Search

Background Trend data on hypertension prevalence and attainment indicators at each step of the care cascade (awareness, treatment, control) are required in Chile. This study aims to quantify trends (2003–2017) in prevalence and in the proportion of individuals with hypertension attaining each step of the care cascade among adults aged 17 years or older, and to assess the impact of lowering the blood pressure (BP) thresholds used to define elevated BP on these indicators. Methods We used data from 2003, 2010, and 2017 Chilean national health surveys. Each year we assessed levels of (1) mean systolic (SBP) and diastolic (DBP) blood pressure, (2) hypertension prevalence (BP ≥ 140/90 mmHg or use of antihypertensive treatment), and (3) awareness, treatment, and control. Logistic regression on pooled data was used to assess trends in binary outcomes; linear regression was used to assess trends in continuous SBP and DBP. We compared levels of hypertension prevalence using two sources to ascertain antihypertensive treatment (self-reported versus medicine inventory). The 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines were used to re-define hypertension using lower thresholds (BP ≥ 130/80 mmHg). Results Hypertension prevalence was 34.0, 32.0 and 30.8% in 2003, 2010 and 2017, respectively. Levels of treated- and controlled-hypertension were significantly higher in 2017 than in 2003 (65% versus 41% for treatment, P P P = 0.130). Awareness, treatment, and control levels were higher among females in 2003, 2010, and 2017 (P Conclusions Chile has experienced a positive population-wide lowering in blood pressure distribution which may be explained partly by a significant rise in levels of treated- and controlled-hypertension since 2003. Lowering the thresholds used to define elevated BP would substantially increase the financial public health challenge of further improving attainment levels at each step of the care cascade. Innovative and collaborative strategies are needed to improve hypertension management, especially among males.

Objective.Genetic and environmental backgrounds influence the development of rheumatoid arthritis (RA). In Latin America, epidemiologic data are scarce. We aimed to determine the prevalence of RA in Chile in a population-based study.Methods.The National Health Survey was a cross-sectional household survey with a stratified multistage probability sample of 6233 participants performed between August 2016 and March 2017. A screening instrument for RA was applied to a random sample of 3847 subjects > 30 years old. Positive screening was defined by at least 1 of the following: 2 swollen joints for at least 4 consecutive weeks (past/present), and/or a diagnosis of arthritis in the past. Individuals with positive screening had rheumatoid factor, anticitrullinated protein antibodies, and C-reactive protein measured, as well as clinical examination performed by a rheumatologist. Self-report of doctor-diagnosed RA was also performed.Results.The screening questionnaire was applied to 2998 subjects. A positive screening was found for 783 (22.1%). Among subjects with positive screening, 493 (66%) had a clinical evaluation performed by a rheumatologist. Using the American College of Rheumatology/European League Against Rheumatism 2010 classification criteria, prevalence was 0.6% (95% CI 0.3–1.2). Prevalence was higher in women, and 3.3% of subjects self-reported having RA.Conclusion.According to this national population-based study, RA prevalence in Chile is 0.6% (0.3–1.2), a value similar to what has been found in developed countries and slightly lower than some Latin American countries. Self-reporting leads to overestimating RA.

Background Physical inactivity is one of the main risk factors for death worldwide. There is a paucity of studies about the association between transport and objective health measures using nationally representative samples worldwide, especially from Latin American countries. The aim of this research is to explore the relationship between active transportation and objective health measures in Chile. Methods We analysed the Chilean National Health Survey (ENS) 2016–2017, based on a nationally representative sample of non-institutionalised adults aged ≥15 years (n = 6,113). ENS included anthropometric measures (weight, height, waist circumference), a specific question about the main mode of transportation and several metabolic markers. Results 41%, 38% and 21% of participants used public transport, motor vehicles and active (cycling and walking) transport respectively. Higher levels of active transport were observed in males, younger groups, less educated and rural populations. Both active and public transport were associated with multiple nutritional and metabolic benefits such as lower BMI, lower waist circumference, less obesity, higher vitamin D, lower cholesterol and lower hepatic inflammation. Associations persisted after adjusting for other healthy lifestyles. Stronger benefits were observed in males than in females. Conclusions Promoting active transportation in urban planning policies may help Chile tackle the growing burden of chronic diseases.

Background: Inappropriate medication use in older people is an important source of adverse events and complications. Aim: To determine the frequency of inappropriate medication use in the general population. Material and methods: As part of the 2010 Chilean National Health Survey, 1048 persons aged 65 years or more were interviewed about medication use. The information obtained was analyzed using standardized Beer’s criteria, adapted for the Chilean population, to define inappropriate medication use. A logistic regression model was performed to define risk factors for inappropriate medication use. Results: Ten percent of subjects had a high risk of inappropriate medication use. The most common medications used were chlorphenamine, amitriptyline, diazepam, chlorpromazine, chlordiazepoxide and piroxicam. The risk factors detected were female gender, polypharmacy and a bad health self-perception. Conclusions: Inappropriate medication use is common among Chilean older people and should be discouraged.

Background Maule Cohort (MAUCO), a Chilean cohort study, seeks to analyze the natural history of chronic diseases in the agricultural county of Molina (40,000 inhabitants) in the Maule Region, Chile. Molina´s population is of particular interest because in the last few decades it changed from being undernourished to suffering excess caloric intake, and it currently has the highest national rates of cardiovascular diseases, stomach cancer and gallbladder cancer. Between 2009 and 2011 Molina´s poverty rate dropped from 24.1 % to 13.5 % (national average 20.4 %); in this period the county went from insufficient to almost complete basic sanitation. Despite these advances, chemical pollutants in the food and air are increasing. Thus, in Molina risk factors typical of both under-developed and developed countries coexist, generating a unique profile associated with inflammation, oxidative stress and chronic diseases. Methods/Design MAUCO is the core project of the recently established Advanced Center for Chronic Diseases (ACCDiS), Universidad de Chile & Pontificia Universidad Católica de Chile. In this study, we are enrolling and following 10,000 adults aged 38 to 74 years over 10 years. All eligible Molina residents will be enrolled. Participants were identified through a household census. Consenting individuals answer an epidemiological survey exploring risk factors (psycho-social, pesticides, diet, alcohol, and physical activity), medical history and physical and cognitive conditions; provide fasting blood, urine, and saliva samples; receive an electrocardiogram, abdominal ultrasound and bio-impedance test; and take a hand-grip strength test. These subjects will be re-interviewed after 2, 5 and 7 years. Active surveillance of health events is in place throughout the regional healthcare system. The MAUCO Bio-Bank will store 30 to 50 aliquots per subject using an NIH/NCI biorepository system for secure and anonymous linkage of samples with data. Discussion MAUCO´s results will help design public health interventions tailored to agricultural populations in Latin America.