Cardiovascular and renal risk factors and socioeconomics profile in indivicuals of the wichi ethnia group from “El Impenetrable”, Chaco, Argentina
Keywords:
natives; aborigins; wichi; risk factors; cardiovascular risk; renal risk; socioeconomic aspects; access to health
Abstract
Introduction: Several studies have shown a high prevalence of obesity, diabetes mellitus, hypertension, proteinuria, and chronic kidney disease in indigenous populations. Aim: To detect cardiovascular and renal risk factors, hypertension, overweight and obesity, truncal obesity, diabetes and proteinuria, and to evaluate educational level, employment situation, socioeconomic level and health care coverage in subjects from the Wichi ethnic group who inhabit in "El Impenetrable” in Chaco. Methods: An observational, descriptive, cross-sectional study was carried out, with a random sample of subjects over 18 years of age. The semi-structured survey, translated into the Wichi language, included: age, sex, sedentary lifestyle, smoking habit, educational level, employment situation, health care coverage and socioeconomic level. Weight, height, waist circumference, systolic and diastolic blood pressure, blood glucose and proteinuria were measured. Body mass index was calculated. Results: 156 people were evaluated (58.3% men; age: 34 ± 12 years). The body mass index was 27.9 ± 5.3, with no difference between the sexes. Hypertension was present in 10.8% of individuals; overweight in 34.0%; obesity in 30.9%; truncal obesity in 40.1% (higher in women, p = 0.03); smoking habit in 17.4%; sedentary lifestyle in 83.3%, and proteinuria in 14.5%. A single case of diabetes was registered. Only 6.4% reported having a job, 49.3% had not completed primary studies, 61.7% qualified as marginal in terms of socioeconomic status, and only 3.8% had health care coverage. Conclusion: This population group shows a high degree of food, educational, occupational, social and health vulnerability, reflected in the high prevalence of cardiovascular and renal risk factors (particularly excess weight and truncal obesity), in the low educational, employment and socioeconomic levels, and in the lack of health coverage.
References
1) Daniel M, Rowley KG, McDermott R, Mylvaganam A, O'Dea K. Diabetes incidence in an Australian aboriginal population. An 8-year follow-up study. Diabetes Care. 1999;22(12):1993‐8. doi: 10.2337/diacare.22.12.1993.
2) Leung L. Diabetes mellitus and the Aboriginal diabetic initiative in Canada: An update review. J Family Med Prim Care. 2016;5(2):259‐65. doi: 10.4103/2249-4863.192362.
3) Díaz AA, Tringler MF. Prevalence of hypertension in rural populations from Ibero-America and the Caribbean. Rural Remote Health. 2014;14:2591.
4) Hoy WE, Kondalsamy-Chennakesavan S, Wang Z, Briganti E, Shaw J, Polkinghorne K, et al. Quantifying the excess risk for proteinuria, hypertension and diabetes in Australian Aborigines: comparison of profiles in three remote communities in the Northern Territory with those in the AusDiab study. Aust N Z J Public Health. 2007;31(2):177‐83. doi: 10.1111/j.1753-6405.2007.00038.x.
5) Maeder EJA, Gutiérrez R. Atlas histórico del nordeste argentino. Resistencia: IIGHI-CONICET, Universidad Nacional del Nordeste, 1995. 197 p.
6) Atlas sociolingüístico de pueblos indígenas en América Latina y el Caribe. Madrid: UNICEF, FUNPROEID Andes, 2009. 510 p.
7) Argentina. Instituto Nacional de Estadísticas y Censos, Dirección de Estadísticas y Censos de la provincia del Chaco. Situación demográfica de la provincia del Chaco. Buenos Aires: INDEC, 2000. 97 p. (Serie Análisis Demográfico; 25).
8) Arenas P, ed. [Capítulos 1, 2 y 3]. En: López HL, Ponte Gómez J, comp. Etnografía y alimentación entre los Toba-Ñachilamole'ek y Wichí-Lhuku’tas del Chaco Central (Argentina). La Plata: Programa para el Estudio y Uso Sustentable de la Biota Austral, Facultad de Ciencias Naturales y Museo, Universidad Nacional de La Plata, 2003. 562 p. (Serie Documentos; 15).
9) Mondino ER [Defensor del Pueblo de la Nación]. [Demanda contra el Estado Nacional y la provincia del Chaco, a fin de que se los condene a adoptar las medidas que resulten necesarias para modificar la actual condición de vida de los habitantes de la región sudeste del Departamento General Güemes y noroeste del Departamento Libertador General San Martín de esa provincia] [Internet]. Buenos Aires, 2007. Disponible en: (consulta: 15/01/2020).
