Cardiometabolic diseases such as hypertension, diabetes, and other disorders associated with the heart, circulation, and metabolism do not arise from one moment to the next. Their appearance may be the result of a trajectory of events that can be traced back to childhood. That is one of the findings of a study that found that these diseases may also be related to social and even emotional conditions.
In most cases, explanations for these two diseases focus on their description and immediate causes: arterial hypertension is a chronic disease that occurs when the pressure with which blood circulates through the arteries remains persistently elevated, and type 2 diabetes is a metabolic disease, that is, an alteration in the way the body processes glucose or sugar in the blood, associated mainly with factors such as obesity, sedentary lifestyles, and certain living habits.
The data have also been the subject of observation and analysis. As of December 31, 2024, 6,077,364 people diagnosed with hypertension in Colombia had been reported to the High Cost Account (CAC), a figure still preliminary and subject to audit. During that year alone, 214,659 new cases were reported. The Andean region concentrated the largest number of new diagnoses, followed by the Caribbean region, although the latter registered the highest standardized incidence in the country. In addition, nearly 3 million people in the country live with diabetes.
Influence of social, economic, emotional, and cultural factors
But for more than four years, researcher Mariluz Romero, who holds a master’s degree in Nursing from the National University of Colombia (UNAL), became interested in the subject while working with patients who arrived at intensive care units with underlying diseases such as hypertension and diabetes. “I always wondered what was behind these pathologies,” she said, quoted in a statement by the UNAL News Agency, and that question guided the research she carried out.
When she reviewed the scientific literature, Romero found a fact that also determined the course of her research: between 60 percent and 80 percent of cases of these diseases could be prevented through lifestyle changes. From there, she decided to focus her master’s thesis on nine people linked to the cardiovascular care pathway of Unisalud, the healthcare provider institution of UNAL. They were six women and three men between 36 and 75 years old, from Santander, Huila, Boyaca, the Coffee Region, and Bogota. Some lived with hypertension, others with type 2 diabetes, and several with both diseases.
Romero studied the diet of those patients, their physical activity, and stress throughout their lives, and instead of focusing only on adulthood or medical treatment, she sought to understand how experiences accumulated since childhood, and even since gestation, could be related to the appearance, many years later, of cardiometabolic diseases such as hypertension, diabetes, and other disorders associated with the heart, circulation, and metabolism.
“The evidence shows that these conditions do not appear from one moment to the next; there are social, economic, emotional, and cultural factors that influence their development,” Romero said in the same outlet, and explained that one of the main findings appeared in nutrition, since many eating habits were determined by economic resources and the cultural customs of each region.
Several participants grew up in households where there was not always access to nutritious food and where diets rich in carbohydrates and starch-heavy products predominated. “Diet was built on what was available and what they could afford with their money,” the researcher added. “In some cases, frequent patterns of consumption of processed meats and ultra-processed foods also appeared, which shows that social inequalities also shape cardiovascular health.”
Risks from childhood, even since gestation
Regarding physical activity, most participants remained active through play or everyday activities. But that movement decreased in adulthood because of lack of time, long workdays, fatigue, or health problems. While some people tried to remain active with daily walks or routines from their cellphones, others faced physical and emotional barriers that made it difficult to maintain those habits.
Stress was another of the most important axes of the study, since the author identified experiences of physical violence, family abandonment, attempted sexual abuse, and child labor from early ages. “These situations can keep the body’s alarm system active for years and favor inflammatory processes related to chronic diseases,” Romero explained. “Among the cases studied there were feelings of sadness, anger, and frustration that remained for a long time.”
Some participants recounted that they had to work from childhood to help support their families financially; others described emotional consequences related to parental abandonment or family conflicts.
The researcher also identified gestation as a particularly vulnerable stage for cardiovascular and metabolic health. Two of the participants received diagnoses related to hypertension or diabetes during pregnancy, and there were also accounts associated with anxiety, emotional changes, and postpartum depression.
Thus, she confirmed a general principle of medicine: “Maternal health influences not only the woman, but also the future of the child. Conditions present during pregnancy would influence the risk of developing hypertension, diabetes, and other metabolic disorders in later stages of life,” she said.
Another finding that drew her attention was that none of the participants had obesity, which demonstrates that these diseases do not affect only overweight people. “A thin person can also develop hypertension or diabetes,” she emphasized.
For the researcher, one of the main contributions of her work is proposing an approach less focused exclusively on treatment and more focused on prevention. “When we know a person’s life history, we can design more specific interventions according to each stage of life,” she added.
In her opinion, addressing these diseases requires support in nutrition, physical activity, and mental health from early stages of life, even before symptoms appear. “These recommendations are not only for those who already have the disease, but they are also important for people at risk and for those who still do not present symptoms,” she concluded.