Detection of Markers of Cardiovascular and Renal Risk in Cuba: Isle of Youth Study (ISYS)

Herrera, Raúl; Almaguer, Miguel; Chipi, José; Toirac, X.; Martínez, O.; Castellanos, O.; Bacallao, Jorge; Licourt, R.M.; Velásquez, Ilais Moreno; Diéguez, Luisa González; Hernández, Manuel Crespo; Caballero, W.; Urra, Patricio Solís; Rodríguez-Triana, N.

doi:10.1159/000321505

Cited by 4 publications

(5 citation statements)

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“…These data concur with our finding of similar hypertension prevalence at the time of the resurvey in 2006–08 (34%). The proportions of people with hypertension that was diagnosed, treated, and controlled were not reported in the national studies, and such results are only available from a few cross-sectional surveys in local areas,15, 16, 17 which cannot be generalised reliably to Cuba as a whole.…”

Section: Discussionmentioning

confidence: 99%

Burden of hypertension and associated risks for cardiovascular mortality in Cuba: a prospective cohort study

Rojas¹,

Dobell

Lacey

et al. 2019

The Lancet Public Health

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SummaryBackgroundIn Cuba, hypertension control in primary care has been prioritised as a cost-effective means of addressing premature death from cardiovascular disease. However, there is little evidence from large-scale studies on the prevalence and management of hypertension in Cuba, and no direct evidence of the expected benefit of such efforts on cardiovascular mortality.MethodsIn a prospective cohort study, adults in the general population identified via local family medical practices were interviewed between Jan 1, 1996, and Nov 24, 2002, in five areas of Cuba, and a subset of participants were resurveyed between July 14, 2006, and Oct 19, 2008, in one area. During household visits, blood pressure was measured and information obtained on diagnosis and treatment of hypertension. We calculated the prevalence of hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg, or receiving treatment for hypertension) and the proportion of people with hypertension in whom it was diagnosed, treated, and controlled (systolic blood pressure <140 mm Hg, diastolic blood pressure <90 mm Hg). Deaths were identified through linkage by national identification numbers to the Cuban Public Health Ministry records, to Dec 31, 2016. We used Cox regression analysis to compare cardiovascular mortality between participants with versus without uncontrolled hypertension. Rate ratios (RRs) were used to estimate the fraction of cardiovascular deaths attributable to hypertension.Findings146 556 participants were interviewed in the baseline survey in 1996–2002 and 24 345 were interviewed in the resurvey in 2006–08. After exclusion for incomplete data and age outside the range of interest, 136 111 respondents aged 35–79 years (mean age 54 [SD 12] years; 75 947 [56%] women, 60 164 [44%] men) were eligible for inclusion in the analyses. 34% of participants had hypertension. Among these, 67% had a diagnosis of hypertension. 76% of participants with diagnosed hypertension were receiving treatment and blood pressure was controlled in 36% of those people. During 1·7 million person-years of follow-up there were 5707 cardiovascular deaths. In the age groups 35–59, 60–69, and 70–79 years, uncontrolled hypertension at baseline was associated with RRs of 2·15 (95% CI 1·88–2·46), 1·86 (1·69–2·05), and 1·41 (1·32–1·52), respectively, and accounted for around 20% of premature cardiovascular deaths.InterpretationIn this Cuban population, a third of people had hypertension. Although levels of hypertension diagnosis and treatment were commensurate with those in some high-income countries, the proportion of participants whose blood pressure was controlled was low. As well as reducing hypertension prevalence, improvement in blood pressure control among people with diagnosed hypertension is required to prevent premature cardiovascular deaths in Cuba.FundingMedical Research Council, British Heart Foundation, Cancer Research UK.

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Section: Discussionmentioning

confidence: 99%

Burden of hypertension and associated risks for cardiovascular mortality in Cuba: a prospective cohort study

Rojas¹,

Dobell

Lacey

et al. 2019

The Lancet Public Health

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“…On Cuba's Isle of Youth, a clinical epidemiological study of total population has been conducted for the past five years, looking at markers of renal and vascular damage from chronic vascular diseases and their common risk factors (Isle of Youth Study, ISYS). [15] With this study, microalbuminuria is being introduced for the first time in the country in population screening for chronic diseases involving atherosclerotic vascular damage.…”

Section: Original Researchmentioning

confidence: 99%

Albuminuria as a Marker of Kidney and Cardio-cerebral Vascular Damage. Isle of Youth Study (ISYS), Cuba

Herrera

Almaguer²,

Chipi³

et al. 2010

MEDICC Review

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INTRODUCTIONThe disease complex comprised of atherosclerosis, chronic kidney disease (CKD) and other associated chronic vascular diseases is the leading cause of mortality worldwide. Microalbuminuria is a marker for vascular damage in the heart, kidney and brain. This paper presents selected findings of the clinical-epidemiological Isle of Youth Study (ISYS) of markers for kidney and vascular damage from chronic vascular diseases and their common risk factors in total population, focusing on Phase 2 reassessment (in 2010) of Phase 1 (2004 to 2006) results.OBJECTIVES (1) Update the prevalence of risk factors in the study population aged ≥20 years (adult population). ( 2) Confirm presence of microalbuminuria in at-risk adults diagnosed as presumptive positives in Phase I. (3) Evaluate association between microalbuminuria and selected risk factors. METHODS Of 3779 adults positive for microalbuminuria in ISYSPhase 1, 73.1% were reevaluated. The risk-factor questionnaire was re-administered and blood pressure, weight and height were measured. Blood was tested for creatinine, glycemia, cholesterol and triglycerides. Glomerular filtration rate was calculated using the Modification of Diet in Renal Disease (MDRD) formula. Albuminuria was measured in urine using Micral-Test (Germany) and albumin/ creatinine ratio (ACR) by nephelometry. This paper uses ACR as the reference for analyzing risk factor associations. Double-entry tables were developed to analyze association among microalbuminuria, risk factors and co-morbidities. RESULTSMost prevalent risks were hypertension, consumption of nonsteroidal anti-inflammatory drugs (NSAIDs), excess weight and hypertriglyceridemia. Microalbuminuria was confirmed in 18% of cases, using the same test. Elevated prevalence of microalbuminuria was positively associated with advancing age, male sex, underweight, smoking, NSAID use, dyslipidemia, hypertension, diabetes, heart disease and stroke. CONCLUSIONSThe at-risk cohort studied presented low levels of confirmation for positive microalbuminuria. Positive microalbuminuria stratified individuals at greatest risk, except for obesity.

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“…2 They contribute to the global burden of mortality and disease. 3 A significant number of these obesity related complications are not properly diagnosed and treated. 3 This has led to the failure of treatment, and the lack of effective primary prevention has contributed to the spread of the obesity epidemic.…”

Section: Introductionmentioning

confidence: 99%

“…3 A significant number of these obesity related complications are not properly diagnosed and treated. 3 This has led to the failure of treatment, and the lack of effective primary prevention has contributed to the spread of the obesity epidemic. 3 Also, it is known that being overweight is associated with a higher chance of developing kidney anomalies.…”

Section: Introductionmentioning

confidence: 99%

“…3 This has led to the failure of treatment, and the lack of effective primary prevention has contributed to the spread of the obesity epidemic. 3 Also, it is known that being overweight is associated with a higher chance of developing kidney anomalies. 4 Research carried out on a large population at the University of California in 2013 revealed that the baseline body mass index was linked to the likelihood of developing nephropathy.…”

Section: Introductionmentioning

confidence: 99%

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The impact of microalbuminuria and insulin resistance as prognostic biomarker for nephropathy in obese persons: a systematic review

Jha,

Dhok,

Shukla

et al. 2023

F1000Res

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Background: The progression of weight gain over the normal level is accompanied by an increase in renovascular damage markers, such as microalbuminuria. Microalbuminuria could be an indication of vascular disturbances caused by obesity. The global pandemic of renal disease has something to do with the link between obesity and type-2 diabetes. Furthermore, microalbuminuria can also be a possible factor for developing insulin resistance syndrome and high blood pressure. The goal of this research is to analyze the impact that insulin resistance, as well as microalbuminuria, play in predicting the severity of nephropathy among obese individuals and also look into these markers in identifying patients with this condition. Methods: The selected studies (updated to November 2022) were evaluated using the Electronic PubMed database. Based on our selection criteria only those that included high-quality investigations on the relevance of insulin resistance and microalbuminuria as markers of nephropathy in obese people were included. We evaluated this link using odds ratios with a confidence interval of 95%. Results: Overall, 15 studies, including over 10,000 obese individuals, were evaluated for this study. The summative results revealed that microalbuminuria and insulin may be strong indicators for the advancement of nephropathy in individuals with diabetes mellitus and obese individuals. In support of this, more studies need to be carried out on obese individuals with nephropathy in the absence of diabetes to confirm the relevance of these biomarkers as a prevention measure. Conclusions: Understanding the importance of the impact microalbuminuria and resistance to insulin play as biomarkers in the health of obese individuals may be very important to prevent nephropathy progression and premature death in both diagnosed and undiagnosed situations. A limitation of this review is that it didn't focus on other anomalies related to obesity such as cardiovascular disease or diabetes.

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Detection of Markers of Cardiovascular and Renal Risk in Cuba: Isle of Youth Study (ISYS)

Cited by 4 publications

References 71 publications

Burden of hypertension and associated risks for cardiovascular mortality in Cuba: a prospective cohort study

Burden of hypertension and associated risks for cardiovascular mortality in Cuba: a prospective cohort study

Albuminuria as a Marker of Kidney and Cardio-cerebral Vascular Damage. Isle of Youth Study (ISYS), Cuba

The impact of microalbuminuria and insulin resistance as prognostic biomarker for nephropathy in obese persons: a systematic review

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