Intern
ati
o
n
a
l
Jo
urn
a
l
o
f
P
u
b
lic Hea
l
th Science (IJ
P
HS)
V
o
l.3
,
No
.2
,
Jun
e
2
014
, pp
. 11
7
~
12
8
I
S
SN
: 225
2-8
8
0
6
1
17
Jo
urn
a
l
h
o
me
pa
ge
: h
ttp
://iaesjo
u
r
na
l.com/
o
n
lin
e/ind
e
x.ph
p
/
IJPHS
Cardiovas
c
ular Health B
e
haviors
and Ris
k
Factors am
ong
Argentin
e and Ameri
can
University Students
Gina
Fitzg
erald, Ga
briella
Smith, Do
n Tho
m
pson
Pepperdine University
, USA
Article Info
A
B
STRAC
T
Article histo
r
y:
Received April
16, 2014
Rev
i
sed
May 20
, 20
14
Accepted
May 29, 2014
Cardiovas
c
u
l
ar
dis
eas
e is
the le
ading
cause of death in adults in both the
United States an
d Argentina. Sci
e
ntifi
c
literature has
consistently
shown
the
effects of behaviors and risk factor
s on cardiovascular health
; however, few
have investig
ated cardiov
ascular be
haviors and risk factors in ear
ly
adulthood
. We assessed the
associati
ons between main car
d
iovascular
behaviors and
cardiovascular
risk
factors among 5
94
y
oung
adults
in a
cross-
cultur
a
l analy
s
is between the U
n
ited
States and
Argentina thro
ugh a web-
based surve
y
an
d vital sta
tisti
cs m
eas
urements. We tested our data throug
h
principle component analy
s
is, bivariate
correlations,
and indep
e
n
d
ent
sample
T-tests.After th
orough analy
s
is
we saw
that,
cross culturally
,
correlations
exis
t be
tween
ca
rdiovas
c
ul
ar ris
k
factor
s
and beh
a
viors that ar
e consistent in
both populations
. Health hab
i
t, health
knowledge, health histor
y
and BMI are
all sign
ific
ant
l
y
correl
a
ted
with
m
ean art
e
ri
al pr
essure. T-
tests s
howed tha
t
population grou
ps with a higher risk f
actor mean also had low
e
r behavio
r
means, indicating that
populations with poo
r card
i
ovascular behav
i
ors
correl
a
te
with a
n
accum
u
la
tion
of cardiov
as
cul
a
r ris
k
facto
r
s
.
In
conclus
i
on
,
y
oung
adults with low prev
alen
ce of
car
diov
ascular health
behaviors hav
e
low preva
l
en
ce
of card
i
ovas
c
u
l
a
r
hea
lth
ris
k
f
act
ors
.
Keyword:
Card
iov
a
scu
l
ar Health
B
e
havi
or
Ar
ge
nt
i
n
a
United States
Uni
v
ersity students
Copyright ©
201
4 Institut
e
o
f
Ad
vanced
Engin
eer
ing and S
c
i
e
nce.
All rights re
se
rve
d
.
Co
rresp
ond
i
ng
Autho
r
:
Do
n Th
om
pso
n
,
Pepp
erd
i
n
e
Univ
er
sity,
USA
Em
a
il: th
o
m
p
s
o
n
@p
epp
e
rd
ine.edu
1.
INTRODUCTION
Thr
o
ug
h
out
m
u
ch
of t
h
e w
o
r
l
d, car
di
o
v
asc
u
l
a
r
disease (C
VD) is the leading causes
of adult death
[1]
.
I
n
b
o
t
h
t
h
e Uni
t
e
d St
at
es and A
r
g
e
nt
i
n
a, C
VD an
n
u
a
l
l
y
account
s fo
r ove
r o
n
e t
h
i
r
d of a
dul
t
m
o
rt
al
i
t
y
[2]
,
[3]
.
A
d
di
t
i
onal
l
y
, C
V
D i
s
t
h
e pri
m
ary
cause o
f
deat
h
am
ong Hi
s
p
a
n
i
c
and Lat
i
n
o
po
pul
at
i
o
ns i
n
t
h
e
Un
ited States [4
] and
t
h
is is
o
f
ten
attribu
t
ed
to th
e
l
o
w
s
o
ci
oec
o
n
o
m
i
c st
at
us hel
d
by
a l
a
rge
p
r
o
p
o
rt
i
on
o
f
t
h
ese
po
p
u
l
a
t
i
ons
. R
e
sea
r
c
h
sh
ow
s t
h
at
m
i
ddl
e
-
age
i
n
di
vi
dual
s
wi
t
h
a l
o
w C
V
D
ri
sk
p
r
ofi
l
e
,
defi
ned
as t
h
e
lev
e
ls o
f
estab
lish
e
d
m
o
d
i
fi
ab
le CVD risk
factors, [5
] h
a
v
e
d
r
am
atic
ally
lo
wer m
o
rtality rates, g
r
eater
lo
ng
ev
ity, and
su
bstan
tially lo
wer rates and
risk
s
for C
V
D ev
en
ts in
co
m
p
arison
to ind
i
v
i
du
als
with
ou
t a
lo
w-
risk
profile [5
]
-
[8
]. Fu
rt
h
e
rmo
r
e, a lo
w risk
p
r
o
f
ile in
mid
d
le ag
e is asso
ciated
with
h
i
gher q
u
a
lity o
f
life an
d
l
o
we
r M
e
di
ca
r
e
cha
r
ges
i
n
a
d
vance
d
a
g
e
[
6
]
,
[9]
,
[1
0]
.
Th
ere is su
b
s
t
a
n
tial ep
id
em
i
o
log
i
cal evide
n
ce that s
h
ows that a
pe
rs
o
n
’s
ris
k
f
o
r
ca
rdi
ovasc
ula
r
d
i
sease will b
e
d
r
am
atica
lly
l
o
wer if h
e
or sh
e can
m
a
in
tai
n
op
ti
m
a
l
lev
e
ls o
f
risk
fact
ors un
til
mid
d
l
e ag
e.
Add
itio
n
a
lly,
h
i
s or h
e
r su
rviv
al will b
e
mark
ed
ly lo
ng
er th
an
th
at
o
f
a p
e
rson
who
has d
e
v
e
lop
e
d
o
n
e
or
m
o
re risk
facto
r
s [
1
1]
-[
1
3
]
Pri
m
ary
pr
e
v
enti
on is
viewe
d
as
the princi
pal
mean to halt t
h
e
ons
et of C
V
D, yet
m
o
st
st
udi
es o
f
m
odi
fi
abl
e
be
havi
ors
an
d C
V
D
ri
s
k
fact
or
s exam
i
n
e ol
de
r a
dul
t
s
a
n
d
el
derl
y
,
[1
4]
-
[
1
7
]
whi
l
e
few st
udies
ha
ve investigated beha
vi
ors a
nd
CVD
risk
factors in early ad
ul
thood
[18]. T
h
ere ha
ve been
recent
stu
d
i
es t
h
at exa
m
in
e, in
t
h
e
yo
un
g adu
lt po
pu
latio
n,
t
h
e
association between cardi
ova
s
cular
risk fact
ors
and
b
e
h
a
v
i
ors with card
i
ov
ascu
lar
h
ealth
, as m
easu
r
ed b
y
carotid
in
tim
a th
ic
k
n
e
ss.
Ad
d
ition
a
lly, th
e
prevalen
ce
o
f
th
e id
eal car
d
i
o
v
a
scu
l
ar
(CV
)
h
ealth
m
e
tr
ic h
a
s b
een
stu
d
i
ed
in
p
opulatio
n
s
ar
oun
d
th
e g
l
ob
e, howev
er
it
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJP
H
S
V
o
l
.
3,
No
. 2,
J
u
ne 2
0
1
4
:
11
7 – 1
2
8
11
8
h
a
s
b
e
en
m
o
stly fo
cu
sed
o
n
coun
try
g
r
o
u
p
s
t
h
at are
p
r
i
m
arily o
f
caucasian
ethn
icities, such as
Fin
l
an
d,
Au
st
ralia, and
th
e Un
ited
States.
[
19]
W
e
c
h
os
e to exam
ine
a prim
arily ca
ucasi
a
n
po
p
u
l
a
t
i
on g
r
o
u
p
aga
i
nst
a
pri
m
ari
l
y
hi
spa
n
i
c
po
p
u
l
a
t
i
on
gr
o
up t
o
asses
s
whet
he
r t
h
er
e are di
ffe
renc
es i
n
C
V
beha
vi
o
r
s an
d ri
sk
fact
or
s
b
e
tween
th
e t
w
o
coun
tries an
d wh
et
h
e
r
t
h
e as
sociated tre
n
ds
betwee
n
beha
vi
ors and
risk
factors is a
uni
versal
t
r
en
d or n
o
t
.
Whi
l
e
st
udy
i
n
g i
n
A
r
gent
i
n
a, we
pr
op
ose
d
a
n
d co
ndu
cte
d
a
cr
os
s
-
cultu
ral com
p
ara
tive study
d
e
sign
ed
to
evalu
a
te id
eal CV h
ealth
in
you
ng
adu
lts in
bo
th
th
e
Un
ited
States an
d
Argen
tin
a b
y
assessin
g
the
association bet
w
een ca
rdiova
scular
h
eal
t
h
beha
vi
o
r
s a
n
d
ri
sk
fact
o
r
s a
s
a m
eans to pre
v
e
n
t the onset of
cardi
ovasc
ular disease.
Ide
a
l
cardi
ovasc
ul
ar
h
eal
t
h
i
s
de
fi
ne
d
as o
p
t
i
m
al
l
e
vel
s
fo
r f
o
ur
be
h
a
vi
o
r
s -
b
o
d
y
m
a
ss
i
nde
x (B
M
I
), s
m
oki
ng, p
h
y
s
i
cal
act
i
v
i
t
y
, an
d di
et
, an
d t
h
re
e C
V
ri
sk fact
ors -
bl
o
od
pre
ssure
, fast
i
n
g p
l
asm
a
g
l
u
c
o
s
e, and
ch
o
l
estero
l [19
]
,[2
0
]
Add
itio
nally, id
eal CV
h
ealth
h
a
s b
e
en
asso
ciated
with
CV m
o
rb
idity [2
1
]
an
d
t
h
e
nu
m
b
er o
f
id
eal CV h
ealth
m
e
trics
is
asso
ci
ated
with
lo
wer CVD an
d
g
e
n
e
ral
m
o
rtalit
y [2
2
]
,[23
].
Du
e
to
th
e lim
i
t
ed
fund
ing
and
reso
urces av
ailab
l
e in
bo
th
l
o
c
a
tions,
we c
hose to e
x
am
ine one
easily assessable
r
i
sk f
actor
, b
l
oo
d
press
u
r
e
, a
g
ai
nst
com
posi
t
es o
f
t
h
e
fo
u
r
l
i
st
ed be
ha
vi
o
r
s
.
W
e
foc
u
se
d o
n
t
h
e rel
a
t
i
ons
hi
p o
f
th
e risk
fact
o
r
an
d b
e
h
a
v
i
ors
in
th
ese t
w
o po
pu
latio
ns,
k
e
ep
ing
so
cio
e
cono
m
i
c statu
s
, age, and
n
a
tion
a
lity in
each population
c
onsta
nt. We
hypothes
ize
d
that the
poor
CV be
ha
viors
would be
associated with
poor C
V
ri
sk fact
ors
.
Ad
di
t
i
onal
l
y
,
we hy
p
o
t
h
e
s
i
zed t
h
at
t
h
e re
l
a
t
i
onshi
p bet
w
een
ri
sk fac
t
ors an
d
beha
vi
o
r
s i
s
hom
oge
neo
u
s
i
n
bot
h c
o
u
n
t
r
i
e
s.
2.
R
E
SEARC
H M
ETHOD
In t
h
e
fal
l
of
20
1
1
,st
u
de
nt
s
at
Peppe
rdi
n
e Uni
v
ersity,
in
Malib
u
,
Califo
r
n
i
a, were in
v
ited
to
part
i
c
i
p
at
e i
n
an IR
B
sanct
i
one
d,
v
o
l
u
nt
ar
y
web-
base
d
sur
v
ey
. Al
s
o
i
n
t
h
e fal
l
of
20
11
, st
u
d
e
n
t
s
at
Uni
v
ersi
dad C
a
t
ó
l
i
ca de Arg
e
nt
i
n
a (UC
A
)
,
i
n
B
u
en
os Ai
re
s, Ar
ge
nt
i
n
a,
were i
n
vi
t
e
d b
y
a
t
e
am
of car
di
ol
o
g
y
resi
de
nt
s an
d
a Pep
p
er
di
ne
r
e
search st
ud
en
t
t
o
part
i
c
i
p
ate
in the sam
e
r
e
search
projec
t. A data colle
ction
st
at
i
on wa
s set
u
p
at
UC
A Sc
ho
ol
of M
e
di
ci
ne
whi
l
e
resi
d
e
nt
s an
d t
h
e re
searche
r
i
n
vi
t
e
d A
r
gent
i
n
e
st
ude
nt
s
t
o
v
o
l
unt
ari
l
y
part
i
c
i
p
at
e st
u
d
y
,
usi
n
g a
ha
rd
co
py
of
t
h
e
we
b
base
d s
u
rvey
t
h
at
ha
d
b
een t
r
a
n
sl
at
ed
i
n
t
o
Sp
an
ish.
After th
e st
u
d
e
n
t
s co
m
p
leted
the surv
ey,
th
e r
e
s
i
d
e
n
t
s
and
th
e s
t
ud
en
t r
e
s
e
ar
c
h
,
u
n
d
e
r the
su
perv
ision
o
f
th
e attend
ing
card
i
o
log
i
st, co
llected
th
e st
u
d
en
ts’
d
a
ta.
The
web
-
base
dsu
r
vey
assess
ed st
u
d
e
n
t
de
v
e
l
opm
ent
in the areas
of c
u
rrent m
e
dical inform
ation,
pers
o
n
al
heal
t
h
hi
st
o
r
y
,
fam
i
l
y
heal
t
h
hi
st
o
r
y
,
per
s
o
n
al
ha
bi
t
s
, an
d k
n
o
w
l
e
dge
of car
di
ova
scul
ar
heal
t
h
. T
h
e
survey assess
ed dem
ogra
p
hic inform
ation as well.
The survey include
d 35 ite
ms, exclusi
v
e of the
dem
ogra
phi
c
q
u
est
i
o
ns, t
o
be
answe
r
e
d
by
t
h
e pa
rt
i
c
i
p
ant
,
as wel
l
as 11 i
t
em
s t
o
be
m
e
asure
d
by
t
h
e st
ud
y
adm
i
nistrator to asse
ss t
h
e st
ude
nts’ c
u
rrent cardi
ova
scul
ar
h
ealth
. Par
t
i
c
ip
an
ts
r
e
sp
ond
ed to 27
yes
o
r
no
q
u
e
stio
n
s
,
an
d 8
fill
in
th
e b
l
an
k
s
.
A Spa
n
i
s
h
pap
e
r co
py
of t
h
e
web
based s
u
r
v
ey
was creat
e
d
fo
r t
h
e resea
r
ch g
r
ou
p i
n
B
u
en
os Ai
res
,
Arge
ntina. T
h
e
survey wa
s created by
a
n
A
r
gent
i
n
e
car
di
ol
ogi
st
wi
t
h
t
h
e
assistance of t
h
e stude
n
t rese
arche
r
in
Arg
e
n
tin
a.
Th
e con
t
ex
t of th
e con
s
en
t form
an
d
all su
rv
ey qu
estions rem
a
in
ed
th
e sa
m
e
b
e
tween
th
e
Eng
lish
web surv
ey and
th
e Sp
an
ish
p
a
p
e
r
su
rv
ey, as ou
tlin
ed b
e
l
o
w.
1.
Dem
ogra
phi
c Form
:
Dem
ographi
c i
n
fo
rm
ati
on was c
o
l
l
ect
ed by
m
eans of a self-re
p
ort docum
e
nt in
whi
c
h pa
rt
i
c
i
p
ant
s
we
re as
k
e
d t
h
ei
r a
g
e
,
sex, cl
ass
st
andi
ng
, c
o
l
l
e
ge
m
a
jor
,
et
h
n
i
c
i
t
y
, and cam
pus
m
a
ilbox a
n
d e
m
ail address
(for
Peppe
r
di
ne
stude
nts
only,
as a m
eans of
receiving t
h
e
participation
gift
card).
2.
Perso
n
a
l Health
Histo
r
y:
In
formatio
n
w
a
s self
r
e
po
r
t
ed
an
d
co
nsisted
o
f
11 ite
m
s
categ
o
r
i
zed
u
n
d
e
r
b
l
ood
press
u
re,
dyslipidem
ia, and diabetes.
3.
