Education and cardiovascular risk

Study with 1,116 subjects shows that the prevalence of metabolic syndrome is over 35% and is directly associated with educational level.

By Fábio de Castro

Agência FAPESP – A study conduction in São Carlos (SP) showed metabolic syndrome to be highly prevalent in the city. It also showed that the severity of the problem is directly related to the population’s educational level.

Metabolic syndrome is a combination of cardiovascular risk factors including hyperglycemia (with or without diabetes), elevated blood pressure, obesity and abdominal obesity. São Carlos has a population of 220,000 and is 230 kilometers from São Paulo city. 

The study, which was conducted by researchers from the Universidade Federal de São Carlos (UFSCar), appeared in the online version of Brazilian Journal of Medical and Biological Research and will soon be published in the print version. The study received  FAPESP funding under its Regular Publishing Awards program.

According to the article’s main author, UFSCar Medical School professor and endocrinologist Angela Leal, the population study involved 1,116 individuals aged 30 to 79 years. The project included blood samples, blood pressure monitoring and measuring of weight and abdominal circumference, aside from questionnaires about health conditions and sociodemographic indicators.

Analysis of the data revealed that the syndrome is prevalent in 35.7% of men and 38% of women. When abdominal circumference was included, prevalence rose to 45.3% of men and 45.5% of women. “The results showed an extremely high prevalence of metabolic syndrome. But what most called our attention was the clear association of the condition with level of education. The lower the education level, the greater the risk of metabolic syndrome,” Leal told Agência FAPESP.

According to her, the results suggest that public health policy planning aimed at reducing risk of metabolic syndrome in developing countries should take improving education into account. “Poor education is a roadblock for health in Brazil. We won’t be able to improve health in general if people aren’t well educated. This project joins the ranks of many others that showed a correlation between health and education,” she explained.

In addition to associating the prevalence of metabolic syndrome with educational level, the study also detected an association of the problem with age, weight and race, albeit to lesser degrees according to Leal. No relationship was found between metabolic syndrome and income or smoking, however.

Increased abdominal circumference was nearly twice as frequent in women as in men: 66.5% compared to 37.4%, according to the study.

Aside from Leal, who coordinated the study, graduate and post-graduate students from the Medical School participated in the project along with professors and students from UFSCar’s Physiotherapy and Statistics Departments.

According to the researcher, the team collected samples from August 2007 to June 2008. A cross-sectional sample was designed for the study by statistics professor Jorge Oishi.

“Population-based studies help to show the profile of the population. The project brought together data on abnormal cholesterol, triglyceride and blood pressure levels as well as data on health records sociodemographic variables. We also collected data on exercise, which will be evaluated in the second half of 2011,” said Leal.

According to the diagnostic criteria adopted, 13.5% of the subjects had diabetes mellitus. A study conducted by the same group in 2009 (also under Leal’s direction) had already concluded that 13.5% of São Carlos’ population had diabetes mellitus. The figure suggests an increase in prevalence of disease, compared to the findings of previous Brazilian studies.

The present study used international criteria established by the International Diabetes Federation (which included abdominal circumference variable) and the National Cholesterol Education Program Adult Treatment Panel 3 (NCEP-ATPIII) to analyze metabolic syndrome.

To read the article Prevalence of metabolic syndrome and its association with educational inequalities among Brazilian adults: a population-based study, by Angela Leal and others published in the Brazilian Journal of Medical and Biological Research click here.