Risk Factors for Chronic Diseases and Multimorbidity in a Primary Care Context of Central Argentina: A Web-Based Interactive and Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Participants and Setting
2.2. Data Collection
2.3. Web Page Design and Devolution of Results
2.4. Statistical Analysis
3. Results
3.1. Population Characteristics
3.2. Anthropometry, Blood Pressure and Blood Test Analysis
3.3. Risk Factors for Prevalent Chronic Diseases and Multimorbidity
3.4. Characteristics of Participants with Regard to Hypertension and Diabetes
3.5. Characteristics of Participants with Regard to Multimorbidity
3.6. Sharing of Results with Participants via Website
4. Discussion
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Variables | N | % |
---|---|---|
Gender (N = 1044) | ||
Male | 365 | 35.0 |
Female | 679 | 65.0 |
Age (N = 1028; mean, SD) | 43 | 15 |
18–20 | 47 | 4.5 |
21–64 | 882 | 84.4 |
>64 | 99 | 9.5 |
Education (N = 1034) | ||
Primary school | 423 | 40.5 |
Secondary school | 369 | 35.3 |
Tertiary/University | 242 | 23.2 |
Employment status (N = 1037) | ||
Employed | 691 | 67.3 |
Unemployed | 32 | 3.1 |
Students | 48 | 4.7 |
Unpaid domestic work | 155 | 15.1 |
Retired | 101 | 9.8 |
Marital status (N = 1035) | ||
Single | 318 | 30.7 |
Married | 515 | 49.8 |
Divorced | 127 | 12.3 |
Widowed | 75 | 7.2 |
Hypertension * (N = 1044) | 375 | 35.9 |
Diabetes * (N = 1044) | 155 | 14.8 |
High Cholesterol * (N = 1044) | 269 | 25.8 |
AMI or Stroke (N = 1044) | 73 | 7.0 |
Asthma (N = 1044) | 56 | 5.4 |
Hypothyroidism (N = 1044) | 91 | 8.7 |
Celiac Disease (N = 1044) | 4 | 0.4 |
Cancer (N = 1044) | 15 | 1.4 |
Other chronic diseases ** (N = 1044) | 146 | 14.0 |
Multimorbidities (N = 1044) | 346 | 33.1 |
0 | 396 | 37.9 |
1 | 302 | 28.9 |
2 | 208 | 19.9 |
3 | 95 | 9.1 |
4 | 27 | 2.6 |
5 | 12 | 1.1 |
6 | 4 | 0.4 |
Characteristics | BMI (kg/m2) ** | Waist Circumference (cm) | Systolic Blood Pressure (mmHg) | Diastolic Blood Pressure (mmHg) | Total Cholesterol (mg/dL) | LDL-C (mg/dL) | HDL-C (mg/dL) | Triglycerides (mg/dL) | Blood Glucose (mg/dL) |
---|---|---|---|---|---|---|---|---|---|
Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | |
General | 28.71 ± 6.65 | 95.07 ± 17.71 | 124.69 ± 20.51 | 78.68 ± 12.02 | 193.05 ± 44.57 | 116.45 ± 36.70 | 49.16 ± 11.03 | 148.99 ± 113.65 | 98.20 ± 32.31 |
Gender | 0.009 ** | <0.001 ** | <0.001 ** | <0.001 ** | NS * | 0.033 * | <0.001 ** | <0.001 ** | <0.001 ** |