H
ealth
H
i
stor
y o
f
Par
e
n
t
s:
Par
t
i
c
i
p
ant
s
were
pr
o
v
i
d
e
d
a l
i
s
t
of 6 c
o
n
d
i
t
i
ons
cont
ri
b
u
t
i
n
g t
o
cardi
ova
scul
a
r
heal
t
h
, a
nd
we
re aske
d t
o
i
d
e
n
t
i
f
y
t
hose t
h
at
t
h
ei
r pare
nt
s h
a
ve o
r
ha
ve n
o
t
suffe
red
fr
om
, or i
f
t
h
e st
ude
nt
doe
s not
k
n
o
w
.
4.
Pers
onal
Habi
t
s
:
Particip
an
ts self reported
th
eir
week
l
y
habi
t
s
. Th
e
sect
i
on co
nsi
s
t
e
d o
f
1
7
i
t
e
m
s
exam
i
n
i
ng
pat
t
e
rns
i
n
sl
eep,
s
m
oki
ng,
di
et
, a
n
d
exe
r
ci
se.
5.
K
now
ledg
e:
Pa
rt
i
c
i
p
ant
s
we
re aske
d
3
c
o
m
p
rehe
nsi
v
e
que
st
i
onst
o
assess t
h
ei
r k
n
o
wl
e
dge
of
card
i
o
v
a
scu
l
ar
h
ealth
and
risk
facto
r
s. In
each
q
u
e
stio
n particip
an
ts
will b
e
presen
ted
with
a list and
aske
d t
o
i
d
e
n
t
i
f
y
va
ri
o
u
s
pa
rt
s. F
o
r
e
x
am
pl
e, “Gi
v
en
t
h
e follo
wing
11
risk factors, id
en
tify th
e
4 th
at are
m
o
st directly correlated
w
ith cardi
ovasc
ular disease.”
6.
Cu
rren
t Med
i
cal In
fo
rm
atio
n
:
Aft
e
r com
p
l
e
t
i
ng t
h
e s
u
r
v
ey
, Pep
p
er
di
ne
st
ude
nt
s wer
e
i
nvi
t
e
d t
o
joi
n
researc
h
ers out
s
ide of the Pe
pperdine
Wa
ves
Café be
tween
th
e
hou
rs of 1
2
:0
0-16
:00
.
Th
ere
th
e
st
ud
en
ts’
heart
rat
e
an
d
bl
oo
d
press
u
r
e
were t
a
ke
n
by
a sur
v
ey
adm
i
ni
st
er (sup
ervi
se
d by
a cert
i
f
i
e
d n
u
r
s
e
’
s
assi
st
ant
)
an
d r
ecor
d
e
d
al
o
ngs
i
d
e t
h
ei
r s
u
r
v
e
y
resul
t
s
. St
u
d
e
nt
s w
ho
ha
d n
o
t
t
a
ken t
h
e su
rvey
we
re i
n
vi
t
e
d
t
o
com
p
l
e
t
e
t
h
e sur
v
ey
o
n
pa
per a
nd
ha
ve t
h
ei
r vi
t
a
l
s
t
a
ke
n u
p
on i
m
m
e
diat
e com
p
l
e
t
i
on. In B
u
e
nos
Ai
res,
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
A C
o
mp
ar
at
i
ve St
u
d
y
of
C
a
rdi
o
va
scul
ar
Heal
t
h
Be
havi
o
rs
a
n
d
Ri
sk F
a
ct
or
s ...
. (
G
i
n
a
Fi
t
z
ger
a
l
d
)
11
9
the cardiol
ogis
t
s and stude
n
t resea
r
che
r
set
up a
data
c
o
l
l
ection area
in the
UCA Sc
hool
of Medici
ne
plaza. Stude
n
ts were a
p
proa
ched a
n
d invited to
partic
ipa
t
e in the surve
y
and
have their vital statistics
measured.
B
l
oo
d p
r
ess
u
r
e
was m
easur
ed
usi
n
g a
n
a
u
t
o
m
a
t
e
d sphy
gm
o
m
anom
et
er de
vi
ce (
O
m
r
o
n
, m
odel
HEM-705CP, Om
ron Healthcare Inc.,
US
A). The blood pressure cuff was
placed around the right upper arm
.
Sy
st
ol
i
c
and di
ast
o
l
i
c
bl
o
od p
r
essu
res were m
easured by
the bl
ood
pres
s
u
re c
u
ff as
well as heart rate.
Thre
e
basel
i
n
e B
P
re
adi
n
gs we
re t
a
ken at
2-m
i
n int
e
r
v
al
s by
o
n
e
of t
h
e i
nvest
i
g
at
ors
,
w
h
i
l
e
anot
her i
nvest
i
g
at
o
r
ch
atted
amicab
ly with
th
e
subject to dispe
l
nervousnes
s. An ave
r
age
of the 3 m
easure
m
ents was us
ed for
analysis. The a
v
era
g
e systolic
and a
v
er
ag
e diasto
lic
v
a
lu
es were u
s
ed
to
ca
lculate the
mean arterial pre
ssure
b
y
th
e
fo
rm
u
l
a: MAP =
[(2xDiasto
lic Avg
.
) +
(Systo
lic
Av
g.)]/3
Hei
g
ht
an
d wei
ght
val
u
es
wer
e
sel
f
rep
o
r
t
e
d
by
t
h
e pa
rt
i
c
i
p
ant
s
as t
h
ey
we
re n
o
t
com
f
ort
a
bl
e ha
vi
n
g
these m
easure
m
ents in
publi
c
. T
h
e
values
were
re
port
ed
i
n
i
n
c
h
es
a
n
d po
u
nds
, res
p
ec
t
i
v
el
y
,
an
d bot
h were
later co
nv
erted to
cen
tim
e
t
ers an
d
k
ilog
r
am
s, resp
ectiv
ely,
du
ri
n
g
dat
a
sc
r
u
b
b
i
n
g a
nd a
n
al
y
s
i
s
and we
r
e
used
to
calcu
late th
e in
d
i
v
i
du
als B
M
I,
u
s
ing
t
h
e fo
rm
u
l
a: weigh
t
(k
g)/[h
e
igh
t
(m
)
]
2
Aft
e
r t
a
ki
n
g
t
h
e su
rvey
,
U
C
A st
ude
nt
s h
a
d t
h
ei
r hei
g
h
t
, wei
ght
, bl
o
od
pres
su
re, a
nd
heart
rat
e
measured. A
porta
b
le stadiometer was use
d
to m
easure
h
e
igh
t
in
cen
timeters, an
d a
p
o
rtab
le
d
i
g
ital weigh
scal
e was used
t
o
m
easure wei
ght
i
n
ki
l
o
gr
am
s. An Om
ron HEM
6
29 w
r
i
s
t
bl
oo
d p
r
es
sure m
oni
t
o
r
was us
e
to
co
llect th
e
p
a
rticip
an
ts restin
g
b
l
ood
p
r
essu
re an
d
rest
in
g
h
e
art rate.
Th
ree m
easu
r
emen
ts were tak
e
n
of
bot
h
t
h
e part
i
c
i
p
ant
s
bl
o
od p
r
essu
re
a
nd he
art
rat
e
.
A
n
a
v
erage
of t
h
e three m
eas
u
r
emen
ts f
o
r
bo
th b
l
oo
d
press
u
re a
n
d heart was
used for analysis.
3.
R
E
SU
LTS AN
D ANA
LY
SIS
Part
i
c
i
p
ant
s
w
e
re s
u
r
v
ey
ed
once
,
a
n
d
dat
a
was a
n
al
y
zed
usi
n
g
SPS
S.
Ove
r
1,
00
0 st
ude
nt
s
wer
e
in
v
ited
to
p
a
rticip
ate in
th
is research
stud
y.
After a pr
o
c
ess o
f
d
a
ta scru
bb
ing
,
594
p
a
rti
c
ip
an
ts were elig
ib
le
f
o
r
analysis. Th
e
d
a
ta scrubb
ing
pro
cess i
n
clud
ed d
e
letin
g
d
a
ta
o
f
p
a
rticip
an
ts no
t bo
rn
in
eit
h
er
USA
or
A
r
g
e
n
tin
a, purg
i
ng
subj
ects w
ith
in
co
m
p
let
e
su
rv
eys, and eli
m
in
atin
g
su
rv
ey r
e
sp
on
ses f
r
o
m
stu
d
e
n
t
s w
ho
di
d
not
ha
ve t
h
ei
r vi
t
a
l
st
at
i
s
t
i
cs (hea
rt
rat
e
a
nd
bl
o
o
d
press
u
re
) m
easured. As a re
sult,
we were a
b
le to
record
resul
t
s
as f
o
l
l
o
ws:
Ar
ge
nt
i
n
e sam
p
l
e
si
ze =
39
9, f
e
m
a
l
e
subsam
pl
e si
ze = 24
1, m
a
l
e
sub
s
am
pl
e si
ze =
15
8;
US
A sam
p
l
e
size = 19
5,
fem
a
l
e
subsam
pl
e Si
ze = 10
1, m
a
le su
bsam
pl
e size = 94
.