10) Bianchi ME, Farías EF, Bolaño J, Massari PU. Epidemiology of renal and cardiovascular risk factors in Toba Aborigines. Ren Fail. 2006;28(8):665‐70. doi: 10.1080/08860220600925750.
11) Ventura A. Estado nutricional, hábitos alimentarios y sedentarismo en aborígenes de la etnia toba de la provincia del Chaco [Tesis]. Corrientes: 2010. 87 p.
12) Argentina. Dirección Nacional de Promoción de la Salud y Control de Enfermedades No Transmisibles. Segunda Encuesta Nacional de Factores de Riesgo 2009 [Internet]. Buenos Aires: Ministerio de Salud, 2011. 244 p. Disponible en: (consulta: 20/01/2020).
13) Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273(5):402-7. doi:10.1001/jama.273.5.402.
14) World Health Organization. WHO policy on non-recruitment of smokers or other tobacco users. Frequently asked questions [Internet]. Ginebra: WHO, 2008. Disponible en: (consulta: 20/01/2020).
15) Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206‐52. doi: 10.1161/01.HYP.0000107251.49515.c2.
16) American Diabetes Association. Standards of medical care in diabetes--2012. Diabetes Care. 2012;35 Suppl 1(Suppl 1):S11‐S63. doi: 10.2337/dc12-s011.
17) World Health Organization. Obesity: preventing and managing the global epidemic [Internet]. Ginebra: WHO, 2000. 252 p. (WHO Technical Report Series; 894). Disponible en:
18) Han TS, van Leer EM, Seidell JC, Lean ME. Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. BMJ. 1995;311(7017):1401‐5. doi: 10.1136/bmj.311.7017.1401.
19) Asociación Argentina de Marketing; Sociedad Argentina de Investigadores de Marketing y Opinión. Nivel socioeconómico en la Argentina, 2015 [Internet]. Estratificación y variables. Buenos Aires: Observatorio Social de SAIMO, 2015. 16 p. Disponible en: (consulta: 20/01/2020).
20) Claudia R. Valeggia CR, Burke KM, Fernández-Duquea E. Nutritional status and socioeconomic change among Toba and Wichí populations of the Argentinean Chaco. Econ Hum Biol. 2010;8(1):100-10. doi: 10.1016/j.ehb.2009.11.001.
21) Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012;70(1):3‐21. doi: 10.1111/j.1753-4887.2011.00456.x.
22) Bianchi ME, Pacce O, Rodríguez N, Velasco G, Cusumano A. Evolución del estado nutricional en una cohorte de aborigen en la etnia toba luego de 15 años de seguimiento [Abstract]. ISN World Congress of Nephrology (WCN) Abstracts, Melbourne, Australia april 12-15, 2019. Kidney Int Rep. 2019;4(7):A1. doi: 10.1016/S2468-0249(19)31388-9.
23) Pouliot MC, Després JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, et al. Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol. 1994;73(7):460‐8. doi: 10.1016/0002-9149(94)90676-9.
24) Edwards KL, Austin MA, Newman B, Mayer E, Krauss RM, Selby JV. Multivariate analysis of the insulin resistance syndrome in women. Arterioscler Thromb. 1994;14(12):1940‐5. doi: 10.1161/01.atv.14.12.1940.
25) Wang Y, Rimm EB, Stampfer MJ, Willett WC, Hu FB. Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men. Am J Clin Nutr. 2005;81(3):555‐63. doi: 10.1093/ajcn/81.3.555.
26) Després JP. Excess visceral adipose tissue/ectopic fat the missing link in the obesity paradox? J Am Coll Cardiol. 2011;57(19):1887‐9. doi: 10.1016/j.jacc.2010.10.063.
27) Canoy D, Luben R, Welch A, Bingham S, Wareham N, Day N, et al. Fat distribution, body mass index and blood pressure in 22,090 men and women in the Norfolk cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) study. J Hypertens. 2004;22(11):2067‐74. doi: 10.1097/00004872-200411000-00007.
28) Marin MJ, Fábregues G, Rodríguez PD, Díaz M, Paez O, Alfie J, et al. Registro nacional de hipertensión arterial. Conocimiento, tratamiento y control de la hipertensión arterial. Estudio RENATA. Rev Argent Cardiol. 2012;80(2):121-9.
29) Bianchi MEV, Cusumano AM, Torres C, Rojas NG, Velasco GA. Prevalencia de obesidad e hipertensión arterial y su asociación con edad y sexo en la ciudad de Resistencia (Argentina), años 2008-2014. Hipertens Riesgo Vasc. 2019;36(1):14‐20. doi: 10.1016/j.hipert.2018.04.003.
