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Determinantes clínicos y sociales del riesgo cardiovascular en una población con enfermedades crónicas no transmisibles en Maicao - La Guajira, Colombia. 2024

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dc.contributor.advisorRamírez Alexandra, Porras
dc.contributor.authorAngarita Melo, Paula Tatiana
dc.contributor.authorPanche Castellanos, Karen
dc.contributor.authorRizo Tello, Victor Zein
dc.contributor.authorForero Torres, Ana Yibby
dc.contributor.orcidAngarita Melo, Paula Tatiana [0009-0002-8783-0666]
dc.date.accessioned2025-07-21T16:23:32Z
dc.date.available2025-07-21T16:23:32Z
dc.date.issued2025-06
dc.description.abstractAntecedentes: Las enfermedades cardiovasculares (ECV) son la principal causa de mortalidad en Colombia, con especial impacto en regiones vulnerables como Maicao, La Guajira. Esta zona presenta condiciones socioeconómicas, ambientales y culturales que pueden aumentar el riesgo cardiovascular, especialmente en población con enfermedades crónicas no transmisibles (ECNT). Objetivo: Caracterizar el riesgo de ECV mediante la escala de Framingham y analizar sus determinantes clínicos y sociales en personas con diagnóstico de hipertensión arterial y/o diabetes mellitus tipo 2. Métodos: Estudio de corte transversal analítico en 273 participantes adscritos a programas de ECNT. Se aplicó encuesta estructurada y se tomaron mediciones antropométricas, bioquímicas y de presión arterial. Se estimó el riesgo de ECV a 10 años con la escala de Framingham. Se utilizó regresión logística multivariable para identificar factores asociados al riesgo. Resultados: El 16.85% de los participantes presentó riesgo cardiovascular elevado, con mayor prevalencia en mujeres (23.5% vs. 3.3%; p < 0.01). Las mujeres mostraron mayor frecuencia de obesidad (46.45%) y obesidad abdominal (89.07%). El riesgo de ECV se asoció significativamente con diabetes mellitus tipo 2 (OR: 21.87; IC95%: 6.96 – 68.71; p < 0.001), presión arterial elevada (OR: 16.04; IC95%: 3.15 – 81.69; p = 0.001) y devengar un salario mensual (OR: 4.62; IC95%: 1.56 – 13.64; p = 0.006). Niveles normales de colesterol HDL (OR: 0.21; IC95%: 0.07–0.61) y el sexo masculino (OR: 0.03; IC95%: 0.007–0.16) se comportaron como factores protectores. Conclusiones: El riesgo cardiovascular en esta población está condicionado por determinantes clínicos y sociales interrelacionados, especialmente en mujeres. Se recomienda adaptar intervenciones preventivas al contexto local, reforzar la atención primaria con enfoque intercultural, e implementar escalas de riesgo validadas para poblaciones vulnerables.
dc.description.abstractenglishBackground: Cardiovascular diseases (CVDs) are the leading cause of mortality in Colombia, with a particular impact in vulnerable regions such as Maicao, La Guajira. This area presents socioeconomic, environmental, and cultural conditions that can increase cardiovascular risk, especially in populations with chronic noncommunicable diseases (CNCDs). Objective: To characterize CVD risk using the Framingham Score and analyze its clinical and social determinants in people diagnosed with high blood pressure and/or type 2 diabetes mellitus. Methods: A cross-sectional analytical study was conducted in 273 participants enrolled in NCCD programs. A structured survey was administered, and anthropometric, biochemical, and blood pressure measurements were taken. Ten-year CVD risk was estimated using the Framingham Score. Multivariate logistic regression was used to identify factors associated with risk. Results: 16.85% of participants presented high cardiovascular risk, with a higher prevalence in women (23.5% vs. 3.3%; p < 0.01). Women showed a higher frequency of obesity (46.45%) and abdominal obesity (89.07%). The risk of CVD was significantly associated with type 2 diabetes mellitus (OR: 21.87; 95% CI: 6.96–68.71; p < 0.001), high blood pressure (OR: 16.04; 95% CI: 3.15–81.69; p = 0.001) and earning a monthly salary (OR: 4.62; 95% CI: 1.56–13.64; p = 0.006). Normal HDL cholesterol levels (OR: 0.21; 95% CI: 0.07–0.61) and male sex (OR: 0.03; 95% CI: 0.007–0.16) were protective factors. Conclusions: Cardiovascular risk in this population is influenced by interrelated clinical and social determinants, especially in women. It is recommended to adapt preventive interventions to the local context, strengthen primary care with an intercultural approach, and implement validated risk scores for vulnerable populations.
