Assuntos

RESUMO

OBJECTIVE: To determine the significance of the selected risk markers in the development of high blood pressure in a relatively short period of time. DESIGN: Longitudinal or cohort study of a sample of a population from the municipality of Cienfuegos, as a second measurement of the Cienfuegos Global Project. CONTEXT: Community. Municipality of Cienfuegos; geographic area of the subject-object intervention-investigation of the Cienfuegos Global Project. SUBJECT: 1,369 adults aged 15 years of more (619 men and 750 women; 1,294 alive and 75 dead) were followed from January 1992 to February 1994, which constitutes an alleatory, stratified, equiprobabilistic sample by age and sex. Persons diagnosed as hypertensive in the initial evaluation of Cienfuegos Global Project were excluded, so that the new series for hypertensive patients was constituted by 731 individuals with 125 new patients when the risk markers age, sex, color of skin, family history of high blood pressure, salt consumption, sedentarism, alcoholism and tobaccoism were studied. The association of the risk markers hypercholesterolemia or risky cholesterolemia and obesity was studied with another series formed by a second sample of 417 individuals, this sample introduced 74 new cases of high blood pressure. MAIN OUTCOME: It was intended to estimate the odds ratio for high blood pressure for the different risk markers studied, in those patients exposed or not to them. RESULTS: The odds ratio for each of the risk markers was determined. The odds related to age increased from 1.37, to 1.86 in males and decreased to 0.64 in white individuals. These 3 results were statistically significant as risk markers for high blood pressure. The odds ratio for the remaining risk markers had no statistical significance. CONCLUSION: The age, male sex, and black race, in the comparatively short term--slightly over two years--are the main risk markers that will markedly favor the appearance of high blood pressure.

Assuntos

RESUMO

OBJECTIVE: To find the value of different risk markers (RM) used for the development of cerebrovascular disease (CVD) in the relatively short term. MATERIAL AND METHODS: We carried out a longitudinal or cohort study in a sample of the population of Cienfuegos as part of the second series of measurements of the Global Project of Cienfuegos (GPC). We followed up 1,369 adults aged 15 years and over (619 men and 750 women: 1,294 alive and 75 posthumously) between January 1992 and February 1994. They formed an equiprobable randomized sample, stratified in groups of age and sex. Persons diagnosed as having CVD in the initial evaluation of the GPC were excluded. Thus the series of CVD for the study of RM was made up of 1,330 individuals requiring a medical interview and 14 new cases. The Odds Ratio (OR) of having CVD was estimated for the different RM studied: Age, sex, colour of skin, smoking, alcoholism, sedentary life, arterial hypertension and the combination of smoking and arterial hypertension. RESULTS: The OR corresponding to age rose to 2.89, which is statistically significant as RM for CVD. The OR of the other RM markers was not found to be statistically significant. CONCLUSIONS: Age, in the comparatively short term--slightly over two years--is the main RM markedly predisposing to the appearance of CVD.

Assuntos

RESUMO

The Caribbean nation of Cuba is comprised of over 10 million persons who trace their ancestry primarily to Africa and Spain. To date, little data on blood pressure (BP) or hypertension prevalence from Cuba have appeared in English language journals. Because the current government has pursued an active policy of reducing social differentiation on the basis of ethnic origin, Cuba provides an important population laboratory from which to advance the understanding of black-white differences in BP and hypertension. The authors conducted a population-based random sample among adults (aged > 15 years) in the city of Cienfuegos. Overall response rate was 95%, yielding 1633 participants who provided BP readings, self-reported racial group, demographic information, and treatment status. Overall prevalence of hypertension (SBP > or = 140 mm Hg or DBP > or = 90 mm Hg or currently treated) was 44% (46% among blacks and 43% whites; P = 0.19). Excess BP among black subjects was reduced slightly by excluding those under treatment, but attained statistical significance after adjustment for sex and age (P = 0.01). The black-white difference was small, however, relative to that observed in the United States. Racial differences in treatment status and control were also observed. Although there remains a difference in socioeconomic profile between those of African and of European origin in Cuba, this has decreased over recent decades. In the United States, the greater magnitude of social differentiation parallels a greater relative risk of BP elevation among blacks, suggesting that social, economic and psychological factors may play an important role in the observed racial gap in cardiovascular risk.

Assuntos

RESUMO

The 1991 to 1994 epidemic of neuropathy in Cuba has been one of the more devastating in recent history, affecting more than 50,000 people throughout the entire country with clinical manifestations of optic and peripheral neuropathy. Although the causes are not entirely clear, it seems that a combination of acute nutritional deficiency and the toxic effects of tobacco and possibly other unidentified toxic substances is involved. The epidemic coincided with the acute worsening of the economic situation on the island following political changes in Eastern European countries and a tightening of the US economic embargo. This paper reviews reports of a strikingly similar epidemic known as the "Amblyopia of the Blockade," which occurred in Cuba almost a century ago when the island was undergoing a US naval blockade during the Cuban-Spanish-American war. It discusses the parallelism with the recent epidemic as well as the implications of this historical evidence to clarify further the ultimate causes of these epidemics.

Assuntos