Risk factors and cardiovascular events in adult Latin American immigrants in the Macarena district, Seville, Spain: a pilot study

325 Re Esc En e m USP 2013; 47(2):325-30 www.ee.usp.b / eeusp/ Risk ac o s and ca dio ascula e en s in adul la in ame ican immig an s in he Maca ena Dis ic , Se ille, Spain: a pilo s udy González-López JR, Lomas-Campos MM, Rod íguez-Gázquez MA RESUMo Es e es udo e e como obje i o es ima a p e alência de au o- ela o de a o es de isco e e en os ca dio ascula es na popu- lação la inoame icana imig an e adul a do Dis i o 2 (Maca ena) de Se illa. Es udo pilo o de in es igação desc i i a de co e ans e sal, u ilizou-se um ques ioná io anônimo com au o- ela o de a o es de isco e e en os ca dio ascula es. Pa icipa- am 34 pessoas, (18% do o al da mos a), idade média: 31,8 anos, esidência média: 6,5 anos, mulhe es: 52.9%. P e alências de a o es de isco: 8,8% diabe es, 26.5% co- les e ol ele ado e 14,5% hipe ensão a e- ial. P e alência de e en os co oná ios é de 8,8%: angina de pei o, in a o do miocá dio e aciden e ce eb o ascula , com 2,9% cada um. A conclusão é que a au o- ela ada p e alência de e en os ca dio ascula es é maio do que a li e a u a, es a ques ão me ece a a enção de agências de saúde, es e conhecimen o de e se conside ada pelas en e mei as pa a desen ol e planos de cuidados cul u almen e ap op iado do con ex o dos imig an es. DEScRi oRES Mig ação in e nacional Amé ica La ina Doenças ca dio ascula es Fa o es de isco P omoção da Saúde Cuidados de en e magem Risk ac o s and ca dio ascula e en s in adul la in ame ican immig an s in he Maca ena Dis ic , Se ille, Spain: a pilo s udy* O iginal a icle AbS RAc In o de o es ima e he p e alence o sel - epo ed isk ac o s and ca dio ascula e en s in an adul immig an La in Ame i- can popula ion o Dis ic 2 (Maca ena) in Se ille, we conduc ed a pilo s udy using c oss-sec ional desc ip i e esea ch. We used an anonymous ques ionnai e wi h sel - epo ed isk ac o s and ca dio ascu- la e en s. 34 people pa icipa ed (18% o he sample); mean age: 31.8 yea s, mean esidence: 6.5 yea s, women: 52.9%. P e - alence o isk ac o s: diabe es 8.8%, high choles e ol 14.7% and high blood p essu e 23.5%. P e alence o co ona y e en s was 8.8%; angina pec o is, myoca dial in a c- ion and s oke, 2.9% each. The conclusion is ha sel - epo ed p e alence o ca dio- ascula e en s was highe han in he li - e a u e, his issue dese ing he a en ion o heal h agencies. This knowledge should be conside ed by nu ses o de elop cul u - ally app op ia e ca e plans o he con ex o immig an s. DEScRiP oRS Emig a ion and immig a ion La in Ame ica Ca dio ascula diseases Risk ac o s Heal h P omo ion Nu sing ca e RESUMEn Con el obje i o de es ima la p e alencia po au o epo e de ac o es de iesgo y e en os ca dio ascula es en población la i- noame icana inmig an e adul a del Dis i o 2 (Maca ena) de Se illa, se ealizó un es- udio pilo o de in es igación desc ip i a de co e ans e sal. Se u ilizó un cues iona io anónimo con au o epo e de ac o es de iesgo y e en os ca dio ascula es. Resul a- dos: pa icipa on 34 pe sonas, (18% de la mues a), edad media: 31,8 años, esiden- cia media: 6,5 años, muje es: 52,9%. P e- alencias de ac o es de iesgo: 8,8% dia- be es, 14,7% coles e ol ele ado y 23,5% hi- pe ensión a e ial. P e alencia de e en os co ona ios es de 8,8%: angina de pecho, in a o de mioca dio y acciden e ce eb o- ascula , con 2,9% cada uno. La conclusión es que la p e alencia de e en os ca dio- ascula es au o epo ados es supe io a la li e a u a, me eciendo es e asun o la a ención de los o ganismos sani a ios, es e