dc.description.degreelevelMaestríaspa
dc.description.degreenameMagíster en Epidemiologíaspa
dc.description.sponsorshipInstituto Nacional de Salud de Colombia
dc.format.mimetypeapplication/pdf
dc.identifier.instnameinstname:Universidad El Bosquespa
dc.identifier.reponamereponame:Repositorio Institucional Universidad El Bosquespa
dc.identifier.repourlrepourl:https://repositorio.unbosque.edu.co
dc.identifier.urihttps://hdl.handle.net/20.500.12495/15004
dc.language.isoes
dc.publisher.facultyFacultad de Medicinaspa
dc.publisher.grantorUniversidad El Bosquespa
dc.publisher.programMaestría en Epidemiologíaspa
dc.relation.references1. Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019. J Am Coll Cardiol. 2020;76: 2982–3021. doi:10.1016/j.jacc.2020.11.010
dc.relation.references2. Luengo-Fernandez R, Walli-Attaei M, Gray A, Torbica A, Maggioni AP, Huculeci R, et al. Economic burden of cardiovascular diseases in the European Union: a population-based cost study. Eur Heart J. 2023;44: 4752–4767. doi:10.1093/EURHEARTJ/EHAD583
dc.relation.references3. Kazi DS, Elkind MSV, Deutsch A, Dowd WN, Heidenreich P, Khavjou O, et al. Forecasting the Economic Burden of Cardiovascular Disease and Stroke in the United States Through 2050: A Presidential Advisory From the American Heart Association. Circulation. 2024;150: e89–e101. doi:10.1161/CIR.0000000000001258
dc.relation.references4. Teo KK, Rafiq T. Cardiovascular Risk Factors and Prevention: A Perspective From Developing Countries. Canadian Journal of Cardiology. 2021;37: 733–743. doi:10.1016/j.cjca.2021.02.009
dc.relation.references5. Mocumbi AO. Cardiovascular Health Care in Low- and Middle-Income Countries. Circulation. 2024;149: 557–559. doi:10.1161/CIRCULATIONAHA.123.065717
dc.relation.references6. Departamento Administrativo Nacional de Estadística. Defunciones no fetales año 2023 y año corrido 2024. 2024. Available: https://www.dane.gov.co/files/operaciones/EEVV/2024/19-dic-2024/bol-EEVV-Defunciones-2024pr.pdf
dc.relation.references7. Romero M, Vásquez E, Acero G, Huérfano L, Romero M, Vásquez E, et al. Estimación de los costos directos de los eventos coronarios en Colombia. Revista Colombiana de Cardiología. 2018;25: 373–379. doi:10.1016/J.RCCAR.2018.05.010
dc.relation.references8. Melo-Becerra LA, Arango-Thomas LE, Ávila-Montealegre Ó, Ayala-García J, Bonilla-Mejía L, Botero-García JA, et al. Aspectos financieros y fiscales del sistema de salud en Colombia. Ensayos sobre Política Económica. 2023; 1–92. doi:10.32468/espe106
dc.relation.references9. Corte Constitucional de Colombia. Sentencia T-302-17 . 2017 [cited 23 Jan 2025]. Available: https://www.corteconstitucional.gov.co/relatoria/2017/t-302-17.htm
dc.relation.references10. Londoño-Ortega E, Gonzáles L, Criollo D. Crisis humanitaria en la Guajira. Planeación y Desarrollo. 2023. Available: https://colaboracion.dnp.gov.co/CDT/PublishingImages/Planeacion-y-desarrollo/2023/agosto/pdf/2023-08-25_Art3_PyD.pdf. Accessed 30 Jan 2025.