We o
r
gani
ze
d o
u
r
su
rv
e
y
an
d
v
ital statistics
m
easu
r
emen
ts in
to
ei
g
h
t
v
a
riab
les.
Alt
h
oug
h
h
e
art rate in
literatu
re is n
o
t
co
n
s
i
d
ered
a
card
i
o
v
a
scu
l
ar
b
e
h
a
v
i
or or risk
factor
, it was in
clu
d
e
d
in
our stu
d
y
to
inv
e
stig
ate th
e p
o
s
sib
ility o
f
h
eart rat
e
bei
n
g a
fact
or
of ca
r
d
i
o
vascu
l
ar heal
t
h
,
si
nc
e i
t
i
s
so cl
osel
y
rel
a
t
e
d wi
t
h
t
h
e f
u
nct
i
oni
ng
of t
h
e car
di
o
v
a
s
cul
a
r
syste
m
.
1)
Bod
y
M
a
ss Inde
x
(B
MI
):
Target
B
M
I
ra
nge
i
s
18
.5
0 - 24
.9
9 k
g
/
m
2
2)
Me
an
Ar
te
ri
al
Pressure
(
M
A
P
)
:
Ta
rget
value is
90 mmHg
3)
Res
t
i
n
g Pul
s
e:
Ta
rget
val
u
e is 80
bpm
4)
C
o
u
n
tr
y:
Ar
g
e
n
tin
a = 1,
USA
= 2
5) Gender:
Female = 1
,
Male = 2
6) He
al
th Hi
s
t
ory Sc
ore
:
a com
posi
t
e
score
equal
t
o
t
h
e s
u
m
of t
h
e fol
l
o
wi
n
g
bi
na
ry
sc
ores
(N
o = 1,
Yes =
2)
base
d
on
fa
m
i
ly
heal
t
h
hi
s
t
ory
:
hi
g
h
c
h
ol
est
e
rol
,
di
abet
e
s
, co
r
ona
ry
art
e
ry
di
sease,
he
art
fai
l
u
re, st
r
o
ke,
a
n
d
lo
wer lim
b
artery d
i
sease.
7)
He
al
th Kn
ow
l
e
dge Scor
e:
a c
o
m
posi
t
e
sco
r
e e
q
u
a
l
t
o
t
h
e s
u
m
of t
h
e f
o
l
l
o
wi
ng
bi
nary
sc
o
r
es
(i
n
c
or
rect
k
now
ledg
e = 1
,
cor
r
ect know
ledg
e = 2
)
based
on
ind
i
v
i
d
u
a
l
’
s kn
ow
led
g
e
th
at: d
i
abetes cau
ses CVD
,
h
i
g
h
chol
est
e
r
o
l
ca
uses C
V
D
,
s
m
oki
ng ca
use
s
hy
pe
rt
ensi
on
, sm
oki
ng ca
u
s
es m
y
ocardi
a
l
i
n
farct
i
o
n, s
m
oki
ng
causes
stroke,
and sm
oking c
a
uses C
V
D.
8)
Heal
t
h
H
a
b
i
t Score
:
a co
m
posi
t
e
score
equal
t
o
t
h
e s
u
m
of bi
nary
sc
ores
(N
o =
1,
Yes = 2
)
base
d
on t
h
e
fol
l
o
wi
n
g
pe
rs
onal
heal
t
h
ha
bi
t
s
:
fast
food
cons
um
er,
par
t
i
c
i
p
ant
reg
u
l
a
r
exerci
se, dai
l
y
cons
um
er of t
w
o
or
m
o
re fr
ui
t
&
veget
a
bl
e i
t
e
m
s
,
dai
l
y
co
nsu
m
er o
f
di
et
so
da,
dai
l
y
co
ns
um
er of
s
oda
,
f
o
rm
er sm
oker,
a
n
d
current sm
oker.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJP
H
S
V
o
l
.
3,
No
. 2,
J
u
ne 2
0
1
4
:
11
7 – 1
2
8
12
0
3.
1
Pri
n
ci
p
a
l
Co
mp
onen
t A
n
al
y
s
i
s
Fi
gure 1:
P
r
i
n
ci
pal
C
o
m
pone
nt
A
n
al
y
s
i
s
Gi
ve
n t
h
e n
u
m
ber of i
ndi
c
a
t
o
rs i
n
o
u
r
d
a
t
a
set
,
we began
ou
r anal
y
s
i
s
by
con
duct
i
ng p
r
i
n
ci
pl
e
com
pone
nt
an
al
y
s
i
s
(PC
A
) t
o
d
e
t
e
rm
i
n
e ho
w va
ri
at
i
o
n
i
n
t
h
i
s
ensem
b
l
e
of
va
ri
abl
e
s m
a
y
best
be e
x
p
l
ai
ned
.
Our PCA
reve
als that three variables
fr
om
our sam
p
l
e
expl
ai
n ove
r 5
8
%
of sam
p
l
e
vari
at
i
on. T
h
ese ar
e B
M
I,
M
A
P, a
nd
p
u
l
s
e. In a
d
di
t
i
on,
21
% o
f
va
ri
at
i
on i
s
due t
o
co
nt
ri
b
u
t
i
o
ns m
a
de by
t
h
e c
o
u
n
t
ry
i
n
whi
c
h a sub
j
ec
t
was st
u
d
y
i
ng a
nd
gen
d
e
r
(Fi
g
ure
1). T
h
e re
m
a
i
n
i
ng va
ri
at
i
on i
s
at
t
r
i
but
a
b
l
e
t
o
sel
f
rep
o
rt
e
d
per
s
o
n
al
heal
t
h
i
n
f
o
rm
at
i
on. The p
r
i
n
ci
pal
c
o
m
pone
nt
s t
h
e
m
sel
v
es and
pers
o
n
al
heal
t
h
hi
st
o
r
y
bel
o
ng t
o
t
h
e l
i
s
t
of 7
in
d
i
cators
o
f
C
V
h
ealth
as id
en
tified
b
y
t
h
e
Am
erican
Heart Asso
ciation
.
[17]
These
7 indicators
are
com
p
rise
d
of
3
ri
sk
fact
o
r
s:
bl
o
o
d
press
u
re
, fast
i
n
g
pl
a
s
m
a
gl
ucose, a
nd c
h
ol
est
e
r
o
l
,
and
4
be
havi
o
r
s:
B
M
I, sm
oki
n
g
,
physical activi
t
y, and
diet. M
o
re
over, beca
use we
gathe
r
ed d
a
ta in
t
w
o co
un
tries and
acro
ss bo
th sexes and
because we wi
sh to help s
u
bjects increase their unde
rsta
nding of CVD risk - prom
p
ting our desi
re to capture
CV
D
kn
ow
ledg
e,
w
e
in
cl
u
d
e
d
sev
e
r
a
l
q
u
e
st
io
n
s
abo
u
t
g
e
ner
a
l CV
D know
ledg
e.
A
s
a
resu
lt o
f
th
e
p
r
i
n
cip
a
l
com
pone
nt
an
al
y
s
i
s
, we
m
e
asure
d
t
h
e bi
v
a
ri
at
e correl
a
t
i
on
of t
h
ese
2
8
pai
r
s
of va
r
i
abl
e
s, gi
vi
ng
us t
h
e
co
rrelatio
n
m
a
trix
d
e
p
i
cted
in
in
Figure 1
.
In
ad
d
itio
n
,
we cap
tu
red
th
e
PCA v
a
rian
ce
an
alysis as sh
own
i
n
Figure
2. From
these
we ca
n s
ee that
th
e m
o
st critical v
a
riables th
at con
t
ri
bu
te to th
e
v
a
riatio
n
in th
e d
a
ta are,
i
n
decreasi
ng
or
der
of i
m
por
t
a
nce - B
M
I, M
A
P, an
d p
u
l
s
e. The
r
ef
ore
,
i
n
ou
r m
odel
i
ng
of d
a
t
a
, we
have
fo
cu
sed
o
n
d
e
t
e
rm
in
in
g
th
e
ways th
at v
a
riab
l
e
s 4-8 driv
e the first t
h
ree
v
a
riab
les.
