Leonelo Bautista - Academia.edu (original) (raw)
Papers by Leonelo Bautista
International Journal of Cardiology Hypertension
Journal of Public Health and Emergency
Figure 2 Cross-correlograms of weekly observed and residual number of cases of possible Zika viru... more Figure 2 Cross-correlograms of weekly observed and residual number of cases of possible Zika virus infections (ZIKV), microcephaly, and Guillain-Barré syndrome (GBS), in Salvador, Brazil (2016).
BMC public health, Jan 24, 2018
We evaluated whether outbreaks of Zika virus (ZIKV) infection, newborn microcephaly, and Guillain... more We evaluated whether outbreaks of Zika virus (ZIKV) infection, newborn microcephaly, and Guillain-Barré syndrome (GBS) in Latin America may be detected through current surveillance systems, and how cases detected through surveillance may increase health care burden. We estimated the sensitivity and specificity of surveillance case definitions using published data. We assumed a 10% ZIKV infection risk during a non-outbreak period and hypothetical increases in risk during an outbreak period. We used sensitivity and specificity estimates to correct for non-differential misclassification, and calculated a misclassification-corrected relative risk comparing both periods. To identify the smallest hypothetical increase in risk resulting in a detectable outbreak we compared the misclassification-corrected relative risk to the relative risk corresponding to the upper limit of the endemic channel (mean + 2 SD). We also estimated the proportion of false positive cases detected during the outbr...
American Journal of Hypertension
Medical Science Monitor International Medical Journal of Experimental and Clinical Research, Aug 1, 2004
![Research paper thumbnail of [The Mini-Mental State Examination as a selected diagnostic test for dementia: a Colombian population study. GENECO]](https://attachments.academia-assets.com/65892392/thumbnails/1.jpg)
](Revista De Neurologia, 2000
Introduction: Folstein's Mini Mental State Examination (MMSE) is widely used as screening test fo... more Introduction: Folstein's Mini Mental State Examination (MMSE) is widely used as screening test for cognitive impairment. Objective: To test a Spanish version of the MMSE in a population of high illiteracy rate. Material and methods: Population-based survey of a stratified random sample of urban and rural residents of five regions of Colombia, followed by neurological and neuropsychological evaluation of suspect cases (phase 2). Dementia was diagnosed using DSM-IV criteria. Results: 1,611 subjects age 50 or older filled out both the WHO Protocol for Epidemiologic Studies of Neurological Disorders and a Spanish version of the MMSE; 55.2% of them had three or less years of schooling; 536 individuals with scores below cutoff points were sent to phase 2. Of the population with satisfactory scores in MMSE 366 (34.0%) were evaluated by neurologists to exclude other neurological conditions. Twelve cases of dementia were diagnosed among individuals with scores below cutoff point and one among subjects with high scores. Age-adjusted prevalence was 8.1 per thousand subjects age 50 or over (95% CI: 3.7-12.5); and 34.2 per thousand for ages 75 or over (95% CI: 12.2-56.2). Sensitivity and specificity were 92.3 and 53.7%; 16 of the 19 questions show significant differences (p < 0.001) according to educational level. A gender gap is significant in low educational levels (p < 0.001) but not in subjects with more than five years of schooling. Conclusions: MMSE scores correlated closely with level of education. Low specificity leads to many non-demented subjects with low educational status requiring further investigation.
Hypertension is a major contributor to the global burden of cardiovascular diseases (CVD). Worldw... more Hypertension is a major contributor to the global burden of cardiovascular diseases (CVD). Worldwide, 13% of deaths and 6% of disability-adjusted life years are attributed to hypertension. About 80% of the attributable health burden occurs in low- and middle-income countries. Although hypertension is relatively easy to diagnose and treat, hypertension awareness, treatment, and control (ATC) rates are low in most populations. To determine the prevalence of and identify factors associated to hypertension ATC in Latin America (LA), we used cross-sectional data from 10,228 hypertensives from the LA Studies on Obesity (LASO), which includes random samples from eight LA countries. We estimated the prevalence of hypertension ATC post-stratifying by the age and gender distribution of the population. We used continuation ratio models with the complementary log-log link to identify determinants of progressing from one stage to the next. Hypertension and ATC prevalence were 20.3%, 59.2%, 44.6%...