conocimien o debe ene se en cuen a po en e me ía pa a elabo a planes de cuida- dos adap ados cul u almen e al con ex o de es e colec i o inmig an e. DEScRiP oRES Mig ación in e nacional Amé ica La ina En e medades ca dio ascula es Fac o es de iesgo P omoción de la Salud A ención de en e me ía José Ra ael González-López1, Ma ía de las Me cedes Lomas-campos2, Ma ía de los Ángeles Rod íguez-Gázquez3 FATORES DE RISCO E EVENTOS CARDIOVASCULARES EM IMIGRANTES LATINO AMERICANOS ADULTOS NO DISTRITO MACARENA, SEVILLA, ESPANHA: ESTUDO PILOTO FACTORES DE RIESGO y EVENTOS CARDIOVASCULARES EN INMIGRANTES LATINOAMERICANOS ADULTOS EN EL DISTRITO MACARENA, SEVILLA, ESPAñA: ESTUDIO PILOTO * F om Resea ch P ojec “Análisis de las conduc as de salud y p e alencia de en e medades de la población inmig an e y au óc ona de la ciudad de Se illa”, Uni e si y o Se ille, 2009-2012. 1Ph.D. In e na ional in Heal h Sciences. Mas e in New T ends in Heal h Sciences. Nu se. P o esso Facul y o Nu sing, Physio he apy and Podia y. Depa men o Nu sing, Uni e si y o Se ille, Spain. [email p o ec ed] 2Ph.D. in Medicine. Full P o esso , Facul y o Nu sing, Physio he apy and Podia y. Depa men o Nu sing, Uni e si y o Se ille, Spain. [email p o ec ed] 3Ph.D. in Public Heal h, Epidemiologis , Nu se. Associa e P o esso , Facul y o Nu sing, Uni e si y o An ioquia, Medellín, Colombia. [email p o ec ed] Recei ed: 05/08/2011 App o ed: 07/16/2012 Po uguês / Inglês www.scielo.b / eeusp 326 Re Esc En e m USP 2013; 47(2):325-30 www.ee.usp.b / eeusp/ Risk ac o s and ca dio ascula e en s in adul la in ame ican immig an s in he Maca ena Dis ic , Se ille, Spain: a pilo s udy González-López JR, Lomas-Campos MM, Rod íguez-Gázquez MA in RoDUc ion In a globalized wo ld, i is indispu able ha mig a ion is an inc easingly impo an phenomena, bo h in i s scope and complexi y, a ec ing i ually e e y coun y in he wo ld(1). In Spain, du ing he i s decade o he 21s cen u y, he immig an popula ion g ew om 1.8% o 11.4% o all esi- den s; 40% o he o eigne s came om Eu ope, ollowed by 31% om Sou h Ame ica(2). The inc ease in immig a ion has been a majo challenge o social adap a ion, includ- ing he issues ela ed o heal h and he o ganiza ion o he heal h sys em(3). This phenomenon has equi ed he pe - o mance o s udies abou he heal h o he immig an s, which iden i ied his g oup as a heal hy young popula- ion(4), wi h a good pe cei ed heal h s a us and wi h mo - bidi y simila o ha o he local popula ions(5). Access o and use o heal h se ices on he pa o he immig an s has been he ocus o much o he esea ch in e es ; addi ionally, since he ea ly nine ies, pe iodic popula ion based su eys ha e been used o ob ain an epidemiological p o ile, as well as o unde s and he accessi- bili y and u iliza ion o heal h se ices(6). In Spain, al hough some wo k exis s e- la ed o immig an heal h, he impo ance o socio-demog aphic, economic and li e- s yle ac o s(7), quali y o li e(8), and he use o heal h se ices(9), he e has been a sca ci- y o esea ch in o he p e alence o isk ac- o s and ch onic diseases in his popula ion. Despi e he ac ha hey we e conduc ed in he au och honous popula ion, exis ing li - e a u e indica es ha some heal h p oblems a e simila in bo h popula ions(6), p edomi- nan ly espi a o y in ec ions, dep essi e synd omes and low back pain, in p ima y ca e se ings(10); whe eas he p e alence o o he p ob- lems is lowe in ecen immig an s han wha is es ima ed in he na i e popula ion(11). Howe e , a e an ex ended s ay, hey may su e diseases mo e ela ed o he li es yle o he hos coun ies, such as hype ension, diabe es and a ious espi a o y o ca dio ascula diseases(10). Acco ding o he Na ional Immig an Su ey(12), 8% o he La in Ame ican immig an s in Spain in 2009 we e in Andalusia; his g oup ep esen ed almos hal o he im- mig an popula ion (46.3%) in Se ille, o which one o e - e y h ee could be ound in he Maca ena dis ic . Nu sing as a p o ession p o ides ca e o sick and heal hy people h oughou hei li espan; i is equi ed ha p o essionals add ess he human esponses o indi- iduals, amilies and communi ies in a comp ehensi e manne (13). We belie e, he e o e, ha one o he g ea challenges posed o his discipline is o p omo e heal h h ough he p o ision o quali y ca e, a oiding isky be- ha io s and p omo ing heal hy li es yles, conside ing a - i udinal and beha io al aspec s o he use . Hence, we p oposed o measu e he p e alence o isk ac o s and ca dio ascula e en s, in he La in Ame ican adul immi- g an popula ion in he Maca ena dis ic o he ci y o Se ille, in o de o use his measu emen as a ac o in- dica i e o heal h p oblems and he need o ca e o his g oup, om he nu sing discipline. Taking in o accoun ha o p o ide nu sing ca e o suppo people in main aining o egaining hei heal h mus ake in o accoun he cul u e, heal h and illness be- lie s, alues and p ac ices o he people(14), nu ses mus be p epa ed o ace he challenge o ca ing o he im- mig an communi y(15). To accomplish his, i is o in e - es o know he heal h beha io s(15), many o which a e cul u ally de e mined(16), so ha hey can in e ene o main ain o es o e heal h. In he pas decade, how ca e should be ailo ed o he immig an popula ion has been an issue o conce n in nu sing(15), asse ing ha he nu s- ing ca e o his g oup is based on he appli- ca ion o in eg a ed ca e based on cul u al knowledge and o he ini ial assessmen , iden i ying he main nu sing diagnoses wi h hose who will implemen hei in e en ion in conjunc ion wi h he immig an pe son, esul ing in a plan o ca e cul u ally ailo ed o hei con ex (17). The objec i e o ou in- es iga ion was o es ima e he p e alence o sel - epo o isk ac o s and ca dio as- cula e en s in he La in Ame ican adul im- mig an popula ion in Dis ic 2 (Maca ena) o Se ille, du ing he yea 2010. ME HoD A quan i a i e, desc ip i e s udy was de- eloped, using a ans e sal me hod wi h a s a i ied p opo ional sample o he a i- ables o gende , age and na ionali y, in which 34 adul La in Ame ican immig an s pa icipa ed, co esponding o 17.8% o he popula ion, es ima ed o cons i u e a pilo s udy. The ange o age in his s udy was be ween 25 o 44 yea s, which is he mos equen age g oup in his popula ion(12). We used some sec ions o he Beha io al Risk Fac o Su eillance Sys em ques ionnai e associa ed wi h beha - io (2009) om he Cen e s o Disease Con ol and P e- en ion o he Uni ed S a es(18). In his a icle we p esen he esul s o : a) sociodemog aphic da a o he espon- den (gende , age, ma i al s a us, educa ional le el, place o bi h, leng h o s ay in Spain, and occupa ion), b) knowl- edge o ha ing su e ed om hype ension, diabe es and / o high choles e ol; c) changes in die a y habi s, p ac ice o physical exe cise; d) co ec knowledge o signs and symp oms o a hea a ack o o a ce eb al ascula ac- ciden : ecogni ion o a leas ou o he six signs and / o symp oms lis ed o each pa hology (op ions o esponse: Taking in o accoun ha o p o ide nu sing ca e o suppo people in main aining o egaining hei heal h mus ake in o accoun he cul u e, heal h and illness belie s, alues and p ac ices o he people, nu ses mus be p epa ed o ace he challenge o ca ing o he immig an communi y. 327 Re Esc En e m USP 2013; 47(2):325-30 www.ee.usp.b / eeusp/ Risk ac o s and ca dio ascula e en s in adul la in ame ican immig an s in he Maca ena Dis ic , Se ille, Spain: a pilo s udy González-López JR, Lomas-Campos MM, Rod íguez-Gázquez MA Yes/No)(18); and e) in e ences abou he a iables men- ioned p e iously. The p e alence o he isk ac o s and ca dio ascula e en s we e calcula ed by di iding he numbe o pe sons who a i med ha a physician o a nu se had commen ed ha hey had a ac o o ha hey we e su e ing / had su e ed a ca dio ascula e en , by he o al numbe o pa icipan s in he s udy. Fo his in es iga ion, we adop ed he de ini ion o im- mig an used by he Na ional Ins i u e o S a is ics (INE) in i s Na ional Immig an Su ey o 2007 (ENI 2007)(19): any pe son who has as his/he coun y o o igin one o he han Spain, who a he momen o conduc ing he su ey has es ablished his/he habi ual esidence wi hin he na- ional e i o y. The collec ion o da a occu ed in he mon h o Ap il o 2011, he ec ui men o pa icipan s was made h ough di e en immig an associa ions. The selec ion c i e ia we e: esiden o ei he gende in one o he o i- cial neighbo hoods o census ac s o he second admin- is a i e dis ic (Maca ena) o Se ille; aged be ween 25 and 44 yea s; ha ing been bo n in some o he coun ies conside ed by he Uni ed Na ions(20) in i s classi ica ion o na ionali ies, e i o ies and egions as La in Ame ican o Sou h Ame ican coun ies (A gen ina, Boli ia, B azil, Chile, Colombia, Cuba, Ecuado , Pa aguay, Pe u, U uguay, Venezuela) and ha ing mig a ed o Spain; abili y o com- munica e and unde s and he equi emen s o he s udy and ha ing signed he in o med consen . To a oid biases in in o ma ion we had a single in e iewe , a heal hca e p o ide , who asked he ques ions and illed in he e- sponses. The in e iew las ed an a e age o 15 minu es and occu ed in di e en associa ions and g oups o La in Ame ican immig an s in he dis ic o acili a e he collec- ion o he da a. The p ocedu es used o conduc his s udy ollowed gene al e hical p inciples, and we e app o ed by he E h- ics Commi ee o he Uni e si y o Se ille o s udies wi h human subjec s in Spain and he Eu opean Union. Fo his, we ob ained in o med w i en consen and, in ela ion o sociodemog aphic da a, in o de p o ec hono and pe - sonal p i acy, he ques ionnai es we e anonymous be- cause he esponden s we e no asked hei names. Da a we e analyzed using he s a is ical p og am, S a is ical Package o he Social Sciences (SPSS) e sion 17.0 o Windows. Desc ip i e analyses we e pe o med, using measu es o cen al endency and dispe sion such as mean and s anda d de ia ion. To check whe he he quan i a i e a iables complied wi h he c i e ia o no - mali y, he Kolmogo o -Smi no (KS) es o a sample was employed. In he case o quali a i e a iables, p opo ions we e calcula ed and he chi-squa e es was applied (X2). In all cases, we adop ed he alue o p < 0.05 o s a is ical signi icance. RESUL S Sociodemog aphic Cha ac e is ics The age a iable, which was no mally dis ibu ed (p obabili y in he z o he es K-S = 0.192), had a mean o 31.8 ± 5.8 yea s. In Table I he sociodemog aphic p o ile o he 34 people s udied can be seen; women, less han 30 yea s, single and who had seconda y educa ion p edomi- na ed. Fo coun y o o igin, he majo i y came om Bo- li ia and Ecuado . In ela ion o cu en and p e ious occu- pa ion, he majo i y o subjec s we e employed by o he s. When analyzing he ime o esidence in Spain, i was ound ha he sample had a mean o 6.5 ± 3.5 yea s, sligh ly highe han he mean esidence ime in he ci y o Se ille (5.8 ± 3.6 yea s). Bo h a iables also had a no mal dis ibu ion, which was e i ied in he p