30) Benghanem Gharbi M, Elseviers M, Zamd M, Belghiti Alaoui A, Benahadi N, Trabelssi EH, et al. Chronic kidney disease, hypertension, diabetes, and obesity in the adult population of Morocco: how to avoid "over"- and "under"-diagnosis of CKD. Kidney Int. 2016;89(6):1363‐1371. doi: 10.1016/j.kint.2016.02.019.
31) Kwon Y, Han K, Kim YH, Park S, Kim DH, Roh YK, et al. Dipstick proteinuria predicts all-cause mortality in general population: A study of 17 million Korean adults. PLoS One. 2018;13(6):e0199913. doi: 10.1371/journal.pone.0199913.
32) Maya AP, Cruz Sánchez M. De eso que se ha llamado interculturalidad en salud: un enfoque reflexivo. Rev Univ Ind Santander Salud. 2018;50(4):366-84. doi: 10.18273/revsal.v50n4-2018010.
2) Leung L. Diabetes mellitus and the Aboriginal diabetic initiative in Canada: An update review. J Family Med Prim Care. 2016;5(2):259‐65. doi: 10.4103/2249-4863.192362.
3) Díaz AA, Tringler MF. Prevalence of hypertension in rural populations from Ibero-America and the Caribbean. Rural Remote Health. 2014;14:2591.
4) Hoy WE, Kondalsamy-Chennakesavan S, Wang Z, Briganti E, Shaw J, Polkinghorne K, et al. Quantifying the excess risk for proteinuria, hypertension and diabetes in Australian Aborigines: comparison of profiles in three remote communities in the Northern Territory with those in the AusDiab study. Aust N Z J Public Health. 2007;31(2):177‐83. doi: 10.1111/j.1753-6405.2007.00038.x.
5) Maeder EJA, Gutiérrez R. Atlas histórico del nordeste argentino. Resistencia: IIGHI-CONICET, Universidad Nacional del Nordeste, 1995. 197 p.
6) Atlas sociolingüístico de pueblos indígenas en América Latina y el Caribe. Madrid: UNICEF, FUNPROEID Andes, 2009. 510 p.
7) Argentina. Instituto Nacional de Estadísticas y Censos, Dirección de Estadísticas y Censos de la provincia del Chaco. Situación demográfica de la provincia del Chaco. Buenos Aires: INDEC, 2000. 97 p. (Serie Análisis Demográfico; 25).
8) Arenas P, ed. [Capítulos 1, 2 y 3]. En: López HL, Ponte Gómez J, comp. Etnografía y alimentación entre los Toba-Ñachilamole'ek y Wichí-Lhuku’tas del Chaco Central (Argentina). La Plata: Programa para el Estudio y Uso Sustentable de la Biota Austral, Facultad de Ciencias Naturales y Museo, Universidad Nacional de La Plata, 2003. 562 p. (Serie Documentos; 15).
9) Mondino ER [Defensor del Pueblo de la Nación]. [Demanda contra el Estado Nacional y la provincia del Chaco, a fin de que se los condene a adoptar las medidas que resulten necesarias para modificar la actual condición de vida de los habitantes de la región sudeste del Departamento General Güemes y noroeste del Departamento Libertador General San Martín de esa provincia] [Internet]. Buenos Aires, 2007. Disponible en:
10) Bianchi ME, Farías EF, Bolaño J, Massari PU. Epidemiology of renal and cardiovascular risk factors in Toba Aborigines. Ren Fail. 2006;28(8):665‐70. doi: 10.1080/08860220600925750.
11) Ventura A. Estado nutricional, hábitos alimentarios y sedentarismo en aborígenes de la etnia toba de la provincia del Chaco [Tesis]. Corrientes: 2010. 87 p.
12) Argentina. Dirección Nacional de Promoción de la Salud y Control de Enfermedades No Transmisibles. Segunda Encuesta Nacional de Factores de Riesgo 2009 [Internet]. Buenos Aires: Ministerio de Salud, 2011. 244 p. Disponible en:
13) Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273(5):402-7. doi:10.1001/jama.273.5.402.
14) World Health Organization. WHO policy on non-recruitment of smokers or other tobacco users. Frequently asked questions [Internet]. Ginebra: WHO, 2008. Disponible en:
15) Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206‐52. doi: 10.1161/01.HYP.0000107251.49515.c2.
16) American Diabetes Association. Standards of medical care in diabetes--2012. Diabetes Care. 2012;35 Suppl 1(Suppl 1):S11‐S63. doi: 10.2337/dc12-s011.
