ABC | Volume 110, Nº6, June 2018

Original Article Soares et al Cardiovascular risk in an indigenous population Arq Bras Cardiol. 2018; 110(6):542-550 1. Simão AF, Precoma DB, Andrade JP, Correa Fº H, Saraiva JF, Oliveira GM, et al; Sociedade Brasileira de Cardiologia. [I Brazilian Guidelines for cardiovascular prevention]. Arq Bras Cardiol. 2013;101(6 Suppl 2):1-63. 2. Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Análise de Situação de Saúde. Plano de ações estratégicas para o enfrentamento das doenças crônicas não transmissíveis (DCNT) no Brasil 2011-2022. Brasília; 2011. 3. GrundySM,BaladyGJ,CriquiMH,FletcherG,GreenlandP,HiratzkaLF,etal. Primary prevention of coronary heart disease: guidance fromFramingham: a statement for healthcare professionals from the AHA task force on risk reduction. Circulation. 1998;97(18):1876-87. 4. Coimbra Jr CE, Flowers NM, Salzano FM, Santos RV. The Xavante in Transition: Health, Ecology and Bioanthropology in Central Brazil. Ann Arbor: University of Michigan Press; 2002. 5. Santos RV, Cardoso AM, Garnelo L, Coimbra Jr CE, Chaves MB. Saúde dos povos indígenas e políticas públicas no Brasil. In: Escorel S, Lobato LV, Noronha JC, Carvalho AI. (Org.). Políticas e Sistema de Saúde no Brasil. Rio de Janeiro: Editora Fiocruz; 2008. p. 1035-56. 6. Brasil,InstitutoBrasileirodeGeografiaeEstatística.(IBGE).CensoDemográfico 2010 – Características gerais dos indígenas. Rio de Janeiro; 2010. p.1- 245. 7. World Health Organization. (WHO). Obesity: preventing and managing the global epidemic. Report of a World Health Organization Consultation. Geneva; 2000. p. 252. (WHO Obesity Technical Report Series, n. 284). 8. Castelli WP, Abbott RD, McNamara PM. Summary estimates of cholesterol used to predict coronary heart disease. Circulation. 1983;67(4):730-4. 9. 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In addition, some smaller, less accessible indigenous communities were not included in the study, affecting the participation rate. Limitations regarding communication between indigenous people and investigators, which may have been a source of bias, were partly prevented by participation of health professionals, members of the indigenous community in data collection. Also, due to cultural differences, we cannot assure that all volunteers were in fasting conditions on blood collection day despite instructions to do so; in addition to a more irregular eating pattern, they may have not understood the importance of such condition for laboratory tests. Thus, caution is need in interpreting TG levels and TG/HDL ratio and HW values. Another limitation was the fact that we did not evaluate smoking habit, which is a key cardiovascular risk factor, not only isolated but also as a Framingham score component. All subjects were rated as non‑smokers in the score calculation, and hence the possibility that cardiovascular risk by this indicator was underestimated cannot be ruled out. These results are significant for this population and, to our knowledge, this is the first study to evaluate cardiovascular risk using all these indicators. Conclusions Xavante people have high cardiovascular risk according to indicators such as HDL-c, TG/HDL-c ratio, BMI, WC, HW and glucose levels. Considering that CVD patients are initially asymptomatic, and that CVDs are important causes of morbidity and mortality, the present analysis of cardiovascular risk factors may be used as a basis for the planning of preventive measures and early treatment to minimize the impact of these diseases on this population. Author contributions Conception and design of the research: Soares LP, Moises RS, Vieira-Filho JPB, Franco LJ; Acquisition of data, Analysis and interpretation of the data, Statistical analysis and Critical revision of the manuscript for intellectual content: Soares LP, Dal Fabbro AL, Silva AS, Sartorelli DS, Franco LF, Kuhn PC, Moises RS, Vieira-Filho JPB, Franco LJ; Obtaining financing: Franco LJ; Writing of the manuscript: Soares LP, Franco LJ. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding This study was funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq (Proc. 476347/2007-6) and Fundação de Amparo à Pesquisa do Estado de São Paulo – FAPESP (Proc. 2010/05634-0). Study Association This article is part of the thesis of Doctoral submitted by Luana Padua Soares, from Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Ethics approval and consent to participate This study was approved by the Comissão Nacional de Ética em Pesquisa (CONEP) under the protocol number 598/2008 (CONEP 14914 / Process no 25000.103891/2008-41). All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study. 548