Male | 29.25 ± 6.12 | 100.66 ± 16.86 | 129.42 ± 18.41 | 82.13 ± 12.07 | 197.41 ± 48.32 | 120.43 ± 40.12 | 44.20 ± 9.69 | 181 ± 144.31 | 105.14 ± 38.91 |
Female | 28.42 ± 6.91 | 92 ± 17.43 | 122.11 ± 21.15 | 76.80 ± 11.58 | 190.66 ± 42.24 | 114.28 ± 34.54 | 51.87 ± 10.79 | 131.47 ± 88.08 | 94.38 ± 27.33 |
Age | <0.001 ** | <0.001 ** | <0.001 ** | <0.001 ** | <0.001 * | <0.001 * | NS ** | <0.001 ** | <0.001 ** |
18–20 | 22.86 ± 3.24 | 79.19 ± 9.04 | 109.69 ± 12.13 | 69.16 ± 8.07 | 145.16 ± 29.78 | 83.97 ± 25.83 | 45.05 ± 12.28 | 80.47 ± 32.95 | 85.74 ± 6.64 |
21–64 | 28.82 ± 6.64 | 94.93 ± 18.08 | 122.98 ± 19.32 | 78.71 ± 11.98 | 194.18 ± 44.07 | 117.41 ± 36.49 | 49.21 ± 11.13 | 150.35 ± 114.33 | 97.64 ± 31.87 |
>64 | 29.42 ± 6.72 | 100.52 ± 13.34 | 142.30 ± 21.91 | 81.13 ± 12.03 | 196.55 ± 45.72 | 117.01 ± 37.73 | 49.81 ± 10.05 | 157.68 ± 117.74 | 106.01 ± 38.22 |
Education | 0.001 ** | <0.001 ** | <0.001 ** | 0.003 ** | NS * | NS * | NS ** | NS ** | <0.001 ** |
Primary school | 29.64 ± 6.91 | 98.63 ± 17.30 | 129.89 ± 22.57 | 80.38 ± 13.0 | 194.06 ± 45.5 | 117.32 ± 36.66 | 48.25 ± 10.08 | 151.67 ± 106.36 | 103.17 ± 38.05 |
Secondary school | 28.12 ±6.40 | 92.88 ± 17.93 | 121.04 ± 18.04 | 77.68 ± 10.79 | 191.99 ± 45.56 | 115.37 ± 38.06 | 49.39 ± 11.85 | 148.51 ± 127.13 | 95.85 ± 30.63 |
Tertiary/University | 27.83 ± 6.29 | 91.53 ± 16.95 | 120.06 ± 17.35 | 76.90 ± 11.38 | 193.08 ± 40.90 | 116.60 ± 34.60 | 50.77 ± 11.46 | 145.20 ± 104.55 | 91.53 ± 16.15 |
Employment status | 0.001 **** | <0.001 **** | <0.001 **** | <0.001 **** | NS *** | NS *** | NS **** | 0.009 **** | 0.011 **** |
Employed | 28.49 ± 6.42 | 94.19 ± 18.07 | 123.04 ± 18.81 | 78.50 ± 12.03 | 196.10 ± 45.71 | 118.77 ± 38.25 | 49.11 ± 11.51 | 154.63 ± 120.40 | 97.69 ± 32.29 |
Unemployed | 28.52 ± 7.67 | 95.97 ± 21.56 | 112.50 ± 11.66 | 73.27 ± 10.69 | 167.72 ± 41.44 | 98.77 ± 30.07 | 50.11 ± 11.97 | 106.28 ± 95.47 | 106.56 ± 58.93 |
Students | 24.87 ± 5.62 | 85.38 ± 14.69 | 110.11 ± 13.47 | 71.78 ± 8.62 | 169.44 ± 39.06 | 97.79 ± 33.36 | 52.67 ± 9.01 | 128.67 ± 106.09 | 85.72 ± 8.71 |
Unpaid domestic work | 30.57 ± 7.88 | 97.27 ± 17.88 | 125.65 ± 21.88 | 79.73 ± 12.41 | 189.92 ± 41.56 | 113.83 ± 32.22 | 49.19 ± 9.88 | 143.20 ± 106.34 | 97.79 ± 28.71 |
Retired | 28.41 ± 5.48 | 99.42 ± 13.92 | 140.26 ± 23.02 | 81.82 ± 10.92 | 191.91 ± 41.92 | 114.94 ± 34.62 | 48.49 ± 10.48 | 149.48 ± 114.00 | 102.01 ± 29.97 |