Boletin De La Oficina Sanitaria Panamericana Pan American Sanitary Bureau, May 1, 1996
The present study reanalyzed data from the Dominican Republic National Health Survey, conducted i... more The present study reanalyzed data from the Dominican Republic National Health Survey, conducted in 1991, in order to identify the socioeconomic characteristics and the factors related to medical care, the pregnancy, and the child which influenced the total duration of breast-feeding (TDBF). A representative sample of 1984 mother-infant pairs was studied. Of the children of each mother, only the last one who was breast-fed and was less than three years old at the time of the survey was included. Data on TDBF and the factors studied were collected by interviewing the mothers. The risk of having been weaned at various ages was calculated by means of a life table, and the independent effect of each variable of interest was estimated using Cox&amp;#39;s regression model. The median TDBF was 7 months and the relative weaning rate (RWR) was higher among weaned children (RWR = 8.56; 95%CI: 4.25-17.20), those whose mothers had a university education (RWR = 1.48; 95%CI: 1.24-1.77), those who began to suckle late (RWR = 1.25; 95%CI: 1.11-1.40), those who were born in public institutions (RWR = 1.62; 95%CI: 1.24-2.11) and private institutions (RWR = 2.19; 95%CI: 1.65-2.91), and those born to first-time mothers of a low socioeconomic level (RWR = 1.80; 95%CI: 1.45-2.24). Among the strategies of programs to promote breast-feeding, the importance of delayed weaning should be underscored, since this factor has the greatest influence on duration of breast-feeding.
The endothelium plays a critical role in vascular homeostasis. Recently, a noninvasive method has... more The endothelium plays a critical role in vascular homeostasis. Recently, a noninvasive method has been developed to assess flow mediated vasodilatation of the brachial artery (FMD). This test is remarkably stable overtime but no clear set of normal values has been developed. The purposes of our study were to evaluate the accuracy and reproducibility and to identify a set of normal values of FMD. We included 253 normotensive healthy volunteers from three Colombian cities (mean age: 38.2 years; 33% were women). All subjects underwent ultrasound evaluation of endothelial and smooth muscle function. Flow mediated vessel diameter change was measured by two independent observers. The interobserver Lin&amp;amp;amp;amp;amp;#39;s concordance correlation coefficient was 0.88% (95% CI: 0.82, 0.94) and there was no evidence of systematic difference between the two measurements (mean difference of -0.30% with limits of agreement of -4.48 to 3.87). Mean %FMD was 11.98% (95% CI: 11.36, 12.61), 13.32% (95% CI: 12.39, 14.25) in women and 11.32% (95% CI: 10.52, 12.13) in men. Subjects with no cardiovascular risk factors had a mean %FMD of 13.74% (95% CI: 13.14, 14.35), in contrast to a mean of only 7.40% (95% CI: 4.33, 9.91) in those with at least one risk factor. A %FMD cut point of 10.4 had a sensitivity of 71.2% and an specificity of 77.2% to identify subjects with at least one cardiovascular risk factor. Using this cut point, endothelial dysfunction was 3.13 times more frequent in subjects with than in subjects without cardiovascular risk factors (95% CI: 2.30, 4.25). In addition, obesity, smoking and hypercholesterolemia were the modifiable risk factors with largest independent significant reduction effects on %FMD. FMD measurements can be made with high accuracy and precision, and a cut point of 10.4% is useful to discriminate between subjects with and without cardiovascular risk factors, and can be recommended as a screening test for the detection of patients at risk of CVD.