Our underlying hy
pot
hesis is that each of
the va
ria
b
les - BMI, MAP,
and
pulse - are negatively
cor
r
el
at
ed
wi
t
h
heal
t
h
hi
st
ory
,
k
n
o
w
l
e
d
g
e
,
a
n
d
he
al
t
h
habi
t
.
H
o
weve
r,
be
cause B
M
I
i
s
a C
V
be
havi
or
w
h
i
l
e
MAP is a CV risk fact
o
r
we pred
icted that BMI
and
MAP
are p
a
irwise p
o
s
itiv
el
y
co
rrelated
. Pu
lse
is
unknown t
o
be either a
be
ha
vior
or
ris
k
fa
ctor but because
it
is one
of
the principal
varia
b
les of
va
riation
alo
n
g
with
BM
I and
M
A
P, we p
r
ed
icted th
at
p
u
l
se is al
so
po
sitiv
ely co
rrel
ated
with bo
th
BMI and
M
A
P. The
cor
r
el
at
i
ons
i
n
Fi
g
u
re
2 l
a
r
g
el
y
con
f
i
r
m
our
hy
pot
heses,
wi
t
h
t
h
e
exce
pt
i
o
n
of
p
u
l
s
e
vs
B
M
I a
n
d
heal
t
h
h
i
sto
r
y, bo
th of
wh
ich r
e
qu
ire f
u
r
t
h
e
r
inv
e
st
ig
atio
n
.
Fu
r
t
h
e
r
an
alysis
o
f
t
h
e co
rr
elatio
n by g
e
nd
er and
co
un
tr
y
reveale
d
that t
h
e
only signifi
cant val
u
e is
fe
m
a
le arge
nt
i
n
e st
ude
nt
s,
f
o
r
wh
om
B
M
I vs.
p
u
l
s
e co
rrel
a
t
e
s as -
0.
11
5
wi
t
h
p
-
val
u
e
0.
09
5.
As f
o
r
p
u
l
s
e vs.
heal
t
h
hi
st
ory
,
we car
ri
ed o
u
t
ge
n
d
er
and c
o
unt
ry
c
ont
rol
l
e
d
analysis and
we disc
overe
d
that the only significa
nt
co
rrel
a
t
i
o
n
bel
o
n
g
s t
o
t
h
o
s
e st
ude
nt
s
wh
o a
r
e
m
a
l
e
Ar
ge
nt
i
n
es.
T
h
e c
o
r
r
el
at
i
o
n
was
0.
1
3
7
wi
t
h
si
gni
fi
cance
o
f
0.
08
6.
T
h
i
s
t
o
o
req
u
i
r
es
fu
rt
he
r
researc
h
, a
s
pl
an
ned
f
o
r
o
u
r
next
st
udy
.
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2-8
8
0
6
A C
o
mp
ar
at
i
ve St
u
d
y
of
C
a
rdi
o
va
scul
ar
Heal
t
h
Be
havi
o
rs
a
n
d
Ri
sk F
a
ct
or
s ...
. (
G
i
n
a
Fi
t
z
ger
a
l
d
)
12
1
3.2
Over
all Correlations
Fi
gure 2:
O
v
e
r
al
l
C
o
r
r
el
at
i
o
n
s
am
ong
Su
rve
y
Vari
a
b
l
e
s
Fro
m
Fig
u
re
2
it can
b
e
seen
t
h
at MAP and
BMI are si
g
n
i
fican
tly p
o
s
itively co
rrelated
b
y
a fact
o
r
o
f
0.290 in the com
b
ined Am
erican and
Arg
e
n
t
in
e p
opu
latio
n. Th
is i
m
p
lies t
h
at as a pers
on’s BMI increas
es, so
d
o
e
s th
ei
r
m
e
a
n
ar
ter
i
al pr
essu
r
e
. Pu
lse and
BMI
ar
e sign
ifican
tly n
e
g
a
tively co
rr
elated
b
y
a
f
actor
o
f
-0
.115.
This im
plies that as a person’s BMI increase
s
, their he
art rate d
ecreases. B
M
I an
d
th
e
h
e
alth
h
a
b
it co
m
p
o
s
ite
score a
r
e si
gnificantly negat
i
vely correlated by a
fact
or
o
f
-0.137
. Th
i
s
i
m
p
lies th
at as th
e
h
ealth h
a
b
it
com
posite score decreases
, their BMI increa
ses. To
unde
rstan
d
th
is correl
a
tio
n
,
it is i
m
p
o
rtan
t to
n
o
t
e t
h
at a
l
o
w
heal
t
h
ha
b
i
t
score i
ndi
cat
es p
o
o
r
habi
t
s
suc
h
as sm
oki
ng
,
not
eat
i
n
g
dai
l
y
fr
ui
t
s
an
d
veget
a
bl
es, a
n
d
n
o
t
exerci
si
n
g
p
r
o
p
erl
y
. T
h
us
ha
vi
n
g
un
heal
t
h
y
ha
bi
t
s
i
s
co
rrel
a
t
e
d t
o
a
n
i
n
cre
a
se i
n
a
pe
rs
on
’s B
M
I.
M
A
P a
n
d
t
h
e
heal
t
h
hi
st
ory
com
posi
t
e
sco
r
e are si
gni
fi
cant
l
y
negat
i
vel
y
co
rrel
a
t
e
d
by
a fact
o
r
of
-
0
.
1
1
3
.
Th
is imp
lies th
at as th
e h
ealth
h
i
story co
m
p
o
s
ite
sc
ore
decrease
s
,
the m
ean arterial press
u
re inc
r
eases
(Figu
r
e 2).
To
u
n
d
e
rstand
th
is co
rrelatio
n, it
is i
m
p
o
r
tan
t
t
o
note t
h
at a low health
h
i
stor
y
sco
r
e ind
i
cates po
or
fam
i
l
y
cardi
o
v
a
scul
ar
heal
t
h
suc
h
as
pa
rent
s w
h
o
have
heart failure, di
abetes,
high
c
holesterol, etc. Thus
havi
ng
p
o
o
r
fa
m
i
ly
heal
t
h
hi
st
ory
i
s
cor
r
el
at
ed t
o
an i
n
crea
se in a pers
on’s MAP. T
h
is is a trend t
h
at expa
nds
acros
s both
Am
erican and Arge
n
tin
e
po
pu
latio
ns. M
A
P an
d h
ealt
h
kno
w
l
edg
e
co
m
p
o
s
ite scor
e ar
e
si
gni
fi
ca
nt
l
y
n
e
gat
i
v
el
y
co
rre
l
a
t
e
d by
a
fact
or
o
f
-
0
.
1
48
. Th
is im
p
lies th
at as th
e
h
ealth
k
nowledg
e com
p
o
s
ite
score
decre
a
se
s, m
ean arterial press
u
re increases. To
unde
rstand
th
is correlatio
n
,
it is i
m
p
o
rtan
t to
n
o
t
e th
at a
l
o
w heal
t
h
kn
owl
e
dge
sco
r
e
i
ndi
cat
es
t
h
e i
ndi
vi
dual
k
n
o
w
s
l
e
ss
a
b
o
u
t
cardi
ovasc
ul
ar
heal
t
h
(suc
h as
n
o
t
kn
o
w
i
n
g t
h
at
s
m
oki
ng
or
hi
g
h
c
hol
est
e
rol
i
s
l
i
nke
d t
o
ca
r
d
i
o
vasc
ul
ar
di
s
ease,et
c).
Th
us
ha
vi
n
g
p
o
o
r
h
eal
t
h
knowledge is c
o
rrelated t
o
an
in
crease in
a person’s M
A
P.
Th
is is a
t
r
e
n
d
t
h
at
ex
pa
nds
a
c
ross
bot
h Am
eri
can
an
d Arg
e
n
tin
e
p
opu
latio
n
s
.
3.3 Correl
ati
o
n
American Males
Figure 3:
Am
erican
Male C
o
rrelations
am
on
g Su
rv
ey
Va
ri
abl
e
s
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
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:
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252
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06
IJP
H
S
V
o
l
.
3,
No
. 2,
J
u
ne 2
0
1
4
:
11
7 – 1
2
8
12
2
Fro
m
Fig
u
re
3
it can
b
e
seen
t
h
at MAP and
BMI are si
g
n
i
fican
tly p
o
s
itively co
rrelated
b
y
a fact
o
r
o
f
0.224 i
n
Am
erican m
a
les. Thi
s
im
plies that as a
pers
on
’s
BMI inc
r
eases, s
o
doe
s their m
e
an a
r
terial pres
sure
.
