title: Total adult cardiovascular risk in Central America.
abstract: OBJECTIVE
  To evaluate prevalence of cardiovascular risk among adults 40 years and older using population-based samples from six Central American countries.
  
  
  METHODS
  Risk factors were derived from a multi-national cross-sectional survey implemented in 2003-2006, which included a sample of 4 202 participants aged 40 years and older. Charts produced by the World Health Organization and the International Society of Hypertension for the Region of the Americas sub-region B were used to predict risk on the basis of factors including age, sex, blood pressure, total serum cholesterol, smoking status, and diabetes status.
  
  
  RESULTS
  Overall, 85.9% of the population was classified as having < 10% risk for cardiovascular events during the following ten years. The likelihood of being in this risk group decreased with age in both males and females. Four percent of respondents were identified as having > 20% risk. More than 75% of those with a 30-40% risk had previously been identified by health services, and an additional 23% were identified during the study, suggesting they could be diagnosed by opportunistic screening for diabetes, hypertension and hypercholesterolemia. Results of bivariate analysis showed that respondents who were male, older, obese and/or less educated had higher risk for cardiovascular events, but a multivariate analysis including education indicated highest risks for older, obese, and less educated females.
  
  
  CONCLUSIONS
  Measuring cardiovascular disease risk identifies most cases of (or at risk for) diabetes, hypertension and hypercholesterolemia among adults 40 years and older. This strategy can facilitate implementation of control programs and decrease disabilities and premature mortality.
authors.affiliation: Department of Chronic Diseases and Mental Health, Pan American Health Organization, Washington, DC, United States of America, barceloa@paho.org.
authors.forename: A
authors.initials: A
authors.lastname: Barceló
authors.affiliation: Epidemiology and Statistics Branch, Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention.
authors.forename: E W
authors.initials: EW
authors.lastname: Gregg
authors.affiliation: Office of Epidemiology and Surveillance, Caja Costarricense de Seguro Social, San José, Costa Rica.
authors.forename: R
authors.initials: R
authors.lastname: Wong-McClure
authors.affiliation: Faculdade de Ceilândia, Universidade de Brasília.
authors.forename: M
authors.initials: M
authors.lastname: Meiners
authors.affiliation: Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala.
authors.forename: M
authors.initials: M
authors.lastname: Ramirez-Zea
authors.affiliation: Department of Chronic Diseases and Mental Health, Pan American Health Organization, Washington, DC, United States of America, barceloa@paho.org.
authors.forename: J
authors.initials: J
authors.lastname: Segovia
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002489:Central America; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology