36 results on '"Rubinstein, Adolfo Luis"'
Search Results
2. Associations between major dietary patterns and biomarkers of endothelial dysfunction in two urban midsized cities in Argentina
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Defagó, María Daniela, Elorriaga, Natalia, Eynard, Aldo Renato, Poggio, Rosana, Gutiérrez, Laura, Irazola, Vilma Edith, and Rubinstein, Adolfo Luis
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- 2019
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3. Community-based cardiovascular health promotion in Argentina. A systematic review
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Bardach, Ariel Esteban, Elorriaga, Natalia, Alcaraz, Andrea Olga, Rubinstein, Adolfo Luis, and Tavella, Julio Marcelo
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- 2018
4. Argentinian digital health strategy
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Rizzato Lede, Daniel A., Pedernera, Federico A., López, Emiliano, Speranza, Cintia D., Guevel, Carlos Gustavo, Maid, Jesse J., Mac Culloch, Patricia, Rolandi, Florencia, Ayala, Fabiana, Abadie, Daniel A., Baqué, María I., Gassino, Fernando, Campos, Fernando, Kaminker, Diego, Cejas, Cintia A., López Osornio, Alejandro, and Rubinstein, Adolfo Luis
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EHEALTH ,purl.org/becyt/ford/3.3 [https] ,NATIONAL HEALTH PROGRAMS ,HEALTH LEVEL SEVEN ,HEALTH INFORMATION EXCHANGE ,SNOMED ,purl.org/becyt/ford/3 [https] ,ELECTRONIC HEALTH RECORDS - Abstract
Digital Health is one of the three pillars for the effective implementation of Universal Health Coverage in Argentina. The Ministry of Health published the National Digital Health Strategy 2018-2024 in order to establish the conceptual guidelines for the design and development of interoperable health information systems as a state policy. The World Health Organization "National eHealth Strategy Toolkit", "Global Strategy on Digital Health" and other international and local evidence and expert recommendations were taken into account. The path to better healthcare involves adopting systems at the point of care, allowing for the primary recording of information and enabling information exchange through real interoperability. In that way, people, technology and processes will synergize to enhance integrated health service networks. In this paper, we describe the plan and the first two years of implementation of the strategy. Fil: Rizzato Lede, Daniel A.. Ministerio de Salud de la Nación; Argentina Fil: Pedernera, Federico A.. Ministerio de Salud de la Nación; Argentina Fil: López, Emiliano. Ministerio de Salud de la Nación; Argentina Fil: Speranza, Cintia D.. Ministerio de Salud de la Nación; Argentina Fil: Guevel, Carlos Gustavo. Ministerio de Salud de la Nación; Argentina Fil: Maid, Jesse J.. Ministerio de Salud de la Nación; Argentina Fil: Mac Culloch, Patricia. Ministerio de Modernización; Argentina Fil: Rolandi, Florencia. Ministerio de Modernización; Argentina Fil: Ayala, Fabiana. Ministerio de Modernización; Argentina Fil: Abadie, Daniel A.. Ministerio de Modernización; Argentina Fil: Baqué, María I.. Ministerio de Modernización; Argentina Fil: Gassino, Fernando. Ministerio de Salud de la Nación; Argentina. Hospital Italiano; Argentina Fil: Campos, Fernando. Hospital Italiano; Argentina Fil: Kaminker, Diego. No especifíca; Fil: Cejas, Cintia A.. Ministerio de Salud de la Nación; Argentina Fil: López Osornio, Alejandro. Ministerio de Salud de la Nación; Argentina Fil: Rubinstein, Adolfo Luis. Ministerio de Salud de la Nación; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
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- 2020
5. Health care access and health-related quality of life among people with diabetes in the Southern Cone of Latin America—a cross-sectional analysis of data of the CESCAS I study
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Kartschmit, Nadja, primary, Beratarrechea, Andrea, additional, Gutiérrez, Laura, additional, Cavallo, Ana Soledad, additional, Rubinstein, Adolfo Luis, additional, and Irazola, Vilma, additional
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- 2020
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6. Economic evaluations on cardiovascular preventive interventions in Argentina
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Colantonio, Lisandro Damián, Martí, Sebastián García, and Rubinstein, Adolfo Luis
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- 2010
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7. La costo-efectividad de las intervenciones y políticas para el control de las enfermedades no transmisibles y sus factores de riesgo en América Latina y el Caribe: revisión sistemática
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Watkin, David, Poggio, Rosana, Augustovski, Federico Ariel, Brouwer, Elizabeth, Pichon Riviere, Andrés, Rubinstein, Adolfo Luis, Nugent, Rachel, Legetic, Branka, Medici, Andre, and Hernández Ávila, Mauricio
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ECONOMICAS ,purl.org/becyt/ford/3.3 [https] ,DIMENSIONES ,TRANSMISIBLES ,ENFERMEDADES ,purl.org/becyt/ford/3 [https] - Abstract
Las enfermedades no transmisibles (ENT) son la principal causa de muerte en las Américas; entre ellas, las enfermedades cardiovasculares (ECV) ocasionan 45% de las defunciones (Hospedales, Barcelo, Luciani y colaboradores 2012). Se calcula que en América Latina y el Caribe (ALC), las defunciones atribuibles a las ECV, en particular la enfermedad coronaria (EC), aumentarán en alrededor de 145%, tanto en los hombres como en las mujeres, entre 1990 y el año 2020. Estas cifras contrastan con un aumento de 28% en las mujeres y de 50% en los hombres durante el mismo periodo en los países desarrollados (Yusuf, Hawken, Ounpuu y colaboradores 2004). Fil: Watkin, David. No especifíca; Fil: Poggio, Rosana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Brouwer, Elizabeth. No especifíca; Fil: Pichon Riviere, Andrés. No especifíca; Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Nugent, Rachel. No especifíca
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- 2017
8. Avaliação do impacto na saúde do Programa Estações Saudáveis na Cidade Autônoma de Buenos Aires, Argentina
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Elorriaga, Natalia, Garay, Osvaldo Ulises, Belizán, María Melina Eleonora, González, Verónica Beatriz, Rossi, María Laura, Chaparro, Raul Martin, Caporale, Joaquín E., de Ruggiero, Marina, Antún, María Cecilia, Pichón Riviere, Andrés, Rubinstein, Adolfo Luis, Irazola, Vilma, and Augustovski, Federico Ariel
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PROMOCIÓN DE LA SALUD ,ARGENTINA ,CIENCIAS MÉDICAS Y DE LA SALUD ,CONOCIMIENTOS, ACTITUDES Y PRÁCTICA EN SALUD ,Epidemiología ,Ciencias de la Salud ,ESTILO DE VIDA SALUDABLE ,PREVENCIÓN PRIMARIA ,ENFERMEDADES CARDIOVASCULARES ,EVALUACIÓN EN SALUD - Abstract
Objetivo. Explorar las motivaciones y expectativas de los usuarios del Programa de Estaciones Saludables en la Ciudad Autónoma de Buenos Aires y evaluar su potencial impacto sanitario. Métodos. Se realizaron entrevistas en profundidad (n = 34) y una encuesta autoadministrada (n = 605) a usuarios del programa. Se desarrolló un modelo epidemiológico para estimar el impacto del programa sobre los eventos cardiovasculares y los años de vida ajustados por discapacidad (AVAD). Resultados. Los principales factores motivadores para el uso de las estaciones saludables fueron la accesibilidad geográfica, económica (servicios gratuitos) y la satisfacción con la atención recibida. El 14,4% (intervalos de confianza del 95% [IC95%] 10,3–18,5%) de los usuarios hipertensos y el 24,8% (IC95% 17,6–32,0%) de los diabéticos informó haberse enterado de sus valores alterados en las estaciones saludables. Más de la mitad de los encuestados reportó alguna mejora de conocimientos sobre los beneficios de realizar actividad física y una alimentación saludable; esto fue más frecuente entre los usuarios más jóvenes, de menor nivel educativo, usuarios del sistema público de salud, usuarios de estaciones saludables de la zona sur y los que tenían algún factor de riesgo cardiometabólico (p
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- 2018
9. Health impact assessment of the Health Stations Program in Buenos Aires, Argentina
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Elorriaga, Natalia, Garay, Osvaldo Ulises, Belizan, Maria, González, Verónica Beatriz, Rossi, Maria Laura, Chaparro, Martín, Caporale, Joaquin, De Ruggiero, Marina, Antún, María Cecilia, Pichón-Riviere, Andrés, Rubinstein, Adolfo Luis, Irazola, Vilma, and Augustovski, Federico Ariel
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Practice ,Primary prevention ,CIENCIAS MÉDICAS Y DE LA SALUD ,Argentina ,Healthy lifestyle ,Ciencias de la Salud ,Otras Ciencias de la Salud ,purl.org/becyt/ford/3.3 [https] ,Cardiovascular diseases ,Health evaluation ,Attitudes ,Health promotion ,purl.org/becyt/ford/3 [https] ,Health knowledge - Abstract
Objetivo. Explorar las motivaciones y expectativas de los usuarios del Programa de EstacionesSaludables en la Ciudad Autónoma de Buenos Aires y evaluar su potencial impacto sanitario.Métodos. Se realizaron entrevistas en profundidad (n = 34) y una encuesta autoadministrada(n = 605) a usuarios del programa. Se desarrolló un modelo epidemiológico para estimarel impacto del programa sobre los eventos cardiovasculares y los años de vida ajustadospor discapacidad (AVAD).Resultados. Los principales factores motivadores para el uso de las estaciones saludablesfueron la accesibilidad geográfica, económica (servicios gratuitos) y la satisfacción con la atenciónrecibida. El 14,4% (intervalos de confianza del 95% [IC95%] 10,3?18,5%) de los usuarioshipertensos y el 24,8% (IC95% 17,6?32,0%) de los diabéticos informó haberse enterado de susvalores alterados en las estaciones saludables. Más de la mitad de los encuestados reportóalguna mejora de conocimientos sobre los beneficios de realizar actividad física y una alimentaciónsaludable; esto fue más frecuente entre los usuarios más jóvenes, de menor nivel educativo,usuarios del sistema público de salud, usuarios de estaciones saludables de la zona sur y los quetenían algún factor de riesgo cardiometabólico (p
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- 2018
10. Epidemiology of early repolarization pattern in an adult general population
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Matta, María Gabriela, primary, Gulayin, Pablo Elias, additional, García-Zamora, Sebastián, additional, Gutierrez, Laura, additional, Rubinstein, Adolfo Luis, additional, Irazola, Vilma Edith, additional, Poggio, Rosana, additional, and Gonzalez-Zuelgaray, Jorge, additional
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- 2019
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11. Epidemiology of early repolarization pattern in an adult general population.
