Background Adiposity is a major component of the metabolic syndrome (MetS), low muscle strength has also been identified as a risk factor for MetS and for cardiovascular disease. We describe the prevalence of MetS and evaluate the relationship between muscle strength, anthropometric measures of adiposity, and associations with the cluster of the components of MetS, in a middle-income country. Methods MetS was defined by the International Diabetes Federation criteria. To assess the association between anthropometric variables (waist circumference (WC), waist-to-hip ratio (W/H), body mass index (BMI)), strength (handgrip/kg bodyweight (HGS/BW)) and the cluster of MetS, we created a MetS score. For each alteration (high triglycerides, low HDLc, dysglycemia, or high blood pressure) one point was conferred. To evaluate the association an index of fat:muscle and MetS score, participants were divided into 9 groups based on combinations of sex-specific tertiles of WC and HGS/BW. Results The overall prevalence of MetS in the 5,026 participants (64% women; mean age 51.2 years) was 42%. Lower HGS/BW, and higher WC, BMI, and W/H were associated with a higher MetS score. Amongst the 9 HGS/BW:WC groups, participants in the lowest tertile of HGS/BW and the highest tertile of WC had a higher MetS score (OR = 4.69 in women and OR = 8.25 in men;p < 0.01) compared to those in the highest tertile of HGS/BW and in the lowest tertile of WC. Conclusion WC was the principal risk factor for a high MetS score and an inverse association between HGS/BW and MetS score was found. Combining these anthropometric measures improved the prediction of metabolic alterations over either alone.

BACKGROUND A higher prevalence of hypertension is reported among Afro-descendants compared to other ethnic groups in high-income countries, however there is a paucity of information in low- and medium-income countries. METHODS We evaluated 3745 adults from 3 ethnic groups (552 White, 2,746 Mestizos, 447 Afro-descendants) enrolled in the prospective population-based cohort study (PURE) - Colombia. We assessed associations between anthropometric, socioeconomic, behavioral factors and hypertension. RESULTS The overall prevalence of hypertension was 39.2% and was higher in Afro-descendants (46.3%) than in Mestizos (37.6%) and Whites (41.5%), differences that were due to the higher prevalence in Afro-descendant women. Hypertension was associated with older age, increased body mass index, waist circumference and waist-to-hip ratio, independent of ethnicity. Low education was associated with hypertension in all ethnic groups, and particularly in Afro-descendants, for whom it was the factor with the strongest association with prevalence. Notably, 70% of Afro-descendants had a low level of education, compared to 52% of Whites - 26% of Whites were university graduates while only 7% of Afro-descendants were. We did not find that education level alone had a mediator effect, suggesting that it is not a causal risk factor for hypertension but is an indicator of socioeconomic status, itself an important determinant of hypertension prevalence. CONCLUSIONS We found that a higher prevalence of hypertension in Colombian Afro-descendants than other ethnic groups. This was principally associated with their lower mean educational level, an indicator of lower socioeconomic status.

High blood pressure (BP) is the leading global preventable cause of death and the most common risk factor for cardiovascular disease (CVD). However, due to its asymptomatic nature, the lack of awareness of this condition causes underdiagnosis and low rates of adherence to pharmacological treatment. Looking for practical approaches to increase awareness worldwide, the International Society of Hypertension (ISH) implemented the 2nd May Measurement Month campaign in 2018 (MMM18). In order to contribute to this initiative, Colombia participated as one of the 89 countries involved in this hypertension screening programme. Blood pressure was measured in subjects from 11 departments in Colombia. Under the leadership of the Fundación Oftalmológica de Santander (FOSCAL), 400 volunteers across the country collected the data following the MMM protocol. Measurements from 35 548 participants with a mean age of 41.9 years were obtained. In total, 9475 (26.7%) of the total population studied had hypertension. Of those with hypertension, 69.9% of these subjects were aware of their condition, 65.0% were on antihypertensive medication, and 43.1% had controlled BP. Of those on medication, 66.3% had controlled BP. Hypertension screening, awareness, treatment, and control should be a priority in public health objectives due to its elevated burden of disease and direct association with increased CVD. The MMM campaign provided a positive impact in the diagnosis of hypertension across Colombia. Although efforts are being made to expand treatment capability and adherence, still more are needed to insure a broader coverage of antihypertensive medication in Colombia.

Objective: Higher prevalence of hypertension among afro-descendants compared to other ethnic groups has been reported in high-income countries. Genetic, behavioral, and socioeconomic factors could explain these differences, and body composition could contribute. This study aims to assess the association between handgrip strength (HGS) and hypertension in different ethnicities in a middle-income country. We additionally evaluated the role of socioeconomic and behavioral factors to explain ethnic differences. Design and method: We evaluated the association between HGS measured by Jamar Dynamometer and the risk hypertension in 4102 adults aged 35 to 70 years from 3 ethnic groups (593 whites, 3001 mestizos, 508 afro-descendants) enrolled in the prospective population-based cohort study PURE-Colombia. We calculated unadjusted and adjusted odds ratios (95% CI) for the prevalence of hypertension across tertiles of HGS and the association with anthropometric, socioeconomic, and behavioral factors. Results: Results: The overall prevalence of hypertension was 39.2%, being greater in the afro-descendants (46.3%) than in whites (41.5%) and mestizos (37.6%). A higher prevalence of hypertension was found in mestizos and afro-descendants in tertile 1 of HGS (< 21 kg) compared to those in tertile 3 of HGS (> 29.7 kg) (OR = 1.48; 95% CI: 1.20 - 1.84 and OR = 1.70; 95% IC: 1.01 – 2.85, respectively). However, when adjusting by confounders, the association lost statistical significance. The prevalence of hypertension was positively associated with body mass index and waist circumference. There was a higher prevalence amongst individuals with a low educational level compared to those with a high educational level in whites (OR = 1.74; 95% CI: 1.08 - 2.78), mestizos (OR = 1.5 95% CI: 1.13 - 2.01), and afro-descendants (OR = 2.46; 95% CI: 1.11 - 5.45). Behavioral factors, such as alcohol and tobacco intake, protein, and fat consumption, were not associated with a higher prevalence of hypertension. Conclusions: HGS could partially contribute to explaining ethnic differences in the prevalence of hypertension. However, socioeconomic factors such as education level play a key role. Therefore, a greater focus on screening for low HGS, interventions aimed at attenuating age-related declines, and addressing social inequalities could positively impact these differences.