Sex Differences in Cardiovascular Disease Risk Factor Prevalence, Morbidity, and Mortality in Colombia: Findings from the Prospective Urban Rural Epidemiology (PURE) Study
Background: Controversies exist on whether the presence of cardiovascular risk factors and their association with major cardiovascular events (MACE) is different between men and women. Most of the evidence comes from high-income countries, hindering extrapolation of sociocultural and demographic fac...
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| Format: | Article |
| Language: | English |
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Ubiquity Press
2024-01-01
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| Series: | Global Heart |
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| Online Access: | https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1289 |
| _version_ | 1797315812534517760 |
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| author | Jose Patricio Lopez-Lopez Martin Rebolledo-Del Toro Daniel Martinez-Bello Ángel A. Garcia-Peña Gary O’Donovan Maritza Perez-Mayorga Johanna Otero Sumathy Rangarajan Salim Yusuf Patricio Lopez-Jaramillo |
| author_facet | Jose Patricio Lopez-Lopez Martin Rebolledo-Del Toro Daniel Martinez-Bello Ángel A. Garcia-Peña Gary O’Donovan Maritza Perez-Mayorga Johanna Otero Sumathy Rangarajan Salim Yusuf Patricio Lopez-Jaramillo |
| author_sort | Jose Patricio Lopez-Lopez |
| collection | DOAJ |
| description | Background: Controversies exist on whether the presence of cardiovascular risk factors and their association with major cardiovascular events (MACE) is different between men and women. Most of the evidence comes from high-income countries, hindering extrapolation of sociocultural and demographic factors of other regions. Objective: To evaluate sex differences in the prevalence of cardiovascular risk factors and the incidence of MACE and diabetes in Colombian adults. Methods: We performed a survival analysis from women and men aged 35–70 belonging to the Prospective Urban Rural Epidemiology-Colombia prospective study. Incidence rates for MACE composite (myocardial infarction, stroke, heart failure, death) and each outcome and diabetes were calculated. Kaplan-Meier curves and log-rank tests were performed. The association between demographic, behavioral, and metabolic variables with MACE and diabetes were evaluated with Cox proportional hazards models. Results: 7,552 participants (50±9.7 years) were included; 64% were women. Women had higher hypertension prevalence, body mass index, levels of total cholesterol, LDL-c, and HDL-c but lower triglycerides levels. Women were more sedentary but fewer smokers or active alcohol consumers and had higher educational levels. After 12-year mean follow-up (SD 2.3), the incidence rate of MACE composite was higher in men [4.2 (3.6–4.9) vs. 3.2 (2.8–3.7) cases per 1000 person-years]. Diabetes had the greatest association with MACE (HR = 2.63 95%CI:1.85;3.76), followed by hypertension (HR = 1.75 95%CI:1.30;2.35), low relative grip strength (HR = 1.53 95%CI:1.15;2.02), smoking (HR = 1.47 95%CI: 1.11;1.93), low physical activity (HR = 1.42 95%CI: 1.03;1.96). When evaluating risk factors by sex, only an increased waist-to-hip ratio was more strongly associated with MACE in men (p-interaction <0.05). Conclusions: The composite MACE outcome was higher in men despite having a lower overall burden of risk factors. The risk factors contribution was similar, leading us to reconsider the need to carrying out differentiated cardiovascular risk prevention and management campaigns, at least in our region. |
| first_indexed | 2024-03-08T03:09:16Z |
| format | Article |
| id | doaj.art-c3c080a7c67d43b4bf6b0fe79702b6fd |
| institution | Directory Open Access Journal |
| issn | 2211-8179 |
| language | English |
| last_indexed | 2024-03-08T03:09:16Z |
| publishDate | 2024-01-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | Global Heart |
| spelling | doaj.art-c3c080a7c67d43b4bf6b0fe79702b6fd2024-02-13T07:31:46ZengUbiquity PressGlobal Heart2211-81792024-01-01191101010.5334/gh.12891270Sex Differences in Cardiovascular Disease Risk Factor Prevalence, Morbidity, and Mortality in Colombia: Findings from the Prospective Urban Rural Epidemiology (PURE) StudyJose Patricio Lopez-Lopez0https://orcid.org/0000-0001-8865-0929Martin Rebolledo-Del Toro1https://orcid.org/0000-0002-4189-4317Daniel Martinez-Bello2https://orcid.org/0000-0003-3219-0753Ángel A. Garcia-Peña3https://orcid.org/0000-0002-3606-2102Gary O’Donovan4https://orcid.org/0000-0001-6748-6218Maritza Perez-Mayorga5https://orcid.org/0000-0002-4240-6776Johanna Otero6https://orcid.org/0000-0002-2044-2071Sumathy Rangarajan7https://orcid.org/0000-0003-2420-5986Salim Yusuf8https://orcid.org/0000-0003-4776-5601Patricio Lopez-Jaramillo9https://orcid.org/0000-0002-9122-8742Masira Research Institute, Universidad de Santander (UDES), Bucaramanga; Internal Medicine Department, Cardiology