62 Chapter 3 approval from Institutional Review Boards for all participating institutions in Argentina, Chile, Uruguay and the United States (3). Data collection took place in a home visit and through clinical examination. During the home visit, a standard questionnaire was used to collect data on sociodemographic characteristics (including age, sex and educational level), history of cardiovascular disease and RF (including CHD, hypertension, diabetes, dyslipidemia, and treatment for these conditions), lifestyle RF (such as cigarette smoking, alcohol consumption and physical activity) and diet. Physical activity was assessed using the International physical activity questionnaire-short form (16). The activities registered in the questionnaire were converted into metabolic equivalents (METs). The food frequency questionnaire used to collect nutritional information was adapted from the NCI Dietary History Questionnaire and validated in the Argentina, Chile and Uruguay (17,18). Blood pressure and anthropometric variables were measured during the clinical examination using standardized procedures. Blood pressure was measured 3 times with standard mercury or aneroid sphygmomanometers. Participants were on a sitting position after 5 minutes of rest for the blood pressure measurements, and the mean of the 3 readings was used for analysis. Body weight, height and waist circumference were measured twice and the mean of the two values was used for the analysis. Body weight was measured with standing scales and height was measured with stadiometers. Waist circumference was measured at 1cm above the navel at minimal respiration. Lipids and glucose were measured from overnight fasting blood samples. Blood glucose, total cholesterol, HDL-cholesterol and triglycerides were measured with standard methods, and LDL-cholesterol was calculated with the Friedewald equation if participants had a triglyceride level <400mg/dL (19). CHD was defined as self-reported previous acute myocardial infarction (MI), angina or coronary procedure, determined by the following questions during an interview with trained staff: “Has a doctor ever said that you have angina”, “Has a doctor ever said that you had a heart attack?” and “Have you had a balloon angioplasty, a stent, or bypass surgery to the arteries in your heart to improve the blood flow to your heart?”. Hypertension was defined as mean systolic blood pressure (BP) ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or current use of antihypertensive medication. Dyslipidemia was determined as total cholesterol ≥240 mg/dL and/or LDL-cholesterol ≥160 mg/dL and/ or HDL-cholesterol <40 mg/dL and/or triglyceride ≥200 mg/dL and/or use of lipid-lowering medication. Participants were considered diabetic if they reported to have diabetes, or if they presented fasting glucose levels ≥126 mg/dL, or if they used hypoglycemic medication. Obesity was defined as BMI ≥30kg/m2 (14), and central obesity was determined at waist circumference ≥102 cm (women) and ≥88 cm (men) (14,20). Alcohol consumption was considered excessive for men reporting >14 units per week or >5 units at one occasion (around two hours more than once per month), and women reporting >7 units per week or >4 units in one occasion (21). Alcohol units were considered
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