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Matta, María Gabriela, Gulayin, Pablo Elias, García-Zamora, Sebastián, Gutierrez, Laura, Rubinstein, Adolfo Luis, Irazola, Vilma Edith, Poggio, Rosana, and Gonzalez-Zuelgaray, Jorge
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- 2020
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12. Impact of level and patterns of alcohol drinking on coronary heart disease and stroke burden in Argentina
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Bardach, Ariel Esteban, primary, Caporale, Joaquín Enzo, additional, Rubinstein, Adolfo Luis, additional, and Danaei, Goodarz, additional
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- 2017
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13. Community-based cardiovascular health promotion in Argentina. A systematic review
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Bardach, Ariel Esteban, primary, Elorriaga, Natalia, additional, Alcaraz, Andrea Olga, additional, Rubinstein, Adolfo Luis, additional, and Tavella, Julio Marcelo, additional
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- 2017
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14. Influence of Food Patterns on Endothelial Biomarkers: A Systematic Review
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Defagó, María Daniela, primary, Elorriaga, Natalia, additional, Irazola, Vilma Edith, additional, and Rubinstein, Adolfo Luis, additional
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- 2014
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15. Impact of level and patterns of alcohol drinking on coronary heart disease and stroke burden in Argentina
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Bardach, Ariel Esteban, Caporale, Joaquín Enzo, Rubinstein, Adolfo Luis, and Danaei, Goodarz
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Biology and Life Sciences ,Nutrition ,Diet ,Alcohol Consumption ,Medicine and Health Sciences ,Neurology ,Cerebrovascular Diseases ,Stroke ,Hemorrhagic Stroke ,Vascular Medicine ,Ischemic Stroke ,Coronary Heart Disease ,Cardiology ,Cardiovascular Medicine ,Cardiovascular Diseases ,People and places ,Geographical locations ,South America ,Argentina ,People and Places ,Demography ,Death Rates ,Public and Occupational Health - Abstract
Background: Deaths from cardiovascular disease (CVD), including coronary heart disease (CHD) and stroke are expected to increase in Latin America. Moderate and regular alcohol consumption confers cardiovascular protection, while binge drinking increases risk. We estimated the effects of alcohol use on the number of annual CHD and stroke deaths and disability-adjusted life years (DALYs) in Argentina. Methods: Alcohol use data were obtained from a nationally representative survey (EnPreCosp 2011), and etiological effect sizes from meta-analyses of epidemiological studies. Cause-specific mortality rates were from the vital registration system. Results: There were 291,475 deaths in 2010 including 24,893 deaths from CHD and 15,717 from stroke. 62.7% of men and 38.7% of women reported drinking alcohol in the past year. All heavy drinkers (i.e. women who drank >20g/day and men who drank >40g/day of alcohol) met the definition of binge drinking and therefore did not benefit from cardioprotective effects. Alcohol drinking prevented 1,424 CHD deaths per year but caused 935 deaths from stroke (121 ischemic and 814 hemorrhagic), leading to 448 CVD deaths prevented (58.3% in men). Alcohol use was estimated to save 85,772 DALYs from CHD, but was responsible for 52,171 lost from stroke. Conclusions: In Argentina, the cardioprotective effect of regular and moderate alcohol drinking is slightly larger than the harmful impact of binge drinking on CVD. However, considering global deleterious effects of alcohol in public health, policies to reduce binge drinking should be enforced, especially for young people. Studies are still needed to elucidate effects on cardiovascular health.
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- 2017
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16. Detection and follow-up of cardiovascular disease and risk factors in the Southern Cone of Latin America: the CESCAS I study.
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Rubinstein, Adolfo Luis, Irazola, Vilma Edith, Poggio, Rosana, Bazzano, Lydia, Calandrelli, Matías, Zanetti, Fernando Tomas Lanas, Manfredi, Jose Anibal, Olivera, Héctor, Seron, Pamela, Ponzo, Jacqueline, and Jiang He
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Introduction: Cardiovascular diseases (CVD) are increasing throughout the world and cause 16.7 million deaths each year, 80% of which occur in low and middle income countries. In Argentina, Chile and Uruguay, the available data on cardiovascular risk factors come predominantly from cross-sectional studies that are principally based on self-report or studies conducted with small convenience samples. The CESCAS I study will generate reliable estimates of the prevalence and distribution of and secular trends in CVD and its risk factors in this region. Methods and analysis: CESCAS I is an observational prospective cohort study with a multistage probabilistic sample of 8000 participants aged 35-74 years from four mid-sized cities representing the Southern Cone of Latin America: Bariloche and Marcos Paz in Argentina, Temuco in Chile and Pando-Barros Blancos in Uruguay. In the first phase, baseline data regarding exposure to risk factors and prevalence of CVD will be collected in two stages: (1) in homes and (2) in health centres. Information will be gathered on medical history, risk factors, lifestyles and health utilisation through specific questionnaires, physical measurements, an ECG and an overnight, fasting blood sample to measure levels of serum lipids, glucose and creatinine. In the second phase, annual follow-up data will be obtained on the incidence rate of CVD events and the association between exposure and events. Ethics and dissemination: The protocol has obtained formal ethics approval from institutional review boards in Argentina, Chile, Uruguay and the USA. The lack of follow-up studies has prevented Argentina, Chile and Uruguay from implementing risk factor stratification and management strategies at a population level. However, the CESCAS I study data will help the development of public health strategies based on primary care intervention, thus helping to improve cardiovascular health in this region. [ABSTRACT FROM AUTHOR]
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- 2011
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17. Evaluating a multicomponent program to improve hypertension control in Guatemala: study protocol for an effectiveness-implementation cluster randomized trial
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Alejandra Paniagua-Avila, Meredith P. Fort, Adolfo Rubinstein, Kristyne Mansilla, Diego Hernández-Galdamez, Eduardo Palacios, Russell E. Glasgow, Manuel Ramirez-Zea, Ana Lucia Peralta, Pablo Gulayin, Dina Roche, Vilma Irazola, and Jiang He
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Psychological intervention ,Medicine (miscellaneous) ,Collaborative Care ,Blood Pressure ,030204 cardiovascular system & hematology ,Study Protocol ,0302 clinical medicine ,PRIMARY CARE ,IMPLEMENTATION SCIENCE ,LOW-INCOME AND MIDDLE-INCOME COUNTRIES ,Medicine ,Pharmacology (medical) ,030212 general & internal medicine ,Cluster randomised controlled trial ,media_common ,Randomized Controlled Trials as Topic ,Community Health Workers ,Multicomponent program ,lcsh:R5-920 ,Guatemala ,Cardiovascular disease ,Primary care ,Home Care Services ,Hypertension ,HEALTH SYSTEMS ,Implementation science ,purl.org/becyt/ford/3 [https] ,Medical emergency ,lcsh:Medicine (General) ,Implementation strategies ,Health coaching ,MULTICOMPONENT PROGRAM ,media_common.quotation_subject ,CARDIOVASCULAR DISEASE ,Fidelity ,GUATEMALA ,Audit ,Low-income and middle-income countries ,purl.org/becyt/ford/3.3 [https] ,03 medical and health sciences ,Health systems ,IMPLEMENTATION STRATEGIES ,Humans ,Non-communicable diseases ,Poverty ,Protocol (science) ,HYPERTENSION ,NON-COMMUNICABLE DISEASES ,Primary Health Care ,business.industry ,medicine.disease ,Blood pressure ,Clinical Trials, Phase III as Topic ,business - Abstract
Background: Hypertension is a major risk factor for cardiovascular disease (CVD). Despite advances in hypertension prevention and treatment, the proportion of patients who are aware, treated and controlled is low, particularly in low-income and middle-income countries (LMICs). We will evaluate an adapted version of a multilevel and multicomponent hypertension control program in Guatemala, previously proven effective and feasible in Argentina. The program components are: protocol-based hypertension treatment using a standardized algorithm; team-based collaborative care; health provider education; health coaching sessions; home blood pressure monitoring; blood pressure audit; and feedback.Methods: Using a hybrid type 2 effectiveness-implementation design, we will evaluate clinical and implementation outcomes of the multicomponent program in Guatemala over an 18-month period. Through a cluster randomized trial, we will randomly assign 18 health districts to the intervention arm and 18 to enhanced usual care across five departments, enrolling 44 participants per health district and 1584 participants in total. The clinical outcomes are (1) the difference in the proportion of patients with controlled hypertension (< 130/80 mmHg) between the intervention and control groups at 18 months and (2) the net change in systolic and diastolic blood pressure from baseline to 18 months. The context-enhanced Reach, Efficacy, Adoption, Implementation, Maintenance (RE-AIM)/Practical Robust Implementation and Sustainability Model (PRISM) framework will guide the evaluation of the implementation at the level of the patient, provider, and health system. Using a mixed-methods approach, we will evaluate the following implementation outcomes: acceptability, adoption, feasibility, fidelity, adaptation, reach, sustainability, and cost-effectiveness.Discussion: We will disseminate the study findings, and promote scale up and scale out of the program, if proven effective. This study will generate urgently needed data on effective, adoptable, and sustainable interventions and implementation strategies to improve hypertension control in Guatemala and other LMICs. Fil: Paniagua Avila, Alejandra. Columbia University; Estados Unidos Fil: Fort, Meredith P.. Institute Of Nutrition Of Central America And Panamá; Guatemala Fil: Glasgow, Russell E.. University of Colorado; Estados Unidos Fil: Gulayin, Pablo Elías. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Hernández Galdamez, Diego. institute of Nutrition of Central America and Panamá; Guatemala Fil: Mansilla, Kristyne. institute of Nutrition of Central America and Panamá; Guatemala Fil: Palacios, Eduardo. Ministerio de Salud y Asistencia Social; Guatemala Fil: Peralta, Ana Lucia. Institute of Nutrition of Central America and Panamá ; Guatemala Fil: Roche, Dina. Institute of Nutrition of Central America and Panamá ; Guatemala Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: He, Jiang. University Translational Science Institute; Estados Unidos Fil: Ramirez Zea, Manuel. Institute of Nutrition of Central America and Panamá ; Guatemala Fil: Irazola, Vilma. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
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- 2020
18. mHealth Interventions to Counter Noncommunicable Diseases in Developing Countries
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Andrea Beratarrechea, Adolfo Rubinstein, Daniela Moyano, and Vilma Irazola
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Low- And Middle-Income Countries ,Telemedicine ,CIENCIAS MÉDICAS Y DE LA SALUD ,Mhealth ,Psychological intervention ,Ciencias de la Salud ,Developing country ,030204 cardiovascular system & hematology ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Environmental health ,Health care ,Epidemiología ,Medicine ,030212 general & internal medicine ,mHealth ,business.industry ,General Medicine ,Chronic disease ,Chronic Disease ,Health education ,Cardiology and Cardiovascular Medicine ,business - Abstract
mHealth constitutes a promise for health care delivery in low- and middle-income countries (LMICs) where health care systems are unprepared to combat the threat of noncommunicable diseases (NCDs). This article assesses the impact of mHealth on NCD outcomes in LMICs. A systematic review identified controlled studies evaluating mHealth interventions that addressed NCDs in LMICs. From the 1274 abstracts retrieved, 108 articles were selected for full text review and 20 randomized controlled trials were included from 14 LMICs. One-way SMS was the most commonly used mobile function to deliver reminders, health education, and information. mHealth interventions in LMICs have positive but modest effects on chronic disease outcomes. Fil: Beratarrechea, Andrea Gabriela. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Moyano, Daniela Luz. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
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- 2017
19. Validation and calibration of the patient health questionnaire (PHQ-9) in Argentina
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Fernando Coppolillo, Gabriela Herlax, Guillermo Saba, Vilma Irazola, Federico Manuel Daray, María Urtasun, Adolfo Rubinstein, Ricardo Araya, and Germán Leandro Teti
