Cardiovascular risk factors and proteinuria in Toba aborigines from Chaco, Argentina

Abstract

The Province of Chaco (Argentina) was part of the ‘Great Chaco’, a geographical region of area 300,000 km, which comprised the North East of Argentina, the South East of Paraguay, and Bolivia. Since ancient times, the region has been inhabited by aborigine ethnic groups. At present, aborigines constitute 4.8% of the Province inhabitants. Originally gatherers and hunters, during the last century they have been absorbed into Western civilization. In 2006, in a cross-sectional study of a random sample of the 365 Toba urban individuals, of mean age 36 years, a high prevalence of cardiovascular (CV) risk factors was found: hypertension (HT) 25%, central obesity 49.5%, overweight 33.5%, and obesity 21.3%. Proteinuria was present in 21.8% of the population, measured by urine protein (mg)/urine creatinine (mg) ratio; the values ranged between 0.20–0.49 in 67 individuals (80%), 0.50–1.00 in 10 (12%), and greater than 1.00 in 7 (8%). Only in 5.5% was the estimated glomerular filtration rate <60 ml/min. The relative risk for proteinuria for ages between 45–64 years was 3.84 (95% confidence interval 2.04–7.23) after adjusting for CV risk factors and gender. Follow-up of the 2006 cohort during 37 months showed an increase in the prevalence of CV risk factors: HT rose to 33% (only 5% of the previously known hypertensive group having control of their blood pressure); obesity reached 25%. The global mortality rate was 36/1000. The principal causes were infection and CV diseases. Toba aborigines are a vulnerable community with a high prevalence of risk CV apparently linked to the adoption of a Western lifestyle.