Abstract P112: Peripheral Arterial Disease and Carotid Atherosclerosis among Middle-aged Women Living in Chiapas, Mexico: Preliminary Results

Abstract

Background: Mexico is undergoing a fast-paced epidemiological and nutritional transition. Evaluating the presence of early cardiovascular disease and understanding risk factors leading to it in this context may provide insight on prevention strategies for the growing burden of this disease in developing countries. Methods and Results: We evaluated subclinical cardiovascular disease in 443 women aged ≥40 years in an urban and a rural site in Chiapas, Mexico. All women were participants in the ongoing ESMaestras cohort, a prospective study of 116,683 Mexican female teachers, which started in 2006-2008. In September 2012, an evaluation of subclinical cardiovascular disease was undertaken in a sub-cohort of 2,000 ESMaestras participants. We present preliminary results from this initial effort. Women were invited to a clinical site where ankle-brachial index (ABI) were measured by previously standardized personnel using the automated VaSera VS-1000 sphyngmomanometer. Carotid intima-media thickness (IMT) was assessed by a neurologist. In 52 participants IMT measurements were repeated to assess the reproducibility of the measurements. Mean age was 48.1 (SD 4.2) and mean body mass index (BMI) was 28.7 kg/m2 (SD 4.7). Mean ABI was 1.06 (SD 0.09) and peripheral artery disease (ABI of <0.90), was present in 4.1% of participants. Mean IMT was 0.68 mm (SD 0.08) and the prevalence of carotid atherosclerosis (IMT ≥1.2 mm) was 1.9%. The intraclass correlation to assess reproducibility of IMT measurements was 0.89 (95% confidence interval 0.82-0.94). Pearson’s correlation coefficients for IMT and BMI (n=312) and ABI and BMI (n=443) were 0.25 (p<0.001) and -0.17 (p<0.001), respectively. No differences were observed between the urban and rural site. Conclusions: In an initial effort to characterize subclinical cardiovascular disease we found a relatively high prevalence of peripheral arterial disease in a middle-aged population of Mexican women, underlining the increasing burden cardiovascular disease in this population.