Marital status | <0.001 **** | <0.001 **** | <0.001 **** | <0.001 **** | <0.001 *** | <0.001 *** | 0.007 **** | 0.012 **** | <0.001 **** |
Single | 27.14 ± 6.52 | 90.38 ± 19.67 | 118.43 ± 19.53 | 75.58 ± 11.26 | 180.16 ± 41.76 | 106.79 ± 33.16 | 48.47 ± 11.31 | 136.34 ±10.9.34 | 94.03 ± 28.60 |
Married | 29.29 ± 6.42 | 96.71 ± 16.87 | 126.37 ± 18.92 | 79.97 ± 11.62 | 196.31 ± 42.37 | 118.48 ± 34.70 | 48.49 ± 10.96 | 160.94 ± 125.63 | 100.03 ± 34.06 |
Divorced | 28.96 ± 6.81 | 96.47 ± 16.15 | 123.82 ± 22.12 | 79.28 ± 13.02 | 196.80 ± 47.85 | 119.05 ± 40.89 | 52.05 ± 10.98 | 131.40 ± 84.32 | 92.71 ± 17.59 |
Widowed | 29.96 ± 7.49 | 98.25 ± 15.82 | 136.41 ± 24.36 | 79.99 ± 13.69 | 209.07 ± 53.21 | 131.16 ± 46.50 | 51.55 ± 10.03 | 141.75 ± 67.24 | 108.25 ± 44.67 |
Characteristics | Obesity | Central Obesity | LDL-C Risk | HDL-C Risk | High Triglycerides | Dyslipidemia | Smoking | Alcohol Consumption | Low Intake of Fruits and Vegetables | Low Level of Physical Activity | Metabolic Syndrome | Total Risk Factors (N = 417) |
---|---|---|---|---|---|---|---|---|---|---|---|---|
% (n) | % (n) | % (n) | % (n) | % (n) | % (n) | % (n) | % (n) | % (n) | % (n) | % (n) # | Mean ± SD | |
General | 35.2 (278) | 54.4 (426) | 32.1 (227) | 19.7 (139) | 32.8 (232) | 43.5 (269) | 22.5 (232) | 28.7 (300) | 91.8 (959) | 71.5 (746) | 21.1 (220) | 4.5 ± 1.9 |
Gender | 0.003 | 0.003 | 0.032 | <0.001 | <0.001 | NS | NS | <0.001 | 0.001 | NS | 0.010 | <0.001 * |
Male | 38.1 (106) | 47.3 (131) | 37.2 (93) | 35.6 (89) | 44.8 (112) | 41.8 (79) | 25.6 (92) | 43.0 (157) | 95.6 (349) | 69.8 (254) | 25.5 (93) | 5.1 ± 2.0 |
Female | 33.6 (172) | 58.3 (295) | 29.3 (134) | 10.9 (50) | 26.3 (120) | 44.3 (190) | 20.8 (140) | 21.1 (143) | 89.7 (610) | 72.4 (492) | 18.7 (127) | 4.1 ± 1.8 |
Age | <0.001 | <0.001 | 0.008 | 0.033 | 0.005 | NS | 0.001 | <0.001 | <0.001 | NS | <0.001 | 0.048 ** |
18–20 | 4.8 (1) | 14.3 (3) | 0 (0) | 42.1 (8) | 0 (0) | 33.3 (3) | 21.7 (10) | 55.3 (26) | 87.2 (41) | 72.3 (34) | 0 (0) | 3.4 ± 1.5 |
21–64 | 35.3 (240) | 53 (357) | 32.6 (198) | 19.6 (119) | 33.2 (202) | 41.8 (219) | 24.1 (211) | 28.1 (248) | 93.4 (824) | 70.9 (625) | 19.8 (175) | 4.5 ± 1.9 |
>64 | 41.4 (36) | 76.5 (65) | 36.4 (28) | 15.6 (12) | 39 (30) | 54.9 (45) | 8.1 (8) | 23.2 (23) | 77.8 (77) | 76.8 (76) | 45.5 (45) | 5.0 ± 1.7 |
Education | 0.011 | <0.001 | NS | NS | NS | <0.001 | NS | 0.014 | NS | NS | <0.001 | 0.002 ** |
Primary school | 42 (145) | 66.3 (226) | 32.2 (100) | 19.3 (60) | 37.3 (116) | 54.3 (127) | 24.7 (104) | 25.4 (107) | 89.6 (379) | 72.6 (307) | 30.3 (128) | 4.9 ± 1.7 |
Secondary school | 32.2 (88) | 48.2 (131) | 31.5 (79) | 21.9 (55) | 28.7 (72) | 41 (87) | 21.5 (79) | 28.2 (104) | 93.2 (344) | 73.4 (271) | 16.8 (62) | 4.5 ± 2.0 |
Tertiary/University | 25.9 (44) | 40.5 (68) | 32.9 (47) | 16.8 (24) | 30.8 (44) | 31.8 (54) | 20.1 (48) | 36.0 (87) | 93 (225) | 66.1 (160) | 12.4 (30) | 4.1 ± 2.0 |
Employment status | 0.027 | <0.001 | NS | NS | NS | 0.011 | 0.003 | <0.001 | <0.001 | NS | <0.001 | 0.011 ** |
Employed | 33.6 (176) | 47.8 (249) | 35.0 (161) | 21.1 (97) | 33.9 (156) | 45.4 (209) | 25.4 (174) | 33.3 (230) | 94.9 (656) | 70.9 (490) | 17.5 (121) | 4.6 ± 2.0 |
Unemployed | 35.0 (7) | 55.6 (10) | 16.7 (3) | 22.2 (4) | 22.2 (4) | 16.7 (3) | 21.9 (7) | 15.6 (5) | 93.8 (30) | 68.8 (22) | 9.4 (3) | 3.0 ± 1.0 |
Students | 9.5 (2) | 33.3 (7) | 22.2 (4) | 5.6 (1) | 16.7 (3) | 22.2 (4) | 17.0 (8) | 37.5 (18) | 91.7 (44) | 66.7 (32) | 2.1 (1) | 3.1 ± 1.2 |
Unpaid domestic work | 46.2 (60) | 71.3 (92) | 25.4 (32) | 17.5 (22) | 29.4 (37) | 34.1 (43) | 22.1 (34) | 12.3 (19) | 87.7 (136) | 76.8 (119) | 32.3 (50) | 4.7 ± 1.7 |
Retired | 35.2 (31) | 72.7 (64) | 30.8 (24) | 19.2 (15) | 39.7 (31) | 42.3 (33) | 7.9 (8) | 25.7 (26) | 76.2 (77) | 70.3 (71) | 43.6 (44) | 4.6 ± 1.6 |
Marital status | <0.001 | <0.001 | 0.002 | 0.005 | NS | <0.001 | 0.002 | NS | 0.001 | NS | <0.001 | NS ** |
Single | 27.2 (58) | 41.0 (86) | 22.6 (42) | 21.5 (40) | 26.9 (50) | 28.0 (52) | 27.1 (85) | 32.7 (104) | 95.6 (304) | 68.6 (218) | 12.3 (39) | 4.2 ± 1.7 |
Married | 37.0 (153) | 57.7 (237) | 34.0 (128) | 22.9 (86) | 36.7 (138) | 46.0 (173) | 19.3 (99) | 28.8 (148) | 91.7 (472) | 73.8 (380) | 26.4 (136) | 4.7 ± 2.0 |
Divorced | 39.8 (39) | 58.2 (57) | 33.3 (29) | 9.2 (8) | 27.6 (24) | 43.7 (38) | 29.4 (37) | 26.0 (33) | 86.6 (110) | 69.3 (88) | 18.1 (23) | 4.6 ± 2.0 |
Widowed | 42.2 (27) | 72.6 (45) | 48.2 (27) | 8.9 (5) | 35.7 (20) | 55.4 (31) | 12.0 (9) | 18.7 (14) | 84.0 (63) | 72.0 (54) | 29.3 (22) | 4.6 ± 1.7 |
Variables | Hypertensive | Diabetics | ||
---|---|---|---|---|
% (n) | p Value for Chi-Square Test | % (n) | p Value for Chi-Square Test | |
Gender | NS | NS | ||
Male | 32.1 (117) | 14.5 (53) | ||
