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Rev Port Cardiol. 2008 Dec;27(12):1495-529.

Metabolic syndrome in Portugal: prevalence and implications for cardiovascular risk--results from the VALSIM Study.

[Article in English, Portuguese]

Collaborators (830)

Dias AD, Neves AS, Frazão A, Pereira AA, Do Vale AF, Dias Simas AM, Estrela C, Amorim EA, Almeida FE, Amaral GM, Silva IM, Sousa JM, Morgado JM, Santos JC, Senra JF, Amaral LG, Aleixo LG, Soares LM, Cafede MC, Colleo MO, Senra MC, Ramiro MJ, Borges MM, Amaral PN, Andrade RM, Costa RP, Conde AI, Rodrigues A, Santana A, Morais AS, Cardoso AA, Barros A, Perez A, Matias A, Carina A, Cardoso AM, Dinis AR, Santana A, Baltazar A, Vieira AJ, Farias AM, Martins AV, Magalhães AM, Graça BR, Neves C, Oliveira C, Aparício CT, Macedo C, Lincho C, Santos C, Branco C, Santos CA, Carvalho DS, Pereira E, Hermenegildo E, Nora F, Praça FG, Fardilha FM, Martins F, Conceição GM, Torres HM, Pinho H, Duque I, Ferreira I, Lapa I, Sousa IM, Sarmento JM, Fernandes J, Pousa J, Neves L, Silva L, Abrantes MC, Veiga ME, De Melo MH, Valente MJ, Maia MM, Pinho MO, Miller MA, Santos MN, Matos M, Albuquerque MS, Cavaco M, Almeida MC, Sousa MJ, Correia P, Mota R, Duarte R, Mateus R, Ribeiro R, Almeida SI, Catarino SM, De Sá Ferreira VM, Almeida CB, Agostinho C, Ingrig I, Martinho LC, Marinho MA, Feitas MC, Silva MG, Brito MM, Silva MT, Mourão A, Lopes A, Monteiro AJ, Grownan AM, Cunha AP, Soutelino A, Carvalho AF, Gomes AR, Falcão C, Carvalho DM, Zenha FM, Rodrigues FB, Andrade H, Rego JA, Lourenço J, Ferreira JA, Almeida JM, Ramos JT, Antunes L, Boto LE, Marquês L, Ferreira LM, Miguel MA, Dias MA, Faria MC, Portela ME, Peixoto MF, Oliveira MG, Teixeira MJ, Costa MN, Figueiredo MT, Andrade M, Souza M, Millet MO, Miguel MA, Mendonça MJ, Silva OF, Leston R, Armada R, Soares RM, Teixeira R, Castro S, Fonseca T, Lopes TA, Direito A, Vaz A, Pimentel A, Baia I, Abegon IM, Pinto MC, Soledade M, Furriel T, Grilo AD, Pombo AM, Reis AM, Ferreira AS, Bento AN, Reboredo C, Figueiredo CM, Rato EP, Gago FF, Brito FH, Nunes JA, De Lima JC, Guerra JN, Alves JM, Gouveia J, Ramos JA, Rodrigues L, Elvas LA, Pego MA, Amaral MA, Rodrigues MB, Batista MC, Simões MF, Calvário ME, Clarinha MJ, Amaral MF, Ferreira MH, Lima MM, Loureiro MG, Craveiro SC, Mendes TM, Pedroso T, Queiroz V, Morgado Z, Novo AJ, Grilo AM, Moura AC, Pita AF, Vieira AM, Vaz AM, Cordeiro AP, Dinis AR, Moreira AT, Baltazar A, Silva AJ, Pereira AJ, Garret AV, Farias AM, Santos A, Martins AV, Graça BR, Sergio CI, Guardado CS, Bettencourt CI, Vicente C, Carvalho DS, Pereira EN, Monteiro EG, Seabra F, Rocha G, Ferreira HJ, Pinho H, Carvalho I, Duque I, Tomé I, Dias IM, Cardão J, Arcanjo JC, Sarmento JM, Parra L, Cortesão LB, Santos MC, Santos MS, Rodrigues MA, Cabral MC, Abrantes MC, Sousa MD, Almeida Mdo C, Nina ME, Leal MF, Neto MG, Carvalho MH, Sequeira MH, Simões MH, Lopes MJ, Celavisa MM, Santos MM, Cerqueira MZ, Rodrigues MA, Pinto MA, Carvalho Mdo C, Gouveia MF, França MF, Simões MH, Viegas MI, Trindade MJ, Valente MJ, Miranda MM, Vicente MO, Cerqueira MZ, Pereira MD, Sousa MJ, Pinguel MF, Mauricio NM, Costa P, Sousa