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Study for the detection and follow up of cardiovascular disease risk factors in the southern cone of Latin America (CESCAS I)

Period: 2009-2013

Researchers

Adolfo Rubinstein, Jiang He, Vilma Irazola, Héctor Olivera, Nora Mores, Matías Calandrelli, Fernando Lanas, Pamela Serón, Jacqueline Ponzo, Rosana Poggio, Edgardo Sobrino, Natalia Elorriaga

Abstract

Even though cardiovascular disease accounts for 17.7 million deaths per year globally (which accounts for 11% of total deaths) there is no data specific to cardiovascular disease in the Southern Cone. This scientific study is the first study ever to measure the status of cardiovascular disease in this region’s population.

This study was designed to research into the prevalence (frequency), incidence, and distribution of risk factors for cardiovascular disease and chronic obstructive pulmonary disease (COPD) in the general population. This means that, among other things, this study will create knowledge about the amount of infarctions, strokes and other cardiovascular diseases, and the role played by each risk factor (high cholesterol, diabetes, overweight, obesity, hypertension, smoking, a sedentary lifestyle, and an unhealthy diet).

Currently, the long-term impact of said risk factors is ignored. This study is already making measurements, and study participants (from Uruguay, Argentina and Chile) will be followed up for 4 years. Thus, it will be possible to know the true clinical, social, and economic impact of cardiovascular disease risk factors in the Southern Cone.

The main strengths of this study include: sample size (8,000 participants), a 4-year follow-up and the fact that the study is very representative. The sample is a random multistage sample that represents the Southern Cone’s adult population broadly by covering four districts (1,000 people between 35 and 74 years of age per area): Bariloche (province of Río Negro, Argentina), Marcos Paz (province of Buenos Aires, Argentina), Temuco (Chile), and Canelones (Uruguay).

During the first part of the study, a team of interviewers—especially trained and duly identified—visits 8,000 households conducting a survey about habits and health-related lifestyle aspects. Respondents are required to undergo medical examinations which are completely free of charge (blood pressure, weight, height, and abdominal girth are recorded; EKG; pulmonary function test; and fasting blood glucose, lipid profile, and creatinine level). Lastly, and until the end of the project, an annual follow-up telephone call is made to participants and more tests are conducted. In addition to this, blood samples are then stored in ultra-freezers at -80°C for future studies to be conducted with participants’ consent.

This study is being carried out by CESCAS I (the Southern Cone American Center of Excellence of Cardiovascular Health, for its Spanish acronym), which is coordinated by the IECS (the Argentine Institute for Clinical Effectiveness and Health Policy, for its Spanish acronym) in close collaboration with Tulane School of Public Health and Tropical Medicine (USA), and two Southern Cone universities: Universidad de La Frontera de Temuco (Chile), and Universidad de la República de Montevideo (Uruguay).

Funds

NIH-NHLBI

Study type

Cohort Study

Publications

Rubinstein A, López A, Caporale J, Valanzasca P, Irazola V, Rubinstein F. Serie sobre hospitalizaciones evitables y fortalecimiento de la atención primaria en salud. El caso de Argentina. Washington, DC: Banco Interamericano de Desarrollo; 2012.

Rubinstein AL, Irazola VE, Bazzano LA, Sobrino E, Calandrelli M, Lanas F, et al. Detection and follow-up of chronic obstructive pulmonary disease (COPD) and risk factors in the Southern Cone of Latin America: the pulmonary risk in South America (PRISA) study. BMC pulmonary medicine. 2011;11:34. Epub 2011/06/02.

Rubinstein A, Irazola V, Poggio R, Bazzano L, Calandrelli M, LanasZanetti F, ManfrediJ.A., Olivera H, Seron P, Ponzo J, He J. Detection and follow-up of cardiovascular disease and risk factors in the Southern Cone of Latin America: the CESCAS I study. BMJ Open. 2011 May 26;1(1):e000126.

Cerqueira MT, Cravioto A, Dianis N, Ghannem H, Levitt N, Yan LL, et al. Global response to non-communicable disease. BMJ (Clinical research ed). 2011;342:d3823. Epub 2011/07/05.

RubisteinA, ColantonioL, BardachA, CaporaleJ, GarcíaMartíS, KopitowskiK, AlcarazA, GibbonsL, AugustovskiF, Pichon-RiviereA; Estimation of the burden of cardiovascular disease attributable to modifiable risk factors and cost-effectiveness analysis of preventative interventions to reduce this burden in Argentina. BMC Public Health. Octubre 2010;1471-2458-10-627

PoggioR;CohenAraziH;GiorgiM;MiriukaS.Prediction of severe cardiovascular events by VE/VCO2 slope versus peak VO2 in systolic heart failure:A meta-analysis of the published literature.American Heart Journal; Agosto 2010; Am Heart J. 2010 Dec;160(6):1004-14.

ColantonioLD, Marti SG, Rubinstein AL. Economic evaluations on cardiovascular preventive interventions in Argentina. Expert review of pharmacoeconomics& outcomes research. 2010;10(4):465-73. Epub 2010/08/19.

Rubinstein A, Colantonio L, Bardach A, Caporale J, GarcíaMartí S, KopitowskiK,Alcaraz A, Gibbons L, Augustovski F, Pichon-Riviere A. Estimación de la carga de las enfermedades cardiovasculares atribuible a factores de riesgo modificables en Argentina. RevPanam Salud Publica 2010;27(4):237-45.

A Rubinstein, L Alcocer, A Chagas. High blood pressure in Latin America: a call to action. Therapeutic Advances in Cardiovascular Disease. (2009) 0(0) 1-27.

Heath I, Rubinstein A, Stange KC, van Driel ML. Quality in primary health care: a multidimensional approach to complexity. BMJ (Clinical research ed). 2009;338:b1242. Epub 2009/04/04. doi: 10.1136/bmj.b1242. PubMed PMID: 19342404.

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