ABSTRACT Cardiovascular diseases (CVD) account for 30% of all deaths worldwide. Cardiovascular pr... more ABSTRACT Cardiovascular diseases (CVD) account for 30% of all deaths worldwide. Cardiovascular prevention in Latin America (LA) is based on the use of the Framingham equation as a tool to predict cardiovascular risk. A calibrated version of the Framingham equation for use in Latin America is not available, even though it is needed for cost-effective cardiovascular prevention. The objective of this study was to recalibrate the Framingham equation for use in the LA population. We used cross-sectional data from 22,468 free-living individuals 30 to 74 years old from the Latin American Studies on Obesity (LASO) to estimate the distribution of CVD risk factors. We estimated the baseline incidence of CVD in LA using two approaches. First, we used CVD prevalence data from LASO to back estimate the incidence of CVD using the DisMod II model. Second, we conducted a meta-analysis of published data on the incidence of CVD in LA countries to get a pooled estimate of the incidence of CVD using a random-effects model. Then, we recalibrated the Framingham equation by plugging into the formula the above mentioned estimates while keeping the original regression coefficients. The Framingham equation was accurate in predicting 10-year risk of CVD in women and overestimated the risk by 41% in men. The degree of overestimation in men decreased as age increased, as well as in patients with hypertension, hypercholesterolemia, obesity, or diabetes. Findings from this study suggest that the original Framingham equation is accurate to identify women but not men at high risk of CVD in LA.
American Journal of Hypertension, 2016
Coronary Artery Dis, 2004
To ascertain whether C-reactive protein (CRP), an inflammatory marker related to increased cardio... more To ascertain whether C-reactive protein (CRP), an inflammatory marker related to increased cardiovascular risk, is associated with blood pressure in a sample of healthy, middle-aged people. A case-control study among 904 participants, 39-50 years old, from a cardiovascular risk screening study. Participants with systolic blood pressure &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =140 mmHg or diastolic blood pressure &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =90 mmHg (n=120) were considered as case participants and all others as control participants (n=784). Exposure was defined using quintiles of high-sensitivity CRP among control participants. A continuous increase in blood pressure was observed across CRP quintiles. Systolic blood pressure increased 1.17 mmHg [95% confidence interval (CI), 0.60-1.74] and diastolic blood pressure 1.04 mmHg (95% CI, 0.64-1.45) from one quintile to the next. The prevalence of hypertension was 13.3% and it increased with CRP exposure: Q1, 8.9%; Q2, 11.9%; Q3, 12.2%; Q4, 14.3%; and Q5, 18.6%. After adjustment for sex, obesity, race, serum insulin level and family history of coronary heart disease, odds ratios for hypertension increased progressively across CRP quintiles. Participants in the highest CRP quintile were 2.35 times more likely to have hypertension than those in the lowest quintile (P=0.03, trend test P=0.04). These results are consistent with a continuous, independent association between serum CRP and elevated blood pressure.
Colombia Medica, Jun 1, 2005
Objetivo: Comparar el patrón de consumo de alimentos entre los años 2002 y 2003 con el patrón obs... more Objetivo: Comparar el patrón de consumo de alimentos entre los años 2002 y 2003 con el patrón observado en 1998. Métodos: Participantes entre 20 y 60 años de edad, que consumían su dieta regular, completaron dos períodos de siete días de registro de ingesta ponderada de alimentos en 1998 y entre 2002 y 2003. El consumo promedio individual de nutrientes se calculó usando tablas de composición de alimentos. Se usaron pruebas t para comparar las medias de consumo de nutrientes específicas de edad y sexo en ambos períodos. Resultados: El grupo de alimentos constituido por cereales, raíces, tubérculos y el plátano fue el mayor contribuyente al consumo diario de energía (43.2%), seguido por el grupo de carnes, huevos y leguminosas secas (26%), el grupo de azúcares y dulces (12.1%), los productos lácteos (10.2%), y las grasas (9.9%). Aproximadamente 16% del consumo diario de energía fue aportado por bebidas alcohólicas. Comparando con el año 1998, el consumo diario de energía se incrementó en 12% en hombres y 10% en mujeres. Se encontraron disminuciones significativas en el consumo de vegetales (60% en hombres y 20% en mujeres) y frutas (30% en hombres y 16% en mujeres); el consumo de grasas permaneció estable.