dc.relation.references11. Gobernación de La Guajira. Análisis de situación de salud participativo 2023. Departamento de La Guajira. 2024. Available: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/PSP/asis-la-guajira-2023.zip
dc.relation.references12. Ministerio de Salud. Reportes Caracterización SISPRO. [cited 24 Jan 2025]. Available: https://rssvr2.sispro.gov.co/Caracterizacion/
dc.relation.references13. Ministerio de Salud y Protección Social. Plan Decenal de Salud Pública 2022-2031. 2022.
dc.relation.references14. KANNEL WB, DAWBER TR, KAGAN A, REVOTSKIE N, STOKES J. Factors of Risk in the Development of Coronary Heart Disease—Six-Year Follow-up Experience. Ann Intern Med. 1961;55: 33–50. doi:10.7326/0003-4819-55-1-33
dc.relation.references15. Stewart A, Marfell-Jones M, Olds T, De Ridder J. International Standards for Anthropometric Assessment. Potchefstroom, South Africa, ISAK. 2011.
dc.relation.references16. World Health Organization. Obesity and overweight. 2024 [cited 30 Jan 2025]. Available: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
dc.relation.references17. Ministerio de Salud y Protección Social. Resolución 2465 de 2016. Colombia; 2016.
dc.relation.references18. McEvoy JW, McCarthy CP, Bruno RM, Brouwers S, Canavan MD, Ceconi C, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024;45: 3912–4018. doi:10.1093/eurheartj/ehae178
dc.relation.references19. García-Peña A, Buitrago-Sandoval A, Álvarez-Jaramillo M, Buelvas Herazo J, Duque-González L, Gálvez M, et al. Consenso colombiano para el diagnóstico y tratamiento de las dislipidemias en adultos. Revista Colombiana de Cardiología. 2024;31: 3–66. Available: https://rccardiologia.com/portadas/rcc_24_31_supl-4.pdf
dc.relation.references20. Chen SC, Su HM, Tsai YC, Huang JC, Chang JM, Hwang SJ, et al. Framingham risk score with cardiovascular events in chronic kidney disease. PLoS One. 2013;8. doi:10.1371/JOURNAL.PONE.0060008
dc.relation.references21. Ministerio de Salud y Protección Social de Colombia. Resolución 3280 de 2018. 2018.
dc.relation.references22. Çorbacıoğlu ŞK, Aksel G. Receiver operating characteristic curve analysis in diagnostic accuracy studies: A guide to interpreting the area under the curve value. Turk J Emerg Med. 2023;23: 195–198. doi:10.4103/TJEM.TJEM_182_23
dc.relation.references23. Álvarez-Castaño LS, Goez-Rueda JD, Carreño-Aguirre C. Factores sociales y económicos asociados a la obesidad: los efectos de la inequidad y de la pobreza. Revista Gerencia y Políticas de Salud. 2012;11: 98–110. Available: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S1657-70272012000200006&lng=en&nrm=iso&tlng=es
dc.relation.references24. Lopez-Lopez JP, Cohen DD, Alarcon-Ariza N, Mogollon-Zehr M, Ney-Salazar D, Chacon-Manosalva MA, et al. Ethnic Differences in the Prevalence of Hypertension in Colombia: Association With Education Level. Am J Hypertens. 2022;35: 610–618. doi:10.1093/ajh/hpac051
dc.relation.references25. Pan American Health Organization (PAHO). Nine Latin American and Caribbean countries intensify efforts to curb obesity with PAHO support. 4 Mar 2025 [cited 6 Jul 2025]. Available: https://www.paho.org/en/news/4-3-2025-nine-latin-american-and-caribbean-countries-intensify-efforts-curb-obesity-paho-0