Unit, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, BogotáInternal Medicine Department, Cardiology Unit, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, BogotáMasira Research Institute, Universidad de Santander (UDES), BucaramangaInternal Medicine Department, Cardiology Unit, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, BogotáMasira Research Institute, Universidad de Santander (UDES), BucaramangaMasira Research Institute, Universidad de Santander (UDES), Bucaramanga; School of Medicine, Universidad Militar Nueva Granada, Clínica Marly, BogotáMasira Research Institute, Universidad de Santander (UDES), BucaramangaThe Population Health Research Institute, McMaster University, HamiltonThe Population Health Research Institute, McMaster University, Hamilton; Department of Medicine, McMaster University, HamiltonMasira Research Institute, Universidad de Santander (UDES), Bucaramanga, CO; Universidad UTE, Facultad de Ciencias de la Salud Eugenio Espejo, QuitoBackground: Controversies exist on whether the presence of cardiovascular risk factors and their association with major cardiovascular events (MACE) is different between men and women. Most of the evidence comes from high-income countries, hindering extrapolation of sociocultural and demographic factors of other regions. Objective: To evaluate sex differences in the prevalence of cardiovascular risk factors and the incidence of MACE and diabetes in Colombian adults. Methods: We performed a survival analysis from women and men aged 35–70 belonging to the Prospective Urban Rural Epidemiology-Colombia prospective study. Incidence rates for MACE composite (myocardial infarction, stroke, heart failure, death) and each outcome and diabetes were calculated. Kaplan-Meier curves and log-rank tests were performed. The association between demographic, behavioral, and metabolic variables with MACE and diabetes were evaluated with Cox proportional hazards models. Results: 7,552 participants (50±9.7 years) were included; 64% were women. Women had higher hypertension prevalence, body mass index, levels of total cholesterol, LDL-c, and HDL-c but lower triglycerides levels. Women were more sedentary but fewer smokers or active alcohol consumers and had higher educational levels. After 12-year mean follow-up (SD 2.3), the incidence rate of MACE composite was higher in men [4.2 (3.6–4.9) vs. 3.2 (2.8–3.7) cases per 1000 person-years]. Diabetes had the greatest association with MACE (HR = 2.63 95%CI:1.85;3.76), followed by hypertension (HR = 1.75 95%CI:1.30;2.35), low relative grip strength (HR = 1.53 95%CI:1.15;2.02), smoking (HR = 1.47 95%CI: 1.11;1.93), low physical activity (HR = 1.42 95%CI: 1.03;1.96). When evaluating risk factors by sex, only an increased waist-to-hip ratio was more strongly associated with MACE in men (p-interaction <0.05). Conclusions: The composite MACE outcome was higher in men despite having a lower overall burden of risk factors. The risk factors contribution was similar, leading us to reconsider the need to carrying out differentiated cardiovascular risk prevention and management campaigns, at least in our region.https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1289genderrisk factorscardiovascular disease |
| spellingShingle | Jose Patricio Lopez-Lopez Martin Rebolledo-Del Toro Daniel Martinez-Bello Ángel A. Garcia-Peña Gary O’Donovan Maritza Perez-Mayorga Johanna Otero Sumathy Rangarajan Salim Yusuf Patricio Lopez-Jaramillo Sex Differences in Cardiovascular Disease Risk Factor Prevalence, Morbidity, and Mortality in Colombia: Findings from the Prospective Urban Rural Epidemiology (PURE) Study Global Heart gender risk factors cardiovascular disease |
| title | Sex Differences in Cardiovascular Disease Risk Factor Prevalence, Morbidity, and Mortality in Colombia: Findings from the Prospective Urban Rural Epidemiology (PURE) Study |
| title_full | Sex Differences in Cardiovascular Disease Risk Factor Prevalence, Morbidity, and Mortality in Colombia: Findings from the Prospective Urban Rural Epidemiology (PURE) Study |
| title_fullStr | Sex Differences in Cardiovascular Disease Risk Factor Prevalence, Morbidity, and Mortality in Colombia: Findings from the Prospective Urban Rural Epidemiology (PURE) Study |
| title_full_unstemmed | Sex Differences in Cardiovascular Disease Risk Factor Prevalence, Morbidity, and Mortality in Colombia: Findings from the Prospective Urban Rural Epidemiology (PURE) Study |
| title_short | Sex Differences in Cardiovascular Disease Risk Factor Prevalence, Morbidity, and Mortality in Colombia: Findings from the Prospective Urban Rural Epidemiology (PURE) Study |
| title_sort | sex differences in cardiovascular disease risk factor prevalence morbidity and mortality in colombia findings from the prospective urban rural epidemiology pure study |
| topic | gender risk factors cardiovascular disease |
| url | https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1289 |
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