THE METABOLIC DISORDERS AND CARDIOVASCULAR RISK AMONG LOWER SOCIOECONOMIC SUBJECTS IN YOGYAKARTA-INDONESIA
DOI:
https://doi.org/10.22159/ajpcr.2017.v10i3.16310Abstract
ABSTRACT
Objectives: The prevalence of hypertension, diabetes mellitus, dyslipidemia, and obesity in developing countries was high regardless the socioeconomic
status, whereas the awareness and the control of these metabolic disorders were inadequate. The aim was to compare the cardiovascular risk based
on numbers of metabolic disorders among lower socioeconomic subjects.
Methods: The study was done with the analytical cross-sectional method. The subjects were selected with cluster random sampling from four villages.
We included the subjects of 30-65 years old and signed the informed consent but excluded the subjects who had not fasted for 8-10 hrs. We analyzed the cardiovascular parameters among groups with ANOVA statistics, the difference between actual and heart vascular age (HVA) with paired t-test, and the change of six cardiovascular parameters with radar diagram. Results: The eligible subjects (n=222) comprised 0-4 metabolic disorders at 25.2%, 33.8%, 28.8%, 9.9%, and 1.8%, respectively; with age at 50.1±9.0 years; body mass index (BMI) 24.1±4.8 kg/m2; blood pressure (BP) 141.6±23.4/82.8±11.7 mmHg; fasting blood sugar (FBS) 98.7±37.4 mg/dL; total and high-density lipoprotein cholesterol 201.0±37.9 and 55.1±12.7 mg/dL; Framingham score was 11.4±8.9% (referred as medium risk); the difference between actual and HVA at 13.2±13.0 (p<0.05). Increasing metabolic disorders lead to higher BP, FBS, cholesterol, Framingham score, and the difference between actual and HVA (p<0.05) excluding BMI in the four metabolic disorder subgroup.
Conclusion: The subjects had the medium cardiovascular risk with above normal BMI, BP, and total cholesterol profiles. The average age, BP, FBS,
cholesterol, Framingham score, and HVA were likely to increase equivalent to the numbers of metabolic disorders.
Keywords: Hypertension, Diabetes mellitus, Dyslipidemia, Obesity, Cardiovascular risk, Metabolic disorders.
Downloads
References
Aizawa T, Helble M. Forthcoming. Socioeconomic Related Inequity in Excessive Weight in Indonesia. ADBI Working Paper Series. Tokyo: Asian Development Bank Institute. Available from: http://www.asiapathways-adbi.org/2016/03/rapid-growth-of-overweight-and-obesity-in-indonesia-increasing-risk-for-the-poor/. [Last accessed on 2016 Jun 30].
Hatma RD. Lipid profiles among diverse ethnic groups in Indonesia. Acta Med Indones 2011;43:4-11.
Pramono LA, Setiati S, Soewondo P, Subekti I, Adisasmita A, Kodim N, et al. Prevalence and predictors of undiagnosed diabetes mellitus in Indonesia. Acta Med Indones 2010;42:216-23.
Roemling C, Qaim M. Obesity trends and determinants in Indonesia. Appetite 2012;58:1005-13.
Widjaja FF, Santoso LA, Barus NR, Pradana GA, Estetika C. Prehypertension and hypertension among young Indonesian adults at a primary health care in a rural area. Med J Indones 2013;22(1):39-45.
Scheltens T, Bots ML, Numans ME, Grobbee DE, Hoes AW. Awareness, treatment and control of hypertension: The ‘rule of halves’ in an era of risk-based treatment of hypertension. J Hum Hypertens 2007;21:99-106.
Rao V, Daniel A. Application of the rule of halves†for hypertension as an assessment tool in an urban slum at davangere. Natl J Community Med 2014;5(3):333-6.
Schroeder EB, Hanratty R, Beaty BL, Bayliss EA, Havranek EP, Steiner JF. Simultaneous control of diabetes mellitus, hypertension, and hyperlipidemia in 2 health systems. Circ Cardiovasc Qual Outcomes 2012;5:645-53.
Jensen MD, Ryan DH, Apovian CM, Ard JD, Commuzzie AG, Donato KA, et al. AHA/ACC/TOS guideline for the management of overweight and obesity in adults: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Obesity Society. Circulation 2013;???:???.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults
AQ1(adult treatment panel III). JAMA 2001;285:2486-97.
World Health Organization. World Heart Federation, World Stroke Organization. Global Atlas on Cardiovascular Disease Prevention and Control: Policies, Strategies, and Interventionsl; 2011. Available from: http://www.who.int/cardiovascular_diseases/publications/atlas_cvd/en. [Last accessed on 2015 May 17].