obabili es o he es o K-S o 0.480 and 0.914, espec i ely. Table 1 – Gene al cha ac e is ics o 34 La in Ame ican adul im- mig an s o he Maca ena Dis ic o Se ille Va iable Value Gende ; n (%) Female 18 (52.9) Male 16 (47.1) Age g oup; n (%) 25 o 29 yea s 17 (50.0) 30 o 34 yea s 7 (20.6) 35 o 39 yea s 6 (17.6) 40 yea s and olde 4 (11.8) Ma i al s a us; n (%) Single 16 (47.1) Ma ied 15 (44.1) Li ing oge he / unma ied pa ne 2 (5.9) Sepa a ed 1 (2.9) Le el o educa ion; n (%) P ima y educa ion*4 (11.7) Seconda y educa ion†19 (55.9) Highe educa ion‡6 (17.6) Uni e si y deg ee§5 (14.8) Na ionali y; n (%) Boli ia 13 (38.2) B azil 1 (2.9) Colombia 3 (8.8) Ecuado 9 (26.5) Pa aguay 2 (5.9) Pe ú 4 (11.8) Venezuela 2 (5.9) P e ious occupa ion; n (%) Employee 28 (82.4) Sel -employed 2 (5.9) Unemployed 1 (2.9) S uden 3 (8.8) Cu en occupa ion; n (%) Employee 26 (76.5) Sel -employed 2 (5.9) Unemployed 4 (11.8) S uden 2 (5.9) *: P ima y s udies / Elemen a y school; †: Seconda y s udies / Elemen a y Baccalau ea e / FP / Basic T aining Cou se; ‡: Highe Educa ion / Baccalau ea e / Highe Fo ma i e Cycle; §: Uni e si y deg ee (3 wi h unde g adua e deg ee and 2 wi h g adua e deg ee o doc o a e). 328 Re Esc En e m USP 2013; 47(2):325-30 www.ee.usp.b / eeusp/ Risk ac o s and ca dio ascula e en s in adul la in ame ican immig an s in he Maca ena Dis ic , Se ille, Spain: a pilo s udy González-López JR, Lomas-Campos MM, Rod íguez-Gázquez MA P e alence and p e en i e beha io s o h ee isk ac- o s o ca dio ascula disease Diabe es. O he o al popula ion su eyed, 41.2% (14 indi iduals) we e measu ed equen ly o blood glucose, including 13 pe sons (38.2%) who did so se e al imes a yea , whe eas one pe son (2.9%) did so se e al imes a mon h. The emaining popula ion ne e did his. I is impo an o no e ha 38.2% o he subjec s in he s udy sample we e o e weigh and 20.6% we e obese, while he emaining (51.2%) we e o no mal weigh . The p obabili y o he z o he es o K-S o he IMC was 0.969, which signi ied ha his a iable had a no mal dis- ibu ion. The p e alence o sel - epo ed diabe es was 8.8%, namely: h ee people claimed o ha e been diagnosed as diabe ic ( wo wi h ges a ional diabe es and a man wi h ype I diabe es). O he h ee people who epo ed ha ing been diagnosed wi h diabe es: one was aking medica ion o con ol i ; all had changed hei ea ing habi s o con- ol hei blood suga ; none examined hei ee o de ec possible wounds by i i a ion; only one p ac iced physical exe cise as a way o imp o e insulin sensi i i y, and all said hey had no a ended any educa ional ac i i y o lea n how o con ol blood suga . Hype ension. O he o al popula ion su eyed, 55.9% (19 people) said ha hei a e ial blood p essu e was measu ed se e al imes a yea , wi h hose ne e do- ing so accoun ing o 44.1% (15 people). When asked how long ago he blood p essu e le el was analyzed: 16 people (47.1%) s a ed ha hey measu ed i in he pas yea , nine people (26.5%) had ne e had i done, ou people (11.8 %) had measu ed i in he pas wo yea s, wo people (5.9%) in he pas i e yea s, and o h ee people (8.8%) i was i e yea s o mo e. In 76.5% o he o al sample (26 people), none had a medical o nu sing p o essional indica e ha hey p esen ed wi h high blood p essu e o hype ension. The sel - epo ed p e alence o his disease was 23.5%, o he emaining eigh people who claimed o ha e been diagnosed wi h he disease, one o which was du ing he p egnancy. In he analysis o he eigh people who said hey we e diagnosed wi h hype ension, only one (12.5%) epo ed aking medica ion o con ol he high blood p es- su e; i e (62.5%) had changed hei ea ing habi