Gender differences in population-based prevalences of cardiovascular and cerebrovascular diseases in Chile: are men being under-diagnosed?

  • Corinna Dressler Department of Health Sciences University of York, York, United Kingdom
  • Báltica Cabieses Lecturer at Faculty of Medicine Universidad del Desarrollo Clinica Alemana Visiting scholar at Department of Health Sciences University of York, UK Postal address: Avenida Las Condes 12.587 Lo Barnechea, Santiago, Chile; 7590943
Keywords: , "Chile/epidemiology"[Mesh], "Hypertension"[Mesh], "Health Surveys"[Mesh], “Cerebrovascular Disorders” [Mesh]

Abstract

Background: Cardiovascular diseases (CVD) are the biggest killer worldwide. Chile has a long standing CVD preventive system, but no gender-focused study has been conducted so far. The purpose of this study was to analyse the existence of gender differences in the prevalence of CVD in Chile. This was a secondary analysis of the cross-sectional Chilean Health Survey 2009- 2010, including 5277 adult participants. 

Method: The relationship between CVDs and gender, crude and adjusted by potential confounders, were estimated by weighted Poisson regressions.

Results and discussion: Crude overall prevalence of self-reported hypertension was 28.13% and it was significantly lower in men (10.92%) than women (17.20%). Half of the population were overweight/obese (39.20%/22.92%) and alcohol consumption in the past month was high (58.42%). Around 40.19% currently smoke. Gender was significantly associated with hypertensions (PR 1.58, 95% CI [1.23-2.03]) as well as having public healthcare insurance (PR1.45, 95% CI [1.01-2.10]).

Conclusion: The results suggest that men reported hypertension less often than women, but comparisons with objective measures suggested they were under-diagnosed. These discrepancies need further consideration in preventive programmes and gender-focused policies in Chile. Nurses and other health professionals are key in creating, implementing and evaluating novel recruitment strategies for men.

Author Biographies

Corinna Dressler, Department of Health Sciences University of York, York, United Kingdom

Dr. Corinna Dressler

 

Báltica Cabieses, Lecturer at Faculty of Medicine Universidad del Desarrollo Clinica Alemana Visiting scholar at Department of Health Sciences University of York, UK Postal address: Avenida Las Condes 12.587 Lo Barnechea, Santiago, Chile; 7590943
Dr. Báltica Cabieses

References

Albala, C., & Vio, F. (1995). Epidemiological transition in Latin America: the case of Chile. Public Health, 109(6), 431-442.

Albala, C., & Yanez, F. V. D. (1997). Epidemiological transition in Latin America. A comparison of four countries. [Article]. Revista Medica De Chile, 125(6), 719-727.

Arteaga, O., Astorga, I., & Pinto, A. M. (2002). [Inequalities in public health care provision in Chile]. Cad Saude Publica, 18(4), 1053-1066. doi: S0102-311X2002000400011 [pii]

Arteaga, O., Thollaug, S., Nogueira, A. C., & Darras, C. (2002). [Information for health equity in Chile]. Rev Panam Salud Publica, 11(5-6), 374-385. doi: S1020-49892002000500012 [pii]

Atena, E. (Ed.). (1991). Chile: Sistema de Salud en Transición a la Democracia. Santiago: J. Jiménez org. .

Bastias, G., Pantoja, T., Leisewitz, T., & Zarate, V. (2008). Health care reform in Chile. CMAJ, 179(12), 1289-1292. doi: 179/12/1289 [pii]10.1503/cmaj.071843

Bitran, R., Escobar, L., & Gassibe, P. (2010). After Chile's health reform: increase in coverage and access, decline in hospitalization and death rates. Health Aff (Millwood), 29(12), 2161-2170. doi: 29/12/2161 [pii]10.1377/hlthaff.2010.0972

Burrows, J. (2008). Inequalities and healthcare reform in Chile: equity of what? J Med Ethics, 34(9), e13. doi: 34/9/e13 [pii]10.1136/jme.2007.022715