World Heart Federation. Cardiovascular Disease Risk Factors; 2015. Available from: http://www.world-heart-federation.org/cardiovascular-health/cardiovascular-disease-risk-factors. [Last accessed on 2015 Apr 16].
Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, et al 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;129 25 Suppl 2:S1-45.
American Diabetes Association. Erratum. Classification and diagnosis of diabetes. Sec 2. In Standards of Medical Care in Diabetes-2016. Diabetes Care 2016;39 Suppl 1:S13-S22. Diabetes Care 2016;39:1653.
Bromfield S, Muntner P. High blood pressure: The leading global burden of disease risk factor and the need for worldwide prevention programs. Curr Hypertens Rep 2013;15:134-6.
Fowler MJ. Microvascular and macrovascular complications of diabetes. Clin Diabetes 2008;26(2):77-82.
Smith SC, Collins A, Ferrari R. Holmes DR, Logstrup S, McGhie DV, et al. WHF/AHA/ACCF/EHN/ESC presidential advisory our time : A call to save preventable death from cardiovascular disease (heart disease and stroke). J Am Coll Cardiol 2012;60(22):2343-8.
Yusuf S, Rangarajan S, Teo K, Islam S, Li W, Liu L, et al. Cardiovascular risk and events in 17 low-, middle-, and high-income countries. N Engl J Med 2014;371:818-27.
Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013;31:1281-357.
Framingham Heart Study. Cardiovascular Disease (10-Year Risk); 2015. Available from: https://www.framinghamheartstudy.org/risk-functions/cardiovascular-disease/10-year-risk.php. [Last accessed on 2015 Apr 13].
WHO. Global Data on Body Mass Index, BMI Classification; 2006. Available from: http://www.apps.who.int/bmi/index.jsp?introPage=intro_3.html. [Last accessed on 2015 Dec 14].
McDonald M, Hertz RP, Unger AN, Lustik MB. Prevalence, awareness, and management of hypertension, dyslipidemia, and diabetes among United States adults aged 65 and older. J Gerontol A Biol Sci Med Sci 2009;64(2):256-63.
Millán J, Pintó X, Muñoz A, Zúñiga M, Rubiés-Prat J, Pallardo LF, et al. Lipoprotein ratios: Physiological significance and clinical usefulness in cardiovascular prevention. Vasc Health Risk Manag 2009;5:757-65.
Venkataraman R, Kumar S, Kumarswamy M, Singh R, Pandey M, Tripathi P, et al. Smoking, alcohol, and hypertension. Int J Pharm Pharm Sci 2013;5(4):28-32.
Wang T, Xu Y, Xu M, Wang W, Bi Y, Lu J, et al. Awareness, treatment and control of cardiometabolic disorders in Chinese adults with diabetes: A national representative population study. Cardiovasc Diabetol 2015;14:28.
Prince MJ, Ebrahim S, Acosta D, Ferri CP, Guerra M, Huang Y, et al. Hypertension prevalence, awareness, treatment and control among older people in Latin America, India and China: A 10/66 cross-sectional population-based survey. J Hypertens 2012;30(1):177-87.
Li S, Bruen BK, Lantz PM, Mendez D. Impact of health insurance expansions on nonelderly adults with hypertension. Prev Chronic Dis 2015;12:E105.
Liao Y, Gilmour S, Shibuya K. Health insurance coverage and hypertension control in China: Results from the China health and nutrition survey. PLoS One 2016;11(3):e0152091.
Elbur AI. Level of adherence to lifestyle changes and medications among male hypertensive patients in two hospitals in Taif; Kingdom of Saudi Arabia. Int J Pharm Pharm Sci 2015;7(4):168-72.
Goodpaster BH, Park SW, Harris TB, Kritchevsky SB, Nevitt M, Schwartz AV, et al. The loss of skeletal muscle strength, mass, and quality in older adults: The health, aging and body composition study.J Gerontol A Biol Sci Med Sci 2006;61(10):1059-64.
Maltais ML, Desroches J, Dionne IJ. Changes in muscle mass and strength after menopause. J Musculoskelet Neuronal Interact 2009;9(4):186-97.32. Willard-Grace R, Chen EH, Hessler D, DeVore D, Prado C, Bodenbeimer T, et al. Health coach by medical assistants to improve control of diabetes, hypertension, and hyperlipidemia in low-income patients: A randomized controlled trial. Ann Fam Med 2015;13:130-8.
Published
How to Cite
Issue
Section
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