PR, Ferreira RF, Januário SC, Pascoal T, Lourenço AA, Palácios CF, Crujo FJ, Caeiro HJ, Real HM, Marques JG, Fonseca JM, Vieira JV, Leitão L, Carvalho MA, Fernandes MG, Martins MR, Amaral MV, Silva OM, Carvalho RM, Baptista ST, Vale AP, Vicente A, Stiwell AV, Caetano A, Maria AJ, Silva AV, Pinheiro C, Santana C, Gaspar D, Machado E, Santos E, Rita FJ, Pinto FE, Viegas I, Santos JR, Pina J, Santos JO, Barros JV, Sanchez JH, Berrocal JH, Correia J, Santos L, Cavaco L, Simão MC, Ferreira MC, Barroso MD, Mora MG, Agostinho MM, Ramos M, Godinho M, Pinto MD, Albergaria MJ, Santos ML, Salas ML, Rollo OS, Simoes PA, Silva S, Lopes AN, Ferreira AS, Guerra JM, Gouveia JM, Rodrigues LA, Amaral L, Amaral MA, Grilo MA, Clara MJ, Ferreira MH, Cunha MR, Pereira MC, Gomes MF, Pedroso TM, Queiroz VA, Morgado ZM, Grilo A, Mota AR, Barros AM, Wilson AP, Lucas AF, Silva A, Spencer BD, Ferreira CA, Gaspar CI, Aguiar C, Alves CM, Velho DA, Coutinho GI, Pinto GM, Ribeiro H, Pereira IT, Quadrado JA, Pires JM, Casquilho L, Rodrigues MA, Ferreira MF, Pais MF, Leitão MF, Magalhães MG, Cabral MG, Cruz MI, Magalhães MG, Samora MJ, Rocha ML, Sa Marques MM, Patricio MP, Carvalho MJ, Antunes PA, Verde VM, Estudante A, Rosa A, Farinha A, Isabel A, Carvalho AI, Franco AI, Roque CV, Freitas AM, Oliveira IG, Moinhos AM, Gouveia AM, Cavaleiro AM, Ribeiro AM, Real AM, Pestana AP, Fonseca AP, Araujo A, Marques A, Dumiense AG, Macedo AJ, Farinha A, Sacardando C, Pereira C, Duarte Coimbra CL, Paiva CA, Ripado C, Banha CP, Duarte C, Legrant C, Silva CF, Dumiense, Fernandes C, Barradas C, Fervenca C, Deus GR, Marques CM, Duarte EP, Marques EP, Vaz EL, Guerreiro E, Beirolas F, Mata FE, Almeida F, Silva FS, Santos G, Febra H, Gago HM, Pontes H, Coutinho HM, Nascinmento HJ, Almeida IJ, Castelão I, Rebelo IA, Ferreira I, Pereira JL, Silva JB, Robalo JM, Brito JR, Palma J, Barata JF, Pronto J, Cortez JC, Falcão JM, Neves J, Silva LF, Rodrigues L, Martinho L, Martins L, Palma L, Romeiro L, Safara L, Rosmaninho M, Soares MS, Ripado M, Cruz M, Serra M, Dias MA, Pereira MA, Albuquerque MA, Fernandes MA, Afonso MC, Cunha MC, Dias MC, Moita MC, Dores M, Trindade MD, Fonseca ME, Almeida ME, Goncalves MF, Galvão MF, Moura MF, Ferreira MC, Lopes MF, Lima MF, Dias Agudo MH, Madeira MI, Mendes MI, Braisinha MI, Tavares MI, Carvalho MJ, Ferreira MJ, Almiro MJ, Bessa MJ, Jorge MJ, Verdasca PP, Luis MJ, Gordo MJ, Gonçalves MJ, Faro ML, Bento ML, Tiago ML, Ribeiro MM, Perestrelo MM, Santos MM, Anjos MM, Henriques MM, Lopes MM, Castro MR, Lopes MR, Caetano MS, Franco MT, Laginha MT, Lopes MT, Mota MT, Silva MV, Soares MS, Almiro MJ, Matos MR, Gonçalves O, Miranda OF, Marques PM, Matias P, Mourão P, Rafael PP, Pereira P, Pestana, Fonseca R, Gallego R, Braz R, Barreiro S, Correia SC, Gimenez SM, Marques SM, Oliveira TC, Gonçalves T, Libório T, Navarro T, Pitta T, Feijó TV, Vargas T, Silva VM, Pita AF, Sá A, Paulino A, Andrade CB, Correia E, Araújo J, Freitas JC, Abreu L, Remédios MT, Costa M, Rodrigues R, Almeida R, Freitas S, Sanches S, Telesfóro AA, Romero AP, Martins AZ, Barrigas CL, Dias DF, Lopes ES, Rodrigues F, Pinto IM, Martins JB, Lucas JA, Cabaço