Chilean Ministry of Health. (2010). National Health Survey 2009-2010. Executive Summary. M. a. PUC (Ed.) Retrieved from www.minsal.cl

Chilean Ministry of Health. (2011). National Health Objectives 2011-2020. Retrieved 23rd June, 2012, from www.minsal.cl

Coutinho, L. M., Scazufca, M., & Menezes, P. R. (2008). Methods for estimating prevalence ratios in cross-sectional studies. Rev Saude Publica, 42(6), 992-998. doi: S0034-89102008000600003 [pii]

Cruz-Coke, R. (1985). Cardiovascular diseases in Chile. Preventive Medicine, 14(4), 541-547. doi: 10.1016/0091-7435(85)90013-1

Dachs, J. N. W., Ferrer, M., Florez, C. E., Barros, A. J. D., Narvaez, R., & Valdivia, M. (2002). Inequalities in health in Latin America and the Caribbean: descriptive and exploratory results for self-reported health problems and health care in twelve countries. [; Research Support, Non-U.S. Gov't]. Revista panamericana de salud publica = Pan American journal of public health, 11(5-6), 335-355.

de Fatima Marinho de Souza, M., Gawryszewski, V. P., Orduñez, P., Sanhueza, A., & Espinal, M. A. (2012). Cardiovascular disease mortality in the Americas: current trends and disparities. Heart, 98(16), 1207-1212. doi: 10.1136/heartjnl-2012-301828

Deddens, J. A., & Petersen, M. R. (2008). Approaches for estimating prevalence ratios. Occup Environ Med, 65(7), 481, 501-486. doi: 65/7/501 [pii]10.1136/oem.2007.034777

Fasce, E., Campos, I., Ibanez, P., Flores, M., Zarate, H., Romdn, O., & Fasce, F. (2007). Trends in prevalence, awareness, treatment and control of hypertension in urban communities in Chile. Journal of Hypertension, 25(9), 1807-1811. doi: 10.1097/HJH.0b013e328244e481

Feigin, V. L., Lawes, C. M. M., Bennett, D. A., Barker-Collo, S. I., & Parag, V. (2009). Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. [Review]. Lancet Neurology, 8(4), 355-369. doi: 10.1016/s1474-4422(09)70025-0

Goldhaber-Fiebert, J. D., Goldhaber-Fiebert, S. N., & Andorsky, D. J. (2005). Male involvement in cardiovascular preventive healthcare in two rural Costa Rican communities. [Article]. Preventive Medicine, 40(6), 690-695. doi: 10.1016/j.ypmed.2004.09.009

Gray, L., Merlo, J., Mindell, J., Hallqvist, J., Tafforeau, J., O'Reilly, D., .Leyland, A. H. (2012). International differences in self-reported health measures in 33 major metropolitan areas in Europe. Eur J Public Health, 22(1), 40-47. doi: ckq170 [pii]10.1093/eurpub/ckq170

Infante, A., De la Matta, I., & Lopez-Acuna, D. (2000). Reforma de los sistemas de salud en América Latina y el Caribe: Situación y tendencias. . Revista Panamericana de la Salud, 8, 13-20.

Infante A., D. l. M., I., Lopez-Acuna D. . (2000). Reforma de los sistemas de salud en América Latina y el Caribe: Situación y tendencias. . Revista Panamericana de la Salud, 8, 13-20.

Jadue, L., & Marin, F. (2005). Determinantes sociales de la salud en Chile. En la perspectiva de la equidad. Available (First ed.). Santiago: Universidad del Desarrollo, MINSAL.

