Eficacia clínica de la modificación del estilo de vida en el riesgo cardiovascular en prehipertensos: estudio PREHIPER I

Márquez-Celedonio, Félix Guillermo; Téxon-Fernández, Obdulia; Chávez-Negrete, Adolfo; Hernández-López, Sergio; Marín-Rendón, Sadoc; Berlín-Lascurain, Susana

doi:10.1016/s0300-8932(09)70025-9

Cited by 23 publications

(2 citation statements)

References 13 publications

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“…This reduction is achieved through adequate monitoring and control of the disease that can prevent the development of major renal and ophthalmic complications. Additionally, early intervention strategies targeting habits, nutrition, and physical activity among people with a risk of developing diabetes and hypertension can reduce between 30% and 70% the probability of developing the disease and its complications in the long term [36,22,43].…”

Section: Importance Of Early Detectionmentioning

confidence: 99%

State-of-the-Art Risk Models for Diabetes, Hypertension, Visual Diminution, and COVID-19 Severity in Mexico

Amaya¹,

Enciso

Meizner

et al. 2021

Preprint

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BACKGROUNDDiabetes and hypertension are among top public health priorities, particularly in low and middle-income countries where their health and socioeconomic impact is exacerbated by the quality and accessibility of health care. Moreover, their connection with severe or deadly COVID-19 illness has further increased their societal relevance. Tools for early detection of these chronic diseases enable interventions to prevent high-impact complications, such as loss of sight and kidney failure. Similarly, prognostic tools for COVID-19 help stratify the population to prioritize protection and vaccination of high-risk groups, optimize medical resources and tests, and raise public awareness.METHODSWe developed and validated state-of-the-art risk models for the presence of undiagnosed diabetes, hypertension, visual complications associated with diabetes and hypertension, and the risk of severe COVID-19 illness (if infected). The models were estimated using modern methods from the field of statistical learning (e.g., gradient boosting trees), and were trained on publicly available data containing health and socioeconomic information representative of the Mexican population. Lastly, we assembled a short integrated questionnaire and deployed a free online tool for massifying access to risk assessment.RESULTSOur results show substantial improvements in accuracy and algorithmic equity (balance of accuracy across population subgroups), compared to established benchmarks. In particular, the models: i) reached state-of-the-art sensitivity and specificity rates of 90% and 56% (0.83 AUC) for diabetes, 80% and 64% (0.79 AUC) for hypertension, 90% and 56% (0.84 AUC) for visual diminution as a complication, and 90% and 60% (0.84 AUC) for development of severe COVID disease; and ii) achieved substantially higher equity in sensitivity across gender, indigenous/non-indigenous, and regional populations. In addition, the most relevant features used by the models were in line with risk factors commonly identified by previous studies. Finally, the online platform was deployed and made accessible to the public on a massive scale.CONCLUSIONSThe use of large databases representative of the Mexican population, coupled with modern statistical learning methods, allowed the development of risk models with state-of-the-art accuracy and equity for two of the most relevant chronic diseases, their eye complications, and COVID-19 severity. These tools can have a meaningful impact on democratizing early detection, enabling large-scale preventive strategies in low-resource health systems, increasing public awareness, and ultimately raising social well-being.

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Section: Importance Of Early Detectionmentioning

confidence: 99%

State-of-the-Art Risk Models for Diabetes, Hypertension, Visual Diminution, and COVID-19 Severity in Mexico

Amaya¹,

Enciso

Meizner

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Maruthur et al [11] studied the effect of PREMIER on estimated coronary heart disease (CHD) risk and observed substantial reductions of 12% to 14% in estimated CHD risk, which have important public health benefits. Márquez-Celedonio et al [12] also found in a study in Mexico that lifestyle modification decreased cardiovascular disease risk in individuals with prehypertension. Prehypertension, defined as blood pressure between 120-139/80-89 mmHg, is a major public health concern [13].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a church-based lifestyle intervention programme to control high normal blood pressure and/or high normal blood glucose in church members: a randomized controlled trial in Pretoria, South Africa

2014

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BackgroundIn persons 15 years and above in South Africa the prevalence of pre-diabetes and diabetes has been estimated at 9.1% and 9.6%, respectively, and the prevalence of systolic prehypertension and hypertension, 38.2% and 24.6%, respectively. Elevated blood glucose and elevated blood pressure are prototype of preventable chronic cardiovascular disease risk factors.Lifestyle interventions have been shown to control high normal blood pressure and/or high normal blood glucose.Methods/DesignThis study proposes to evaluate the efficacy of a community (church)-based lifestyle intervention programme to control high normal blood pressure and/or high normal blood glucose in church members in a randomized controlled trial in Gauteng, South Africa. The objectives are to: (1) measure non-communicable diseases profile, including hypertension and diabetes, health behaviours, weight management and psychological distress of church members; (2) measure the reduction of blood glucose and blood pressure levels after the intervention; (3) prevent the development of impaired glucose tolerance; (4) compare health behaviours, weight management and psychological distress, blood glucose and blood pressure levels between intervention and control groups, and within group during 6, 12, 24 and 36 months during and post intervention. The study will use a group-randomized design, recruiting 300 church members from 12 churches. Churches will be randomly assigned to experimental and control conditions.DiscussionLifestyle interventions may prevent from the development of high blood pressure and/or diabetes. The findings will impact public health and will enable the health ministry to formulate policy related to lifestyle interventions to control blood pressure and glucose.Trial registration numberPACTR201105000297151

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Multiple risk factor interventions for primary prevention of cardiovascular disease in low- and middle-income countries

Uthman

Hartley

Rees

et al. 2015

Cochrane Database of Systematic Reviews

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Due to the limited evidence currently available, we can draw no conclusions as to the effectiveness of multiple risk factor interventions on combined CVD events and mortality. There is some evidence that multiple risk factor interventions may lower blood pressure levels, body mass index and waist circumference in populations in LMIC settings at high risk of hypertension and diabetes. There was considerable heterogeneity between the trials, the trials were small, and at some risk of bias. Larger studies with longer follow-up periods are required to confirm whether multiple risk factor interventions lead to reduced CVD events and mortality in LMIC settings.

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Eficacia clínica de la modificación del estilo de vida en el riesgo cardiovascular en prehipertensos: estudio PREHIPER I

Cited by 23 publications

References 13 publications

State-of-the-Art Risk Models for Diabetes, Hypertension, Visual Diminution, and COVID-19 Severity in Mexico

State-of-the-Art Risk Models for Diabetes, Hypertension, Visual Diminution, and COVID-19 Severity in Mexico

Efficacy of a church-based lifestyle intervention programme to control high normal blood pressure and/or high normal blood glucose in church members: a randomized controlled trial in Pretoria, South Africa

Multiple risk factor interventions for primary prevention of cardiovascular disease in low- and middle-income countries

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