Colombia Medica, Nov 23, 2012
In spite nearly 40% of the variability in blood pressure can be explained by genetic factors, the... more In spite nearly 40% of the variability in blood pressure can be explained by genetic factors, the identification of genes associated to essential high blood pressure is difficult in populations where individuals have different genetic precedents; in these circumstances it is necessary to determinate whether the population is sub-structured because this can bias studies associated with this disease. Objectives: To determine the genetic structure of the population in Bucaramanga from genetic polymorphisms associated with the regulation of blood pressure: 448G>T, 679C>T y 1711C>T from the gene kinase 4 of the dopaminergic receptor linked to the protein G and Glu298Asp, -786T>C and the VNTR of the intron 4 of the gene of endothelial nitric oxide. Methodology: A sample of 552 unrelated individuals was studied through analysis of Restriction fragment length polymorphism. The allelic, haplotypic and genotypic frequencies were calculated, the Hardy-Weinberg equilibrium was determined and a molecular analysis of variance was performed to determine the genetic structure. Results: 38 Haplotypes were identified, with GCCTG4b as the most frequent (21.2%). The most diverse polymorphism was 448G>T with a frequency of 49.9% for heterozygous. The six polymorphisms were found in genetic equilibrium and genetic structure of populations was not evidenced (F ST = 0,0038). Conclusion: The population studied does not present a genetic sub-structure and the polymorphisms analyzed were found in genetic equilibrium, this indicates that the population mixes randomly and there are no sub-groups capable of affecting the results of the association studies.
Objetivo: Comparar el patrón de consumo de alimentos entre los años 2002 y 2003 con el patrón obs... more Objetivo: Comparar el patrón de consumo de alimentos entre los años 2002 y 2003 con el patrón observado en 1998. Métodos: Participantes entre 20 y 60 años de edad, que consumían su dieta regular, completaron dos períodos de siete días de registro de ingesta ponderada de alimentos en 1998 y entre 2002 y 2003. El consumo promedio individual de nutrientes se calculó usando tablas de composición de alimentos. Se usaron pruebas t para comparar las medias de consumo de nutrientes específicas de edad y sexo en ambos períodos. Resultados: El grupo de alimentos constituido por cereales, raíces, tubérculos y el plátano fue el mayor contribuyente al consumo diario de energía (43.2%), seguido por el grupo de carnes, huevos y leguminosas secas (26%), el grupo de azúcares y dulces (12.1%), los productos lácteos (10.2%), y las grasas (9.9%). Aproximadamente 16% del consumo diario de energía fue aportado por bebidas alcohólicas. Comparando con el año 1998, el consumo diario de energía se incrementó en 12% en hombres y 10% en mujeres. Se encontraron disminuciones significativas en el consumo de vegetales (60% en hombres y 20% en mujeres) y frutas (30% en hombres y 16% en mujeres); el consumo de grasas permaneció estable.
American journal of hypertension, Jan 7, 2015
Non-adherence to antihypertensive medication increases the risk of uncontrolled hypertension. Ant... more Non-adherence to antihypertensive medication increases the risk of uncontrolled hypertension. Antihypertensive drug-related symptoms (side effects) are frequently cited as a main cause of non-adherence, but with little support from prospective studies. We evaluated the association between drug side effects and prospective adherence to treatment. We collected data on the number and dose of antihypertensive drugs at enrollment and at 3, 6, 9, and 12 months of follow-up in a cohort of 175 hypertensive patients starting or restarting antihypertensive treatment (mean age: 50 years; 58% women). During the follow-up visits, we gathered data on 24 side effects during the last month and the pill count adherence ratio (PCAR = pills taken out of number prescribed × 100) since the previous visit. The association between side effects at a visit and adherence through the next visit was estimated using mixed effect models. Eighty-five percent of the participants experienced side effects, and 34.5%...
