CARDIOVASCULAR – KIDNEY – METABOLIC SYNDROME: CHARACTERIZATION ON PATIENTS ENROLLED IN A CARDIOVASCULAR HEALTH PROGRAM AT PRIMARY CARE CENTRE IN SANTIAGO, CHILE

 

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CARDIOVASCULAR – KIDNEY – METABOLIC SYNDROME: CHARACTERIZATION ON PATIENTS ENROLLED IN A CARDIOVASCULAR HEALTH PROGRAM AT PRIMARY CARE CENTRE IN SANTIAGO, CHILE

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Magdalena
Castro
Magdalena Castro mcastroc12@correo.uss.cl University San Sebastián Laboratory of Renal Physiopathology, Facultad de Ciencias Santiago Chile *
Francisca Peña-D'Ardaillon francisca.pena@umayor.cl University Mayor/ Fundación de Salud Renal Integral Escuela de Nutrición y Dietética, Facultad de Medicina y Ciencias de la Salud Santiago Chile -
Ignacio Naranjo ignacio.naranjo@saludelbosque.cl Centro de Salud Familiar Santa Laura Salud Santiago Chile -
Nicolás Vargas nicolas.vargas@saludelbosque.cl Centro de Salud Familiar Santa Laura Salud Santiago Chile -
Cristián A. Amador cristian.amador@uss.cl University San Sebastián Laboratory of Renal Physiopathology, Facultad de Ciencias Santiago Chile -
 
 
 
 
 
 
 
 
 
 

Cardiovascular disease (CVD), diabetes mellitus (DM), and chronic kidney disease (CKD) are major public health problems associated with high morbidity and mortality in Chile and worldwide. Recently, the American Heart Association introduced the concept on cardiovascular – kidney – metabolic Syndrome (CKMS), which reflects the interrelated factor that increase cardiovascular risk (CVR), given the frequent coexistence on these tree conditions. CKMS is classified into five stages (0-4) and allows not only the identification of individuals at high CVR, but also the implementation of preventive, therapeutic and follow up strategies. The aim of this study is to characterize a population of adult patients enrolled in a cardiovascular health program (CVHP) of a primary health centre in Chile, according CKMS definition.

A descriptive cross-sectional observational study was conducted using a historical cohort of 3,606 adult patients registered in the CVHP at primary health centre in Santiago of Chile. A descriptive statistical analysis was performed including the variables required to identify the five CKMS stages (Table 1). Waist circumference and HDLc were adjusted by sex, as was the calculation of the dysfunctional adiposity index. In patients without fasting glucose records HbA1c was used for classification in stages > 1.

Of the total 2,321 (64.4%) were woman and 1,285 (35.6%) men, with a median age of 64 years (range: 17 – 100 for women and 19 – 94 for men). Hypertension was diagnosed in 79.8% of patients, type 2 DM in 48% and CKD in 13.6%. Nutritional status distribution was underweighted 0.4%, normal weight 14.8%, overweight 35.9% and obesity type 1,2 and 3 in 29%, 13.7% and 6.2%, respectively. A total of 1,481 patients had fasting glucose measurements, which is essential for Stage – 0 classification. The distribution of CKMS stages was Stage -0 = 0%; Stage -1 = 0.5%; Stage – 2 = 98.1%; Stage – 3 = 1.2% and Stage – 4 = 0.2% (Table 2).


Among patients enrolled in the CVHP at primary health centre in Santiago, Chile, 99.3% were classified in stages 2-3 of CKMS and no individuals were free of risk factors. This finding is consistent with the current criteria, for inclusion of CVHP and explains why 59% of participants lacked fasting glucose records. This classification framework facilitates the timely priories of self – care education and optimizes the therapeutic work of the multidisciplinary primary care team, not only to treat but to prevent the progression of cardiovascular and kidney damage. Furthermore, its strengths the relevance of the systematic data registry of key variables needed for CKMS assessment, the early identification of the stages, and to apply the AHA algorithms for a prompt clinical management.

Kewords