OBJECTIVES: to identify associated factors to the control of blood pressure (BP), low-density lipoprotein cholesterol (LDL) and glycated hemoglobin (hba1c) in a low-income population from the Caribbean region of Colombia, enrolled in “De todo corazón -DTC” program between 2013-2018

METHODS:retrospective cohort study. A population of 128,265 patients enrolled in DTC, with hypertension (HTA), diabetes mellitus (DM2), dyslipidemia or chronic kidney disease (CKD) was considered for eligibility. Patients with BP<140/90, LDL<=100mg/dl) and Hba1c<=7.5% were considered as controlled. Last measurement of these variables in 2018 was used for evaluating control. Multivariate logistic regression models were adjusted for demographics, lifestyle and clinical variables. Outcome variables were expressed as “no control”. Subgroup analyses were conducted based in previous diagnoses (HTA, HTA+DM2 or DM2). p value <0.05 was considered significant

RESULTS:a sample of 110,929 (HTA=87,325; HTA+DM2=28,413 and DM2=8,205) patients with a mean (SD) age of 63.0 (13.8) years was obtained. Among these, 65.5% were women, 76.3% had dyslipidemia, 93.0% were either overweight or obese, 47.1% had a medium risk Framingham Score, 21.4% were current smokers and 70.1% never perform physical activity. Control of BP, hba1c and LDL were 74.8%, 58,6% and 44,6%, respectively. Risk factors for uncontrolled BP among patients with HTA and HTA+DM2 were male sex, uncontrolled LDL, obesity, two or more antihypertensive medications and uncontrolled hba1c (p<0.050). Risk factors for uncontrolled hba1c among patients with HTA+DM2 and DM2 were uncontrolled LDL, uncontrolled BP and two or more antidiabetic medications (p<0.050). Uncontrolled BP was a risk factor for uncontrolled LDL among patients with HTA and HTA+DM2 (p<0.050).

CONCLUSIONS:Despite of the success of DTC program, the LDL and Hba1c remains as hard risk factors to be controlled. Uncontrolled risks factors were positively associated each other and this should be considered in creating strategies to effectively identify and treat patients that are not being responsive to the intervention