3.4 Correl
ati
o
n
Ar
gentine Males
Fi
gure 4:
Argen
tin
e Male C
o
rrelatio
n
s
am
on
g
Su
rv
ey
Va
riables
Fro
m
Fig
u
re
4
it can
b
e
seen
t
h
at MAP and
BMI are si
g
n
i
fican
tly p
o
s
itively co
rrelated
b
y
a fact
o
r
o
f
0
.
2
2
7
i
n
Arg
e
ntin
e m
a
les. Th
is im
p
lies th
at as a
p
e
rson
’s
BMI inc
r
eases, s
o
doe
s their m
e
an a
r
terial pres
sure
.
3.5
Correl
ati
o
n American F
emales
Fi
gure 5:
Am
erican Fem
a
le
Correlati
ons
am
on
g
Su
rv
ey
Va
ri
abl
e
s
From
Fi
gu
re
5
i
t
can be see
n
t
h
at
B
M
I an
d
heal
t
h
habi
t
ar
e si
gni
fi
ca
nt
l
y
negat
i
v
el
y
c
o
r
r
e
l
a
t
e
d by
a
facto
r
of
0
.
1
97 in
Am
erican
fe
m
a
les. Th
is i
m
p
l
ies th
at
as
a per
s
o
n
’
s
heal
t
h
ha
bi
t
s
get
w
o
rse
(c
om
posi
t
e
sco
r
e
decrease
s
), the
i
r BMI inc
r
eas
es.
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8
0
6
A C
o
mp
ar
at
i
ve St
u
d
y
of
C
a
rdi
o
va
scul
ar
Heal
t
h
Be
havi
o
rs
a
n
d
Ri
sk F
a
ct
or
s ...
. (
G
i
n
a
Fi
t
z
ger
a
l
d
)
12
3
3.6
Correl
ati
o
n Ar
gentine F
emales
Fi
gure 6:
A
r
g
e
nt
i
n
e Fem
a
l
e
C
o
r
r
el
at
i
ons
a
m
ong S
u
r
v
ey
Vari
a
b
l
e
s
Fro
m
Fig
u
re 6, it can
b
e
seen th
at MAP and BMI
are sign
ifican
tly p
o
s
itively co
rrelated
b
y
a factor
o
f
0
.
1
9
8
in
Arg
e
n
tin
e
fem
a
le
s. MAP an
d
pu
lse are sign
ifican
tly p
o
s
itively co
rrelated
b
y
a facto
r
o
f
0
.
1
4
6
.
BMI is sig
n
i
fi
can
tly n
e
g
a
tively co
rrelated
with
h
ealth
h
a
b
its b
y
a f
actor
of
-0
.1
62
, imp
l
yin
g
th
at as
h
ealthy
habits i
n
crease
,
BMI
decrea
se
s.
3.
7 I
ndepe
nde
nt T
-
Tests
To di
g
deepe
r
i
n
t
o
t
h
e rel
a
t
i
ons
hi
p bet
w
ee
n t
h
e m
a
i
n
CV ri
sk fact
or
and t
h
e f
o
ur b
e
havi
ors
,
w
e
begi
n by
co
ns
i
d
eri
n
g a com
p
ari
s
on
of t
h
e
m
eans of t
h
e
fi
ve fact
o
r
s as a funct
i
o
n o
f
t
h
e t
w
o co
u
n
t
r
i
e
s
,
co
n
t
ro
lling
for g
e
n
d
e
r.
We
presen
t t
h
ese
resu
lts in
Figu
res 8
and
1
0
b
e
l
o
w. Fi
g
u
re
8
sh
ows t
h
e
resu
l
t
s for
fem
a
le subject
s, whe
r
eas
Figures
10
deta
ils
th
e resu
lts for
male su
bj
ects.
3.7.1. Ar
gentina vs
. American Females
Fi
gure 7:
Female Grou
p Statistics
Fi
gure 8:
Fem
a
le T-Tests
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
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252
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06
IJP
H
S
V
o
l
.
3,
No
. 2,
J
u
ne 2
0
1
4
:
11
7 – 1
2
8
12
4
Fro
m
Fig
u
res
7
and
8, it is ev
id
en
t th
at th
ere is
a significa
nt differe
n
ce in the bet
w
ee
n the m
eans of
the m
ean arterial pre
ssure
of th
e
A
r
ge
nt
i
n
e an
d
Am
eri
c
an
fem
a
l
e
pop
ul
at
i
ons
.
As T
1
(f
rom
t
h
e T
-
t
e
st
fo
rm
ul
a) repr
e
s
ent
s
A
r
g
e
nt
i
n
e
fem
a
l
e
s and
T2 Am
eri
can
fem
a
l
e
s, it
can be
not
e
d
t
h
at
Arge
nt
i
n
e
f
e
m
a
le
population
ha
s a significa
ntly larger m
e
an, m
ean ar
terial p
r
essure (Fig
ure 7).
Add
itio
n
a
lly, th
ere are
significa
nt differences in
t
h
e
m
ean habi
t
,
he
al
t
h
and k
n
o
wl
edge sc
ores
be
tween the Arge
ntine and America
n
fem
a
l
e
pop
ul
at
i
ons
(Fi
g
u
r
e
8)
. O
n
ce a
g
ai
n
,
t
h
e
Ar
gent
i
n
e f
e
m
a
l
e
pop
ul
at
i
o
n
has
si
g
n
i
f
i
c
ant
l
y
l
o
we
r m
e
ans i
n
h
a
b
it, h
ealth
an
d
k
now
ledg
e sco
r
es. Th
ese lo
w
m
ean
sco
r
es co
rr
espond
to
p
oor
er
health
h
a
b
its, health
history, and
he
alth knowledge. From
these
two
pieces
of
evide
n
ce, it ca
n
be inferre
d
t
h
at populations with
sig
n
i
fican
tly
p
o
o
rer h
ealth
h
a
b
its, h
i
sto
r
y
an
d
kno
wl
edg
e
will h
a
v
e
sig
n
i
fican
tly h
i
g
h
e
r m
ean
arterial
press
u
re.
T
hus pre
v
alence of poor
car
di
o
v
as
cul
a
r heal
t
h
be
havi
ors c
o
r
r
es
p
o
n
d
s t
o
po
o
r
cardi
ovasc
ul
ar
d
i
sease
risk facto
r
.
3.7.2. Ar
gentina vs
. American Males
Fi
gure 9:
Male Group
Statistics
Figure 10:
Ma
le T-Tests
Fro
m
Fig
u
res
9
an
d 10
it is
ev
id
en
t th
at there is
a si
gni
ficant di
ffe
rence
betwee
n t
h
e
means of t
h
e
mean arterial pressure a
nd t
h
e
m
ean BMI of
the Arge
n
tine
and
Am
erican male populations.
As T
1
re
presents
Arge
ntine m
a
les and T
2
American m
a
les,
it can be note
d
that the
m
ean, m
ean arterial pressure and the
m
ean
B
M
I of t
h
e A
r
gent
i
n
e m
a
l
e
pop
ul
at
i
on i
s
g
r
eat
er t
h
an
t
h
os
e of t
h
e Am
erican m
a
le population (Fi
g
ure
10).
Add
itio
n
a
lly, t
h
ere are
sign
ifican
t d
i
fferen
ces in
t
h
e m
ean
h
a
b
it, h
e
alth
an
d kno
wled
ge scores
b
e
tween
the
Arg
e
n
tin
e an
d Am
erican
m
a
le p
opu
latio
n
s
(Figure 10)
.
Th
e
Arg
e
n
tin
e m
a
le p
o
p
u
l
atio
n h
a
s sign
ifi
can
tly
lo
wer m
ean
s in
h
a
b
it,
h
ealth an
d kno
wledg
e
sco
r
es.
T
h
e
s
e low m
eans
score
s
corres
p
ond to poore
r
health
habits, health history,
and health
knowledge. From
these two
pieces
of
e
v
ide
n
ce, it can
be inferred that
p
opu
latio
n
s
wi
th
sign
ifican
tl
y p
o
o
r
er
h
ealth
h
a
b
its,
h
i
story, and
kn
owl
e
d
g
e
will h
a
ve sig
n
i
fican
tly h
i
gh
er
mean arterial
press
u
re and BMI.
Thus prevalence of poor cardiovasc
u
la
r
h
ealth
b
e
hav
i
or
s co
rr
espo
nd
s t
o
poor cardiova
s
cular
disease
risk f
act
ors
.
