THURSDAY, March 8, 2007 (HealthDay News) -- Stress and tummy fat are among the biggest threats to the cardiovascular health of Latin Americans, a major six-country study finds.
"In the overall study, permanent stress was a major risk factor," noted Dr. Fernando Lanas, a professor of medicine at the Universidad de la Frontera in Temuco, Chile.
His team's study is just one in a special issue of Circulation, which this week is focusing on heart disease in Latin America.
The risk posed by stomach fat, especially, was stressed in an editorial by one U.S. cardiologist, Dr. Sidney C. Smith Jr., a professor of medicine at the University of North Carolina, Chapel Hill.
"In Latin American countries and many others with developing economies, there has been a rapid shift in diet to increased consumption of high energy-dense foods and caloric beverages," Smith wrote.
"The message is that this epidemic can be largely prevented by changes in lifestyle, and we need to work on understanding why dietary changes occurring in Latin America cause it to mirror what is happening in other parts of the world," Smith said in an interview.
A number of Latin American studies spread across six countries -- Argentina, Brazil, Colombia, Chile, Guatemala and Mexico -- compared 1,237 people who suffered first heart attacks against 1,888 people with no such heart problems. The researchers asked participants about their history of smoking, high blood pressure, diabetes, diet and physical activity, as well as psychosocial factors such as stress.
The researchers found that three factors -- abdominal obesity, abnormal blood fat levels and smoking -- accounted for 77.6 percent of the heart attack risk.
Persistent stress clearly is also associated with an increased risk of heart attack, Lanas said.
"Our feeling is that although there may be regional differences in some countries, overall it is an important risk factor," Lanas said.
Societal factors can boost stress levels across populations, he noted. For example, at the time the study was done stress was running high in several Latin American countries. "The rate of crime in Colombia is very high, and Argentina was in a major economic crisis," Lamas said.
Despite those regional differences, "the main message is that in Latin America, the major risk factors are general similar to those in other parts of the world," he said.
Six individual factors were found to double the risk of heart attack: persistent stress, high blood pressure, diabetes, smoking, being in the upper third of abdominal fat and a high ratio of "bad" LDL cholesterol to "good" HDL cholesterol.
The risk was reduced 75 percent for people who did not smoke, exercised regularly and ate fruits and vegetables every day.
The Latin American numbers should be taken to heart by people in the United States, Smith added.
"In the United States, two-thirds of the population is overweight," he said. "There has been a slight decline in hypertension and blood lipids, which has been offset by an increase in obesity and overweight. Abdominal obesity is no stranger to the United States."
As it is worldwide, heart disease remains the leading cause of death in Latin America. Reducing the death toll "requires attention involving all of society," Lanas said. "People must change their ways of living, with better diet and more physical activity."
Some governmental steps are being taken, particularly in Brazil, Smith said. "Seventy percent of the food budget in the schools is for healthy foods," he said. "They are closing streets so that people can exercise and dance."
The World Congress on Cardiology will be held in Buenos Aires in May, 2008, Smith noted. "That will give us an opportunity to discuss this situation in all its aspects," he said.
There's more on preventing heart disease at the American Heart Association.