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Adult ,Male ,medicine.medical_specialty ,Psychometrics ,lcsh:RC435-571 ,Argentina ,MINI INTERNATIONAL NEUROPSYCHIATRIC INTERVIEW ,Validity ,Patient Health Questionnaire ,Sensitivity and Specificity ,Severity of Illness Index ,behavioral disciplines and activities ,Screening instruments ,purl.org/becyt/ford/3.3 [https] ,Cronbach's alpha ,Patient health Questionnaire-9 ,lcsh:Psychiatry ,medicine ,Humans ,Major depressive episode ,Mini international neuropsychiatric interview ,Depression (differential diagnoses) ,Mini-international neuropsychiatric interview ,Depressive Disorder ,ARGENTINA ,PSYCHOMETRICS ,SCREENING INSTRUMENTS ,Depression ,business.industry ,Reproducibility of Results ,PATIENT HEALTH QUESTIONNAIRE-9 ,Middle Aged ,DEPRESSION ,humanities ,Psychiatry and Mental health ,Cross-Sectional Studies ,Convergent validity ,Physical therapy ,Female ,purl.org/becyt/ford/3 [https] ,medicine.symptom ,business ,Research Article - Abstract
Background: The Patient Health Questionnaire-9 (PHQ-9) is a brief tool to assess the presence and severity of depressive symptoms. This study aimed to validate and calibrate the PHQ-9 to determine appropriate cut-off points for different degrees of severity of depression in Argentina. Methods: We conducted a cross-sectional study on an intentional sample of adult ambulatory care patients with different degrees of severity of depression. All patients who completed the PHQ-9 were further interviewed by a trained clinician with the Mini International Neuropsychiatric Interview (MINI) and the Beck Depression Inventory-II (BDI-II). Reliability and validity tests, including receiver operating curve analysis, were performed. Results: One hundred sixty-nine patients were recruited with a mean age of 47.4 years (SD = 14.8), of whom 102 were females (60.4%). The local PHQ-9 had high internal consistency (Cronbach's alpha = 0.87) and satisfactory convergent validity with the BDI-II scale [Pearson's correlation = 0.88 (p < 0.01)]. For the diagnosis of Major Depressive Episode (MDE) according to the MINI, a PHQ-9 ≥ 8 was the optimal cut-off point found (sensitivity 88.2%, specificity 86.6%, PPV 90.91%). The local version of PHQ-9 showed good ability to discriminate among depression severity categories according to the BDI-II scale. The best cut off points were 6-8 for mild cases, 9-14 for moderate and 15 or more for severe depressive symptoms respectively. Conclusions: The Argentine version of the PHQ-9 questionnaire has shown acceptable validity and reliability for both screening and severity assessment of depressive symptoms. Fil: Urtasun, María. Instituto de Efectividad Clínica y Sanitaria; Argentina. Universidad de Alcalá; España Fil: Daray, Federico Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires; Argentina Fil: Teti, Germán Leandro. Gobierno de la Ciudad Autónoma de Buenos Aires. Hospital Neuropsiquiátrico Braulio Aurelio Moyano; Argentina Fil: Coppolillo, Fernando Enrique. Universidad de Buenos Aires. Facultad de Medicina; Argentina Fil: Herlax, Gabriela. Universidad de Buenos Aires. Facultad de Medicina; Argentina Fil: Saba, Guillermo. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Araya, Ricardo. London School of Hygiene and Tropical Medicine; Reino Unido Fil: Irazola, Vilma. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
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- 2019
20. Cost-Effectiveness of a Comprehensive Approach for Hypertension Control in Low-Income Settings in Argentina: Trial-Based Analysis of the Hypertension Control Program in Argentina
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Martin Chaparro, Lizheng Shi, Jiang He, Alfredo Palacios, Andrea Beratarrechea, Andrés Pichón Riviere, Adolfo Rubinstein, Katherine T. Mills, Federico Augustovski, and Vilma Irazola
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Male ,Cost effectiveness ,Cost-Benefit Analysis ,Ciencias de la Salud ,Blood Pressure ,030204 cardiovascular system & hematology ,COST-EFFECTIVENESS ,0302 clinical medicine ,Quality of life ,PRIMARY CARE ,Credible interval ,Medicine ,030212 general & internal medicine ,Cluster randomised controlled trial ,Community Health Workers ,Health Policy ,Health Care Costs ,Middle Aged ,Home Care Services ,Otras Ciencias de la Salud ,Hypertension ,Health Resources ,Female ,purl.org/becyt/ford/3 [https] ,Quality-Adjusted Life Years ,Adult ,medicine.medical_specialty ,CIENCIAS MÉDICAS Y DE LA SALUD ,Argentina ,Subgroup analysis ,Health Promotion ,Article ,03 medical and health sciences ,purl.org/becyt/ford/3.3 [https] ,Patient Education as Topic ,Physicians ,LOW-INCOME SETTING ,Humans ,Poverty ,Aged ,Text Messaging ,Primary Health Care ,HYPERTENSION ,business.industry ,Public Health, Environmental and Occupational Health ,Confidence interval ,Blood pressure ,Physical therapy ,Quality of Life ,business ,Body mass index - Abstract
Background: A recent cluster randomized trial evaluating a multicomponent intervention showed significant reductions in blood pressure in low-income hypertensive subjects in Argentina. Objectives: To assess the cost-effectiveness of this intervention. Methods: A total of 1432 hypertensive participants were recruited from 18 primary health care centers. The intervention included home visits led by community health workers, physician education, and text messaging. Resource use and quality of life data using the three-level EuroQol five-dimensional questionnaire were prospectively collected. The study perspective was that of the public health care system, and the time horizon was 18 months. Intention-to-treat analysis was used to analyze cost and health outcomes (systolic blood pressure [SBP] change and quality-adjusted life-years [QALYs]). A 1 time gross domestic product per capita per QALY was used as the cost-effectiveness threshold (US $14,062). Results: Baseline characteristics were similar in the two arms. QALYs significantly increased by 0.06 (95% confidence interval [CI] 0.04–0.09) in the intervention group, and SBP net difference favored the intervention group: 5.3 mm Hg (95% CI 0.27–10.34). Mean total costs per participant were higher in the intervention arm: US $304 in the intervention group and US $154 in the control group (adjusted difference of US $140.18; 95% CI US $75.41–US $204.94). The incremental cost-effectiveness ratio was $3299 per QALY (95% credible interval 1635–6099) and US $26 per mm Hg of SBP (95% credible interval 13–46). Subgroup analysis showed that the intervention was cost-effective in all prespecified subgroups (age, sex, cardiovascular risk, and body mass index). Conclusions: The multicomponent intervention was cost-effective for blood pressure control among low-income hypertensive patients. Fil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Chaparro, Martin. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Palacios, Alfredo. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Shi, Lizheng. University of Tulane; Estados Unidos Fil: Beratarrechea, Andrea Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Mills, Katherine. University of Tulane; Estados Unidos Fil: He, Jiang. University of Tulane; Estados Unidos Fil: Pichón-Riviere, Andrés. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
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- 2018
21. Using mHealth tools to improve access, coverage and treatment of uninsured people with high cardiovascular disease risk in Argentina: A study protocol for a pragmatic cluster randomised trial
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Adolfo Rubinstein, Alvaro Ciganda, Leo Anthony Celis, Shafika Abrahams-Gessel, Laura Gutierrez, Thomas A. Gaziano, Vilma Irazola, Daniela Moyano, Andrea Beratarrechea, Ariel Fernández, and Eric Winkler
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medicine.medical_specialty ,CIENCIAS MÉDICAS Y DE LA SALUD ,Population ,Disease ,Disease cluster ,03 medical and health sciences ,0302 clinical medicine ,PRIMARY CARE ,Intervention (counseling) ,Medicine ,MHEALTH ,030212 general & internal medicine ,education ,mHealth ,Protocol (science) ,Government ,education.field_of_study ,business.industry ,030503 health policy & services ,Attendance ,General Medicine ,PREVENTION ,CARDIOVASCULAR ,Otras Ciencias Médicas ,Family medicine ,0305 other medical science ,business - Abstract
Introduction Cardiovascular disease (CVD) accounts for approximately one-third of Argentina's deaths. Despite government provision of free primary care health services to the uninsured population, with a focus on non-communicable diseases, screening and management of those with high CVD risk at primary care clinics (PCCs) remain low. Methods and analysis This pragmatic cluster randomised trial will take place in two provinces of Argentina and will recruit 740 participants. Eight PCCs will be randomised to either the intervention or current practice arm. Community health workers (CHWs) in the intervention arm will be trained to use a set of integrated mHealth tools (a validated risk screening tool mobile application; electronic scheduling system using wireless access to PCCs; and educational text messages) to screen for CVD and to schedule appointments with primary care providers for persons with high CVD risk (≥10%). The primary aims of this study are to determine if the use of mHealth tools will (1) increase attendance of first appointments scheduled by CHWs for persons determined to have high risk for CVD during screening and, (2) lead to an increase in follow-up visits at PCCs by high risk patients. Secondary outcomes include assessing the proportion of high-risk patients receiving appropriate medications and a cost-effective analysis of the intervention. Ethics and dissemination This study has been approved by the Institutional Review Boards at Partners/Brigham and Women's Hospital (USA) and the Hospital Italiano de Buenos Aires (Argentina). The open-source software for the mHealth tools will be made publicly available at the end of the study. Trial registration number NCT02913339. Fil: Abrahams Gessel, Shafika. Harvard University; Estados Unidos Fil: Beratarrechea, Andrea Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Moyano, Daniela Luz. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Fernandez, Ariel. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Ciganda, Alvaro. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Celis, Leo Anthony. Massachusetts Institute of Technology; Estados Unidos Fil: Winkler, Eric. Massachusetts Institute of Technology; Estados Unidos Fil: Rubinstein, Adolfo Luis. Ministerio de Salud de la Nación; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Gaziano, Thomas A.. Harvard University; Estados Unidos. Brigham and Women’s Hospital; Estados Unidos
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- 2018
22. Ideal Cardiovascular Health in the southern cone of Latin America
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Fernando Lanas, Laura Gutierrez, Natalia Elorriaga, Pamela Seron, Adolfo Rubinstein, Hector Olivera, Vilma Irazola, Rosana Poggio, Matías Calandrelli, and Jacqueline Ponzo
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Adult ,Male ,Latin Americans ,CIENCIAS MÉDICAS Y DE LA SALUD ,Health Status ,Cardiovascular health ,Health Behavior ,Population ,Ciencias de la Salud ,030204 cardiovascular system & hematology ,Cardiovascular System ,Article ,Probability sampling ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Surveys and Questionnaires ,parasitic diseases ,Prevalence ,Humans ,Medicine ,Epidemiología ,Healthy Lifestyle ,030212 general & internal medicine ,education ,Aged ,education.field_of_study ,Ideal (set theory) ,CARDIOVASCULAR HEALTH ,business.industry ,CARDIOVASCULAR RISK ,Public Health, Environmental and Occupational Health ,General Medicine ,Middle Aged ,Confidence interval ,PREVALENCE ,Cross-Sectional Studies ,Latin America ,Blood pressure ,Cardiovascular Diseases ,Cohort ,Female ,business ,Demography - Abstract
Objective: The American Heart Association developed the concept of ‘Ideal Cardiovascular Health’ which is based on the presence of ideal levels across seven health factors. The goal of this study is to assess the prevalence of Ideal Cardiovascular Health in the Southern Cone of Latin America. Study design: We conducted a cross-sectional analysis as part of CESCAS I cohort. Methods: This report included 5458 participants aged between 35 and 75 years who were selected using stratified multistage probability sampling in Argentina, Chile and Uruguay. Interviews included demographic information, the International Physical Activity Questionnaire, and a food frequency questionnaire on dietary habits. Participants were classified as current, former or non-smokers. Weight, height and blood pressure were measured by trained personnel, and fasting cholesterol and glucose plasma levels were measured. Results: Only 0.1% (95% confidence interval [CI]: 0.0–0.2) met the seven criteria that define the Ideal Cardiovascular Health. The least prevalent healthy behaviour was having a healthy diet: 0.5% (95% CI: 0.3–0.7), while the least prevalent health factor was having blood pressure < 120/80 mmHg: 23.6% (95% CI: 22.1–25.0). Conclusions: The prevalence of Ideal Cardiovascular Health is very low in a representative sample of population from the Southern Cone of Latin America, and the levels of healthy lifestyle behaviours are even lower than ideal biochemical parameters. These results highlight the challenge of developing strategies to improve the levels of Ideal Cardiovascular Health at primary prevention levels. Fil: Seron, P.. Universidad de La Frontera; Chile Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Rubinstein, Adolfo Luis. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Calandrelli, Matías Enrique. Sanatorio San Carlos; Argentina Fil: Ponzo, J.. Universidad de la República; Uruguay Fil: Olivera, H.. Municipalidad de Marcos Paz; Argentina Fil: Gutierrez, L.. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Elorriaga, Natalia. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Poggio, Rosana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Lanas, F.. Universidad de La Frontera; Chile