American Journal of Epidemiology, Nov 1, 2006
Rev Panam Salud Publica, 1997
International Journal of Cardiology Hypertension
Journal of Public Health and Emergency
Figure 2 Cross-correlograms of weekly observed and residual number of cases of possible Zika viru... more Figure 2 Cross-correlograms of weekly observed and residual number of cases of possible Zika virus infections (ZIKV), microcephaly, and Guillain-Barré syndrome (GBS), in Salvador, Brazil (2016).
BMC public health, Jan 24, 2018
We evaluated whether outbreaks of Zika virus (ZIKV) infection, newborn microcephaly, and Guillain... more We evaluated whether outbreaks of Zika virus (ZIKV) infection, newborn microcephaly, and Guillain-Barré syndrome (GBS) in Latin America may be detected through current surveillance systems, and how cases detected through surveillance may increase health care burden. We estimated the sensitivity and specificity of surveillance case definitions using published data. We assumed a 10% ZIKV infection risk during a non-outbreak period and hypothetical increases in risk during an outbreak period. We used sensitivity and specificity estimates to correct for non-differential misclassification, and calculated a misclassification-corrected relative risk comparing both periods. To identify the smallest hypothetical increase in risk resulting in a detectable outbreak we compared the misclassification-corrected relative risk to the relative risk corresponding to the upper limit of the endemic channel (mean + 2 SD). We also estimated the proportion of false positive cases detected during the outbr...
American Journal of Hypertension
Medical Science Monitor International Medical Journal of Experimental and Clinical Research, Aug 1, 2004
Revista De Neurologia, 2000
Introduction: Folstein's Mini Mental State Examination (MMSE) is widely used as screening test fo... more Introduction: Folstein's Mini Mental State Examination (MMSE) is widely used as screening test for cognitive impairment. Objective: To test a Spanish version of the MMSE in a population of high illiteracy rate. Material and methods: Population-based survey of a stratified random sample of urban and rural residents of five regions of Colombia, followed by neurological and neuropsychological evaluation of suspect cases (phase 2). Dementia was diagnosed using DSM-IV criteria. Results: 1,611 subjects age 50 or older filled out both the WHO Protocol for Epidemiologic Studies of Neurological Disorders and a Spanish version of the MMSE; 55.2% of them had three or less years of schooling; 536 individuals with scores below cutoff points were sent to phase 2. Of the population with satisfactory scores in MMSE 366 (34.0%) were evaluated by neurologists to exclude other neurological conditions. Twelve cases of dementia were diagnosed among individuals with scores below cutoff point and one among subjects with high scores. Age-adjusted prevalence was 8.1 per thousand subjects age 50 or over (95% CI: 3.7-12.5); and 34.2 per thousand for ages 75 or over (95% CI: 12.2-56.2). Sensitivity and specificity were 92.3 and 53.7%; 16 of the 19 questions show significant differences (p < 0.001) according to educational level. A gender gap is significant in low educational levels (p < 0.001) but not in subjects with more than five years of schooling. Conclusions: MMSE scores correlated closely with level of education. Low specificity leads to many non-demented subjects with low educational status requiring further investigation.
Hypertension is a major contributor to the global burden of cardiovascular diseases (CVD). Worldw... more Hypertension is a major contributor to the global burden of cardiovascular diseases (CVD). Worldwide, 13% of deaths and 6% of disability-adjusted life years are attributed to hypertension. About 80% of the attributable health burden occurs in low- and middle-income countries. Although hypertension is relatively easy to diagnose and treat, hypertension awareness, treatment, and control (ATC) rates are low in most populations. To determine the prevalence of and identify factors associated to hypertension ATC in Latin America (LA), we used cross-sectional data from 10,228 hypertensives from the LA Studies on Obesity (LASO), which includes random samples from eight LA countries. We estimated the prevalence of hypertension ATC post-stratifying by the age and gender distribution of the population. We used continuation ratio models with the complementary log-log link to identify determinants of progressing from one stage to the next. Hypertension and ATC prevalence were 20.3%, 59.2%, 44.6%...
