Luis Rosero Bixby
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Item Diabetes mellitus en adultos mayores costarricenses(Población y Salud en Mesoamérica. Revista Electrónica, Vol. 5(1), artículo 2, 2007) Brenes Camacho, Gilbert; Rosero Bixby, LuisPoblación y Salud en Mesoamérica - Volumen 5, número 1, artículo 2, jul - dic 2007 Número especial CRELES - Costa Rica: Estudio de Longevidad y Envejecimiento Saludable http://ccp.ucr.ac.cr/revista/ 2Diabetes mellitus en adultos mayores costarricenses1Gilbert Brenes-Camacho2, Luis Rosero-Bixby3RESUMEN El propósito del artículo es describir la prevalencia de la diabetes mellitus (DM) entre los adultos mayores costarricenses. Se analiza la magnitud de la prevalencia, los problemas de medición de la misma, así como los factores asociados con la enfermedad, la enfermedad controlada, y el tener niveles altos de hemoglobina glicosilada (HbA1C) entre la población sin diagnóstico previo de DM. Una cuarta parte de los adultos mayores de Costa Rica padecen de DM y cerca de la mitad de los que la padecen, no la tienen controlada. Los factores asociados con la prevalencia de la enfermedad son los usuales destacados por la literatura científica: actividad física, obesidad e historia familiar de DM. Se halla evidencia de un posible problema de acceso diferencial a servicios de control de DM, ya que los adultos mayores que habitan fuera de la gran área metropolitana de San José tienen un riesgo menor de tener controlada su enfermedad. Los adultos mayores sin pensión también tienen un riesgo mayor de tener niveles altos de HbA1C.Item Prevalencia de hipertensión en adultos mayores de Costa Rica(Población y Salud en Mesoamérica; Volumen 5, Número 1, 2007) Méndez Chacón, Ericka; Rosero Bixby, LuisEste artículo estima la prevalencia de hipertensión (controlada y con o sin diagnóstico previo) entre los adultos mayores costarricenses. Valora los problemas de medición y explora los factores asociados con la enfermedad. Se utilizan datos de una muestra nacional representativa del proyecto CRELES: Costa Rica: Estudio de Longevidad y Envejecimiento Saludable. Se realizaron dos mediciones de la presión arterial con monitores digitales a una muestra de 3000 adultos y se registró el auto reprte de la enfermedad y el uso de medicamentos antihipertensivos. La segunda medición resultó en valores significativamente menores tanto para la presión diastólica como para la sistólica. No se detectaron sesgos en la medición realizada por entrevistador ni por trimestre de trabajo de campo. El 59% de los adultos mayores del país sufre de hipertensión (HTA). La prevalencia es mayor entre las mujeres que entre los hombres. El 16% de todos los adultos mayores no tenían diagnóstico previo de HTA pero en nuestras mediciones resultaron con HTA. Los principales co-factores de HTA identificados en este artículo son: edad, estar asegurado, el índice de masa corporal, los antecedentes familiares, tener menos de 6 años de educación formal, ser fumador activo y consumir más de 3000 calorías al día.Item Differences in the association of cardiovascular risk factors with education: a comparison of Costa Rica (CRELES) and the USA (NHANES)(J Epidemiol Community Health 2010: 64, 2009) Rehkopf, David H.; Dow, William H.; Rosero Bixby, LuisBackground Despite different levels of economic development, Costa Rica and the USA have similar mortalities among adults. However, in the USA there are substantial differences in mortality by educational attainment, and in Costa Rica there are only minor differences. This contrast motivates an examination of behavioural and biological correlates underlying this difference. Methods The authors used data on adults aged 60 and above from the Costa Rican Longevity and Healthy Ageing Study (CRELES) (n¼2827) and from the US National Health and Nutrition Examination Survey (NHANES) (n¼5607) to analyse the cross-sectional association between educational level and the following risk factors for cardiovascular disease (CVD): ever smoked, current smoker, sedentary, high saturated fat, high carbohydrates, high calorie diet, obesity, severe obesity, large waist circumference, HDL cholesterol, LDL cholesterol, triglycerides, hemoglobin A1c, fasting glucose, C-reactive protein, systolic blood pressure and BMI. Results There were significantly fewer hazardous levels of risk biomarkers at higher levels of education for more than half (10 out of 17) of the risk factors in the USA, but for less than a third of the outcomes in Costa Rica (five out of 17). Conclusions These results are consistent with the context-specific nature of educational differences in risk factors for CVD and with a non-uniform nature of association of CVD risk factors with education within countries. Our results also demonstrate that social equity in mortality is achieved without uniform equity in all risk factors.Item