s ; all had educed hei consump ion o sal and alcohol and, inally only h ee people (37.5%) p ac iced physical exe cise as a way o educe blood p essu e. Choles e ol. The e we e 26.5% o he s udy pa ici- pan s (9 pe sons) who had hei blood choles e ol le el checked; i e o hem (55.6%) had done so in he las yea . The p e alence o sel - epo ed hype choles e olemia was 14.7% ( i e people we e in o med by a medical p ac i- ione o nu se). O hese, only wo claimed o ake medi- ca ion o i s con ol; ou had modi ied hei ea ing hab- i s, educing he consump ion o a s; i e had dec eased he consump ion o ciga e es and alcohol; and, only wo used physical exe cise as a way o educe blood high choles e ol. We did no ind s a is ically signi ican di e - ences be ween he a iable choles e ol and alcohol in ake (X2 = 3.214, p = 0.073). P e alence o ca dio ascula e en s and ecogni ion o signs and symp oms associa ed wi h hese complica ions The p e alence o sel - epo o ca dio ascula e en s was 8.8%: wi h one case each o acu e myoca dial in a c- ion, angina pec o is and ce eb o ascula acciden . In he case o ce eb o ascula acciden , he pa ien wen o e- habili a ion and changed his li es yle as a consequence o su e ing ca diac pa hology. Rega ding he ecogni ion o symp oms o he e en s o hea a ack and ce eb o ascula acciden , he mo e ecognized symp oms by his g oup we e: di icul y b ea hing and pain o discom o in he ches , o he o - me , and se e e headache and sudden ouble walking o he la e (Table 2). Table 2 – Recogni ion o symp oms associa ed wi h hea a ack and ce eb o ascula acciden . Symp oms n (%) Hea A ack Symp oms Di icul y b ea hing 28 (82.4) Pain o discom o in he ches 24 (70.6) Feeling dizzy o ain 16 (47.1) Sudden changes in ision 15 (44.1) Pain o discom o in he a ms 15 (44.1) Pain in mandible, neck o back 10 (29.4) Ce eb o ascula Acciden Symp oms In ense pain in he head 28 (82.4) Sudden ouble walking 26 (76.5) Sudden di icul y speaking 22 (64.7) Sudden weakness in ace, a m o leg 22 (64.7) Sudden changes in ision 21 (61.8) Ches pain 10 (29.1) The o al p opo ion o co ec answe s o ecogni- ion o he signs and symp oms o hea a ack was 52.9% e sus 63.2% o ce eb o ascula acciden ; his di e ence was no s a is ically signi ican (X2 = 0.54, p = 0.46). DiScUSSion Habi ually, mo bidi y s udies in o eign popula ions ha e been ocused on impo ed pa hology and only e- cen ly ha e begun o analyze ch onic diseases(21). In ou s udy, in ela ion o diabe es, 8.8% o subjec s had been 329 Re Esc En e m USP 2013; 47(2):325-30 www.ee.usp.b / eeusp/ Risk ac o s and ca dio ascula e en s in adul la in ame ican immig an s in he Maca ena Dis ic , Se ille, Spain: a pilo s udy González-López JR, Lomas-Campos MM, Rod íguez-Gázquez MA old by a medical p o essional o nu se ha hey we e su - e ing om his disease, da a signi ican ly highe han he 2.7%(11) o 5%(22) in o he s udies. The bias could be due o he di e en sample size, since he smalle he sample, he mo e possibili ies exis ha he esul s a e no ep- esen a i e o he s udy popula ion, ano he a ibu able cause may be he ange o ages s udied. I is no ewo hy ha all people wi h diabe es in he sample had changed hei die a y habi s, bu had no a ended any o ma i e cou se on diabe es no we e ee examined o possible wounds om i i a ions. The e o e, a p io i, we obse ed de icien knowledge ela ed o ca e in subjec s wi h dia- be es in ou sample. P oceeding wi h o he ch onic disease such as a e ial hype ension, i s p e alence by sel - epo in ou sample (23.5%) ep esen ed a much highe igu e han he 4.1% eco ded in one s udy(11) o he 10.8% ano he ound(22), bu