Boletin De La Oficina Sanitaria Panamericana Pan American Sanitary Bureau, May 1, 1996
The present study reanalyzed data from the Dominican Republic National Health Survey, conducted i... more The present study reanalyzed data from the Dominican Republic National Health Survey, conducted in 1991, in order to identify the socioeconomic characteristics and the factors related to medical care, the pregnancy, and the child which influenced the total duration of breast-feeding (TDBF). A representative sample of 1984 mother-infant pairs was studied. Of the children of each mother, only the last one who was breast-fed and was less than three years old at the time of the survey was included. Data on TDBF and the factors studied were collected by interviewing the mothers. The risk of having been weaned at various ages was calculated by means of a life table, and the independent effect of each variable of interest was estimated using Cox&amp;#39;s regression model. The median TDBF was 7 months and the relative weaning rate (RWR) was higher among weaned children (RWR = 8.56; 95%CI: 4.25-17.20), those whose mothers had a university education (RWR = 1.48; 95%CI: 1.24-1.77), those who began to suckle late (RWR = 1.25; 95%CI: 1.11-1.40), those who were born in public institutions (RWR = 1.62; 95%CI: 1.24-2.11) and private institutions (RWR = 2.19; 95%CI: 1.65-2.91), and those born to first-time mothers of a low socioeconomic level (RWR = 1.80; 95%CI: 1.45-2.24). Among the strategies of programs to promote breast-feeding, the importance of delayed weaning should be underscored, since this factor has the greatest influence on duration of breast-feeding.
The endothelium plays a critical role in vascular homeostasis. Recently, a noninvasive method has... more The endothelium plays a critical role in vascular homeostasis. Recently, a noninvasive method has been developed to assess flow mediated vasodilatation of the brachial artery (FMD). This test is remarkably stable overtime but no clear set of normal values has been developed. The purposes of our study were to evaluate the accuracy and reproducibility and to identify a set of normal values of FMD. We included 253 normotensive healthy volunteers from three Colombian cities (mean age: 38.2 years; 33% were women). All subjects underwent ultrasound evaluation of endothelial and smooth muscle function. Flow mediated vessel diameter change was measured by two independent observers. The interobserver Lin&amp;amp;amp;amp;amp;#39;s concordance correlation coefficient was 0.88% (95% CI: 0.82, 0.94) and there was no evidence of systematic difference between the two measurements (mean difference of -0.30% with limits of agreement of -4.48 to 3.87). Mean %FMD was 11.98% (95% CI: 11.36, 12.61), 13.32% (95% CI: 12.39, 14.25) in women and 11.32% (95% CI: 10.52, 12.13) in men. Subjects with no cardiovascular risk factors had a mean %FMD of 13.74% (95% CI: 13.14, 14.35), in contrast to a mean of only 7.40% (95% CI: 4.33, 9.91) in those with at least one risk factor. A %FMD cut point of 10.4 had a sensitivity of 71.2% and an specificity of 77.2% to identify subjects with at least one cardiovascular risk factor. Using this cut point, endothelial dysfunction was 3.13 times more frequent in subjects with than in subjects without cardiovascular risk factors (95% CI: 2.30, 4.25). In addition, obesity, smoking and hypercholesterolemia were the modifiable risk factors with largest independent significant reduction effects on %FMD. FMD measurements can be made with high accuracy and precision, and a cut point of 10.4% is useful to discriminate between subjects with and without cardiovascular risk factors, and can be recommended as a screening test for the detection of patients at risk of CVD.