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- 2018
23. External Validation of Cardiovascular Risk Scores in the Southern Cone of Latin America: Which Predicts Better?
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Pablo E. Gulayin, Goodarz Danaei, Laura Gutierrez, Rosana Poggio, Jaqueline Ponzo, Fernando Lanas, Adolfo Rubinstein, and Vilma Irazola
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lcsh:Internal medicine ,lcsh:Diseases of the circulatory (Cardiovascular) system ,CIENCIAS MÉDICAS Y DE LA SALUD ,lcsh:Specialties of internal medicine ,Enfermedad cardiovascular ,lcsh:R ,lcsh:Medicine ,Ciencias de la Salud ,CARDIOVASCULAR DISEASE ,Enfermedad cardiovascular - Factores de riesgo - Evaluación del riesgo - Prevención ,PREVENTION ,purl.org/becyt/ford/3.3 [https] ,Prevención ,lcsh:RC581-951 ,lcsh:RC666-701 ,RISK FACTORS ,Cardiovascular disease - Risk factors ,Epidemiología ,purl.org/becyt/ford/3 [https] ,RISK ASSESSMENT ,lcsh:RC31-1245 ,Evaluación del riesgo ,Factores de riesgo - Abstract
Introducción: La estimación inexacta del riesgo cardiovascular poblacional puede llevar a un manejo inadecuado de las intervenciones médicas preventivas, como, por ejemplo, el uso de estatinas. Objetivo: Evaluar la validez externa de ecuaciones de predicción de riesgo cardiovascular en población general del Cono Sur de Latinoamérica. Material y métodos: Se evaluaron ecuaciones que incluyen variables evaluadas en el estudio CESCAS y que predicen tanto morbilidad como mortalidad cardiovascular global (CUORE, Framingham, Globorisk y Pooled Cohort Studies Equations). Para cada ecuación se realizó un análisis independiente en el que se tuvieron en cuenta los eventos cardiovasculares relevados. Se evaluó la discriminación de cada ecuación a través del cálculo del estadístico-C y el índice Harrell C. Para evaluar la calibración se graficó la proporción de riesgos observados vs. estimados por quintilos de riesgo para cada ecuación y se calculó la pendiente β de regresión lineal para las estimaciones. Se calculó sensibilidad y especificidad para la detección de personas con elevado riesgo cardiovascular. Resultados: La mediana del tiempo de seguimiento de la cohorte al momento del análisis es de 2,2 años, con un rango intercuartilo de 1,9 a 2,8 años. Se incorporaron a los análisis 60 eventos cardiovasculares. Todos los valores de estadístico-C y del índice de Harrell fueron superiores a 0,7. El valor de la pendiente β más alejado de 1 fue el de Pooled Cohort Studies Euations. Conclusiones: Si bien los parámetros de validación externa evaluados fueron similares, CUORE, Globorisk y el índice de Framingham fueron las ecuaciones con mejores indicadores globales de predicción de riesgo cardiovascular. Background: Inaccurate estimates of demographic cardiovascular risk may lead to an inadequate management of preventive medical interventions such as the use of statins. Objectives: The aim of this study was to evaluate the external validity of cardiovascular risk equations in the general population of the Southern Cone of Latin America. Methods: Equations including variables evaluated in the CESCAS cohort study and that estimate overall cardiovascular mortality (CUORE, Framingham, Globorisk and Pooled Cohort Studies) were assessed. For each equation, an independent analysis was performed taking into account the cardiovascular events originally considered. Discrimination of each equation was evaluated through C-statistic and Harrell’s C-index. To assess calibration, a graph was built for each equation with the proportion of observed events vs. the proportion of estimated events by risk quintiles and the β slope of the resulting linear regression was calculated. Sensitivity and specificity were determined for the detection of people at high cardiovascular risk. Results: The median follow-up time of the cohort at the time of the analysis was 2.2 years, with an interquartile range of 1.9 to 2.8 years. Sixty cardiovascular events were incorporated into the analysis. All C-statistic and Harrell’s-C index values were greater than 0.7. The value of the β slope farthest from 1 was that of the Pooled Cohort Studies score. Conclusions: Although the external validation parameters evaluated were similar, CUORE, Globorisk and the Framingham equations showed the best global performance for cardiovascular risk estimation in our population. Fil: Gulayin, Pablo Elías. Universidad Nacional de La Plata; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Danaei, Goodarz. Harvard University. Harvard School of Public Health; Estados Unidos Fil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Poggio, Rosana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Ponzo, Jaqueline. Universidad de la República; Uruguay Fil: Lanas, Fernando. Universidad de La Frontera; Chile Fil: Rubinstein, Adolfo Luis. Ministerio de Salud de la Nación; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
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- 2018
24. Associations between dietary patterns and serum lipids, apo and C-reactive protein in an adult population: evidence from a multi-city cohort in South America
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Vilma Irazola, Rosana Poggio, Laura Gutierrez, Natalia Elorriaga, Adolfo Rubinstein, and Goodarz Danaei
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Male ,CIENCIAS MÉDICAS Y DE LA SALUD ,Apolipoprotein B ,Adult population ,Medicine (miscellaneous) ,Blood lipids ,Ciencias de la Salud ,030204 cardiovascular system & hematology ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Epidemiología ,030212 general & internal medicine ,Food science ,Refined grains ,Cities ,Triglycerides ,Inflammation ,Principal Component Analysis ,Nutrition and Dietetics ,medicine.diagnostic_test ,biology ,Dietary Patterns ,C-reactive protein ,Cholesterol, LDL ,Middle Aged ,South America ,Diet ,Cholesterol ,Cross-Sectional Studies ,Apolipoproteins ,C-Reactive Protein ,Cardiovascular Diseases ,Immunology ,Cohort ,biology.protein ,Red meat ,lipids (amino acids, peptides, and proteins) ,Female ,Diet, Healthy ,Lipid profile ,Biomarkers - Abstract
Several previous epidemiological studies from developed countries have shown that an unhealthy dietary pattern affects plasma lipid levels andinflammation biomarkers. We assessed the cross-sectional associations between dietary patterns and cardiovascular risk factors among 961adults from a multi-city cohort in South America. We conducted a principal component analysis to derive dietary patterns. As outcomes, weexamined plasma levels of apo A-I, apo B, high-sensitivity C-reactive protein (hs-CRP), LDL-, HDL- and serum total cholesterol and TAG. Thecrude and adjusted changes in each outcome were estimated for quartiles of dietary patterns using multivariable linear regression models. Theprudent pattern (PP) characterised by higher intake of fruits, vegetables, fish, seafood, whole cereal and low-fat dairy products was associatedwith reduced plasma concentrations of apo B (−8·5mg/l), total cholesterol (−18·8 mg/dl) and LDL-cholesterol (−16·5mg/dl) and hs-CRP(−1·6mg/l) in men. In women also reduced plasma concentrations of apo B (−6·6mg/l), total (−12·0mg/dl) and LDL (−9·3mg/dl). The ?Westernlike?pattern characterised by higher intake of eggs, pastry and cakes, pizza, snacks, refined grains, red meat, vegetable oils and poultry was notsignificantly associated with any of the selected serum lipid or inflammatory biomarkers. The explained variances were 10·3 and 7·4%,respectively. The PP was associated with better lipid profile, mainly lower atherogenic particles (apo B) and LDL-cholesterol and serum totalcholesterol. This study provides possible evidence of a prudent diet in South American populations to help reduce the burden of CVD. Fil: Poggio, Rosana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Elorriaga, Natalia. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Rubinstein, Adolfo Luis. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Danaei, Goodarz. Harvard University. Harvard School of Public Health; Estados Unidos
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- 2017
25. Determinants and geographical variation in the distribution of depression in the Southern cone of Latin America: A population-based survey in four cities in Argentina, Chile and Uruguay
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Federico Manuel Daray, Laura Gutierrez, Rosana Poggio, Nora Mores, Vilma Irazola, Fernando Lanas, Jacqueline Ponzo, Matías Calandrelli, and Adolfo Rubinstein
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Adult ,Male ,CIENCIAS MÉDICAS Y DE LA SALUD ,Latin Americans ,Cross-sectional study ,Population ,Argentina ,Ciencias de la Salud ,Distribution (economics) ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Surveys and Questionnaires ,medicine ,Prevalence ,Epidemiología ,Humans ,030212 general & internal medicine ,Chile ,Cities ,Major depressive episode ,education ,Population based survey ,Depression (differential diagnoses) ,Aged ,education.field_of_study ,Depressive Disorder, Major ,Geography ,Depression ,business.industry ,Middle Aged ,Health Surveys ,Patient Health Questionnaire ,Psychiatry and Mental health ,Clinical Psychology ,Cross-Sectional Studies ,Latin America ,Stressful Life Events ,Chronic Disease ,Uruguay ,Female ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Demography - Abstract
Background Depression is one of the major contributors to the global burden of diseases; however, population-based data in South America are limited. Methods We conducted a population-based cross sectional study with 7524 participants, aged 35–74 years old, recruited between February 2010 and December 2011 from randomly selected samples in 4 cities (Bariloche and Marcos Paz, Argentina; Temuco, Chile; and Pando-Barros Blancos, Uruguay). Major Depressive Episode (MDE) was assessed using the Patient Health Questionnaire (PHQ) – 9. Results The overall prevalence of MDE was 14.6% (95% CI: 13.6, 15.6). However, there was a geographical variability of up to 3.7 folds between different cities being 5.6% (95% CI: 4.6, 6.7) in Marcos Paz, Argentina; 9.5% (95% CI: 8.2, 10.9) in Bariloche, Argentina; 18.1% (95% CI: 16.3, 20.0) in Temuco, Chile, and 18.2 (95% CI: 16.3, 20.2) in Pando-Barros Blancos, Uruguay. The multivariate model showed that, adjusted by location, being female, being between 35 and 44 years old, having experienced at least one stressful life event, currently smoking, and having a history of chronic medical diseases were independently associated with an increased risk of MDE, while having higher education and being married or living with a partner reduced the risk of MDE. Limitations These results are representative of the selected cities included in the study. As such extrapolation to the general populations of Argentina, Chile, and Uruguay should be done with caution Conclusions This study showed a high prevalence and variability of MDE in the Southern Cone of Latin America. Fil: Daray, Federico Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Odontología; Argentina Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Gutierrez, L.. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Lanas, F.. Universidad de La Frontera; Chile Fil: Mores, N.. Provincia de Buenos Aires. Municipalidad de Marcos Paz; Argentina Fil: Calandrelli, M.. Sanatorio San Carlos; Argentina Fil: Poggio, Rosana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Ponzo, J.. Universidad de la República; Uruguay Fil: Irazola, Vilma. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