JA, Oliveira MA, Silva MC, Rodrigues MC, Rodrigues MG, Pereira ML, Campos MT, Braz RP, Carneiro A, Fernandes A, Ramos A, Ferreira A, Martins A, Mendes A, Teixeira A, Sardinha A, Pinto AS, Coutinho A, Girão A, Lemos AP, Pena A, Tavares AC, Ferreira A, Cardoso A, Sá Leite B, Pais B, Palmeirão CM, Dias C, Rio C, Costa C, Lobo C, Outeirinho C, Pinto C, Costa DM, Sobral D, Borges D, Teixeira E, Diogo E, Pousada E, Lemos E, Loureiro E, Sá F, Ramoa F, Tavares F, Campos F, Ferreira F, Albano F, Porfírio F, Costa F, Cruz F, Lopes GA, Granchinho G, Pinto HM, Martins H, Sousa H, Almeida H, Lobo I, Campos IP, Pereira IM, Machado I, Santos I, Freitas J, Magalhaes JM, Aleixo JA, Lima JL, Pereira JA, Silva J, Jerónimo L, Moreira LM, Cabaços M, Soares MA, Ribeiro MC, Morais MC, Cardoso MC, Magalhães MC, Aleixo MC, Varzielas MC, Figueiredo MC, Sousa MC, Arez Mdel P, Lima ME, Silva ME, Teixeira ME, Loureiro MF, Vieira MF, Silva MG, Campos MG, Neto MJ, Tenente MJ, Rosas MJ, Couto ML, Bessa ML, Figueira ML, Vasconcelos ML, Amaral ML, Ruivo MM, Dias MM, Varela MD, Viana MM, Santos MM, Fontoura MM, Maldonado Mdo C, Rosas MJ, Eira MM, Alves MP, Morais M, Almeida M, Ferreira M, Pinto M, Husgen M, Montenegro MA, Martins M, Costa O, Moreira P, Pissarra P, Pereira PM, Fragua R, Assunção RM, Ferreira RS, Assunção R, Guimaraes SP, Guidi S, Silva SM, Medon R, Duarte RV, Coelho RS, Pinto RS, Pisco S, Brito T, Valente V, Viegas V, Flauzino EO, Dias JM, Correia P, Lopes R, Telhada T, Simplício A, Sousa A, Victor A, Jesuino AC, Duarte AL, Santos AB, Torres A, Dias A, Dias C, Branco CM, Perico CM, Portela C, Rodrigues I, Silva I, Pereira IM, Cunha I, Torre JA, Ratia JC, Da Silva JC, Emanuel J, Pedro J, Adrião JC, Antunes LB, Parames M, Lopes MC, Morgado MC, Romero M, Santos MF, Alves MH, Miguel MI, Serrão MJ, Marques M, Ventura MM, Barbado MM, Capaz MO, Ferreira MP, Oliveira MR, Rosa MT, Rato MT, Parreira MZ, Oliveira MA, Costa M, Pedroso N, Abreu P, Da Silva PA, Dias PM, Soares R, Tomás R, Canário R, Oliveira S, Antunes T, Afonso V, Loureiro AC, Machado AM, Vale A, Cardoso AE, Cardoso A, Santos A, Vieira A, Oliveira A, Aparicio C, Oliveira C, Catarino C, Faustino C, Santos C, Alves E, Fardilha F, Arranz FL, Bouças G, Lopes G, Praça F, Estrada H, Torres HB, Beça H, Alves IA, Pombo I, Rosa IR, Pinto JA, Albuquerque M, Alvarez MA, Pinheiro MB, Abreu MC, Sampaio MC, Veiga ME, Veiga MF, Morais MI, Matos ML, Oliveira MH, Melo MH, Maia MM, Catarino MV, Pires ML, Otero MC, Franco M, Silva P, Correia P, Almeida SI, Catarino S, Ribeiro R, Sá Ferreira V, Rodrigues AF, Costa AA, Lacerda A, Sousa AV, Guerra C, Baia I, Medeiros JH, Cardão J, Cardoso L, Martins L, Oliveira LL, Amaral L, Seixas L, Direito MA, Gorete M, Lamas MM, Veloso MM, Soledade M, Almeida AP, Loureiro AM, Quintela AM, Coelho AA, Semedo A, Costa AA, Lopes AN, Peres AC, Carvalho B, Rosa C, Aguiar C, Sancho EP, Cravino E, Martins GM, Nunes H, Sousa H, Palma H, Rodrigues I, Santos JC, Ferreira JJ, Cardoso LM, Lourenço MC, Brito MG, Pereira ME, Pereira MJ, Santos ML, Ferreira ML, Botelho ML, Ferreira MM, Cunha MR, Gomes MF, Guimarães M, Ferreira MM, Ministro T, Camurça T, Fernandes V.

