IJCS | Volume 31, Nº6, November / December 2018

608 Brajkovich et al. Metabolic syndrome inVenezuela Int J Cardiovasc Sci. 2018;31(6)603-609 Original Article lower than those for men in the US, which increased the prevalence reported. This most recent definition, with more strict cutoff values as in the GLESMO study, 7 represents more appropriately the real public health problem related to the prevalence of MS in Venezuela. The prevalence of metabolic abnormalities also varies among studies. LowHDL-c values and abdominal obesity were the most prevalent abnormalities in Latin America (62.9%and 45.8%, respectively), 16 in the Zulia study (65.3% and 42.9%, respectively), 10 and in a Brazilian study, which found similar results as those in the present study (58.6 and 52%, respectively). LowHDL-c has been established as the most frequent lipid abnormality in Venezuela, observed in 90% of 100 subjects in Valencia city, 21 in the central region, and in 81.1% in those in the Junquitomunicipality. 15 Similar to the observations in men in the present study (49.5%), the above studies (Valencia and Junquito) also reported a high prevalence of elevated triglycerides values (51%), 15,21 compared with those found in Latin America, of 62.5%, 16 and in the CAMDI, of 48.1%. 18 These findings support the need to monitor lipid profile in those subjects with other metabolic abnormalities (abdominal obesity, high blood glucose levels, or hypertension), and not only total cholesterol, as frequently occurs in some Latin American countries. The elevated prevalence of cardiometabolic risk factors in Venezuelan adults could explain the higher burden related to these conditions. Cardiovascular disease and T2D, the most important complications related to MS and dyslipidemia, were the leading disability-adjusted life years (DALYs) risk factors and the leading causes of death, with 44,100 deaths (31% of global death) in 2012. 22 Cardiovascular disease is the first cause of death in Venezuela. 22 Nutritional transition has promoted adverse nutritional and lifestyle habits in Venezuela and other Latin American countries, clearly contributing to the incidence of noncommunicable diseases, especially related to obesity andT2D. 23 Besides, an elevatedweighted prevalence of physical inactivity (68%) has been reported in Venezuela in two studies involving 3,422 adults. 23 The present study has some limitations. The cohort did not represent the entire population of Venezuela, as only three of the eight regions of the country were included. Additionally, in the VEMSOLS, the eating pattern and the physical activity of the population were not investigated in all regions. Despite these limitations, this study is the first to report on MS in more than one region in Venezuela. A national survey in Venezuela is currently ongoing (Estudio Venezolano de Salud Cardiometabólica, EVESCAM study) and data collection was completed in 2017. Conclusions One-third of the subjects assessed in this study presented MS, characterized by abdominal obesity and atherogenic dyslipidemia. These data suggest the need to explore possible environmental factors increasing the cardiometabolic risk, especially those related to lifestyle. Considering that MS is associated with a high risk of mortality and increased health care costs, the cardiometabolic consequences of an inappropriate lifestyle can be monitored through the detection of MS. The high prevalence of MS makes mandatory the implementation of national policies for the prevention of this condition. In practical terms, we recommend promoting the detection of subjects at risk, using both BMI and waist circumference routinely measured in primary care practice, and identifying all MS components when one of them is present. Author contributions Conception and design of the research: Brajkovich I,. González–Rivas JP, Rísquez A, Nieto-Martínez R. Acquisition of data: Brajkovich I, González–Rivas JP, Rísquez A, Nieto-Martínez R. Analysis and interpretation of the data: Brajkovich I, González–Rivas JP, Ugel E, Nieto-Martínez R. Statistical analysis: González–Rivas JP, Ugel E. Writing of the manuscript: Brajkovich I. Critical revision of themanuscript for intellectual content: González–Rivas JP, Rísquez A, Nieto-Martínez R. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding This study was funded by the author. Study Association This article is part of the thesis of master submitted by Alex dos Santos Felix, from InstitutoNacional de Cardiologia . Ethics approval and consent to participate This article does not contain any studies with human participants or animals performed by any of the authors.