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- 2017
26. Implementation Science to Accelerate Clean Cooking for Public Health
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Gautam N. Yadama, Darby Jack, Kenny Sherr, Joshua M Rosenthal, Helen H. Petach, Kirk R. Smith, David Wade Chambers, Sumi Mehta, Rachel Sturke, Jay P. Graham, Lydia Kline, Elisa Puzzolo, Omar Masera, Adolfo Rubinstein, Antonello Punturieri, Kalpana Balakrishnan, Gila Neta, Ilse Ruiz Mercado, Subhrendu K. Pattanayak, Michael Sage, Anita V. Shankar, and Nigel Bruce
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Burden of disease ,medicine.medical_specialty ,CLEAN ,CIENCIAS MÉDICAS Y DE LA SALUD ,Health, Toxicology and Mutagenesis ,Ciencias de la Salud ,010501 environmental sciences ,Brief Communication ,Toxicology ,01 natural sciences ,World health ,COOKING ,purl.org/becyt/ford/3.3 [https] ,03 medical and health sciences ,0302 clinical medicine ,Clinical Research ,Air Pollution ,PUBLIC ,Environmental monitoring ,medicine ,Global health ,Humans ,Cooking ,030212 general & internal medicine ,Indoor ,Environmental planning ,0105 earth and related environmental sciences ,Medical And Health Sciences ,Salud Ocupacional ,Public health ,Public Health, Environmental and Occupational Health ,Environmental exposure ,Environmental Exposure ,Air Pollution, Indoor ,purl.org/becyt/ford/3 [https] ,Business ,Public Health ,HEALTH ,Environmental Sciences ,Environmental Monitoring - Abstract
Clean cooking has emerged as a major concern for global health and development because of the enormous burden of disease caused by traditional cookstoves and fires. The World Health Organization has developed new indoor air quality guidelines that few homes will be able to achieve without replacing traditional methods with modern clean cooking technologies, including fuels and stoves. However, decades of experience with improved stove programs indicate that the challenge of modernizing cooking in impoverished communities includes a complex, multi-sectoral set of problems that require implementation research. The National Institutes of Health, in partnership with several government agencies and the Global Alliance for Clean Cookstoves, has launched the Clean Cooking Implementation Science Network that aims to address this issue. In this article, our focus is on building a knowledge base to accelerate scale-up and sustained use of the cleanest technologies in low- and middle-income countries. Implementation science provides a variety of analytical and planning tools to enhance effectiveness of clinical and public health interventions. These tools are being integrated with a growing body of knowledge and new research projects to yield new methods, consensus tools, and an evidence base to accelerate improvements in health promised by the renewed agenda of clean cooking. Fil: Rosenthal, Joshua. National Institutes Of Health. Fogarty International Center; Estados Unidos Fil: Balakrishnan, Kalpana. Sri Ramachandra University; India Fil: Bruce, Nigel. University of Liverpool; Reino Unido Fil: Chambers, David. National Institutes of Health. National Cancer Institute; Estados Unidos Fil: Graham, Jay. The George Washington University; Estados Unidos Fil: Jack, Darby. Columbia University; Estados Unidos Fil: Kline, Lydia. National Institutes Of Health. Fogarty International Center; Estados Unidos Fil: Masera, Omar Raul. Universidad Nacional Autónoma de México; México Fil: Mehta, Sumi. Global Alliance for Clean Cookstoves; Estados Unidos Fil: Mercado, Ilse Ruiz. Universidad Nacional Autónoma de México; México Fil: Neta, Gila. National Institutes of Health. National Cancer Institute; Estados Unidos Fil: Pattanayak, Subhrendu. University of Duke; Estados Unidos Fil: Puzzolo, Elisa. Global LPG Partnership; Estados Unidos Fil: Petach, Helen. U.S. Agency for International Development; Estados Unidos Fil: Punturieri, Antonello. National Heart, Lung, and Blood Institute; Estados Unidos Fil: Rubinstein, Adolfo Luis. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Sage, Michael. Centers for Disease Control and Prevention; Estados Unidos Fil: Sturke, Rachel. National Institutes Of Health. Fogarty International Center; Estados Unidos Fil: Shankar, Anita. University Johns Hopkins; Estados Unidos Fil: Sherr, Kenny. University of Washington; Estados Unidos Fil: Smith, Kirk. University of California at Berkeley; Estados Unidos Fil: Yadama, Gautam. Washington University in St. Louis; Estados Unidos
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- 2017
27. Educational intervention to improve effectiveness in treatment and control of patients with high cardiovascular risk in low-resource settings in Argentina: study protocol of a cluster randomised controlled trial
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Laura Gutierrez, Rosana Poggio, Andrea Beratarrechea, Martin Chaparro, Alfredo Lozada, Vilma Irazola, Adolfo Rubinstein, Pablo Gulayin, and Marilina Santero
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Pharmacy Technicians ,Ciencias de la Salud ,Disease ,Certification ,030204 cardiovascular system & hematology ,MEDICAL EDUCATION & TRAINING ,0302 clinical medicine ,Risk Factors ,Protocol ,030212 general & internal medicine ,Cluster randomised controlled trial ,Practice Patterns, Physicians' ,Medical Education &Amp; Training ,General Medicine ,Clinical Practice Guideline ,Middle Aged ,Mobile Applications ,Good Clinical Practice Guidelines ,Test (assessment) ,Cardiovascular Diseases ,Research Design ,purl.org/becyt/ford/3 [https] ,Education, Medical, Continuing ,Public Health ,Adult ,medicine.medical_specialty ,CIENCIAS MÉDICAS Y DE LA SALUD ,Hypercholesterolemia ,education ,Argentina ,Pharmacist ,Disease cluster ,Risk Assessment ,Decision Support Techniques ,Medication Adherence ,purl.org/becyt/ford/3.3 [https] ,03 medical and health sciences ,Intervention (counseling) ,medicine ,Humans ,Epidemiología ,Healthy Lifestyle ,Medical prescription ,Developing Countries ,Aged ,Text Messaging ,business.industry ,Statins ,Education, Pharmacy ,Family medicine ,Physical therapy ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,Cardiovascular Risk - Abstract
INTRODUCTION:Hypercholesterolaemia is estimated to cause 2.6 million deaths annually and one-third of the cases of ischaemic heart disease. In Argentina, the prevalence of hypercholesterolaemia increased between 2005 and 2013 from 27.9% to 29.8%. Only one out of four subjects with a self-reported diagnosis of coronary heart disease is taking statins. Since 2014, statins (simvastatin 20 mg) are part of the package of drugs provided free-of-charge for patients according to cardiovascular disease (CVD) risk stratification. The goal of this study is to test whether a complex intervention targeting physicians and pharmacist assistants improves treatment and control of hypercholesterolaemia among patients with moderate-to-high cardiovascular risk in Argentina.METHODS AND ANALYSIS:This is a cluster trial of 350 patients from 10 public primary care centres in Argentina to be randomised to either the intervention or usual care. The study is designed to have 90% statistical power to detect a 0.7 mmol/L reduction in low-density lipoproteins cholesterol from baseline to 12 months. The physician education programme consists of a 2-day initial intensive training and certification workshop followed by educational outreach visits (EOVs) conducted at 3, 6 and 9 months from the outset of the study. An on-site training to pharmacist assistants during the first EOV is performed at each intervention clinic. In addition, two intervention support tools are used: an app installed in physician´s smartphones to serve as a decision aid to improve prescription of statins according to patient´s CVD risk and a web-based platform tailored to send individualised SMS messages to patients.ETHICS AND DISSEMINATION:Ethical approval was obtained from an independent ethics committee. Results of this study will be presented to the Ministry of Health of Argentina for potential dissemination and scale-up of the intervention programme to the entire national public primary care network in Argentina.TRIAL REGISTRATION NUMBER:NCT02380911. Fil: Gulayin, Pablo. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Lozada, Alfredo. Universidad Austral; Argentina Fil: Chaparro, Raul Martin. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Santero, Marilina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Poggio, Rosana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Beratarrechea, Andrea Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
- Published
- 2017
28. Lower tract respiratory infection in children younger than 5 years of age and adverse pregnancy outcomes related to household air pollution in Bariloche (Argentina) and Temuco (Chile)
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Adolfo Rubinstein, Matías Calandreli, Lucila Rey-Ares, Fernando Althabe, Fernando Lanas, Agustina Mazzoni, Vilma Irazola, Edgardo Sobrino, and Pamela Seron
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Environmental Engineering ,CIENCIAS MÉDICAS Y DE LA SALUD ,Air pollution ,Argentina ,CHILDREN ,LOWER TRACT RESPIRATORY INFECTION ,Medicina Clínica ,medicine.disease_cause ,Article ,LATIN AMERICA ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Risk Factors ,Environmental health ,medicine ,Humans ,030212 general & internal medicine ,ADVERSE PREGNANCY OUTCOMES ,Chile ,Pregnancy outcomes ,Respiratory Tract Infections ,Retrospective Studies ,HOUSEHOLD AIR POLLUTION ,business.industry ,Incidence ,Public Health, Environmental and Occupational Health ,Infant, Newborn ,Pregnancy Outcome ,Respiratory infection ,Infant ,Retrospective cohort study ,Building and Construction ,Environmental Exposure ,Middle Aged ,Perinatal morbidity ,030228 respiratory system ,Air Pollution, Indoor ,Child, Preschool ,Housing ,Female ,Medicina Critica y de Emergencia ,business - Abstract
The main objective of this study was to evaluate the association between household air pollution with lower tract respiratory infection (LRTI) in children younger than 5 years old and adverse pregnancy outcomes. This retrospective cohort study took place in two cities in Patagonia. Using systemic random sampling, we selected households in which at least one child 0.05). The use of biomass fuel to cook in traditional cookstoves in ventilated dwellings may increase the risk of perinatal morbidity and LRTI. Fil: Rey Ares, Lucila. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Sobrino, E.. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Mazzoni, A.. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Serón, P.. Universidad de La Frontera; Chile Fil: Lanas, F.. Universidad de La Frontera; Chile Fil: Calandreli, M.. Sanatorio San Carlos; Argentina Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
- Published
- 2016
29. Prevalence, Awareness, Treatment, and Control of Hypertension in the Southern Cone of Latin America
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Adolfo Rubinstein, Chung-Shiuan Chen, Nora Mores, Jiang He, Pamela Seron, Jacqueline Ponzo, Matías Calandrelli, Lydia A. Bazzano, Vilma Irazola, Rosana Poggio, Laura Gutierrez, Jose A. Manfredi, and Fernando Lanas
- Subjects