Kim, A. S., & Johnston, S. C. (2011). Global Variation in the Relative Burden of Stroke and Ischemic Heart Disease. [Article]. Circulation, 124(3), 314-U132. doi: 10.1161/circulationaha.111.018820

Lavados, P. M., Sacks, C., Prina, L., Escobar, A., Tossi, C., Araya, F., Alvarez, G. Incidence, 30-day case-fatality rate, and prognosis of stroke in Iquique, Chile: a 2-year community-based prospective study (PISCIS project). The Lancet, 365(9478), 2206-2215. doi: 10.1016/s0140-6736(05)66779-7

Lloyd-Jones, D., Adams, R. J., Brown, T. M., Carnethon, M., Dai, S., De Simone, G., Subcommittee, S. S. (2010). Heart Disease and Stroke Statistics - 2010 Update. Circulation, 121(7), e46-e215. doi: 10.1161/circulationaha.109.192667

Mendes, S., & Banerjee, A. (2010). Cardiovascular disease: equity and social determinants. In E. Blas & S. A. Kurup (Eds.): World Health Organisation.

National Institutes of Health. (2001). Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Executive Summary Vol. No. 01-3670. l. National heart, and blood institute (Ed.) National Cholesterol Education Programme Retrieved from http://www.nhlbi.nih.gov/guidelines/cholesterol/atp_iii.htm

Oyarzo, C. (2000). La descentralización financiera en Chile en la década de los noventa. Revista Panamericana de Salud Publica, 8, 72-82.

Petersen, M. R., & Deddens, J. A. (2008). A comparison of two methods for estimating prevalence ratios. BMC Med Res Methodol, 8, 9. doi: 1471-2288-8-9 [pii]10.1186/1471-2288-8-9

Pilote, L., Dasgupta, K., Guru, V., Humphries, K. H., McGrath, J., Norris, C., Tagalakis, V. (2007). A comprehensive view of sex-specific issues related to cardiovascular disease. [Review]. Canadian Medical Association Journal, 176(6), S1-S44. doi: 10.1503/cmaj.051455

Pramparo, P. (2002). The epidemiology of hypertension in South America. [Article]. Journal of Human Hypertension, 16, S3-S6. doi: 10.1038/sj/jhh/1001331

Regitz-Zagrosek, V. (2011). Sex and gender differences in symptoms of myocardial ischaemia. European Heart Journal. doi: 10.1093/eurheartj/ehr272

Regitz-Zagrosek, V. (2012). Sex and gender differences in health. [10.1038/embor.2012.87]. EMBO Rep, 13(7), 596-603.

Roberts, R. O., Bergstralh, E. J., Schmidt, L., & Jacobsen, S. J. (1996). Comparison of self-reported and medical record health care utilization measures. J Clin Epidemiol, 49(9), 989-995. doi: 0895-4356(96)00143-6 [pii]

Sandoval, D., Bravo, M., Koch, E., Gatica, S., Ahlers, I., Henríquez, O., & Romero, T. (2012). Overcoming Barriers in the Management of Hypertension: The Experience of the Cardiovascular Health Program in Chilean Primary Health Care Centers. International Journal of Hypertension, 2012, 8. doi: 10.1155/2012/405892

Scarborough, P., GBhantanagar, P., Wickramasinghe, K., Smolina, K., Mitchell, C., & Rayner, M. (2010). Coronary heart disease statistics - 2010 edition. In B. H. F. H. P. R. Group (Ed.). Oxford: British Heart Foundation

Sutton, M., Carr-Hill, R., Gravelle, H., & Rice, N. (1999). Do measures of self-reported morbidity bias the estimation of the determinants of health care utilisation? Soc Sci Med, 49(7), 867-878. doi: S0277953699001690 [pii]

Vargas, V., & Poblete, S. (2008). Health prioritization: the case of Chile. Health Aff (Millwood), 27(3), 782-792. doi: 27/3/782 [pii]10.1377/hlthaff.27.3.782

Vega, J., Bedregal, P., Jadue, L., & Delgado, I. (2003). Gender inequity in the access to health care in Chile. Revista Medica De Chile, 131(6), 669-678.

World Health Organization. (2010, 2010). Cardiovascular Diseases. Retrieved 24.05.2010, 2010, from http://www.who.int/mediacentre/factsheets/fs317/en/index.html

Published
2015-01-28
Section
Community Health Nursing