Review: Hypertension and the cardiometabolic syndrome in Chile: a review of concepts and consequences for the developing world

Abstract

Abstract:We review some recent developments regarding the concept of cardiometabolic syndrome and its relation with hypertension and overall cardiovascular disease risk. We emphasize how this new clinical entity has helped to understand multimorbidity in chronic diseases. This concept has important consequences for individual patient treatment as well as public health policy. The challenge derived from cardiovascular disease and other chronic conditions is increasing worldwide, but the highest burden is located in the developing world. Thus, new and cost-effective approaches are needed for diseases that are mainly occurring in the poorest and less educated populations. We illustrate this situation analyzing hypertension and cardiometabolic syndrome data derived from a recent national health survey in Chile.Keywords: hypertension, metabolic syndrome, cardiometabolic syndrome, cardiovascular disease, cardiovascular risk, epidemiology.The purpose of this review is to summarize and discuss some recent developments regarding the concept of cardiometabolic syndrome and its relation with hypertension and overall cardiovascular risk. By describing the findings of the recent first Chilean National Health Survey (MINSAL: 2003), we wish to emphasize the challenges posed by these conditions to developing countries.Hypertension and cardiometabolic syndrome: the case of Chile ENS was conducted and aimed at measuring the simultaneous population burden and distribution of 21 chronic conditions. ENS 2003 was a crosssectional household survey using a stratified multistage probability sample of non-institutionalized adults over 17 years of age. Three thousand six hundred and nineteen subjects were enrolled; the response rate was 63.5% and the refusal rate was 7.5%. A detailed report, including study protocols and manuals, is available on its website [MINSAL, 2003].Prevalence rates were based on internationally accepted cut-offs, weighted for complex sample design and adjusted to represent the Chilean 2003 population. Hypertension screening was measured for public health surveillance purposes.

A community-based study of hypertension and cardio-metabolic syndrome in semi-urban and rural communities in Nigeria

“…Studies in some other developing countries have noted high prevalence of CMS similar to or even higher than what obtains in developed countries [7,15,21]. In Chile, they noted a prevalence of 31.6% for general population and 61.6% for hypertensive population [7]. These are way above 15.9% and 32.8% noted respectively for general and hypertensive populations in this present study.…”

“…Furthermore, in Nigeria like in most developing countries public awareness of the dangers western life style pose to health is limited. Studies in some other developing countries have noted high prevalence of CMS similar to or even higher than what obtains in developed countries [7,15,21]. In Chile, they noted a prevalence of 31.6% for general population and 61.6% for hypertensive population [7].…”

“…Some recent studies suggested that CMS can predict the development of hypertension [6]. CMS is characterized by the cluster of physical and biochemical abnormalities in an individual which predisposes the person to increased risk of developing cardiovascular disease and it is also predictive of future diabetes mellitus [7]. CMS and some of its components are related to diet [8].…”

Incidence of Lobar and Non-Lobar Spontaneous Intracerebral Haemorrhage in a Predominantly Hispanic-Mestizo Population – The PISCIS Stroke Project: A Community-Based Prospective Study in Iquique, Chile

“…It is possible that some hypertensive patients were misclassified as non-hypertensive if they or their relatives did not know their condition. In the national health survey in Chile only 60% of the hypertensive knew their condition, 33% were being treated and only 30% had normal values [26] . Alcohol intake was also lower in this population than in Hispanics in the USA.…”

El síndrome metabólico: De factor agravante a principal factor de riesgo patogénico en diversas enfermedades crónicas

“…Además, evidencias recientes sugieren que el SMetab también impacta sobre el desarrollo de procesos neurodegenerativos, entre los que tienen especial significado la enfermedad de Alzheimer 11,62 . Por todo ello, el SMetab y sus complicaciones a largo plazo podrían convertirse en una carga socioeconómica y de salud pública dramática para países en vías de desarrollo como Chile 12 .…”