Adult ,Male ,Health Knowledge, Attitudes, Practice ,Latin Americans ,CIENCIAS MÉDICAS Y DE LA SALUD ,Cross-sectional study ,Population ,Ciencias de la Salud ,Blood Pressure ,030204 cardiovascular system & hematology ,Prehypertension ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Hypertension prevalence ,Internal Medicine ,Prevalence ,Medicine ,Humans ,Epidemiología ,030212 general & internal medicine ,Risk factor ,education ,Antihypertensive Agents ,Aged ,Cross-Sectional Survey ,education.field_of_study ,Traditional medicine ,business.industry ,Awareness ,Middle Aged ,South America ,Blood pressure ,Treatment Outcome ,Hypertension Control ,Latin America ,Hypertension ,Population study ,Original Article ,Female ,business ,Demography - Abstract
BACKGROUND Hypertension is the leading global preventable risk factor for premature death. While hypertension prevalence has been declining in high-income countries, it has increased continuously in low- and middle- income countries. METHODS We conducted a cross-sectional survey in 7,524 women and men aged 35-74 years from randomly selected samples in 4 cities (Bariloche and Marcos Paz, Argentina; Temuco, Chile; and Pando-Barros Blancos, Uruguay) in 2010-2011. Three blood pressure (BP) measurements were obtained by trained observers using a standard mercury sphygmomanometer. Hypertension was defined as a mean systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or use of antihypertensive medications. RESULTS An estimated 42.5% of the study population (46.6% of men and 38.7% of women) had hypertension and an estimated 32.5% (36.0% of men and 29.4% of women) had prehypertension. Approximately 63.0% of adults with hypertension (52.5% of men and 74.3% of women) were aware of their disease condition, 48.7% (36.1% of men and 62.1% of women) were taking prescribed medications to lower their BP, and only 21.1% of all hypertensive patients (13.8% of men and 28.9% of women) and 43.3% of treated hypertensive patients (38.1% of men and 46.5% of women) achieved BP control. CONCLUSIONS This study indicates that the prevalence of hypertension is high while awareness, treatment, and control are low in the general population in the Southern Cone of Latin America. These data call for bold actions at regional and national levels to implement effective, practical, and sustainable intervention programs aimed to improve hypertension prevention, detection, and control. Fil: Rubinstein, Adolfo Luis. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Irazola, Vilma. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Calandrelli, Matias. Sanatorio San Carlos, San Carlos de Bariloche; Argentina Fil: Chung-Shiuan, Chen. Tulane University School of Public Health and Tropical Medicine. Department of Epidemiology; Estados Unidos Fil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Lanas, Fernando. Universidad de La Frontera; Chile Fil: Manfredi, Jose A.. Universidad de la República; Uruguay Fil: Mores, Nora. Municipalidad de Marcos Paz, Provincia de Buenos Aires; Argentina Fil: Poggio, Rosana. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Ponzo, Jacqueline. Universidad de la República; Uruguay Fil: Seron, Pamela. Universidad de La Frontera; Chile Fil: Bazzano, Lydia A.. Tulane University School of Public Health and Tropical Medicine. Department of Epidemiology; Estados Unidos Fil: He, Jiang. Tulane University School of Public Health and Tropical Medicine. Department of Epidemiology; Estados Unidos
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- 2016
30. Use of m-Health Technology for Preventive Interventions to Tackle Cardiometabolic Conditions and Other Non-Communicable Diseases in Latin America- Challenges and Opportunities
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Manuel Ramirez-Zea, Francisco Diez-Canseco, Adolfo Rubinstein, J. Jaime Miranda, Andrea Beratarrechea, and Vilma Irazola
- Subjects
Gerontology ,Cardiometabolic ,medicine.medical_specialty ,CIENCIAS MÉDICAS Y DE LA SALUD ,Latin Americans ,media_common.quotation_subject ,Psychological intervention ,Biomedical Technology ,Ciencias de la Salud ,Disease ,030204 cardiovascular system & hematology ,03 medical and health sciences ,purl.org/becyt/ford/3.3 [https] ,0302 clinical medicine ,Metabolic Diseases ,Excellence ,Delivery of Health Care, Integrated/trends ,Risk Factors ,Preventive Health Services ,Epidemiología ,Medicine ,Biomedical Technology/trends ,Humans ,purl.org/pe-repo/ocde/ford#3.02.04 [https] ,030212 general & internal medicine ,Challenges ,mHealth ,Cardiovascular Diseases/diagnosis/epidemiology/prevention & control ,media_common ,business.industry ,Latin America/epidemiology ,Delivery of Health Care, Integrated ,Public health ,Health technology ,Preventive Health Services/trends ,Telemedicine ,Cardiometabolic disease ,Metabolic Diseases/diagnosis/epidemiology/prevention & control ,Latin America ,Mobile phone ,Cardiovascular Diseases ,Telemedicine/trends ,purl.org/becyt/ford/3 [https] ,Diffusion of Innovation ,Cardiology and Cardiovascular Medicine ,business ,Risk Reduction Behavior ,Forecasting - Abstract
In Latin America, cardiovascular disease (CVD) mortality rates will increase by an estimated 145% from 1990 to 2020. Several challenges related to social strains, inadequate public health infrastructure, and underfinanced healthcare systems make cardiometabolic conditions and non-communicable diseases (NCDs) difficult to prevent and control. On the other hand, the region has high mobile phone coverage, making mobile health (mHealth) particularly attractive to complement and improve strategies toward prevention and control of these conditions in low- and middle-income countries. In this article, we describe the experiences of three Centers of Excellence for prevention and control of NCDs sponsored by the National Heart, Lung, and Blood Institute with mHealth interventions to address cardiometabolic conditions and other NCDs in Argentina, Guatemala, and Peru. The nine studies described involved the design and implementation of complex interventions targeting providers, patients and the public. The rationale, design of the interventions, and evaluation of processes and outcomes of each of these studies are described, together with barriers and enabling factors associated with their implementation. Fil: Beratarrechea, Andrea Gabriela. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Diez Canseco, Francisco. Universidad Peruana Cayetano Heredia; Perú Fil: Irazola, Vilma. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Miranda, Jaime. Universidad Peruana Cayetano Heredia; Perú Fil: Ramirez Zea, Manuel. Institute of Nutrition of Central America and Panama; Guatemala Fil: Rubinstein, Adolfo Luis. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
- Published
- 2016
31. Prevalence of Pragmatically Defined High CV Risk and its Correlates in LMIC: A Report From 10 LMIC Areas in Africa, Asia, and South America
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Krisela Steyn, Naomi S. Levitt, Rajeev Gupta, J. Jaime Miranda, Adolfo Rubinstein, Vilma Irazola, Xian Li, Xiaolin Xu, Yangfeng Wu, Thomas A. Gaziano, Mohammed K. Ali, Denis Xavier, Chendi Cui, Nikhil Tandon, Rodrigo M. Carrillo-Larco, Dorairaj Prabhakaran, Lijing L. Yan, and Dewan S. Alam
- Subjects
Gerontology ,Male ,Cardiac & Cardiovascular Systems ,Epidemiology ,Cross-sectional study ,Psychological intervention ,Myocardial Infarction ,Ciencias de la Salud ,030204 cardiovascular system & hematology ,Stroke/epidemiology ,Body Mass Index ,0302 clinical medicine ,Risk Factors ,Prevalence ,Medicine ,purl.org/pe-repo/ocde/ford#3.02.04 [https] ,030212 general & internal medicine ,Myocardial infarction ,Stroke ,Aged, 80 and over ,RISK ,Smoking ,Age Factors ,South America/epidemiology ,Smoking/epidemiology ,Middle Aged ,Heart Diseases/epidemiology ,ETHNIC-GROUPS ,CARDIOVASCULAR ,PREVALENCE ,Cardiovascular Diseases ,Hypertension ,Diabetes Mellitus/epidemiology ,Educational Status ,Female ,Cardiology and Cardiovascular Medicine ,Life Sciences & Biomedicine ,Risk ,Adult ,Asia ,CIENCIAS MÉDICAS Y DE LA SALUD ,Heart Diseases ,RECURRENCE RATES ,World Health Organization ,Article ,03 medical and health sciences ,LMIC ,Sex Factors ,Hypertension/epidemiology ,Diabetes mellitus ,Diabetes Mellitus ,Myocardial Infarction/epidemiology ,Humans ,Epidemiología ,CORONARY-HEART-DISEASE ,INCOME COUNTRIES ,Developing Countries ,Aged ,Community and Home Care ,Science & Technology ,Asia/epidemiology ,business.industry ,STROKE PREVENTION ,MORTALITY ,Cardiovascular Diseases/epidemiology ,CARDIOVASCULAR-DISEASE RISK ,GLOBAL BURDEN ,South America ,medicine.disease ,Confidence interval ,Blood pressure ,Cross-Sectional Studies ,Africa/epidemiology ,CLINICAL-PRACTICE ,Africa ,Cardiovascular System & Cardiology ,business ,Body mass index ,human activities ,Demography ,SYSTOLIC BLOOD-PRESSURE - Abstract
Background Currently available tools for assessing high cardiovascular risk (HCR) often require measurements not available in resource-limited settings in low- and middle-income countries (LMIC). There is a need to assess HCR using a pragmatic evidence-based approach. Objectives This study sought to report the prevalence of HCR in 10 LMIC areas in Africa, Asia, and South America and to investigate the profiles and correlates of HCR. Methods Cross-sectional analysis using data from the National Heart, Lung, and Blood Institute - UnitedHealth Group Centers of Excellence. HCR was defined as history of heart disease/heart attack, history of stroke, older age (≥50 years for men and ≥60 for women) with history of diabetes, or older age with systolic blood pressure ≥160 mm Hg. Prevalence estimates were standardized to the World Health Organization's World Standard Population. Results A total of 37,067 subjects ages ≥35 years were included; 53.7% were women and mean age was 53.5 ± 12.1 years. The overall age-standardized prevalence of HCR was 15.4% (95% confidence interval: 15.0% to 15.7%), ranging from 8.3% (India, Bangalore) to 23.4% (Bangladesh). Among men, the prevalence was 1.7% for the younger age group (35 to 49 years) and 29.1% for the older group (≥50); among women, 3.8% for the younger group (35 to 59 years) and 40.7% for the older group (≥60). Among the older group, measured systolic blood pressure ≥160 mm Hg (with or without other conditions) was the most common criterion for having HCR, followed by diabetes. The proportion of having met more than 1 criterion was nearly 20%. Age, education, and body mass index were significantly associated with HCR. Cross-site differences existed and were attenuated after adjusting for age, sex, education, smoking, and body mass index. Conclusions The prevalence of HCR in 10 LMIC areas was generally high. This study provides a starting point to define targeted populations that may benefit from interventions combining both primary and secondary prevention strategies. Fil: Carrillo Larco, Rodrigo M.. Cronicas Centro de Excelencia En Enfermedades Crónicas; Perú Fil: Miranda, J. Jaime. Cronicas Centro de Excelencia En Enfermedades Crónicas; Perú. Universidad Peruana Cayetano Heredia; Perú Fil: Li, Xian. Peking University; China Fil: Cui, Chendi. University of Pittsburgh; Estados Unidos Fil: Xu, Xiaolin. Duke Kunshan University; China Fil: Ali, Mohammed. Centre For Chronic Disease Control; India Fil: Alam, Dewan S.. International Centre For Diarrhoeal Disease Research Bangladesh; Bangladesh Fil: Gaziano, Thomas A.. Harvard University. Harvard School of Public Health; Estados Unidos Fil: Gupta, Rajeev. Fortis Healthcare Limited; India. Rajasthan University Of Health Sciences; India Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Levitt, Naomi S.. University of Cape Town; Sudáfrica Fil: Prabhakaran, Dorairaj. Public Health Foundation Of India; India. Centre For Chronic Disease Control; India Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Steyn, Krisela. University of Cape Town; Sudáfrica Fil: Tandon, Nikhil. Centre For Chronic Disease Control; India Fil: Xavier, Denis. St. John's Medical College; India Fil: Wu, Yangfeng. Peking University; China Fil: Yan, Lijing L.. Duke Kunshan University; China. Peking University; China