ABSTRACT Cardiovascular diseases (CVD) account for 30% of all deaths worldwide. Cardiovascular pr... more ABSTRACT Cardiovascular diseases (CVD) account for 30% of all deaths worldwide. Cardiovascular prevention in Latin America (LA) is based on the use of the Framingham equation as a tool to predict cardiovascular risk. A calibrated version of the Framingham equation for use in Latin America is not available, even though it is needed for cost-effective cardiovascular prevention. The objective of this study was to recalibrate the Framingham equation for use in the LA population. We used cross-sectional data from 22,468 free-living individuals 30 to 74 years old from the Latin American Studies on Obesity (LASO) to estimate the distribution of CVD risk factors. We estimated the baseline incidence of CVD in LA using two approaches. First, we used CVD prevalence data from LASO to back estimate the incidence of CVD using the DisMod II model. Second, we conducted a meta-analysis of published data on the incidence of CVD in LA countries to get a pooled estimate of the incidence of CVD using a random-effects model. Then, we recalibrated the Framingham equation by plugging into the formula the above mentioned estimates while keeping the original regression coefficients. The Framingham equation was accurate in predicting 10-year risk of CVD in women and overestimated the risk by 41% in men. The degree of overestimation in men decreased as age increased, as well as in patients with hypertension, hypercholesterolemia, obesity, or diabetes. Findings from this study suggest that the original Framingham equation is accurate to identify women but not men at high risk of CVD in LA.
American Journal of Hypertension, 2016
Coronary Artery Dis, 2004
To ascertain whether C-reactive protein (CRP), an inflammatory marker related to increased cardio... more To ascertain whether C-reactive protein (CRP), an inflammatory marker related to increased cardiovascular risk, is associated with blood pressure in a sample of healthy, middle-aged people. A case-control study among 904 participants, 39-50 years old, from a cardiovascular risk screening study. Participants with systolic blood pressure &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =140 mmHg or diastolic blood pressure &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =90 mmHg (n=120) were considered as case participants and all others as control participants (n=784). Exposure was defined using quintiles of high-sensitivity CRP among control participants. A continuous increase in blood pressure was observed across CRP quintiles. Systolic blood pressure increased 1.17 mmHg [95% confidence interval (CI), 0.60-1.74] and diastolic blood pressure 1.04 mmHg (95% CI, 0.64-1.45) from one quintile to the next. The prevalence of hypertension was 13.3% and it increased with CRP exposure: Q1, 8.9%; Q2, 11.9%; Q3, 12.2%; Q4, 14.3%; and Q5, 18.6%. After adjustment for sex, obesity, race, serum insulin level and family history of coronary heart disease, odds ratios for hypertension increased progressively across CRP quintiles. Participants in the highest CRP quintile were 2.35 times more likely to have hypertension than those in the lowest quintile (P=0.03, trend test P=0.04). These results are consistent with a continuous, independent association between serum CRP and elevated blood pressure.
Colombia Medica, Jun 1, 2005
Objetivo: Comparar el patrón de consumo de alimentos entre los años 2002 y 2003 con el patrón obs... more Objetivo: Comparar el patrón de consumo de alimentos entre los años 2002 y 2003 con el patrón observado en 1998. Métodos: Participantes entre 20 y 60 años de edad, que consumían su dieta regular, completaron dos períodos de siete días de registro de ingesta ponderada de alimentos en 1998 y entre 2002 y 2003. El consumo promedio individual de nutrientes se calculó usando tablas de composición de alimentos. Se usaron pruebas t para comparar las medias de consumo de nutrientes específicas de edad y sexo en ambos períodos. Resultados: El grupo de alimentos constituido por cereales, raíces, tubérculos y el plátano fue el mayor contribuyente al consumo diario de energía (43.2%), seguido por el grupo de carnes, huevos y leguminosas secas (26%), el grupo de azúcares y dulces (12.1%), los productos lácteos (10.2%), y las grasas (9.9%). Aproximadamente 16% del consumo diario de energía fue aportado por bebidas alcohólicas. Comparando con el año 1998, el consumo diario de energía se incrementó en 12% en hombres y 10% en mujeres. Se encontraron disminuciones significativas en el consumo de vegetales (60% en hombres y 20% en mujeres) y frutas (30% en hombres y 16% en mujeres); el consumo de grasas permaneció estable.