Female | 38.0 (258) | 15.0 (102) | ||
Age | <0.001 | <0.001 | ||
18–20 | 10.6 (5) | 8.5 (4) | ||
21–64 | 34.8 (307) | 13.5 (119) | ||
>64 | 59.6 (59) | 32.3 (32) | ||
Education | <0.001 | <0.001 | ||
Primary school | 48.6 (205) | 21.1 (89) | ||
Secondary school | 30.4 (112) | 11.9 (44) | ||
Tertiary/University | 23.6 (57) | 11.7 (21) | ||
Employment status | <0.001 | 0.013 | ||
Employed | 32.6 (225) | 12.3 (85) | ||
Unemployed | 21.9 (7) | 18.8 (6) | ||
Students | 18.8 (9) | 6.3 (3) | ||
Unpaid domestic work | 47.7 (74) | 19.4 (30) | ||
Retired | 56.4 (57) | 27.7 (28) | ||
Marital status | <0.001 | 0.008 | ||
Single | 23.9 (76) | 8.2 (26) | ||
Married | 37.4 (192) | 16.0 (82) | ||
Divorced | 49.6 (63) | 18.9 (24) | ||
Widowed | 57.3 (43) | 30.7 (23) | ||
Smoking | 22.5 (84) | NS | 16.8 (26) | NS |
Alcohol consumption | 25.3 (95) | NS | 23.2 (36) | NS |
Low consumption of fruit and vegetables | 90.1 (338) | NS | 85.8 (133) | 0.003 |
Low level of physical activity | 71.3 (268) | NS | 71.6 (111) | NS |
Obesity | 53.3 (163) | <0.001 | 52.7 (69) | <0.001 |
Central obesity | 74.3 (223) | <0.001 | 70.8 (92) | 0.001 |
BMI (kg/m2); mean ± SD | 31.02 ± 7.23 | <0.001 ** | 31.23 ± 6.97 | <0.001 ** |
Waist circunference (cm); mean ± SD | 100.98 ± 17.34 | <0.001 ** | 101.15 ± 15.59 | <0.001 ** |
Total cholesterol (mg/dL); mean ± SD | 199.02 ± 43.66 | 0.005 * | 196.63 ± 43.84 | NS * |
LDL-C (mg/dL); mean ± SD | 120.07 ± 35.61 | 0.037 * | 115.12 ± 35.59 | NS * |
HDL-C (mg/dL); mean ± SD | 48.91 ± 10.74 | NS ** | 48.45 ± 10.20 | NS ** |
Triglycerides (mg/dL); mean ± SD | 162.74 ± 112.12 | <0.001 ** | 177.82 ± 137.19 | 0.002 ** |
Blood glucose (mg/dL); mean ± SD | 105.44 ± 41.79 | <0.001 ** | 128.31 ± 64.55 | <0.001 ** |
Total risk factors; mean ± SD | 5.10 ± 1.86 | <0.001 ** | 5.13 ± 1.90 | 0.020 ** |
Variables | Non Multimorbidities (N = 698) | Multimorbidities (N = 346) | p Value for Chi-Square Test |
---|---|---|---|
% (n) | % (n) | ||
Gender | 0.019 | ||
Male | 71.5 (261) | 28.5 (104) | |
Female | 64.4 (437) | 35.6 (242) | |
Age | <0.001 | ||
18–20 | 93.4 (44) | 6.4 (3) | |
21–64 | 68.3 (602) | 31.7 (279) | |
>64 | 39.4 (39) | 60.6 (60) | |
Education | <0.001 | ||
Primary school | 56.4 (238) | 43.6 (184) | |
Secondary school | 73.2 (270) | 26.8 (99) | |
Tertiary/University | 74.8 (181) | 25.2 (61) | |
Employment status | <0.001 | ||
Employed | 69.4 (479) | 30.6 (211) | |