- Published
- 2016
32. Obesity and its Relation With Diabetes and Hypertension: A Cross-Sectional Study Across 4 Geographical Regions
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Shivani A. Patel, Vilma Irazola, Muhammad Ashique Haider Chowdhury, Yangfeng Wu, Xian Li, Ali Tanweer Siddiquee, Naomi S. Levitt, Masood Kadir, Thomas A. Gaziano, Adolfo Rubinstein, William Checkley, Antonio Bernabe-Ortiz, Laura Gutierrez, J. Jaime Miranda, Mohammed K. Ali, Lijing L. Yan, Roopa Shivashankar, Dorairaj Prabhakaran, and Dewan S. Alam
- Subjects
Gerontology ,Male ,obesity ,Epidemiology ,Cross-sectional study ,Ciencias de la Salud ,030204 cardiovascular system & hematology ,Body Mass Index ,Cohort Studies ,South Africa ,0302 clinical medicine ,Peru ,Prevalence ,Medicine ,Pakistan ,purl.org/pe-repo/ocde/ford#3.02.04 [https] ,030212 general & internal medicine ,Chile ,China/epidemiology ,Bangladesh ,South Africa/epidemiology ,diabetes ,Argentina/epidemiology ,Middle Aged ,Circumference ,Obesity, Abdominal ,Hypertension ,symbols ,Diabetes Mellitus/epidemiology ,Female ,Waist Circumference ,Cardiology and Cardiovascular Medicine ,Cohort study ,Adult ,China ,Waist ,hypertension ,CIENCIAS MÉDICAS Y DE LA SALUD ,Uruguay/epidemiology ,Argentina ,India ,Article ,03 medical and health sciences ,symbols.namesake ,Young Adult ,Chile/epidemiology ,Hypertension/epidemiology ,Diabetes mellitus ,Diabetes Mellitus ,Epidemiología ,Humans ,Poisson regression ,Obesity ,Bangladesh/epidemiology ,Aged ,Community and Home Care ,Obesity, Abdominal/epidemiology ,business.industry ,Obesity/epidemiology ,medicine.disease ,India/epidemiology ,Cross-Sectional Studies ,Uruguay ,business ,Body mass index ,Pakistan/epidemiology ,Peru/epidemiology ,Demography - Abstract
Background The implications of rising obesity for cardiovascular health in middle-income countries has generated interest, in part because associations between obesity and cardiovascular health seem to vary across ethnic groups. Objective We assessed general and central obesity in Africa, East Asia, South America, and South Asia. We further investigated whether body mass index (BMI) and waist circumference differentially relate to cardiovascular health; and associations between obesity metrics and adverse cardiovascular health vary by region. Methods Using baseline anthropometric data collected between 2008 and 2012 from 7 cohorts in 9 countries, we estimated the proportion of participants with general and central obesity using BMI and waist circumference classifications, respectively, by study site. We used Poisson regression to examine the associations (prevalence ratios) of continuously measured BMI and waist circumference with prevalent diabetes and hypertension by sex. Pooled estimates across studies were computed by sex and age. Results This study analyzed data from 31,118 participants aged 20 to 79 years. General obesity was highest in South Asian cities and central obesity was highest in South America. The proportion classified with general obesity (range 11% to 50%) tended to be lower than the proportion classified as centrally obese (range 19% to 79%). Every standard deviation higher of BMI was associated with 1.65 and 1.60 times higher probability of diabetes and 1.42 and 1.28 times higher probability of hypertension, for men and women, respectively, aged 40 to 69 years. Every standard deviation higher of waist circumference was associated with 1.48 and 1.74 times higher probability of diabetes and 1.34 and 1.31 times higher probability of hypertension, for men and women, respectively, aged 40 to 69 years. Associations of obesity measures with diabetes were strongest in South Africa among men and in South America among women. Associations with hypertension were weakest in South Africa among both sexes. Conclusions BMI and waist circumference were both reasonable predictors of prevalent diabetes and hypertension. Across diverse ethnicities and settings, BMI and waist circumference remain salient metrics of obesity that can identify those with increased cardiovascular risk. Fil: Patel, Shivani A.. University of Emory; Estados Unidos. Centre For Control Of Chronic Conditions; India Fil: Ali, Mohammed K.. University of Emory; Estados Unidos. Centre For Control Of Chronic Conditions; India Fil: Alam, Dewan. University of York; Reino Unido. Li Ka Shing Knowledge Institute; Canadá Fil: Yan, Lijing L.. Peking University; China. Duke Kunshan University; China Fil: Levitt, Naomi S.. University Of Cape Town; Sudáfrica Fil: Bernabe Ortiz, Antonio. Cronicas Centro de Excelencia En Enfermedades Crónicas; Perú Fil: Checkley, William. University Johns Hopkins; Estados Unidos Fil: Wu, Yangfeng. Peking University; China Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Shivashankar, Roopa. Public Health Foundation of India; India Fil: Li, Xian. Peking University; China Fil: Miranda, J. Jaime. Cronicas Centro de Excelencia En Enfermedades Crónicas; Perú. Universidad Peruana Cayetano Heredia; Perú Fil: Chowdhury, Muhammad Ashique Haider. International Centre For Diarrhoeal Disease Research Bangladesh; Bangladesh Fil: Siddiquee, Ali Tanweer. International Centre For Diarrhoeal Disease Research Bangladesh; Bangladesh Fil: Gaziano, Thomas A.. Harvard University. Harvard School of Public Health; Estados Unidos. Brigham And Women's Hospital; Estados Unidos Fil: Kadir, M. Masood. The Aga Khan University; Pakistán Fil: Prabhakaran, Dorairaj. Public Health Foundation of India; India
- Published
- 2016
33. Comparison of Nonblood-Based and Blood-Based Total CV Risk Scores in Global Populations
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Lijing L. Yan, Prabhakaran Dorairaj, Ankur Pandya, J. Jaime Miranda, Mohammed K. Ali, Shafika Abrahams-Gessel, Dewan S. Alam, Gerald S. Bloomfield, Laura Gutierrez, Rodrigo M. Carrillo-Larco, Naomi S. Levitt, Sartaj Alam, Thomas A. Gaziano, Adolfo Rubinstein, Krisela Steyn, Antonio Bernabe-Ortiz, Vilma Irazola, and Denis Xavier
- Subjects
Male ,Cardiac & Cardiovascular Systems ,Epidemiology ,Cross-sectional study ,Cost-Benefit Analysis ,10-YEAR RISK ,Ciencias de la Salud ,030204 cardiovascular system & hematology ,computer.software_genre ,Global Health ,Spearman's rank correlation coefficient ,Hypertension/blood/epidemiology ,Body Mass Index ,South Africa ,0302 clinical medicine ,FRAMINGHAM ,Medicine ,Pakistan ,purl.org/pe-repo/ocde/ford#3.02.04 [https] ,030212 general & internal medicine ,RISK ,education.field_of_study ,Cholesterol, HDL/blood ,Framingham Risk Score ,SCORES ,Smoking ,Age Factors ,Smoking/epidemiology ,Middle Aged ,SOUTH-AFRICA ,CARDIOVASCULAR ,COMMUNITY ,Cholesterol ,Cardiovascular Diseases ,Cohort ,Hypertension ,Diabetes Mellitus/epidemiology ,Female ,Data mining ,Cardiology and Cardiovascular Medicine ,Risk assessment ,Life Sciences & Biomedicine ,GLOBAL ,Adult ,China ,CIENCIAS MÉDICAS Y DE LA SALUD ,National Health and Nutrition Examination Survey ,Concordance ,Population ,India ,COST-EFFECTIVENESS ANALYSIS ,PRESSURE ,PROFILE ,Cholesterol/blood ,Risk Assessment ,03 medical and health sciences ,Sex Factors ,Diabetes Mellitus ,Cardiovascular Diseases/blood/epidemiology ,Epidemiología ,Humans ,CORONARY-HEART-DISEASE ,education ,Risk Assessment/methods ,Dyslipidemias ,Aged ,Community and Home Care ,Science & Technology ,business.industry ,Cholesterol, HDL ,CARDIOVASCULAR-DISEASE RISK ,South America ,PREVENTION ,Kenya ,Cross-Sectional Studies ,Dyslipidemias/blood/epidemiology ,Cardiovascular System & Cardiology ,business ,computer ,Demography - Abstract
Background Cost-effective primary prevention of cardiovascular disease (CVD) in low- and middle-income countries requires accurate risk assessment. Laboratory-based risk tools currently used in high-income countries are relatively expensive and impractical in many settings due to lack of facilities. Objectives This study sought to assess the correlation between a non-laboratory-based risk tool and 4 commonly used, laboratory-based risk scores in 7 countries representing nearly one-half of the world's population. Methods We calculated 10-year CVD risk scores for 47,466 persons with cross-sectional data collected from 16 different cohorts in 9 countries. The performance of the non-laboratory-based risk score was compared with 4 laboratory-based risk scores: Pooled Cohort Risk Equations (ASCVD [Atherosclerotic Cardiovascular Disease]), Framingham, and SCORE (Systematic Coronary Risk Evaluation) for high- and low-risk countries. Rankings of each score were compared using Spearman rank correlations. Based on these correlations, we measured concordance between individual absolute CVD risk as measured by the Harvard NHANES (National Health and Nutrition Examination Survey) risk score, and the 4 laboratory-based risk scores, using both the conventional Framingham risk thresholds of >20% and the recent ASCVD guideline threshold of >7.5%. Results The aggregate Spearman rank correlations between the non-laboratory-based risk score and the laboratory-based scores ranged from 0.915 to 0.979 for women and from 0.923 to 0.970 for men. When applying the conventional Framingham risk threshold of >20% over 10 years, 92.7% to 96.0% of women and 88.3% to 92.8% of men were equivalently characterized as "high" or "low" risk. Applying the recent ASCVD guidelines risk threshold of >7.5% resulted in risk characterization agreement for women ranging from 88.1% to 94.4% and from 89.0% to 93.7% for men. Conclusions The correlation between non-laboratory-based and laboratory-based risk scores is very high for both men and women. Potentially large numbers of high-risk individuals could be detected with relatively simple tools. Fil: Gaziano, Thomas A.. Brigham And Women's Hospital; . Harvard T.h. Chan School Of Public Boston; Fil: Abrahams-Gessel, Shafika. Harvard T.h. Chan School Of Public Boston; Fil: Alam, Sartaj. Harvard T.h. Chan School Of Public Boston; Fil: Alam, Dewan. Saint Michael's Hospital University Of Toronto; Canadá Fil: Ali, Mohammed. Centre For Chronic Disease Control; India Fil: Bloomfield, Gerald. Duke Clinical Research Institute; Fil: Carrillo-Larco, Rodrigo M.. Cronicas Centro de Excelencia En Enfermedades Crónicas; Perú Fil: Dorairaj, Prabhakaran. Public Health Foundation Of India; India. Centre For Chronic Disease Control; India Fil: Gutierrez, Laura. Institute For Clinical Effectiveness And Health Policy, Ciudad Autonoma de Buenos Aires; Argentina Fil: Irazola, Vilma. Institute For Clinical Effectiveness And Health Policy, Ciudad Autonoma de Buenos Aires; Argentina Fil: Levitt, Naomi S.. University Of Cape Town, Faculty Of Health Sciences; Fil: Miranda, J. Jaime. Cronicas Centro de Excelencia En Enfermedades Crónicas; Perú. Universidad Peruana Cayetano Heredia; Perú Fil: Bernabe-Ortiz, Antonio. Cronicas Centro de Excelencia En Enfermedades Crónicas; Perú Fil: Pandya, Ankur. Harvard T.h. Chan School Of Public Boston; Fil: Rubinstein, Adolfo Luis. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Steyn, Krisela. University Of Cape Town, Faculty Of Health Sciences; Fil: Xavier, Denis. St. John's Medical College; India Fil: Yan, Lijing L.. Peking University Health Science Center; China. Duke Kunshan University; China
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- 2016
34. Association of behavioral risk factors with self-reported and symptom or measured chronic diseases among adult population (18-69 years) in India: evidence from SAGE study.
