ABC | Volume 110, Nº1, January 2018

Original Article Prevalence of Dyslipidemias in Three Regions in Venezuela: The VEMSOLS Study Results Juan P. González-Rivas, 1 Ramfis Nieto-Martínez, 2,3 Imperia Brajkovich, 4 Eunice Ugel, 5 Alejandro Rísquez 6 The Andes Clinic of Cardio-Metabolic Studies; 1 Geriatric Research, Education and Clinical Center (GRECC) and South Florida Veterans Affairs Foundation for Research & Education, Miami VA Healthcare System, Miami, FL - USA; 2 Department of Physiology - School of Medicine - University Centro- Occidental “Lisandro Alvarado” and Cardio-metabolic Unit 7, Barquisimeto, Venezuela; 3 Department of Internal Medicine B - School of Medicine “Luis Razetti” - University Hospital of Caracas - Universidad Central de Venezuela; 4 Department of Preventive Medicine - School of Medicine - Universidad CentroOccidental “Lisandro Alvarado”; 5 Department of Social and Preventive Medicine - School of Medicine, Universidad Central de Venezuela 6 Mailing Address: Juan P. González-Rivas • Av. Miranda. The Andes Clinic of Cardio-Metabolic Studies. 3112, Timotes, Mérida E-mail: juanpgonzalezr@hotmail.com, juanpgonzalezr79@gmail.com Manuscript received October 25, 2016, revised manuscript May 15, 2017, accepted July 06, 2017 DOI: 10.5935/abc.20170180 Abstract Background: The prevalence of dyslipidemia in multiple regions of Venezuela is unknown. The Venezuelan Metabolic Syndrome, Obesity and Lifestyle Study (VEMSOLS) was undertaken to evaluate cardiometabolic risk factors in Venezuela. Objective: To determine the prevalence of dyslipidemia in five populations from three regions of Venezuela. Methods: During the years 2006 to 2010, 1320 subjects aged 20 years or older were selected by multistage stratified random sampling from all households in five municipalities from 3 regions of Venezuela: Lara State (Western region), Merida State (Andean region), and Capital District (Capital region). Anthropometric measurements and biochemical analysis were obtained from each participant. Dyslipidemia was defined according to the NCEP/ATPIII definitions. Results: Mean age was 44.8 ± 0.39 years and 68.5% were females. The prevalence of lipids abnormalities related to the metabolic syndrome (low HDL-c [58.6%; 95% CI 54.9 – 62.1] and elevated triglycerides [39.7%; 36.1 – 43.2]) were the most prevalent lipid alterations, followed by atherogenic dyslipidemia (25.9%; 22.7 – 29.1), elevated LDL-c (23.3%; 20.2 – 26.4), hypercholesterolemia (22.2%; 19.2 – 25.2), and mix dyslipidemia (8.9%; 6.8 – 11.0). Dyslipidemia was more prevalent with increasing body mass index. Conclusion: Dyslipidemias are prevalent cardiometabolic risk factors in Venezuela. Among these, a higher prevalence of low HDL is a condition also consistently reported in Latin America. (Arq Bras Cardiol. 2018; 110(1):30-35) Keywords: Dyslipidemias / epidemiology; Cardiovascular Diseases; Risk Factors; Stroke / mortality; Obesity; Metabolic Syndrome. Introduction In Venezuela, cardiovascular disease (CVD), represented by ischemic heart disease (16.3%) and stroke (7.7%), was the major cause of death in 2012. 1 Both are strongly related with modifiable risk factors. According to the INTERHEART 2 and the INTERSTROKE 3 studies, dyslipidemias, assessed as increased levels of apolipoprotein (ApoB/ApoA1 ratio), represented the 49.2% and the 25.9% of the attributable risk for acute myocardial infarction and stroke, respectively. Randomized controlled clinical trials have consistently demonstrated that a reduction in low-density lipoprotein cholesterol (LDL-C) with statin therapy reduces the incidence of heart attack and ischemic stroke. For every 38.6 mg/dL LDL-c reduction, the annual rate of major vascular events decreases to one-fifth. 4 Studies evaluating the prevalence of dyslipidemias in Venezuela have been compiled. 5 However, most of them have small samples, and only two are representative of a city or a state. In 1,848 adults from the city of Barquisimeto, in the western region of the country, the Cardiovascular Risk Factor Multiple Evaluation in Latin America (CARMELA) study 6 reported the lowest prevalence of hypercholesterolemia (cholesterol ≥240mg/dL) observed in Latin America (5.7%). 6 In 3,108 adults from the state of Zulia, Florez et al. 7 documented the prevalence of atherogenic dyslipidemia (high triglycerides and low levels of high- density lipoprotein of cholesterol [HDL-c]) in 24.1%. This number was higher inmen thanwomen, and increasedwith age. No study in Venezuela has included more than one region, prompting the design of the Venezuelan Metabolic Syndrome, Obesity and Lifestyle Study (VEMSOLS). This paper presents the results of VEMSOLS, specifically the prevalence of dyslipidemia in five populations of three regions in Venezuela. Methods Design and Subjects An observational, cross-sectional study was designed to determine the prevalence of cardiometabolic risk factors in 30