Clinical research studyCARMELA: Assessment of Cardiovascular Risk in Seven Latin American Cities
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Patients and Methods
This study was conducted in accordance with the Declaration of Helsinki, Guidelines for Good Clinical Practice, and local bioethics regulations and laws. All subjects provided written informed consent.
Demographics
Table 1 shows the basic demographics of the 11,550 CARMELA participants. As expected per the study design, the mean age of participants was at the mid-range of study enrollment. Approximately 13% reported family members with cardiovascular disease, and 2% reported prior myocardial infarction or stroke.
Risk Factor Prevalence
The estimated prevalences of risk factors are presented in Table 2. Hypertension prevalences clustered into 2 groups: Barquisimeto, Buenos Aires, and Santiago had the highest prevalence (25%, 29%,
Discussion
Cardiovascular risk was distributed heterogeneously across Latin America, with different risk factors concentrated in different cities. Hypertension prevalences were in 2 clusters: Buenos Aires, Barquisimeto, and Santiago had prevalences approximately 25%, comparable to worldwide (26%) and US (29%) prevalences,11, 12 whereas the other 4 cities had lower prevalences. The prevalence of hypercholesterolemia in Quito, Buenos Aires, Mexico City, and Santiago (15%-20%) was similar to that among US
Conclusions
On the basis of the Framingham risk scores, 1 in 7 persons in the CARMELA cities is at significant risk for a cardiovascular event. Although the appropriateness of using the Framingham algorithm for non-US populations has not been demonstrated,29 this algorithm may provide an initial heuristic for exploring risk patterns until a Latin American risk scoring system is developed and validated.
The CARMELA study is a large cross-sectional, observational study with the added value of being conducted
Acknowledgments
The authors thank Dr Gianni Tognoni for input and critical revision of this article; Dr Marta Torres for rigorous efforts in compiling data provided by the clinical analysis laboratories of each city; Héctor Rosso, database designer and administrator, for help with information technology; Aurélia Puech-Bournonville for coordination of the central reading of the echosonographic intima-media thickness measurements; Drs Eric Vicaut and Julien Labreuche for statistical analyses of data on carotid
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The CARMELA Study was funded through an unrestricted research grant from Pfizer, Inc.