Additionally, pre
v
alence of
cer
t
a
i
n
p
o
o
r
cardi
ovasc
ul
ar
heal
t
h
beha
vi
o
r
s
(
h
ab
i
t
,
hi
st
ory
,
an
d
kn
o
w
l
e
d
g
e)
co
rres
p
on
ds t
o
p
o
o
r
B
M
I
,
a
not
her
car
di
o
v
asc
u
l
a
r
heal
t
h
be
h
a
vi
o
r
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
A C
o
mp
ar
at
i
ve St
u
d
y
of
C
a
rdi
o
va
scul
ar
Heal
t
h
Be
havi
o
rs
a
n
d
Ri
sk F
a
ct
or
s ...
. (
G
i
n
a
Fi
t
z
ger
a
l
d
)
12
5
3.8 Discussion
The
pu
rp
ose
of t
h
i
s
st
u
d
y
was t
o
e
x
am
ine y
o
u
n
g
a
d
ul
t
cardi
o
v
asc
u
l
a
r heal
t
h
. I
n
doi
ng
so
, w
e
hy
p
o
t
h
esi
z
e
d
t
h
at
y
o
u
n
g
ad
u
l
t
s
wi
t
h
l
o
w p
r
eval
e
n
ce o
f
c
a
rdi
ovasc
ul
ar
heal
t
h
be
ha
vi
o
r
s w
oul
d ha
ve
l
o
w
pre
v
alence
of cardi
ovasc
ular health
ris
k
factors
.
E
v
en
t
h
ou
gh
n
o
t
eve
r
y
b
e
havi
or
was
si
gni
fi
cant
l
y
cor
r
el
at
e
d
with
th
e MAP
risk
factor,after tho
r
ou
gh
an
alysis we saw that, cro
ss-cu
lturally, co
rrelation
s
ex
ist b
e
t
w
een
CV
ri
sk
fact
or
s an
d C
V
be
havi
or
s t
h
at
are c
ons
i
s
t
e
nt
i
n
b
o
t
h
po
p
u
l
a
t
i
ons
.He
a
l
t
h
habi
t
,
heal
t
h
k
n
o
w
l
e
d
g
e,
heal
t
h
hi
st
ory
,
an
d B
M
I are
al
l
si
gni
fi
cant
l
y
co
rrel
a
t
e
d
with m
ean arterial press
u
re (Fi
g
ure
2).
Th
e AHA
study f
o
und
th
at ideal CV
h
ealth
is u
n
c
o
m
m
o
n
i
n
you
ng
adu
lt p
opu
latio
n
s
i
n
th
e U
S
A,
Fi
nl
an
d, a
nd
A
u
st
ral
i
a
by
co
m
p
ari
ng t
h
e i
d
eal
C
V
hea
lth
metrics ag
ain
s
t caro
tid
i
n
ti
m
a
th
ick
n
e
ss.
While th
e
pre
v
al
ence
o
f
i
d
eal
C
V
heal
t
h
, as m
easure
d
by
c
I
M
T
, m
i
ght
be l
o
w i
n
ou
r
po
p
u
l
a
t
i
ons as
wel
l
,
t
h
i
s
st
udy
exam
i
n
ed t
h
e
r
e
l
a
t
i
onshi
p
bet
w
een
C
V
he
al
t
h
ri
sk
fact
ors
a
n
d
C
V
heal
t
h
beha
vi
o
r
s.
T
h
e
A
H
A
st
u
d
y
s
h
owe
d
that there was
an inverse ass
o
ciation
betwe
e
n ideal CV
health
m
e
trics a
nd t
h
e cIMT, t
hus
risk
factors and
beha
viors are associated
wit
h
vasc
ular hea
lth
in
t
h
e
grea
t
e
r p
o
pul
at
i
o
n
[
19]
.
B
y
anal
y
z
i
ng
Am
eri
c
an a
n
d
A
r
g
e
n
tin
e po
pu
latio
n
s
w
e
sho
w
ed
th
at poor
card
i
ov
ascu
l
a
r
b
e
h
a
v
i
o
r
s t
h
em
selv
es ar
e asso
ciated
w
i
th
poor
CV risk
fact
o
r
s. Th
is is an
im
p
o
r
tan
t
associatio
n
b
ecau
s
e b
y
co
n
t
ro
lling
CV h
ealth
beh
a
v
i
o
r
s, su
ch as n
o
t
sm
oki
ng, e
x
erc
i
si
ng m
o
re, an
d m
a
i
n
t
a
i
n
i
ng
a pr
o
p
er
di
et
, C
V
ri
sk
fact
o
r
s
can be c
o
nt
r
o
l
l
e
d as wel
l
,
l
e
a
d
i
n
g t
o
im
pro
v
ed
car
di
ova
scul
ar
heal
t
h
.
T-
tests show
ed
th
at
po
pu
latio
n gr
oup
s
w
ith
a
h
i
gh
er CV r
i
sk f
actor
(MA
P
) m
ean
also
h
a
d
l
o
w
e
r
beha
vior m
eans, indicating
that populations
with poor C
V
beha
viors
c
o
rrelate with accum
u
la
tion of C
V
ris
k
factor
s (Fi
g
u
r
e
8,
10
).
We ca
n
infer a
n
d s
p
ec
ulate that a wa
y to im
prove yo
ung
adu
lt CV h
ealth
is to
imp
r
ov
e
h
ealth
h
a
b
its an
d h
ealth know
ledg
e, as im
p
r
ov
in
g
h
ealth
histo
r
y
is o
u
t
o
f
o
n
e
’
s
con
t
ro
l.
A prev
i
o
u
s
st
ud
y in
Brazil sho
w
ed
th
at youn
g
ad
u
lts who
co
nsu
m
e a b
e
tt
er, co
mm
o
n
Brazilian
d
i
e
t
di
spl
a
y
he
al
t
h
i
e
r t
r
e
nds
i
n
re
gar
d
s t
o
C
V
ri
sk
fact
or
s w
h
i
l
e t
hose
w
h
o
h
a
ve a
p
o
o
r
,
pr
ocesse
d
di
et
di
spl
a
y
m
o
re h
a
rm
fu
l trend
s
. It is interestin
g
to
note th
at th
e
study stated that the proce
ssed
d
i
et is si
m
i
lar to
th
e
West
er
n t
y
pe of
di
et
am
ong
t
h
e Am
eri
can po
p
u
l
a
t
i
on.
Th
i
s
i
n
cl
ude
d a v
a
ri
et
y
of f
o
o
d
s
such as
ham
bur
ger
s
,
hot
d
ogs
, f
r
e
n
c
h
f
r
i
e
s, et
c.
I
n
t
h
i
s
st
u
d
y
,
di
et
was as
sesse
d
by
t
h
e c
o
nsum
pt
i
o
n
o
f
fr
ui
t
s
and
ve
get
a
bl
es
, fast
food
, and
sod
a
[24
]
. Resp
on
ses to
d
i
et q
u
e
st
io
n
s
were sc
o
r
ed
, in
ad
d
ition
to
o
t
h
e
r h
ealth
h
a
b
its, an
d
was u
s
ed
to create a c
o
m
posite score. In the t-test
analyses
it wa
s found that t
h
e
Am
erican stude
nts
had
higher
com
posi
t
e
scor
es t
h
an
di
d t
h
e
Ar
gent
i
n
e st
u
d
ent
s
, t
h
u
s
t
h
e
Am
eri
can st
udent
s
had
heal
t
h
i
e
r ha
bi
t
s
t
h
a
n
di
d
th
e Arg
e
n
tin
e stu
d
e
n
t
s
(Figu
r
e
7-10
). Th
i
s
trend
co
n
t
rad
i
cts th
e
resu
l
t
s o
f
t
h
e Brazilian
n
u
t
ritio
n stu
d
y
,
ho
we
ver di
et
ar
y
co
m
pone
nt
s were n
o
t
asses
s
ed i
n
de
pt
h i
n
t
h
i
s
st
udy
as it
was i
n
t
h
e ot
her
.
It
i
s
advi
s
a
bl
e t
o
pu
rs
ue t
h
i
s
m
a
t
t
e
r furt
her a
nd i
nvest
i
g
at
e
t
h
e t
r
ue di
ffe
rences i
n
A
r
g
e
nt
i
n
e an
d A
m
eri
can heal
t
h
habi
t
s
.
C
onse
q
uent
l
y
t
h
at
t
y
pe
of
i
n
vest
i
g
at
i
o
n
wo
ul
d
be
abl
e
t
o
pi
n
poi
nt
whi
c
h
speci
fi
c
ha
bi
t
com
pon
ent
a
f
fect
s,
and to
what ext
e
nt, ca
rdi
ovas
c
ul
ar heal
t
h
.
