87 Medication use by insurance coverage in the Southern Cone of Latin America 4 METHODS Study design and study population CESCAS is a population-based cohort study conducted in four cities in the Southern Cone of Latin America: Bariloche and Marcos Paz in Argentina, Temuco in Chile, and Pando-Barros in Uruguay. The baseline data of CESCAS was collected from February 2010 to December 2011 and included 7524 participants aged 35-74 years, which were recruited from random samples in the four locations. For this analysis, we will only include the 593 CESCAS participants with CHD and available information on insurance status. Ethical considerations The CESCAS study was conducted in compliance with the Declaration of Helsinki. The protocol was approved by the Institutional Review Boards of all participating institutions: Hospital Italiano de Buenos Aires (Argentina), Universidad de la Frontera (Chile), Universidad de la República (Uruguay) and Tulane University Human Research Protection Office (United States) (24). Data collection and variable definition Data was collected through a questionnaire and clinical examination. The questionnaire was filled during a home visit, and included data on socio demographics (age, sex, educational level), cardiovascular disease history and risk factors (CHD diagnosis, hypertension, diabetes, dyslipidemia, and treatment for these conditions) and health behaviors (cigarette smoking, alcohol consumption, physical activity and diet), and self-reported use of medications. Physical activity was assessed using the International physical activity questionnaire-short form (25). 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 Argentina, Chile and Uruguay (26,27). Participants who reported a previous heart attack or angina diagnosed by a doctor, or who had undergone cardiac revascularization procedure (angioplasty, stent or bypass surgery) were considered to have CHD. We categorized insurance coverage into only public coverage (participants being treated only in the public health system) and additional coverage, which included subjects with social coverage (insurance costs deducted from salary or given from a relative), and private coverage payed out-of-pocket. Educational level was defined as the highest degree of education attained by participants: primary school, secondary school and tertiary education or university. Employment was defined as having a part-time or full-time gainful job at the time of the interview. Participants who were retired and homemakers were not considered employed.
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