The Latin American Consortium of Studies in Obesity (LASO)(Obesity Reviews, vol.10(3), 2009) Bautista Lorenzo, Leonelo Enrique; Casas, Juan P.; Herrera Galindo, Víctor Mauricio; Miranda Montero, Jaime J.; Perel, Pablo; Pichardo Estevez, Rafael; González, Angel; Sánchez, José R.; Ferreccio, Catterina; Aguilera Sanhueza, Ximena; Silva, Eglé; Oróstegui, Myriam; Gómez Gutiérrez, Luis Fernando; Chirinos Medina, Julio A.; Medina Lezama, Josefina; Pérez, Cynthia M.; Suárez, Erick; Ortiz Martínez, Ana Patricia; Rosero Bixby, Luis; Schapochnik, Noberto; Ortiz, Zulma; Ferrante, DanielCurrent, high-quality data are needed to evaluate the health impact of the epidemic of obesity in Latin America. The Latin American Consortium of Studies of Obesity (LASO) has been established, with the objectives of (i) Accurately estimating the prevalence of obesity and its distribution by sociodemographic characteristics; (ii) Identifying ethnic, socioeconomic and behavioural determinants of obesity; (iii) Estimating the association between various anthropometric indicators or obesity and major cardiovascular risk factors and (iv) Quantifying the validity of standard definitions of the various indexes of obesity in Latin American population. To achieve these objectives, LASO makes use of individual data from existing studies. To date, the LASO consortium includes data from 11 studies from eight countries (Argentina, Chile, Colombia, Costa Rica, Dominican Republic, Peru, Puerto Rico and Venezuela), including a total of 32 462 subjects. This article describes the overall organization of LASO, the individual studies involved and the overall strategy for data analysis. LASO will foster the development of collaborative obesity research among Latin American investigators. More important, results from LASO will be instrumental to inform health policies aiming to curtail the epidemic of obesity in the region.Item Major cardiovascular risk factors in Latin America: a comparison with the United States. The Latin American consortium of studies in obesity (LASO)(PLOS ONE, vol.8(1), 2013) Miranda Montero, Jaime J.; Herrera Galindo, Víctor Mauricio; Chirinos Medina, Julio A.; Gómez Gutiérrez, Luis Fernando; Perel, Pablo; Pichardo Estevez, Rafael; González Medina, Angel; Sánchez Abanro, José Ramón; Ferreccio, Catterina; Aguilera Sanhueza, Ximena; Silva, Eglé; Oróstegui, Myriam; Medina Lezama, Josefina; Pérez, Cynthia M.; Suárez, Erick; Ortiz Martínez, Ana Patricia; Rosero Bixby, Luis; Schapochnik, Noberto; Ortiz, Zulma; Ferrante, Daniel; Casas, Juan P.; Bautista Lorenzo, Leonelo EnriqueLimited knowledge on the prevalence and distribution of risk factors impairs the planning and implementation of cardiovascular prevention programs in the Latin American and Caribbean (LAC) region. For the last two decades cardiovascular diseases have been the main cause of death in Latin America and the Caribbean (LAC). [1] Cardiovascular mortality rates continue to increase in most LAC countries, and in those countries where rates have declined the blunting of the trend has been considerably lower than in the United Sates (US). [2]. Data on the distribution of cardiovascular risk factors in LAC region are limited, and the few studies available show significant variation in the levels of prevalence. For instance, the CARMELA study, [3] conducted in seven major urban cities from LAC, reprted markedly different hypertension levels. For instance, hypertension prevalence in Santiago (Chile), Buenos Aires (Argentina), and Barquisimeto (Venezuela), ranged from 24% to 29%, whereas in Quito (Ecuador), Bogotá (Colombia), Mexico City (Mexico), and Lima (Peru) varied from 9% to 13%. Yet, diabetes prevalence in these cities was similar to world’s estimates, around 7%. [3] Differences in rural-urban residence, socioeconomic development, and internal migration patterns could partly explain the contrasting profiles of cardiovascular risk factors, but knowledge on this regard is also very limited. This scarcity of data on the distribution of risk factors and, in turn, on their impact on incidence and mortality hampers efforts to curtail the growing epidemic of cardiovascular disease in LAC. In fact, national and regional health policies have been customarily based on estimates of the burden of risk factors and disease that rely heavily on demographic profiles. [4]. Here we reprt the distribution of cardiovascular risk factors using data from population-based studies from eight LAC countries. We also compare the distribution of cardiovascular risk factors in LAC and the US, as a way to illustrate the current stage of LAC in the process of the epidemiological transition. Insight into the specific differences in the distribution of risk factors in the LAC and US populations is important to foresee future trends in cardiovascular morbidity and mortality in the region.