Socioeconomic Pathology As a Cause of Regional Differences in the Prevalence of Metabolic Syndrome and Pregnancy-Induced Hypertension

• Published in: Revista española de cardiologia 2007-02, Vol.60 (2), p.168-178
• Main Authors: López-Jaramillo, Patricio, Pradilla, Lina P., Castillo, Víctor R., Lahera, Vicente
• Format: Article
• Language: eng ; spa
• Subjects: Body Mass Index; Cardiovascular disease; Colombia - epidemiology; Desigualdades sociales; Developing Countries; Ecuador - epidemiology; Enfermedades cardiovasculares; Exercise; Female; Hipertensión inducida por el embarazo; Humans; Hypertension, Pregnancy-Induced - epidemiology; Hypertension, Pregnancy-Induced - etiology; Life Style; Male; Metabolic syndrome; Metabolic Syndrome - epidemiology; Metabolic Syndrome - etiology; Obesity - epidemiology; Patología socioeconómica; Pregnancy; Pregnancy Complications, Cardiovascular - epidemiology; Pregnancy Complications, Cardiovascular - etiology; Pregnancy-induced hypertension; Prevalence; Risk Factors; Social inequality; Socioeconomic Factors; Socioeconomic pathology; Spain - epidemiology; Síndrome metabólico
• ISSN: 1885-5857; 1885-5857; 1579-2242
• DOI: 10.1016/S1885-5857(07)60129-7

The epidemic of cardiovascular disease being experienced by developing countries has resulted in a debate about the possible existence of regional differences in etiology and pathophysiology that could be associated with socioeconomic factors. Clear demonstration of these differences is important because there may be a need for different approaches to prevention, diagnosis and treatment. There is some evidence that there are differences between populations in developed and developing countries in the pathophysiologic mechanisms underlying pregnancy-induced hypertension and metabolic syndrome, just as there are in the relative weightings of risk factors that predict the appearance of these conditions. Observations in our country suggest that increasing exposure to changes in lifestyle brought about by the consumer society (eg, a lack of exercise, and a high-fat, high-calorie diet) results in a natural biological response (eg, obesity, metabolic syndrome, and diabetes) that increases the risk of cardiovascular disease. We propose that the term socioeconomic pathology should be used to describe these changes associated with modern society so that they can be differentiated and considered in isolation from socioeconomic factors and other risk factors. We regard the interaction between these various factors as the most important cause of the rapidly increasing incidence of cardiovascular disease observed in developing countries in recent years. La epidemia de enfermedades cardiovasculares que están experimentando los países del tercer mundo ha suscitado controversias acerca de la posible presencia de diferencias regionales en su etiofisiopatología, las cuales estarían asociadas a factores socioeconómicos. La demostración de estas diferencias es importante, pues significaría la necesidad de realizar distintos enfoques en la prevención, el diagnóstico y el tratamiento. Algunos datos indican que hay diferencias en los mecanismos etiofisiopatológicos de la hipertensión inducida por el embarazo y del síndrome metabólico en poblaciones de países desarrollados y en vía de desarrollo, así como en el peso específico de los factores de riesgo que determinan la presentación de estas enfermedades. Varias observaciones realizadas en nuestra población indican que el tiempo de exposición a los cambios de hábitos de vida ocasionados por la sociedad consumista (sedentarismo, dieta hipergrasa, hipercalórica) determina una respuesta biológica normal (obesidad, síndrome metabólico