使用世卫组织 STEPS 方法在玻利维亚科恰班巴评估心血管疾病危险因素的流行情况及其决定因素。
Prevalence and determinants of cardiovascular disease risk factors using the WHO STEPS approach in Cochabamba, Bolivia.
机构信息
Biomedical and Social Research Institute, Faculty of Medicine, San Simon University, Aniceto Arce Avenue, 371, Cochabamba, Bolivia.
Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.
出版信息
BMC Public Health. 2019 Jun 20;19(1):786. doi: 10.1186/s12889-019-7064-y.
BACKGROUND
Cardiovascular diseases (CVDs) are considered the number one cause of death worldwide, especially in low- and middle-income countries, Bolivia included. Lack of reliable estimates of risk factor distribution can lead to delay in implementation of evidence-based interventions. However, little is known about the prevalence of risk factors in the country. The aim of this study was to assess the prevalence of preventable risk factors associated with CVDs and to identify the demographic and socioeconomic factors associated with them in Cochabamba, Bolivia.
METHODS
A cross-sectional community-based study was conducted among youth and adults (N = 10,704) with permanent residence in Cochabamba, selected through a multistage sampling technique, from July 2015 to November 2016. An adapted version of the WHO STEPS survey was used to collect information. The prevalence of relevant behavioural risk factors and anthropometric measures were obtained. The socio-demographic variables included were age, ethnicity, level of education, occupation, place of residence, and marital status. Proportions with 95% confidence intervals were first calculated, and prevalence ratios were estimated for each CVD risk factor, both with crude and adjusted models.
RESULTS
More than half (57.38%) were women, and the mean age was 37.89 ± 18 years. The prevalence of behavioural risk factors were: current smoking, 11.6%; current alcohol consumption, 42.76%; low consumption of fruits and vegetables, 76.73%; and low level of physical activity, 64.77%. The prevalence of overweight was 35.84%; obesity, 20.49%; waist risk or abdominal obesity, 54.13%; and raised blood pressure, 17.5%. Indigenous populations and those living in the Andean region showed in general a lower prevalence of most of the risk factors evaluated.
CONCLUSION
We provide the first CVD risk factor profile of people living in Cochabamba, Bolivia, using a standardized methodology. Overall, findings suggest that the prevalence of CVD risk factors in Cochabamba is high. This result highlights the need for interventions to improve early diagnosis, monitoring, management, and especially prevention of these risk factors.
背景
心血管疾病（CVDs）被认为是全球头号死因，尤其是在中低收入国家，玻利维亚也不例外。缺乏可靠的风险因素分布估计可能导致基于证据的干预措施的实施延迟。然而，人们对该国风险因素的流行程度知之甚少。本研究旨在评估与 CVD 相关的可预防风险因素的流行程度，并确定与玻利维亚科恰班巴相关的人口统计学和社会经济因素。
方法
这是一项在科恰班巴进行的基于社区的青年和成年人的横断面研究（N=10704），这些人是通过多阶段抽样技术选择的，他们在 2015 年 7 月至 2016 年 11 月期间永久居住在科恰班巴。使用世界卫生组织 STEPS 调查的改编版收集信息。获得了相关行为风险因素和人体测量指标的流行率。包括的社会人口学变量有年龄、族裔、教育程度、职业、居住地和婚姻状况。首先计算了具有 95%置信区间的比例，并根据未调整和调整模型估计了每个 CVD 风险因素的患病率比。
结果
超过一半（57.38%）为女性，平均年龄为 37.89±18 岁。行为风险因素的流行率为：当前吸烟率为 11.6%；当前饮酒率为 42.76%；低水果和蔬菜摄入量为 76.73%；低体力活动水平为 64.77%。超重的流行率为 35.84%；肥胖率为 20.49%；腰围风险或腹部肥胖率为 54.13%；高血压的流行率为 17.5%。土著居民和居住在安第斯地区的居民总体上表现出评估的大多数风险因素的流行率较低。
结论
我们使用标准化方法提供了玻利维亚科恰班巴人群 CVD 风险因素的首个概况。总体而言，研究结果表明科恰班巴 CVD 风险因素的流行率很高。这一结果强调需要采取干预措施，以改善这些风险因素的早期诊断、监测、管理，特别是预防。
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