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Patel, Sunita, Ram, Faujdar, Patel, Surendra Kumar, and Kumar, Kaushalendra
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DISEASE risk factors ,CHRONIC diseases ,DELAYED onset of disease ,SEDENTARY behavior ,DISEASE prevalence - Abstract
Background: The objective is to analyze the behavioral risk factors among the adult population and to identify the determinants of and their association with self-reported and symptom or measured chronic diseases in India.Methods: The study utilized data from the Study on Global Aging and Adult Health (SAGE), Wave 1 (2007). Logistic regression was applied to examine the association of self-reported and symptom or measured chronic diseases with behavioral risk factors and socioeconomic-demographic covariates.Results: The results show that the prevalence of the symptom or measured chronic diseases was higher (41.9%) than that of the self-reported chronic diseases (24.1%). The moderate and vigorous physical activity was less likely to be associated with self-reported depression, arthritis, and stroke, but more likely to be associated with the symptom or measured based arthritis and asthma compared to physical inactivity. Adequate intake of fruits and vegetables was significantly less likely to be associated with angina, COPD, and asthma; however, it was more than three times more likely to be associated (OR: 3.45; 95% CI: 1.99-5.97) with self-reported depression. Infrequent moderate alcohol drinking was statistically two times more associated (OR: 1.83; 95% CI: 1.04-3.21) with the symptom or measured based COPD than non-drinking. Likewise, any type of tobacco use was found to be about four times more associated (OR: 3.59; 95% CI: 1.07-12.13) with self-reported stroke. Both self-reported and symptom or measured hypertension, arthritis, and diabetes were associated with overweight, while hypertension was associated with obesity. Females and increased age came out as significant predictors of both self-reported and symptom or measured chronic diseases.Conclusion: The prevalence of chronic diseases and their association with BRFs and socioeconomic and demographic covariates differ markedly when assessed against self-reported criteria versus symptom or measured criteria. Adequate intake of fruits and vegetables is a crucial behavior that controls and delays the onset of chronic diseases. The study suggests that the National Program should remain focused on behavioral risk factors for maximum returns on health outcomes and that proper awareness and knowledge must be spread about healthy lifestyle behaviors throughout the country. [ABSTRACT FROM AUTHOR]- Published
- 2019
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35. Prevalence, Distributions and Determinants of Obesity and Central Obesity in the Southern Cone of America
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Jacqueline Ponzo, Fernando Lanas, Jose A. Manfredi, Matías Calandrelli, Laura Gutierrez, Hector Olivera, Vilma Irazola, Rosana Poggio, Lydia A. Bazzano, Pamela Seron, Natalia Elorriaga, Nora Mores, Jiang He, Adolfo Rubinstein, and Chung-Shiuan Chen
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Male ,Physiology ,lcsh:Medicine ,Ciencias de la Salud ,Blood Pressure ,Cardiovascular Medicine ,030204 cardiovascular system & hematology ,Vascular Medicine ,Body Mass Index ,Habits ,Endocrinology ,0302 clinical medicine ,Risk Factors ,Environmental protection ,Odds Ratio ,Prevalence ,Medicine and Health Sciences ,Smoking Habits ,Public and Occupational Health ,030212 general & internal medicine ,lcsh:Science ,education.field_of_study ,Multidisciplinary ,Smoking ,Middle Aged ,Otras Ciencias de la Salud ,Physiological Parameters ,Cardiovascular Diseases ,Obesity, Abdominal ,Hypertension ,Educational Status ,Female ,purl.org/becyt/ford/3 [https] ,Research Article ,Adult ,medicine.medical_specialty ,CIENCIAS MÉDICAS Y DE LA SALUD ,Endocrine Disorders ,Population ,America ,purl.org/becyt/ford/3.3 [https] ,03 medical and health sciences ,Diabetes mellitus ,Diabetes Mellitus ,medicine ,Humans ,Adults ,Obesity ,Risk factor ,education ,Exercise ,Aged ,Dyslipidemias ,Behavior ,business.industry ,Public health ,lcsh:R ,Body Weight ,Biology and Life Sciences ,Physical Activity ,Odds ratio ,South America ,medicine.disease ,Confidence interval ,Dyslipidemia ,Age Groups ,Metabolic Disorders ,People and Places ,lcsh:Q ,Population Groupings ,business ,Demography - Abstract
Background: Obesity is a major determinant of cardiovascular disease in South America. However, population-based data are limited. Methods: A total of 7,524 women and men, aged 35 to 74 years old, were randomly selected from 4 cities in the Southern Cone of Latin America between February 2010 and December 2011. Obesity clinical measurements and cardiovascular risk factors were measured using standard methodology. Results: The prevalence of obesity and central obesity were 35.7% and 52.9%, respectively. The prevalence of obesity and central obesity were higher in women, and even higher in women with lower education compared with women with higher education. In men and women obesity was associated with a higher prevalence of diabetes, odds ratio (OR) 2.38 (95% Confidence Interval [CI]: 1.86 to 3.05) and 3.01 (95%CI 2.42 to 3.74) respectively, hypertension (OR 2.79 (95%CI 2.32 to 3.36) and 2.40 (95%CI 2.05 to 2.80) respectively, dyslipidemia (OR 1.83 (95%CI 1.50 to 2.24) and 1.69 (95%CI 1.45 to 1.98), respectively, low physical activity (OR 1.38(95%CI 1.14 to 1.68) and 1.38 (95%CI 1.18 to 1.62) respectively and a lower prevalence of smoking (OR, 0.65 (95%CI 0.53 to 0.80) and 0.58(95%CI 0.48 to 0.70) respectively. Conclusions: Obesity and central obesity are highly prevalent in the general population in the Southern Cone of Latin America and are strongly associated with cardiovascular risk factor prevalence. These data suggest that efforts toward prevention, treatment, and control of obesity should be a public health priority in the Southern Cone of Latin America. Fil: Lanas, Fernando. Universidad de La Frontera; Chile Fil: Bazzano, Lydia. University of Tulane; Estados Unidos Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina. Centro de Excelencia en Salud Cardiovascular para el Cono Sur ; Argentina Fil: Calandrelli, Matias. Sanatorio San Carlos; Argentina Fil: Chen, Chung-Shiuan. University of Tulane; Estados Unidos Fil: Elorriaga, Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina. Centro de Excelencia en Salud Cardiovascular para el Cono Sur ; Argentina Fil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; Argentina. Centro de Excelencia en Salud Cardiovascular para el Cono Sur ; Argentina Fil: Manfredi, Maria Jose. Universidad de la República; Uruguay Fil: Seron, Pamela. Universidad de La Frontera; Chile Fil: Mores, Nora. Municipalidad de Marcos Paz; Argentina Fil: Poggio, Rosana. Instituto de Efectividad Clínica y Sanitaria; Argentina. Centro de Excelencia en Salud Cardiovascular para el Cono Sur ; Argentina Fil: Ponzo, Jacqueline. Universidad de la República; Uruguay Fil: Olivera, Hector. Municipalidad de Marcos Paz; Argentina Fil: He, Jiang. University of Tulane; Estados Unidos Fil: Irazola, Vilma. Universidad de La Frontera; Chile
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- 2016
36. Hypertension Prevalence, Awareness, Treatment, and Control in Selected LMIC Communities: Results From the NHLBI/UHG Network of Centers of Excellence for Chronic Diseases
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Lijing L. Yan, Prabhakaran Dorairaj, Adolfo Rubinstein, Naomi S. Levitt, Jiang He, Denis Xavier, Gerald S. Bloomfield, Krisela Steyn, Rodrigo M. Carrillo-Larco, Vilma Irazola, Yangfeng Wu, Thomas A. Gaziano, Antonio Bernabe Ortiz, J. Jaime Miranda, and Laura Gutierrez
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Male ,Health Knowledge, Attitudes, Practice ,Pediatrics ,Cardiac & Cardiovascular Systems ,Epidemiology ,Cross-sectional study ,Prehypertension/epidemiology ,Prevalence ,Ciencias de la Salud ,BLOOD-PRESSURE ,030204 cardiovascular system & hematology ,Prehypertension ,South Africa ,0302 clinical medicine ,DESIGN ,Hypertension prevalence ,Peru ,Medicine ,purl.org/pe-repo/ocde/ford#3.02.04 [https] ,Pakistan ,030212 general & internal medicine ,DEVELOPING-COUNTRIES ,Chile ,China/epidemiology ,METABOLIC SYNDROME ,education.field_of_study ,South Africa/epidemiology ,TREATMENT ,Argentina/epidemiology ,Middle Aged ,Hypertension/drug therapy/epidemiology ,PREVALENCE ,Hypertension ,NONCOMMUNICABLE DISEASES ,Female ,Cardiology and Cardiovascular Medicine ,Life Sciences & Biomedicine ,Adult ,Blood pressure control ,China ,CONTROL ,medicine.medical_specialty ,CIENCIAS MÉDICAS Y DE LA SALUD ,Uruguay/epidemiology ,Population ,Argentina ,India ,Developing country ,Kenya/epidemiology ,URBAN ,Public-Private Sector Partnerships ,Article ,03 medical and health sciences ,Chile/epidemiology ,Humans ,Epidemiología ,education ,Developing Countries ,Antihypertensive Agents ,Aged ,Community and Home Care ,Science & Technology ,Antihypertensive Agents/therapeutic use ,HYPERTENSION ,business.industry ,Public health ,ADULTS ,GLOBAL BURDEN ,Kenya ,United States ,Confidence interval ,India/epidemiology ,Cross-Sectional Studies ,Cardiovascular System & Cardiology ,RISK-FACTORS ,Uruguay ,National Heart, Lung, and Blood Institute (U.S.) ,business ,Pakistan/epidemiology ,Peru/epidemiology ,Demography - Abstract
Background Hypertension is the leading cause of cardiovascular disease and premature death worldwide. The prevalence of this public health problem is increasing in low- and middle-income countries (LMICs) in both urban and rural communities. Objective The aim of this study was to examine hypertension prevalence, awareness, treatment, and control in adults 35 to 74 years of age from urban and rural communities in LMICs in Africa, Asia, and South America. Methods The authors analyzed data from 7 population-based cross-sectional studies in selected communities in 9 LMICs that were conducted between 2008 and 2013. Age- and sex-standardized prevalence rates of pre-hypertension and hypertension were calculated. The prevalence rates of awareness, treatment, and control of hypertension were estimated overall and by subgroups of age, sex, and educational level. Results In selected communities, age- and sex-standardized prevalence rates of hypertension among men and women 35 to 74 years of age were 49.9% (95% confidence interval [CI]: 42.3% to 57.4%) in Kenya, 54.9% (95% CI: 51.3% to 58.4%) in South Africa, 52.5% (95% CI: 50.1% to 54.8%) in China, 32.5% (95% CI: 31.7% to 33.3%) in India, 42.3% (95% CI: 40.4% to 44.2%) in Pakistan, 45.4% (95% CI: 43.6% to 47.2%) in Argentina, 39.9% (95% CI: 37.8% to 42.1%) in Chile, 19.2% (95% CI: 17.8% to 20.5%) in Peru, and 44.1% (95% CI: 41.6% to 46.6%) in Uruguay. The proportion of awareness varied from 33.5% in India to 69.0% in Peru, the proportion of treatment among those who were aware of their hypertension varied from 70.8% in South Africa to 93.3% in Pakistan, and the proportion of blood pressure control varied from 5.3% in China to 45.9% in Peru. Conclusions The prevalence of hypertension varies widely in different communities. The rates of awareness, treatment, and control also differ in different settings. There is a clear need to focus on increasing hypertension awareness and control in LMICs. Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Bloomfield, Gerald. Duke Clinical Research Institute; Estados Unidos Fil: Carrillo-Larco, Rodrigo M.. Cronicas Centro de Excelencia En Enfermedades Crónicas; Perú Fil: Dorairaj, Prabhakaran. Public Health Foundation Of India; India. Centre For Chronic Disease Control; India Fil: Gaziano, Thomas. Harvard University. Harvard School of Public Health; Estados Unidos. Brigham And Women's Hospital; Estados Unidos Fil: Levitt, Naomi S.. University Of Cape Town; Sudáfrica Fil: Miranda, J. Jaime. Universidad Peruana Cayetano Heredia; Perú. Cronicas Centro de Excelencia En Enfermedades Crónicas; Perú Fil: Ortiz, Antonio Bernabe. Cronicas Centro de Excelencia En Enfermedades Crónicas; Perú Fil: Steyn, Krisela. University Of Cape Town; Sudáfrica Fil: Wu, Yangfeng. Peking University; China Fil: Xavier, Denis. St. John's Medical College; India Fil: Yan, Lijing L.. Peking University; China. Duke Kunshan University; China Fil: He, Jiang. University of Tulane; Estados Unidos Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
- Published
- 2016
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