Hernández-Leiva Edgar
Departamento de Cardiología, Instituto de Cardiología-Fundación Cardioinfantil, Universidad de Rosario, Bogotá, Colombia.
Rev Esp Cardiol. 2011 Jul;64 Suppl 2:34-43. doi: 10.1016/j.recesp.2011.01.022.
Cardiovascular disease is the principle cause of death in Latin America. Data from the World Health Organization indicate that the region is currently experiencing a large-scale epidemic of cardiovascular disease. This could be attributable to demographic and lifestyle changes inherent in the epidemiologic transition: one consequence of increased life-expectancy is longer exposure to cardiovascular risk factors, which results in a higher probability of adverse events. Latin America is one of the regions of the world with the highest burden of cardiovascular risk factors, particularly overweight, dyslipidemia and diabetes mellitus. These factors will have a significant impact on the incidence of coronary events and heart failure in the near future. In addition, infectious conditions, especially Chagas disease and rheumatic fever, affect large sections of the population in the region. Unless preventive measures are introduced in the next three to four decades, the number of deaths due to cardiovascular disease in the region will increase by more than 200%. Data currently available indicate that mortality in patients with acute coronary syndrome is greater in Latin America than in developed countries. Among the possible factors that could explain this finding are the underuse of therapies that have been shown to be effective and the more conservative and later use of surgical and percutaneous interventions. In Latin America, heart failure occurs in younger subjects than in the rest of the world and is most frequently related to ischemic heart disease. However, Chagas disease is close to hypertension as the second most common cause. There is an urgent need for well-designed epidemiologic studies to guide the implementation of preventive measures and appropriate treatment.
心血管疾病是拉丁美洲的主要死因。世界卫生组织的数据表明，该地区目前正经历一场大规模的心血管疾病流行。这可能归因于流行病学转变中固有的人口结构和生活方式变化：预期寿命增加的一个后果是更长时间暴露于心血管危险因素，这导致不良事件发生的可能性更高。拉丁美洲是世界上心脑血管危险因素负担最高的地区之一，尤其是超重、血脂异常和糖尿病。这些因素将在不久的将来对冠心病事件和心力衰竭的发病率产生重大影响。此外，传染性疾病，特别是恰加斯病和风湿热，影响着该地区的大部分人口。除非在未来三到四十年内采取预防措施，否则该地区因心血管疾病导致的死亡人数将增加200%以上。目前可得的数据表明，拉丁美洲急性冠状动脉综合征患者的死亡率高于发达国家。可能解释这一发现的因素包括有效治疗方法的使用不足以及手术和经皮介入治疗更为保守且使用较晚。在拉丁美洲，心力衰竭在比世界其他地区更年轻的人群中发生，并且最常与缺血性心脏病相关。然而，恰加斯病是仅次于高血压的第二大常见病因。迫切需要精心设计的流行病学研究来指导预防措施的实施和适当治疗。