Abstract

INTRODUCTION:

The metabolic syndrome (MS) is a constellation of risk factors of metabolic origin that is associated with increased risk of type 2 diabetes mellitus (DM) and cardiovascular disease (CVD). Several regional studies have been conducted to determine its prevalence, but they are insufficient to determine the situation nationally or to characterize overall cardiovascular risk in Portugal.

OBJECTIVE:

To determine the prevalence of MS and each of its components in adult primary health care users in Portugal.

METHODS:

The VALSIM Study, involving 719 general practitioners (GPs), was performed in a primary care setting, based on stratified distribution and proportional to the population density of each region of mainland Portugal and the islands of Madeira and the Azores. The first two adult patients scheduled for an appointment on a given day were invited to participate, irrespective of the reason for the consultation. After informed consent was obtained, a questionnaire on sociodemographic, clinical and laboratory data was completed by the GP. A previous diagnosis of coronary artery disease (CAD), stroke or DM was identified by the GP based on medical records. A diagnosis of MS was defined according to the NCEP ATP III criteria. Logistic regression multivariate analysis was used to assess the risk of MS according to age, body mass index (BMI), waist circumference (WC) and region of residence for each gender, and to determine the association of CAD, stroke and DM with gender, age, BMI, WC, blood pressure and previous diagnosis of hypertension (HT), fasting glucose and previous diagnosis of DM.

RESULTS:

The study included 16,856 individuals (mean age 58.1+/-15.1 years, 18-96 years; 61.62% women). The prevalence of MS adjusted for gender, age and size of region was 27.5% and showed regional variations, being highest in the Alentejo (30.99%) and lowest in the Algarve (24.42%). MS was more common among women and increased with age, BMI and WC. Independent protective factors were residence in the Algarve (odds ratio [OR]: 0.78; 95% confidence interval [CI] 0.66-0.92 p=0.002) or in Lisbon and Tagus Valley (OR: 0.83, 95% CI 0.77-0.91, p<0.001), while residence in the Northern (OR: 1.11; 95% CI 1.01-1.21, p=0.03) or Central regions (OR: 1.08; 95% CI 1.002-1.16, p=0.045) was an independent risk factor after correction for gender and age. MS was linked to increased prevalence of HT (OR: 3.88; 95% CI 3.61-4.18, p<0.001), and high blood pressure was the most frequent MS component, particularly in men (93.7%). MS was the most powerful factor associated with a diagnosis of DM, particularly in women (OR 7.23; 95% CI 6.22-8.40, p<0.001). Although there was a strong association between MS and CAD (OR: 1.16; 95% CI 1.01-1.34, p=0.043), the most potent risk factor associated with CVD was HT.

CONCLUSIONS:

The prevalence of MS in Portugal is high (27.5%) and is strongly linked to the occurrence of CVD, and in particular to DM. These results highlight the need to implement preventive strategies for reducing overall cardiovascular risk in the Portuguese population.

PMID:
19280993
[Indexed for MEDLINE]
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