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Research report
Contribution of modifiable risk factors for hypertension and type-2 diabetes in Peruvian resource-limited settings
  1. Antonio Bernabé-Ortiz1,
  2. Rodrigo M Carrillo-Larco1,
  3. Robert H Gilman1,2,3,
  4. William Checkley1,4,
  5. Liam Smeeth1,5,
  6. J Jaime Miranda1,6,
  7. CRONICAS Cohort Study Group
    1. 1CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
    2. 2Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
    3. 3Área de Investigación y Desarrollo, AB PRISMA, Lima, Peru
    4. 4Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA
    5. 5Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
    6. 6Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
    1. Correspondence to Dr J Jaime Miranda, CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av Armendariz 497, Miraflores, Lima 18, Peru; Jaime.Miranda{at}upch.pe

    Abstract

    Background It is important to understand the local burden of non-communicable diseases including within-country heterogeneity. The aim of this study was to characterise hypertension and type-2 diabetes profiles across different Peruvian geographical settings emphasising the assessment of modifiable risk factors.

    Methods Analysis of the CRONICAS Cohort Study baseline assessment was conducted. Cardiometabolic outcomes were blood pressure categories (hypertension, prehypertension, normal) and glucose metabolism disorder status (diabetes, prediabetes, normal). Exposures were study setting and six modifiable factors (smoking, alcohol drinking, leisure time and transport-related physical activity levels, TV watching, fruit/vegetables intake and obesity). Poisson regression models were used to report prevalence ratios (PR). Population attributable risks (PAR) were also estimated.

    Results Data from 3238 participants, 48.3% male, mean age 45.3 years, were analysed. Age-standardised (WHO population) prevalence of prehypertension and hypertension was 24% and 16%, whereas for prediabetes and type-2 diabetes it was 18% and 6%, respectively. Outcomes varied according to study setting (p<0.001). In multivariable model, hypertension was higher among daily smokers (PR 1.76), heavy alcohol drinkers (PR 1.61) and the obese (PR 2.06); whereas only obesity (PR 2.26) increased the prevalence of diabetes. PAR showed that obesity was an important determinant for hypertension (15.7%) and type-2 diabetes (23.9%).

    Conclusions There is an evident heterogeneity in the prevalence of and risk factors for hypertension and diabetes within Peru. Prehypertension and prediabetes are highly prevalent across settings. Our results emphasise the need of understanding the epidemiology of cardiometabolic conditions to appropriately implement interventions to tackle the burden of non-communicable diseases.

    • DIABETES
    • Epidemiology of chronic non communicable diseases
    • HYPERTENSION

    This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

    https://doi.org/10.1136/jech-2015-205988

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