Colombia Medica, Nov 23, 2012
In spite nearly 40% of the variability in blood pressure can be explained by genetic factors, the... more In spite nearly 40% of the variability in blood pressure can be explained by genetic factors, the identification of genes associated to essential high blood pressure is difficult in populations where individuals have different genetic precedents; in these circumstances it is necessary to determinate whether the population is sub-structured because this can bias studies associated with this disease. Objectives: To determine the genetic structure of the population in Bucaramanga from genetic polymorphisms associated with the regulation of blood pressure: 448G>T, 679C>T y 1711C>T from the gene kinase 4 of the dopaminergic receptor linked to the protein G and Glu298Asp, -786T>C and the VNTR of the intron 4 of the gene of endothelial nitric oxide. Methodology: A sample of 552 unrelated individuals was studied through analysis of Restriction fragment length polymorphism. The allelic, haplotypic and genotypic frequencies were calculated, the Hardy-Weinberg equilibrium was determined and a molecular analysis of variance was performed to determine the genetic structure. Results: 38 Haplotypes were identified, with GCCTG4b as the most frequent (21.2%). The most diverse polymorphism was 448G>T with a frequency of 49.9% for heterozygous. The six polymorphisms were found in genetic equilibrium and genetic structure of populations was not evidenced (F ST = 0,0038). Conclusion: The population studied does not present a genetic sub-structure and the polymorphisms analyzed were found in genetic equilibrium, this indicates that the population mixes randomly and there are no sub-groups capable of affecting the results of the association studies.
Objetivo: Comparar el patrón de consumo de alimentos entre los años 2002 y 2003 con el patrón obs... more Objetivo: Comparar el patrón de consumo de alimentos entre los años 2002 y 2003 con el patrón observado en 1998. Métodos: Participantes entre 20 y 60 años de edad, que consumían su dieta regular, completaron dos períodos de siete días de registro de ingesta ponderada de alimentos en 1998 y entre 2002 y 2003. El consumo promedio individual de nutrientes se calculó usando tablas de composición de alimentos. Se usaron pruebas t para comparar las medias de consumo de nutrientes específicas de edad y sexo en ambos períodos. Resultados: El grupo de alimentos constituido por cereales, raíces, tubérculos y el plátano fue el mayor contribuyente al consumo diario de energía (43.2%), seguido por el grupo de carnes, huevos y leguminosas secas (26%), el grupo de azúcares y dulces (12.1%), los productos lácteos (10.2%), y las grasas (9.9%). Aproximadamente 16% del consumo diario de energía fue aportado por bebidas alcohólicas. Comparando con el año 1998, el consumo diario de energía se incrementó en 12% en hombres y 10% en mujeres. Se encontraron disminuciones significativas en el consumo de vegetales (60% en hombres y 20% en mujeres) y frutas (30% en hombres y 16% en mujeres); el consumo de grasas permaneció estable.
American journal of hypertension, Jan 7, 2015
Non-adherence to antihypertensive medication increases the risk of uncontrolled hypertension. Ant... more Non-adherence to antihypertensive medication increases the risk of uncontrolled hypertension. Antihypertensive drug-related symptoms (side effects) are frequently cited as a main cause of non-adherence, but with little support from prospective studies. We evaluated the association between drug side effects and prospective adherence to treatment. We collected data on the number and dose of antihypertensive drugs at enrollment and at 3, 6, 9, and 12 months of follow-up in a cohort of 175 hypertensive patients starting or restarting antihypertensive treatment (mean age: 50 years; 58% women). During the follow-up visits, we gathered data on 24 side effects during the last month and the pill count adherence ratio (PCAR = pills taken out of number prescribed × 100) since the previous visit. The association between side effects at a visit and adherence through the next visit was estimated using mixed effect models. Eighty-five percent of the participants experienced side effects, and 34.5%...
American Journal of Epidemiology, Nov 1, 2006
Rev Panam Salud Publica, 1997