17) World Health Organization. Obesity: preventing and managing the global epidemic [Internet]. Ginebra: WHO, 2000. 252 p. (WHO Technical Report Series; 894). Disponible en:
18) Han TS, van Leer EM, Seidell JC, Lean ME. Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. BMJ. 1995;311(7017):1401‐5. doi: 10.1136/bmj.311.7017.1401.
19) Asociación Argentina de Marketing; Sociedad Argentina de Investigadores de Marketing y Opinión. Nivel socioeconómico en la Argentina, 2015 [Internet]. Estratificación y variables. Buenos Aires: Observatorio Social de SAIMO, 2015. 16 p. Disponible en:
20) Claudia R. Valeggia CR, Burke KM, Fernández-Duquea E. Nutritional status and socioeconomic change among Toba and Wichí populations of the Argentinean Chaco. Econ Hum Biol. 2010;8(1):100-10. doi: 10.1016/j.ehb.2009.11.001.
21) Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012;70(1):3‐21. doi: 10.1111/j.1753-4887.2011.00456.x.
22) Bianchi ME, Pacce O, Rodríguez N, Velasco G, Cusumano A. Evolución del estado nutricional en una cohorte de aborigen en la etnia toba luego de 15 años de seguimiento [Abstract]. ISN World Congress of Nephrology (WCN) Abstracts, Melbourne, Australia april 12-15, 2019. Kidney Int Rep. 2019;4(7):A1. doi: 10.1016/S2468-0249(19)31388-9.
23) Pouliot MC, Després JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, et al. Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol. 1994;73(7):460‐8. doi: 10.1016/0002-9149(94)90676-9.
24) Edwards KL, Austin MA, Newman B, Mayer E, Krauss RM, Selby JV. Multivariate analysis of the insulin resistance syndrome in women. Arterioscler Thromb. 1994;14(12):1940‐5. doi: 10.1161/01.atv.14.12.1940.
25) Wang Y, Rimm EB, Stampfer MJ, Willett WC, Hu FB. Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men. Am J Clin Nutr. 2005;81(3):555‐63. doi: 10.1093/ajcn/81.3.555.
26) Després JP. Excess visceral adipose tissue/ectopic fat the missing link in the obesity paradox? J Am Coll Cardiol. 2011;57(19):1887‐9. doi: 10.1016/j.jacc.2010.10.063.
27) Canoy D, Luben R, Welch A, Bingham S, Wareham N, Day N, et al. Fat distribution, body mass index and blood pressure in 22,090 men and women in the Norfolk cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) study. J Hypertens. 2004;22(11):2067‐74. doi: 10.1097/00004872-200411000-00007.
28) Marin MJ, Fábregues G, Rodríguez PD, Díaz M, Paez O, Alfie J, et al. Registro nacional de hipertensión arterial. Conocimiento, tratamiento y control de la hipertensión arterial. Estudio RENATA. Rev Argent Cardiol. 2012;80(2):121-9.
29) Bianchi MEV, Cusumano AM, Torres C, Rojas NG, Velasco GA. Prevalencia de obesidad e hipertensión arterial y su asociación con edad y sexo en la ciudad de Resistencia (Argentina), años 2008-2014. Hipertens Riesgo Vasc. 2019;36(1):14‐20. doi: 10.1016/j.hipert.2018.04.003.
30) Benghanem Gharbi M, Elseviers M, Zamd M, Belghiti Alaoui A, Benahadi N, Trabelssi EH, et al. Chronic kidney disease, hypertension, diabetes, and obesity in the adult population of Morocco: how to avoid "over"- and "under"-diagnosis of CKD. Kidney Int. 2016;89(6):1363‐1371. doi: 10.1016/j.kint.2016.02.019.
31) Kwon Y, Han K, Kim YH, Park S, Kim DH, Roh YK, et al. Dipstick proteinuria predicts all-cause mortality in general population: A study of 17 million Korean adults. PLoS One. 2018;13(6):e0199913. doi: 10.1371/journal.pone.0199913.
32) Maya AP, Cruz Sánchez M. De eso que se ha llamado interculturalidad en salud: un enfoque reflexivo. Rev Univ Ind Santander Salud. 2018;50(4):366-84. doi: 10.18273/revsal.v50n4-2018010.
Published
2020-09-16
How to Cite
1.
Bianchi MEV, Velasco GA, López G, Cusumano AM. Cardiovascular and renal risk factors and socioeconomics profile in indivicuals of the wichi ethnia group from “El Impenetrable”, Chaco, Argentina. Rev Nefrol Dial Traspl. [Internet]. 2020Sep.16 [cited 2024Jul.16];40(3):210-2. Available from: http://revistarenal.org.ar/index.php/rndt/article/view/534
Section
Original Article
Copyright (c) 2020 Revista de Nefrología, Diálisis y Trasplante
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