4.
CO
NCL
USI
O
N
A
lth
oug
h
w
e
fo
und
con
s
istency in
d
a
ta, t
h
ere w
e
r
e
a few an
o
m
alies th
at p
r
esen
ted th
em
selv
es. On
e
maj
o
r flaw: the CV co
m
p
o
n
en
t of
h
e
art rate. Co
rrelatio
n testin
g
produced
t
r
e
n
ds t
h
at
we
w
oul
d
n
o
t
ha
v
e
expecte
d
, s
u
ch as an increase
in BM
I correl
a
ted with a dec
r
ease in heart
rate,and
we are una
ble to accurately
ex
p
l
ain
th
em
(
F
ig
ur
e 2,3,5,6).
W
e
h
ypo
th
esize th
at th
ese an
o
m
alies ste
m
fro
m
s
lig
h
t
erro
rs in
d
a
ta co
llectio
n
m
e
thods
. The
public spaces
pre
v
e
n
ted students from
rela
xing properly,
and thus th
eir reporte
d
heart
rates
w
e
r
e
o
f
ten
sk
ew
ed
d
u
e to
emo
tio
n
a
l r
e
sponses to
th
e m
e
t
h
odo
log
y
, su
ch
as anx
i
ety. A
lth
oug
h
h
ear
t
r
a
te in
th
e literatu
re is n
o
t
con
s
idered
a card
i
ov
ascu
lar b
e
h
a
v
i
or
or risk
factor, it was in
clud
ed
in
ou
r st
u
d
y
anyways
because heart
rate is so closely ti
ed to function of the cardi
ovasc
ular
s
y
ste
m
. Due to errone
ous res
u
lts, we
no
w
k
n
o
w
t
h
at
we m
u
st
co
rr
ect
m
e
t
hods
i
n
o
r
de
r t
o
o
b
t
a
i
n
m
o
re acc
urat
e dat
a
i
n
or
der
t
o
i
n
vest
i
g
at
e
hear
t
rate as a c
a
rdiovasc
ular
health indicator.
In
or
der t
o
m
o
re acc
urat
el
y
pi
np
oi
nt
t
h
e
m
o
st
im
port
a
n
t
beha
vi
or
s t
h
at
i
n
fl
uence c
a
rdi
ovasc
ul
a
r
h
ealth
we recommen
d
an
amen
d
e
d
stud
y that will an
alyze
wh
ich
sp
ecific b
e
h
a
v
i
or fro
m
th
e co
m
p
o
s
ite sco
r
e
h
a
s t
h
e m
o
st in
fl
u
e
n
c
e on
C
V
h
ealth
.
Th
is fu
tu
re stud
y
m
u
st b
e
ab
le t
o
q
u
a
n
tify you
ng
adu
lt h
a
b
its and
kn
o
w
l
e
d
g
e t
h
r
o
u
g
h
m
o
re i
n
d
e
pt
h
qu
est
i
oni
ng
, rat
h
er t
h
an
bina
ry questions.
We
realized that e
v
en t
h
ough
we
were ask
i
ng
t
h
e sam
e
qu
estio
n
s
in
bo
th co
un
tries,
th
ese qu
estion
s
were no
t
n
ecessarily stan
d
a
rd
ized
.
For
exam
pl
e,
an A
r
ge
nt
i
n
e’
s
p
e
rc
ept
i
o
n
o
f
ri
g
o
r
ous
w
o
rk
o
u
t
m
i
ght
be di
ffe
re
nt
t
h
a
n
t
h
at
of
an Am
eri
can
st
ude
nt
.
To
b
e
tter
qu
antify o
u
r
resu
lts we will need
to
ask
m
o
re sp
ecific
q
u
e
stion
s
, su
ch as “Ho
w
m
a
n
y
ti
m
e
s p
e
r
w
eek
do
you
en
g
a
g
e
in
ex
er
cise in
w
h
ich
yo
ur
h
e
ar
t r
a
te i
s
with
in
the targ
et rang
e fo
r
yo
ur ag
e
?
(Age 2
0
=
12
0
-
1
7
0
) [
2
5]
. B
y
usi
ng s
u
r
v
ey
s wi
t
h
m
o
re speci
fi
c q
u
est
i
ons
we w
o
ul
d
be abl
e
t
o
qua
nt
i
f
y
heal
t
h
be
havi
o
r
s
m
o
re preci
sel
y
and t
h
us ha
ve
a range
of dat
a
wi
t
h
whi
c
h t
o
pe
rf
orm
i
n
-d
ept
h
st
at
i
s
t
i
cal anal
y
s
i
s
, i
n
st
ead o
f
u
tilizin
g
b
i
n
a
ry d
a
ta co
m
p
ile
d
in
to
co
m
p
o
s
i
t
e sco
r
es. Th
is
m
o
re in
-d
ep
th
an
alysis wou
l
d allo
w us to
p
i
n
p
o
i
nt
t
h
e m
a
jor c
ont
ri
b
u
t
i
ng
be
ha
v
i
ors t
o
p
o
o
r
C
V
heal
t
h
ri
s
k
f
act
ors i
n
eac
h
cou
n
t
r
y
,
w
h
i
c
h
w
oul
d al
l
o
w
us t
o
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJP
H
S
V
o
l
.
3,
No
. 2,
J
u
ne 2
0
1
4
:
11
7 – 1
2
8
12
6
analyze how di
ffe
rent as
pects
of culture a
n
d
so
ciety contribute to ca
rdiova
scular
health.
In c
o
ncl
u
si
o
n
,
y
o
u
ng a
d
ul
t
s
wi
t
h
l
o
w p
r
e
v
al
ence
of ca
r
d
i
o
vasc
ul
ar
he
al
t
h
beh
a
vi
ors
have l
o
w
pre
v
alence
of cardiovasc
u
la
r health
risk factors.
Afte
r th
orough analy
s
is we saw t
h
at, cross c
u
lturally,
cor
r
el
at
i
ons e
x
i
s
t
bet
w
een C
V
ri
sk fact
ors
and C
V
beha
vi
ors t
h
at
are co
nsi
s
t
e
nt
i
n
b
o
t
h
p
o
p
u
l
a
t
i
ons
. Heal
t
h
h
a
b
it, h
ealt
h
kn
owledg
e,
h
ealth
h
i
st
ory and
BMI are all signi
ficantly correl
ated with mean ar
terial pre
ssure
.
T-
tests show
ed
th
at
po
pu
latio
n gr
oup
s
w
ith
h
i
gh
er
C
V
risk
f
act
o
r
m
ean
s also
h
a
d
l
o
w
e
r
b
e
h
a
v
i
o
r
mean
s,
indicating that populations with poor
CV beha
viors correlate with an
accum
u
lation of CV risk factors
.
Furt
her i
nve
st
i
g
at
i
on i
n
t
o
t
h
e
s
e be
havi
ors
wi
t
h
i
m
prove
d
m
e
t
hod
ol
o
g
y
has
been
pr
o
p
o
se
d t
o
pi
n
poi
nt
t
h
e
exact diffe
re
nc
es in cardiovas
cular
h
ealth
b
e
tween
th
e youn
g
ad
u
lt po
pu
l
a
tio
n
s
of Arg
e
n
tin
a and
th
e Un
ited
States.
ACKNOWLE
DGE
M
ENTS
We wish
to
than
k
th
e
Natural Scien
ce Div
i
sion
and
th
e Bu
eno
s
Aires In
tern
ation
a
l Program
o
f
Pepp
erd
i
n
e
Univ
ersity for their su
ppo
rt.
In p
a
rticu
l
ar
we wou
l
d
lik
e to
th
ank
Dr. Lee Kats o
f
th
e
Natu
ral
Sci
e
nce Di
vi
si
on a
nd R
a
fael
De Sanz
o of
t
h
e B
u
en
os Aires Program
.
Additionally, we appreciate the
co
op
eratio
n
of Ju
an
Jo
se Herrera Paz an
d
th
e resi
d
e
n
t
s
of In
stitu
to
Sacre Co
eu
r
fo
r t
h
eir co
llab
o
rat
i
o
n
in
col
l
ect
i
ng dat
a
i
n
B
u
en
os Ai
r
e
s, Ar
gent
i
n
a
.
We wo
ul
d
al
so lik
e to ex
ten
d
o
u
r app
r
eciation
to th
e stud
ents of
b
o
t
h
Pepp
erd
i
ne Un
iv
ersity and
U
n
i
v
e
rsid
ad
Cató
lica d
e
Arg
e
n
tin
a who
p
a
rticip
ated
in th
i
s
stud
y.
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