Risk of cardiovascular diseases and diabetes: a cross-sectional study from North-eastern Brazil

Abstract

Cardiovascular diseases (CVDs), type 2 diabetes mellitus (T2DM), and metabolic syndrome (MS) are related to reduced life expectancy, increased disability and significant socioeconomic burden. Data from Brazil for the related topics are scarce. The aims of the thesis were to investigate the risk of CVDs, T2DM, MS, and their associations in a Brazilian population. We also assessed the glycated haemoglobin (HbA1c) as a diagnostic tool for diabetes and pre-diabetes, the prevalence of MS following different definitions, and the risk of CVDs by socioeconomic and demographic characteristics. A total of 714 subjects aged ≥20 years from North-eastern Brazil were recruited randomly to participate in the study. Structured questionnaires were used to collect socioeconomic, demographic, and clinical information. Anthropometric parameters, blood pressure, blood glucose, HbA1c, lipids and insulin levels were measured. T2DM, MS and increased CVD risk were highly prevalent in this population. Our data suggest that an HbA1c cut-off point of ≥ 6.8% is a sensitive marker for the diagnosis of diabetes. MS defined by the Joint Interim Statement and the International Diabetes Federation showed to be better indicators to identify people with pre-diabetes, T2DM and CVD risk in this population. Central obesity parameters were clearly associated with predicted CVD risk and might be useful in the clinical assessment of patients. Not least males and older people showed an increased risk of CVDs, whereas manual labour seems to provide a protective effect. Our data warrant screening of diabetes and MS in primary care as a routine check-up to detect people at risk at its earliest stage. Targeted strategies for screening, prevention and treatment of diabetes and CVDs may likely decrease disease burden and health expenditure in Brazil.