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      Prevalencia de factores de riesgo cardiovascular clásicos en población adulta de Talca, Chile, 2005 Translated title: Prevalence of cardiovascular risk factors in adult from Talca, Chile

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          Background: Cardiovascular disease (CVD) has several traditional risk factors (RF), and some of them are potentially modifiable. Aim: To determine the prevalence of most common risk factors in adult population in Talca in Central Chile. Subjects and methods: We studied 1007 subjects aged 18 to 74 years (66% women), living in Talca, selected by a probability sampling. They answered a questionnaire and anthropometry, blood pressure, lipid profile and blood glucose were measured. Results: Thirty seven percent of subjects smoked, 70.1% had a body mass index over 25 kg/m² and 41% had an abnormally high circumference. High blood pressure was found in 37% (36% of these subjects were unaware of this condition), 44.5% had hypercholesterolemia, 21.5% had low HDL cholesterol, 40.1% had hypertriglyceridemia and 26.3% had high blood glucose levels. Conclusions: There is a high prevalence of risk factors for CVD in adult population from Talca. The prevalence of risk factors is higher than that reported by the 2003 National Health Survery

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          The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure.

          Racial and ethnic minority populations are growing segments of our society. The prevalence of hypertension in these populations differs across groups, and control rates are not as good as in the general population. Clinicians should be aware of these management challenges, taking social and cultural factors into account. Guidelines are provided for management of children and women with hypertension. In older persons, diuretics are preferred and long-acting dihydropyridine calcium antagonists may be considered. Specific therapy for patients with LVH, coronary artery disease, and heart failure are outlined. Patients with renal insufficiency with greater than 1 g/d of proteinuria should be treated to a therapy blood pressure goal of 125/75 mm Hg; those with less proteinuria should be treated to a blood pressure goal of 130/85 mm Hg. ACE inhibitors have additional renoprotective effects over other antihypertensive agents. Patients with diabetes should be treated to a therapy blood pressure goal of below 130/85 mm Hg. Hypertension may coexist with various other conditions and may be induced by various pressor agents.
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            The Metabolic Syndrome: A Global Public Health Problem and A New Definition

            The constellation of metabolic abnormalities including centrally distributed obesity, decreased high-density lipoprotein cholesterol (HDL-C), elevated triglycerides, elevated blood pressure (BP), and hyperglycaemia is known as the metabolic syndrome. Associated with a 3 fold and 2 fold increase in type 2 diabetes and cardiovascular disease (CVD), respectively, it is thought to be a driver of the modern day epidemics of diabetes and CVD and has become a major public health challenge around the world. Since its initial description, several definitions of the syndrome have emerged. Each of these definitions used differing sets of criteria, which reflected contrasting views on pathogenic mechanisms and the need for clinical usefulness. The use of these definitions to conduct research into the metabolic syndrome in diverse populations resulted in wide ranging prevalence rates, inconsistencies and confusion, and spurred on the vigorous debate regarding how the metabolic syndrome should be defined. In response to this controversy, the International Diabetes Federation (IDF) has recently proposed a new definition, which is applicable to populations around the world. It is envisaged that the development of the new definition for the metabolic syndrome will help resolve the confusion caused by the number of earlier attempts to define this important entity.
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              Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines.

              The Adult Treatment Panel III (ATP III) of the National Cholesterol Education Program issued an evidence-based set of guidelines on cholesterol management in 2001. Since the publication of ATP III, 5 major clinical trials of statin therapy with clinical end points have been published. These trials addressed issues that were not examined in previous clinical trials of cholesterol-lowering therapy. The present document reviews the results of these recent trials and assesses their implications for cholesterol management. Therapeutic lifestyle changes (TLC) remain an essential modality in clinical management. The trials confirm the benefit of cholesterol-lowering therapy in high-risk patients and support the ATP III treatment goal of low-density lipoprotein cholesterol (LDL-C) <100 mg/dL. They support the inclusion of patients with diabetes in the high-risk category and confirm the benefits of LDL-lowering therapy in these patients. They further confirm that older persons benefit from therapeutic lowering of LDL-C. The major recommendations for modifications to footnote the ATP III treatment algorithm are the following. In high-risk persons, the recommended LDL-C goal is <100 mg/dL, but when risk is very high, an LDL-C goal of <70 mg/dL is a therapeutic option, ie, a reasonable clinical strategy, on the basis of available clinical trial evidence. This therapeutic option extends also to patients at very high risk who have a baseline LDL-C < 100 mg/dL. Moreover, when a high-risk patient has high triglycerides or low high-density lipoprotein cholesterol (HDL-C), consideration can be given to combining a fibrate or nicotinic acid with an LDL-lowering drug. For moderately high-risk persons (2+ risk factors and 10-year risk 10% to 20%), the recommended LDL-C goal is <130 mg/dL, but an LDL-C goal <100 mg/dL is a therapeutic option on the basis of recent trial evidence. The latter option extends also to moderately high-risk persons with a baseline LDL-C of 100 to 129 mg/dL. When LDL-lowering drug therapy is employed in high-risk or moderately high-risk persons, it is advised that intensity of therapy be sufficient to achieve at least a 30% to 40% reduction in LDL-C levels. Moreover, any person at high risk or moderately high risk who has lifestyle-related risk factors (eg, obesity, physical inactivity, elevated triglycerides, low HDL-C, or metabolic syndrome) is a candidate for TLC to modify these risk factors regardless of LDL-C level. Finally, for people in lower-risk categories, recent clinical trials do not modify the goals and cutpoints of therapy.
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                Author and article information

                Journal
                rmc
                Revista médica de Chile
                Rev. méd. Chile
                Sociedad Médica de Santiago (Santiago, , Chile )
                0034-9887
                July 2007
                : 135
                : 7
                : 904-912
                Affiliations
                [03] Talca orgnameUniversidad de Talca orgdiv1Facultad de Ciencias orgdiv2Departamento de Salud Pública Chile
                [05] Talca orgnameUniversidad de Talca orgdiv1Escuela de Psicología Chile
                [02] Talca orgnameUniversidad de Talca orgdiv1Instituto de Matemática y Física Chile
                [01] Talca orgnameUniversidad de Talca orgdiv1Facultad de Ciencias orgdiv2Departamento de Bioquímica Clínica e Inmunohematología Chile
                [04] orgnameHospital Regional de Talca orgdiv1Servicio de Medicina Chile
                Article
                S0034-98872007000700011 S0034-9887(07)13500711
                10.4067/S0034-98872007000700011
                986ea26d-efd9-4b8e-80f6-7158909f8ebb

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 04 January 2007
                : 11 October 2006
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 26, Pages: 9
                Product

                SciELO Chile

                Categories
                ARTICULOS DE INVESTIGACION

                Cardiovascular diseases,Risk factors,Obesity,Overweight
                Cardiovascular diseases, Risk factors, Obesity, Overweight

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