Trends in prevalence of cardiovascular risk factors on the United States- Mexico border between 2005-2011

Thesis (Master's)--University of Washington, 2017Background: Cardiovascular disease is a major cause of morbidity and mortality in the United States (U.S.) and Mexico. We aimed to describe the sex-specific prevalence and time trends in five risk factors for cardiovascular disease (smoking, physical activity, obesity, diabetes mellitus and hypertension) by county or municipality that touches the U.S.-Mexico border. Then we aimed to describe the prevalence by socioeconomic status (SES). Methods: We calculated sex-specific estimates on the county-level for diabetes mellitus, hypertension, obesity, physical activity and tobacco use. Data was obtained from surveys; for the U.S., prevalence (95% uncertainty intervals) were calculated using the Center for Disease Control’s annual Behavioral Risk Factor Surveillance System (BRFSS) and the National Health and Nutrition Examination Survey (NHANES), and for Mexico, prevalence (95% confidence intervals) were calculated from the Mexican Encuesta Nacional de Salud y Nutrición (ENSANUT) surveys in 2005-06 and in 2011-12. Results: Prevalence estimates were available for 26 counties in 4 U.S. states and 14 municipalities in 6 Mexican states. The risk factors with the highest prevalence in the U.S. were any physical activity (68.8%), obesity (38.1%) and hypertension (35.5%). The risk factor with the lowest prevalence was diabetes mellitus (17.5%). Whereas, in Mexico the risk factors with the highest average prevalence were any smoking (51.0%), hypertension (48.9%) and obesity (35.9%). The risk factor with the lowest prevalence was diabetes mellitus (7.1%). The prevalence of any physical activity was also alarmingly low at 8.9%. Smoking had a positive association with increasing SES for females but not for males in both countries. Physical activity had a positive association with increasing SES for both sexes. Obesity and diabetes mellitus had a negative association with increasing SES. Hypertension had a negative association with increasing SES but it was stronger for females than males. Conclusions: There is a high burden of cardiovascular risk factors along the U.S.-Mexico border region with a strong association between risk factors prevalence and a county or municipality’s human development index. Public health programs should investigate regional socioeconomic status when planning intervention programs as they may have adverse effects on cardiovascular disease risk factors

Relationship of cardiovascular disease risk factors with socioeconomic, acculturation, behavioral variables with male as reference (n=567).

<p>All odds ratios are adjusted for age.</p><p>Bold=p<0.05.</p>†<p>Male sex is the reference.</p

Socio-economic, acculturation and behavioral characteristics of the study population by sex.

*<p>Chi squared test was used to compare characteristics by sex.</p

Prevalence of Metabolic Syndrome by different waist circumference cutoffs by sex (n=589).

<p>*Based on IDF WC cut-off criteria [WC ≥90 cm (men) or ≥80 cm (women)]. **Based on LASO WC cut-off criteria [WC ≥97 cm (men) or ≥94 cm (women)].</p

Clinical characteristics of the study population by sex.

*<p>Chi squared test was used to compare characteristics by sex.</p><p>HDL; high-density lipoprotein.</p

Sex differences in risk factors for cardiovascular disease: the PERU MIGRANT study.

INTRODUCTION: Although men and women have similar risk factors for cardiovascular disease, many social behaviors in developing countries differ by sex. Rural-to-urban migrants have different cardiovascular risk profiles than rural or urban dwellers. The objective of this study was to evaluate the sex differences with specific cardiovascular risk factors in rural-to-urban migrants. METHODS AND RESULTS: We used the rural-to-urban migrant group of the PERU MIGRANT cross-sectional study to investigate the sex differences in specific cardiovascular risk factors: obesity, hypertension, metabolic syndrome, as well as exposures of socioeconomic status, acculturation surrogates and behavioral characteristics. Logistic regression analysis was used to characterize strength of association between sex and our outcomes adjusting for potential confounders. The sample of migrants was 589 (mean age 46.5 years) and 52.4% were female. In the adjusted models, women were more likely to be obese (OR=5.97; 95%CI: 3.21-11) and have metabolic syndrome (OR=2.22; 95%CI: 1.39-3.55) than men, explaining the greatest variability for obesity and metabolic syndrome but not for hypertension. CONCLUSIONS: Our results suggest that interventions for CVD in Peru should be sex-specific and address the unique health needs of migrant populations living in urban shantytowns since the risk factors for obesity and metabolic syndrome differ between males and females