Cardiovascular diseases are the leading cause of death in Latin America, with ischemic heart disease as the principal cause in most countries. Risk factors for cardiovascular disease are highly prevalent in the region, but there are international variations in the pattern and level of risk factors. Overweight and obesity are increasing. In the 2012 Mexican National Survey, overweight or obesity was found in 64.9% of men and 73% of women, and they were strongly associated with sedentarism. The most characteristic dyslipidemia abnormality in the region is low high-density lipoprotein cholesterol, followed by elevated low-density lipoprotein cholesterol and increased levels of triglycerides. National diabetes mellitus prevalence ranges from 2.8% to 9.4% and tobacco smoking from 12.8% to 42%. According to the INTERHEART (A Study of Risk Factors for First Myocardial Infarction in 52 Countries and Over 27,000 Subjects) data for Latin America, the highest attributable risks for myocardial infarction were related to abdominal obesity, dyslipidemia, and smoking.
Insulin resistance is a prevalent condition commonly associated with unhealthy lifestyles. It affects several metabolic pathways, increasing risk of abnormalities at different organ levels. Thus, diverse medical specialties should be involved in its diagnosis and treatment. With the purpose of unifying criteria about this condition, a scientific-based consensus was elaborated. A questionnaire including the most important topics such as cardio-metabolic risk, non-alcoholic fatty liver disease and polycystic ovary syndrome, was designed and sent to national experts. When no agreement among them was achieved, the Delphi methodology was applied. The main conclusions reached are that clinical findings are critical for the diagnosis of insulin resistance, not being necessary blood testing. Acquisition of a healthy lifestyle is the most important therapeutic tool. Insulin-sensitizing drugs should be prescribed to individuals at high risk of disease according to clinically validated outcomes. There are specific recommendations for pregnant women, children, adolescents and older people.
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