dc.relation.references26. Melo G, Aguilar-Farias N, López Barrera E, Chomalí L, Moz-Christofoletti MA, Salgado JC, et al. Structural responses to the obesity epidemic in Latin America: what are the next steps for food and physical activity policies? The Lancet Regional Health - Americas. 2023;21: 100486. doi:10.1016/j.lana.2023.100486
dc.relation.references27. Beazer JD, Freeman DJ. Estradiol and HDL Function in Women - A Partnership for Life. J Clin Endocrinol Metab. 2022;107: e2192–e2194. doi:10.1210/clinem/dgab811
dc.relation.references28. Zurique Sánchez MS, Zurique Sánchez CP, Camacho López PA, Sanchez Sanabria M, Hernández Hernández SC. Prevalencia de hipertensión arterial en Colombia. Acta Médica Colombiana. 2019;44. doi:10.36104/amc.2019.1293
dc.relation.references29. Meneses-Urrea LA, Vaquero-Abellán M, Villegas Arenas D, Benachi Sandoval N, Hernández-Carrillo M, Molina-Recio G. Factors Associated with Dietary Patterns in Colombia. Nutrients. 2023;15: 2079. doi:10.3390/nu15092079
dc.relation.references30. Mosquera PA, San Sebastian M, Waenerlund A-K, Ivarsson A, Weinehall L, Gustafsson PE. Income-related inequalities in cardiovascular disease from mid-life to old age in a Northern Swedish cohort: A decomposition analysis. Soc Sci Med. 2016;149: 135–144. doi:10.1016/j.socscimed.2015.12.017
dc.relation.references31. Kucharska-Newton AM, Harald K, Rosamond WD, Rose KM, Rea TD, Salomaa V. Socioeconomic Indicators and the Risk of Acute Coronary Heart Disease Events: Comparison of Population-Based Data from the United States and Finland. Ann Epidemiol. 2011;21: 572–579. doi:10.1016/j.annepidem.2011.04.006
dc.relation.references32. Lucumi DI, Schulz AJ, Roux AVD, Grogan-Kaylor A. Income inequality and high blood pressure in Colombia: a multilevel analysis. Cad Saude Publica. 2017;33. doi:10.1590/0102-311x00172316
dc.relation.references33. Hessel P, Rodríguez-Lesmes P, Torres D. Socio-economic inequalities in high blood pressure and additional risk factors for cardiovascular disease among older individuals in Colombia: Results from a nationally representative study. PLoS One. 2020;15: e0234326. doi:10.1371/journal.pone.0234326
dc.relation.references34. Popkin BM, Reardon T. Obesity and the food system transformation in <scp>Latin America</scp>. Obesity Reviews. 2018;19: 1028–1064. doi:10.1111/obr.12694
dc.relation.references35. Kern DM, Auchincloss AH, Stehr MF, Diez Roux A V., Moore KA, Kanter GP, et al. Neighborhood price of healthier food relative to unhealthy food and its association with type 2 diabetes and insulin resistance: The multi-ethnic study of atherosclerosis. Prev Med (Baltim). 2018;106: 122–129. doi:10.1016/j.ypmed.2017.10.029
dc.relation.references36. Hovingh GK, Rader DJ, Hegele RA. HDL re-examined. Curr Opin Lipidol. 2015;26: 127–132. doi:10.1097/MOL.0000000000000161
dc.relation.references37. Popkin BM, Reardon T. Obesity and the food system transformation in Latin America. Obesity Reviews. 2018;19: 1028–1064. doi:10.1111/obr.12694
dc.relation.references38. Buscot M-J, Thomson RJ, Juonala M, Sabin MA, Burgner DP, Lehtimäki T, et al. Distinct child-to-adult body mass index trajectories are associated with different levels of adult cardiometabolic risk. Eur Heart J. 2018;39: 2263–2270. doi:10.1093/eurheartj/ehy161
