35–54 were obese (i.e. BMI ≥30 kg/m 2). The prevalence of treated hypertension or measured blood pressure ≥140/90 mmHg increased about 50% more steeply with age among women than men, to 66% of women and 58% of men aged 65–74. Physical inactivity was highly prevalent but daily alcohol drinking was relatively uncommon.

          Conclusion

          Diabetes, obesity and tobacco smoking are highly prevalent among adults living in Mexico City. Long-term follow-up of this and other cohorts will establish the relevance of such factors to the major causes of death and disability in Mexico.

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          Most cited references7

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          Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization.

          This two-part article provides an overview of the global burden of atherothrombotic cardiovascular disease. Part I initially discusses the epidemiologic transition which has resulted in a decrease in deaths in childhood due to infections, with a concomitant increase in cardiovascular and other chronic diseases; and then provides estimates of the burden of cardiovascular (CV) diseases with specific focus on the developing countries. Next, we summarize key information on risk factors for cardiovascular disease (CVD) and indicate that their importance may have been underestimated. Then, we describe overarching factors influencing variations in CVD by ethnicity and region and the influence of urbanization. Part II of this article describes the burden of CV disease by specific region or ethnic group, the risk factors of importance, and possible strategies for prevention.
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            Anthropometric cutoff points for predicting chronic diseases in the Mexican National Health Survey 2000.

            To determine optimum anthropometric cutoffs for predicting the likelihood ratios of type 2 diabetes mellitus (DM) and hypertension (HT) in Mexicans. Data from a randomly selected, nationally representative health survey (2000) with 11,730 men [37.4 (+/- 12.9) years] and 26,647 women [37.3(+/- 12.9) years] were assessed for values of body mass index (BMI) and waist circumference (WC) for predicting DM or HT by receiver operating characteristic curve analyses. Likelihood ratios for DM and HT were calculated, and BMIs or WCs for public-health screening were developed. Subanalyses included regional data. Likelihood ratios of DM and HT increased from BMI values of 22 to 24 kg/m(2) in both sexes and with WC values of 75 to 80 cm in men and 70 to 80 cm in women. The best BMI cutoffs for predicting DM were 26.3 to 27.4 kg/m(2) in men and 27.7 to 28.9 kg/m(2) in women, with similar values for HT, i.e., 26.2 to 27.0 kg/m(2) and 27.7 to 28.5 kg/m(2), for men and women, respectively; WC cutoffs for DM were 93 to 98 cm in men and 94 to 99 cm in women, and cutoffs for HT were 92 to 96 cm and 93 to 96 cm for men and women, respectively. The WC cutoffs had higher sensitivity and specificity than those of BMI. The risk for DM and HT starts at lower levels of BMI and WC than those suggested by WHO. WC is a better discriminator than BMI measures for use in public health.
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              Cohort profile: the Mexico City Prospective Study.

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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2009
                9 January 2009
                : 9
                : 9
                Affiliations
                [1 ]Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
                [2 ]Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
                [3 ]Secretaria de Salud, Direccion General de Epidemiologia, Mexico City, Mexico
                Article
                1471-2458-9-9
                10.1186/1471-2458-9-9
                2645387
                19134207
                38f0a38f-fa99-438d-9850-d48ca0a9b43b
                Copyright © 2009 Kuri-Morales et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 April 2008
                : 9 January 2009
                Categories
                Research Article

                Public health
                Public health

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