we can es ablish a con incing explana ion o hese di e ences, which may be due o he easons p e iously men ioned o he sample size. I is necessa y o commen ha hal o hose diagnosed subjec s pe o med heal h p omo ing beha io s when con on ing hei disease, such as dec easing he in ake o alcohol and / o sal and / o inc easing physical exe cise. The p esence o blood choles e ol and diagnosis o hype choles e olemia we e indica ed by 14.7% o he sample, a new igu e signi ican ly highe han he 5.4% analyzed by sel - epo (20). These di e ences may be due o he measu emen o he a iable, o he ime o esi- dence in Spain was lowe han in ou sample and hey had no abandoned he nu i ional habi s o he coun y o o i- gin; also all he sample in he la es s udy came om La in Ame ica, as compa ed o only 75%. I should be no ed ha , o all subjec s diagnosed wi h high choles e ol, he o ali y had s opped smoking, and he as majo i y (80%) had changed hei ea ing habi s; no ound in he e iewed li e a u e da a ha was collec ed, bu also signi ican , was ha hal o hose p ac iced exe cise o imp o e hei heal h. Resea ch has ound no s a is ically signi ican di - e ences be ween his a iable and he in ake o alcohol. We can say ha sel -pe cei ed ca dio ascula heal h by pa icipan s o ou s udy was good, only 2.9% (1 pe - son) was diagnosed wi h a hea a ack, also only 2.9% was in o med ha he su e ed angina, and one subjec su e ed a ce eb o ascula acciden , wi h his da a be- ing simila o hose desc ibed elsewhe e(22), in which he e exis ed a p e alence o o he pa hologies o he hea o 3.3% and 1.3% in one s udy(11), wi h da a s em- ming om di e en au onomous communi ies, Ca a- lonia and Mad id, espec i ely. No in es iga ions we e ound abou he knowledge o he immig an popula- ion abou he symp oms ha appea bo h in hea a - ack and in ce eb o ascula disease, al hough we be- lie e ha , gi en he a e age numbe o co ec answe s (58.1%), measu es can be es ablished o an educa ional na u e and o ien ed owa ds p ima y p e en ion o such p oblems o heal h. Among he limi a ions o his s udy, hose ha cha ac- e ize a pilo s udy we e ound and deal mainly wi h he numbe o subjec s s udied. This s udy will p o ide he basis o expanded esea ch in he ci y o Se ille, as well as o e alua e he sui abili y o he ins umen used and he da a collec ion pe o med. concLUSion The esul s o his s udy ha e p o ided an expansion o knowledge abou he heal h s a us o he collec i e o immig an people s udied, which p o ide p e alences o sel - epo ed isk ac o s and ca dio ascula e en s in ou pilo s udy highe han hose ound in he li e a u e, me - i ing he a en ion o he heal h agencies. I is impo an o con inue his line o in es iga ion, in o de o guide he design and implemen a ion o di - e en ial ac ions om he nu sing pe spec i e, adequa e o he needs o he immig an collec i e, such as o ma- i e ac i i ies in he p e en ion o diabe es o obesi y o empowe his popula ion and hus imp o e hei le el o heal h. REFEREncES 1. Naciones Unidas. Diálogo de al o ni el sob e la mig ación in- e nacional y el desa ollo. En: Asamblea Gene al de las Na- ciones Unidas; 2006 sep .14-15; New Yo k [In e ne ]. 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(PI-0138), unded by he Minis y o Heal h o he Go e nmen o Andalusia (Go e nmen o Spain), in he no ice o 2009, and implemen ed by he School o Nu sing, Physio he apy and Podia y, Uni e si y o Se ille, Spain. co espondence add essed o: José Ra ael González López Dep. de En e me ía de la Facul ad de En e me ía, Fisio e apia y Podología Uni e sidad de Se illa - A . Sánchez Pizjuán s/n 41009 – Se illa, España