dc.relation.references39. Elston DM. Survivorship bias. J Am Acad Dermatol. 2021. doi:10.1016/j.jaad.2021.06.845
dc.relation.references40. Joseph P, Lanas F, Roth G, Lopez-Jaramillo P, Lonn E, Miller V, et al. Cardiovascular disease in the Americas: the epidemiology of cardiovascular disease and its risk factors. The Lancet Regional Health - Americas. 2025;42: 100960. doi:10.1016/j.lana.2024.100960
dc.relation.references41. Santana-Jiménez MA, Nieves-Barreto LD, Montaño-Rodríguez A, Betancourt-Villamizar C, Mendivil CO. Consumption of Sugary Drinks among Urban Adults in Colombia: Association with Sociodemographic Factors and Body Adiposity. Int J Environ Res Public Health. 2023;20: 3057. doi:10.3390/ijerph20043057
dc.relation.references42. Vera-Ponce VJ, Loayza-Castro JA, Zuzunaga-Montoya FE, Vásquez-Romero LEM, Sanchez-Tamay NM, Bustamante-Rodríguez JC, et al. Abdominal obesity prevalence in Latin America: a systematic review and meta-analysis comparing ATP III and IDF criteria. Front Endocrinol (Lausanne). 2025;16. doi:10.3389/fendo.2025.1562060
dc.relation.references43. Ho FK, Gray SR, Welsh P, Gill JMR, Sattar N, Pell JP, et al. Ethnic differences in cardiovascular risk: examining differential exposure and susceptibility to risk factors. BMC Med. 2022;20: 149. doi:10.1186/s12916-022-02337-w
dc.relation.references44. Hemann BA, Bimson WF, Taylor AJ. The Framingham Risk Score: An Appraisal of Its Benefits and Limitations. American Heart Hospital Journal. 2007;5: 91–96. doi:10.1111/j.1541-9215.2007.06350.x
dc.relation.references45. Hageman S, Pennells L, Ojeda F, Kaptoge S, Kuulasmaa K, de Vries T, et al. SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe. Eur Heart J. 2021;42: 2439–2454. doi:10.1093/eurheartj/ehab309
dc.rightsAttribution-NonCommercial-ShareAlike 4.0 Internationalen
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.accessrightshttps://purl.org/coar/access_right/c_abf2
dc.rights.localAcceso abiertospa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/
dc.subjectRiesgo cardiovascular
dc.subjectEnfermedades crónicas no transmisibles
dc.subjectHipertensión arterial
dc.subjectDiabetes mellitus tipo 2
dc.subjectFactores sociales en salud
dc.subjectObesidad
dc.subjectFramingham
dc.subjectLa Guajira
dc.subjectSalud pública
dc.subjectInequidades en salud
dc.subject.keywordsCardiovascular risk
dc.subject.keywordsChronic non-communicable diseases
dc.subject.keywordsArterial hypertension
dc.subject.keywordsType 2 diabetes mellitus
dc.subject.keywordsSocial factors in health
dc.subject.keywordsObesity
dc.subject.keywordsFramingham
dc.subject.keywordsLa Guajira
dc.subject.keywordsPublic health
dc.subject.keywordsHealth inequalities
dc.subject.nlmWA 105
dc.titleDeterminantes clínicos y sociales del riesgo cardiovascular en una población con enfermedades crónicas no transmisibles en Maicao - La Guajira, Colombia. 2024
dc.title.translatedClinical and social determinants of cardiovascular risk in a population with chronic noncommunicable diseases in Maicao, La Guajira, Colombia. 2024
dc.type.coarhttps://purl.org/coar/resource_type/c_bdcc
dc.type.coarversionhttps://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.type.localTesis/Trabajo de grado - Monografía - Maestríaspa

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