Cardiovascular risk awareness, treatment, and control in urban Latin America

Effective prevention and treatment of cardiovascular diseases require regular screening for risk
factors, high awareness of the condition, effective treatment of the identified risk factors, and
adherence to the prescribed treatment. The Cardiovascular Risk Factor Multiple Evaluation in Latin
America study was a cross-sectional, population-based, observational study of major cardiovascular
risk factors—including hypertension, diabetes, and hypercholesterolemia—in 7 Latin American
cities. This report presents data on assessment, diagnosis, extent, and effectiveness of treatment,
adherence to treatment, and reasons for nonadherence. Data were collected through household
questionnaire-based interviews administered to 5383 men and 6167 women, 25–64 years of age,
living in the following cities: Barquisimeto, Venezuela; Bogota, Colombia; Buenos Aires, Argentina;
Lima, Peru; Mexico City, Mexico; Quito, Ecuador; and Santiago, Chile. Participants also completed
a clinic visit for anthromorphometric and laboratory assessments. Rates of prior diagnosis of
hypertension and diabetes were high (64% and 78% of affected individuals, respectively) but
relatively low for hypercholesterolemia (41%). The majority of affected individuals (hypercholesterolemia 88%, diabetes 67%, and hypertension 53%) were untreated. Among individuals who were
receiving pharmacologic treatment, targets for control of hypertension, diabetes, and hypercholesterolemia were achieved by 51%, 16%, and 52%, respectively. Adherence to treatment was observed
in 69% of individuals with hypertension, 63% with diabetes, and 66% with hypercholesterolemia.
Forgetfulness was the major cause of nonadherence for all 3 conditions. There is a substantial need
for increasing patient education, diagnosis, treatment, adherence, and control of cardiovascular risk
factors in the 7 Latin American cities.