Unemployed | 84.4 (27) | 15.6 (5) | |
Students | 91.7 (44) | 8.3 (4) | |
Unpaid domestic work | 59.4 (92) | 40.6 (63) | |
Retired | 42.6 (43) | 57.4 (58) | |
Marital status | <0.001 | ||
Single | 80.8 (257) | 19.2 (61) | |
Married | 63.4 (326) | 36.6 (188) | |
Divorced | 56.7 (72) | 43.3 (55) | |
Widowed | 44.0 (33) | 56.0 (42) | |
Tobacco smoking | 24.7 (170) | 18.0 (62) | 0.015 |
Alcohol consumption | 31.9 (223) | 22.3 (77) | 0.001 |
Low consumption of fruit and vegetables | 94.1 (657) | 87.0 (301) | <0.001 |
Low level of physical activity | 70.7 (493) | 73.2 (253) | NS |
Obesity | 26.8 (134) | 49.7 (144) | <0.001 |
Central obesity | 44.6 (221) | 71.4 (205) | <0.001 |
BMI (kg/m2); mean ± SD | 27.48 ± 6.13 | 30.84 ± 6.98 | <0.001 * |
Waist circunference (cm); mean ± SD | 92.22 ± 17.45 | 99.98 ± 17.08 | <0.001 * |
Total cholesterol (mg/dL); mean ± SD | 187.70 ± 44.45 | 202.53 ± 43.27 | <0.001 ** |
LDL-C (mg/dL); mean ± SD | 113.04 ± 36.82 | 122.51 ± 35.77 | <0.001 ** |
HDL-C (mg/dL); mean ± SD | 49.06 ± 10.97 | 49.33 ± 11.17 | NS * |
Triglycerides (mg/dL); mean ± SD | 140.42 ± 113.36 | 164.17 ± 112.81 | 0.008 * |
Blood glucose (mg/dL); mean ± SD | 94.0 ± 23.50 | 105.69 ± 42.88 | <0.001 * |
Total risk factors; mean ± SD | 4.3 ± 1.9 | 5.0 ± 1.9 | 0.001 |
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Olivares, D.E.V.; Chambi, F.R.V.; Chañi, E.M.M.; Craig, W.J.; Pacheco, S.O.S.; Pacheco, F.J. Risk Factors for Chronic Diseases and Multimorbidity in a Primary Care Context of Central Argentina: A Web-Based Interactive and Cross-Sectional Study. Int. J. Environ. Res. Public Health 2017, 14, 251. https://doi.org/10.3390/ijerph14030251
Olivares DEV, Chambi FRV, Chañi EMM, Craig WJ, Pacheco SOS, Pacheco FJ. Risk Factors for Chronic Diseases and Multimorbidity in a Primary Care Context of Central Argentina: A Web-Based Interactive and Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2017; 14(3):251. https://doi.org/10.3390/ijerph14030251
Chicago/Turabian StyleOlivares, David E. V., Frank R. V. Chambi, Evelyn M. M. Chañi, Winston J. Craig, Sandaly O. S. Pacheco, and Fabio J. Pacheco. 2017. "Risk Factors for Chronic Diseases and Multimorbidity in a Primary Care Context of Central Argentina: A Web-Based Interactive and Cross-Sectional Study" International Journal of Environmental Research and Public Health 14, no. 3: 251. https://doi.org/10.3390/ijerph14030251