[National Re-survey of Arterial Hypertension (RENAHTA). Mexican consolidation of the cardiovascular risk factors. national follow-up cohort].
OBJECTIVE
Based on a National Re-survey on Hypertension (HTA) and other cardiovascular risk factors performed in Mexico during 2003 and 2004 in the adult population with HTA, as identified in the 2000 National Survey of Health, this study was planed to determine: 1) morbidity and mortality rates; 2) the incidence and interrelation with other risk factors, such as overweight, obesity, dyslipidemia, nephropathy and diabetes; 3) the main risk factors associated to HTA involved in its complications, need for hospitalization and number of days; and, 4) the degree of therapeutical adhesion and the type of antihypertensive drugs used.


METHODS
The survey was of type III using the step by step method described by WHO. Sampling was weighed a priori taking into account a national prevalence average of HTA of 30.05% and its corresponding rate for each federal state. Permissible maximum error in the estimation = 0.28. Effect of design = 4.5; and, Rate of awaited answer (0.70).


RESULTS
From the initial 14,567 interviewed patients, 1,165 (8%) subjects were considered non-hypertensive or false positives at the 2000 survey. From the 13,402 remaining patients, 335 died during the first 2 years of pursuit, which implies an annual mortality of approximately 1.15% in the hypertensive population. Thus, 13,067 survivors were subjected to the final analysis. The mean age at the re-survey was 45.6 +/- 12.6; 40.5% were men (n = 5,295). There was a statistically significant difference in height, but not in weight between both genders. The control HTA was raised 14.6% in the year 2000 and 19.2% in 2004. The prevalence of diabetes was duplicated from 16% to 30% (< .001). Fifty four percent of the whole population required hospitalization at least once during the period of study. The rates of overweight, obesity, and dyslipidemia rose significantly (p < 0.05) independently from age, federal state, and gender.


CONCLUSIONS
RENAHTA shows the impact of hypertension on the morbidity and mortality during the 3.1 +/- 1.5 years of follow-up in Mexico. It alerts us on the need to reinforce the strategies of attention and prevention of this crucial risk factor and of screening the dynamic nonlinear interaction between the main cardiovascular risk factors in Mexico. New hypotheses are proposed for the metabolic syndrome.
Rosas Peralta
Martín
M
Cardiología Clínica- 3er Piso, Instituto Nacional de Cardiología "lgnacio Chávez", Juan Badiano #1, Col. Sección XVI, Delegación Tlálpan, C.R 14080, México, DF. martinrp02@yahoo.com.mx
Lara Esqueda
Agustín
A
Pastelín Hernández
Gustavo
G
Velázquez Monroy
Oscar
O
Martínez Reding
Jesús
J
Méndez Ortiz
Arturo
A
Lorenzo Negrete
José-Antonio
JA
Lomelí Estrada
Catalina
C
González Hermosillo
Antonio
A
Herrera Acosta
Jaime
J
Tapia Conyer
Roberto
R
Attie
Fause
F
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors