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Marqueta de Salas M, Martín-Ramiro JJ, Juárez Soto JJ. Características sociodemográficas como factores de riesgo para la obesidad y el sobrepeso en la población adulta española. Med Clin (Barc) 2016; 146:471-7. [DOI: 10.1016/j.medcli.2016.03.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 02/27/2016] [Accepted: 03/03/2016] [Indexed: 10/21/2022]
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102
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No evidence of morbidity compression in Spain: a time series study based on national hospitalization records. Int J Public Health 2016; 61:729-38. [PMID: 27233641 DOI: 10.1007/s00038-016-0829-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 04/28/2016] [Accepted: 05/02/2016] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Compression of morbidity postulates that as the populations age, the age of onset of disease is postponed. The objective of this study is to test for evidence of compression of morbidity in Spain. METHODS We calculated the age and sex-specific incidence of myocardial infarction, heart failure, cerebrovascular disease, as well as bladder, prostate, breast, lung, and colon cancer among hospital discharges covering 99.5 % of the Spanish population, approximately 40 million inhabitants for two non-overlapping periods, 1997-2000 and 2007-2010, and estimated the length of life spent with disease using the Sullivan method. RESULTS We found that expansion of morbidity due to an earlier age-specific onset of incident disease and increase in life expectancy was the norm in Spain. Notable exceptions were cardiovascular disease in women (-0.2 % time spent with disease) and lung cancer for men (-0.9 % time spent with disease) from 1997-2000 to 2007-2010. CONCLUSIONS Compression of morbidity is often cited by policy makers when discussing adjustments to the health-care system. If morbidity is measured by age at onset of disease, the burden of morbidity has increased in Spain.
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103
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Suárez-Gómez A, Sánchez-Vega J, Suárez-González F, Peral-Pacheco D, Dorado-Martin JJ, Suárez-Gómez M. [Nutritional status of the population over 65 years of age in the city of Badajoz]. Semergen 2016; 43:80-84. [PMID: 27156230 DOI: 10.1016/j.semerg.2016.03.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 01/27/2016] [Accepted: 03/06/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Nutritional status is strongly associated with the level of health and quality of life of the population, and is especially relevant in the case of the elderly. OBJECTIVE The aim was to study the nutritional status in a population of non-institutionalised over 65 year-olds in the city of Badajoz, describing the sociodemographic variables, biochemical parameters, and functional assessment. MATERIAL AND METHODS A descriptive study was performed using a design population, which was randomised and stratified in health centres of the city, with a sample size of 298 patients being obtained. The sociodemographic variables included gender, age, educational level, anthropometric analysis with estimated body mass index, and percentage fat weight. Statistical tests were performed using SPSS v.15 statistical package. RESULTS The prevalence of overweight and obesity as measured by fat weight was 61.9% (56.1-67.8), with a body mass index of 65.8% (60.2-71.4). It was higher in women, with a fat weight of 67.3% (2.56 to 2.73) and a body mass index of 71.8% (2.64 to 2.78). The nutritional status of the population according to the questionnaire "Know your nutritional health" was rated "good". CONCLUSION The most common nutritional problem in the non-institutionalised population over 65 years in the city of Badajoz is obesity, especially in women, and in people with low educational level. This high prevalence suggests that health education on a better lifestyle in this population should be a priority.
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Affiliation(s)
- A Suárez-Gómez
- Departamento de Ciencias Biomédicas, Facultad de Medicina de Badajoz, Badajoz, España.
| | | | - F Suárez-González
- Centro de Salud San Roque, Badajoz, España; Cátedra de Medicina de Familia SEMERGEN-Universidad de Extremadura, Badajoz, España
| | - D Peral-Pacheco
- Departamento de Terapéutica Médico Quirúrgica, Facultad de Medicina, Badajoz, España
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Statement of the Spanish Interdisciplinary Cardiovascular Prevention Committee (CEIPC for its Spanish acronym) on the 2012 European Cardiovascular Prevention Guidelines. NEUROLOGÍA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.nrleng.2013.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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105
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Royo-Bordonada MA, Lobos Bejarano JM, Villar Alvarez F, Sans S, Pérez A, Pedro-Botet J, Moreno Carriles RM, Maiques A, Lizcano Á, Lizarbe V, Gil Núñez A, Fornés Ubeda F, Elosua R, de Santiago Nocito A, de Pablo Zarzosa C, de Álvaro Moreno F, Cortés O, Cordero A, Camafort Babkowski M, Brotons Cuixart C, Armario P. Statement of the Spanish Interdisciplinary Cardiovascular Prevention Committee (CEIPC for its Spanish acronym) on the 2012 European Cardiovascular Prevention Guidelines. Neurologia 2016; 31:195-207. [PMID: 23969295 DOI: 10.1016/j.nrl.2013.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 03/25/2013] [Indexed: 11/20/2022] Open
Abstract
Based on the two main frameworks for evaluating scientific evidence (SEC and GRADE) European cardiovascular prevention guidelines recommend interventions across all life stages using a combination of population-based and high-risk strategies with diet as the cornerstone of prevention. The evaluation of cardiovascular risk (CVR) incorporates HDL levels and psychosocial factors, a very high risk category, and the concept of age-risk. They also recommend cognitive-behavioural methods (e.g., motivational interviewing, psychological interventions) led by health professionals and with the participation of the patient's family, to counterbalance psychosocial stress and reduce CVR through the institution of positive habits such as a healthy diet, physical activity, smoking cessation, and adherence to treatment. Additionally, public health interventions - such as smoking ban in public areas or the elimination of trans fatty acids from the food chain - are also essential. Other innovations include abandoning antiplatelet therapy in primary prevention and the recommendation of maintaining blood pressure within the 130-139/80-85 mmHg range in diabetic patients and individuals with high CVR. Finally, due to the significant impact on patient progress and medical costs, special emphasis is given to the low therapeutic adherence levels observed. In sum, improving cardiovascular prevention requires a true partnership among the political class, public administrations, scientific and professional associations, health foundations, consumer associations, patients and their families. Such partnership would promote population-based and individual strategies by taking advantage of the broad spectrum of scientific evidence available, from clinical trials to observational studies and mathematical models to evaluate population-based interventions, including cost-effectiveness analyses.
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Affiliation(s)
| | | | | | - S Sans
- Sociedad Española de Salud Pública y Administración Sanitaria, España
| | - A Pérez
- Sociedad Española de Diabetes, España
| | | | | | - A Maiques
- Sociedad Española de Medicina de Familia y Comunitaria, España
| | - Á Lizcano
- Federación de Asociaciones de Enfermería Comunitaria y Atención Primaria, España
| | - V Lizarbe
- Ministerio de Sanidad, Servicios Sociales e Igualdad, España
| | | | - F Fornés Ubeda
- Sociedad Española de Medicina y Seguridad en el Trabajo, España
| | - R Elosua
- Sociedad Española de Epidemiología, España
| | | | | | | | - O Cortés
- Asociación Española de Pediatría de Atención Primaria, España
| | - A Cordero
- Sociedad Española de Cardiología, España
| | | | | | - P Armario
- Sociedad Española de Hipertensión-Liga Española de la Lucha Contra la HTA, España
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Molinuevo JL, Gramunt N, Gispert JD, Fauria K, Esteller M, Minguillon C, Sánchez-Benavides G, Huesa G, Morán S, Dal-Ré R, Camí J. The ALFA project: A research platform to identify early pathophysiological features of Alzheimer's disease. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2016; 2:82-92. [PMID: 29067295 PMCID: PMC5644283 DOI: 10.1016/j.trci.2016.02.003] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Introduction The preclinical phase of Alzheimer's disease (AD) is optimal for identifying early pathophysiological events and developing prevention programs, which are shared aims of the ALFA project, including the ALFA registry and parent cohort and the nested ALFA+ cohort study. Methods The ALFA parent cohort baseline visit included full cognitive evaluation, lifestyle habits questionnaires, DNA extraction, and MRI. The nested ALFA+ study adds wet and imaging biomarkers for deeper phenotyping. Results A total of 2743 participants aged 45 to 74 years were included in the ALFA parent cohort. We show that this cohort, mostly composed of cognitively normal offspring of AD patients, is enriched for AD genetic risk factors. Discussion The ALFA project represents a valuable infrastructure that will leverage with different studies and trials to prevent AD. The longitudinal ALFA+ cohort will serve to untangle the natural history of the disease and to model the preclinical stages to develop successful trials.
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Affiliation(s)
- José Luis Molinuevo
- Barcelonaβeta Brain Research Center, Barcelona, Spain
- Corresponding author. Tel.: (+34) 93 316 0990; Fax: (+34) 93 316 0996 .
| | - Nina Gramunt
- Barcelonaβeta Brain Research Center, Barcelona, Spain
| | | | - Karine Fauria
- Barcelonaβeta Brain Research Center, Barcelona, Spain
| | - Manel Esteller
- Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Physiological Sciences II, School of Medicine, University of Barcelona (UB), Barcelona, Spain
- Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | | | | | - Gema Huesa
- Barcelonaβeta Brain Research Center, Barcelona, Spain
| | - Sebastián Morán
- Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Physiological Sciences II, School of Medicine, University of Barcelona (UB), Barcelona, Spain
| | - Rafael Dal-Ré
- Barcelonaβeta Brain Research Center, Barcelona, Spain
| | - Jordi Camí
- Pasqual Maragall Foundation, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Corresponding author. Tel.: (+34) 93 316 0990; Fax: (+34) 93 316 0996 .
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Marcelino-Rodríguez I, Elosua R, Pérez MDCR, Fernández-Bergés D, Guembe MJ, Alonso TV, Félix FJ, González DA, Ortiz-Marrón H, Rigo F, Lapetra J, Gavrila D, Segura A, Fitó M, Peñafiel J, Marrugat J, de León AC. On the problem of type 2 diabetes-related mortality in the Canary Islands, Spain. The DARIOS Study. Diabetes Res Clin Pract 2016; 111:74-82. [PMID: 26546396 DOI: 10.1016/j.diabres.2015.10.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 09/21/2015] [Accepted: 10/05/2015] [Indexed: 01/21/2023]
Abstract
AIMS To compare diabetes-related mortality rates and factors associated with this disease in the Canary Islands compared with other 10 Spanish regions. METHODS In a cross-sectional study of 28,887 participants aged 35-74 years in Spain, data were obtained for diabetes, hypertension, dyslipidemia, obesity, insulin resistance (IR), and metabolic syndrome. Healthcare was measured as awareness, treatment and control of diabetes, dyslipidemia, and hypertension. Standardized mortality rate ratios (SRR) were calculated for the years 1981 to 2011 in the same regions. RESULTS Diabetes, obesity, and hypertension were more prevalent in people under the age of 64 in the Canary Islands than in Spain. For all ages, metabolic syndrome and insulin resistance (IR) were also more prevalent in those from the Canary Islands. Healthcare parameters were similar in those from the Canary Islands and the rest of Spain. Diabetes-related mortality in the Canary Islands was the highest in Spain since 1981; the maximum SRR was reached in 2011 in men (6.3 versus the region of Madrid; p<0.001) and women (9.5 versus Madrid; p<0.001). Excess mortality was prevalent from the age of 45 years and above. CONCLUSIONS Diabetes-related mortality is higher in the Canary Islands population than in any other Spanish region. The high mortality and prevalence of IR warrants investigation of the genetic background associated with a higher incidence and poor prognosis for diabetes in this population. The rise in SRR calls for a rapid public health policy response.
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Affiliation(s)
- Itahisa Marcelino-Rodríguez
- Unidad de Investigación de Atención Primaria y del Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España; Red de Investigación Cardiovascular del Instituto Carlos III Institute de Salud, Madrid, España
| | - Roberto Elosua
- Red de Investigación Cardiovascular del Instituto Carlos III Institute de Salud, Madrid, España; Grupo de Epidemiología y Genética Cardiovascular, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España
| | - María del Cristo Rodríguez Pérez
- Unidad de Investigación de Atención Primaria y del Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España; Red de Investigación Cardiovascular del Instituto Carlos III Institute de Salud, Madrid, España
| | - Daniel Fernández-Bergés
- Unidad de Investigación Don Benito Villanueva, Programa de Investigación Cardiovascular, Fundesalud, Gerencia Área Sanitaria Don Benito-Villanueva, Badajoz, España
| | - María Jesús Guembe
- Servicio de Docencia y Desarrollo Sanitarios, Grupo de Investigación Riesgo Vascular en Navarra (RIVANA), Departamento de Salud, Gobierno de Navarra, Pamplona, España
| | - Tomás Vega Alonso
- Dirección General de Salud Pública e Investigación Desarrollo e Innovación, Consejería de Sanidad de la Junta de Castilla y León, Valladolid, España
| | - Francisco Javier Félix
- Centro de Salud Villanueva Norte, Servicio Extremeño de Salud, Villanueva de la Serena, Badajoz, España
| | - Delia Almeida González
- Unidad de Investigación de Atención Primaria y del Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España; Red de Investigación Cardiovascular del Instituto Carlos III Institute de Salud, Madrid, España
| | - Honorato Ortiz-Marrón
- Servicio de Epidemiología. Subdirección General de Promoción de la Salud y Prevención, Servicio Madrileño de Salud, Madrid, España
| | - Fernando Rigo
- Grupo Cardiovascular de Baleares de redIAPP, UB Genova, Palma de Mallorca, España
| | - José Lapetra
- Centro de Salud Universitario "San Pablo", Distrito Sanitario Atención Primaria Sevilla, Servicio Andaluz de Salud, Sevilla, España; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, España
| | - Diana Gavrila
- Servicio de Epidemiología, Consejería de Sanidad y Consumo de la Región de Murcia, Murcia, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España
| | - Antonio Segura
- Red de Investigación Cardiovascular del Instituto Carlos III Institute de Salud, Madrid, España; Servicio de Investigación, Instituto de Ciencias de la Salud de Castilla-La Mancha, Toledo, Talavera de la Reina, España
| | - Montserrat Fitó
- Grupo de Riesgo Cardiovascular y Nutrición, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM, Barcelona, España
| | - Judith Peñafiel
- Red de Investigación Cardiovascular del Instituto Carlos III Institute de Salud, Madrid, España; Grupo de Epidemiología y Genética Cardiovascular, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM, Barcelona, España
| | - Jaume Marrugat
- Red de Investigación Cardiovascular del Instituto Carlos III Institute de Salud, Madrid, España; Grupo de Epidemiología y Genética Cardiovascular, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM, Barcelona, España
| | - Antonio Cabrera de León
- Red de Investigación Cardiovascular del Instituto Carlos III Institute de Salud, Madrid, España; Grupo de Epidemiología y Genética Cardiovascular, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM, Barcelona, España; Área de Medicina Preventiva y Salud Pública, Universidad de La Laguna, La Laguna, España.
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Galve E, Guijarro-Herraiz C, Masana-Marin L, Cordero-Fort A. [Consensus on objectives and action guidelines on low density lipoproteins-cholesterol control in very high risk cardiovascular patients]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2015; 28:31-42. [PMID: 26657097 DOI: 10.1016/j.arteri.2015.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 08/28/2015] [Accepted: 09/08/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Cardiovascular disease is the leading cause of death in developed countries. Among cardiovascular disease risk factors one of the most relevant is low-density lipoprotein-associated cholesterol (LDL-c), but there is controversy about the methods used to control it. The aim was to obtain an expert opinion to clarify the most relevant issues regarding the control of dyslipidemia in very high cardiovascular risk patients. MATERIALS AND METHODS A survey with 55 items, stratified into 4 blocks: LDL-c as a therapeutic target, therapeutic goals, causes of the failure to achieve LDL-c goals, and recommendations to optimize their achievement, was addressed to 41 specialists (Cardiology and Internal Medicine) using the Delphi method to achieve professional consensus criteria. RESULTS A high consensus was reached among all items, in line with the European recommendations. The panelists considered that the goal of 70mg/dl for LDL-c for high cardiovascular disease risk (mainly vascular disease, diabetes mellitus, and renal failure), using combined treatment when necessary. Lack of adherence and therapeutic inertia were considered the main reasons for treatment failure. CONCLUSION The Spanish experts show an elevated consensus with the European recommendations, confirming the LDL-c control target of <70mg/dl. The simplification of the guidelines and the combined treatment may favor an improvement the achievement of lipid target goals.
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Affiliation(s)
- Enrique Galve
- Servicio de Cardiología, Hospital Vall d'Hebron, Barcelona, España; Sección de Riesgo Vascular y Rehabilitación, Sociedad Española de Cardiología, España.
| | - Carlos Guijarro-Herraiz
- Servicio de Medicina Interna, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Alcorcón, Madrid, España; Grupo de Trabajo de la Sociedad Española de Arteriosclerosis, España
| | - Luis Masana-Marin
- Unitat de Medicina Vascular i Metabolisme, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, IISPV, CIBERDEM, Reus, Tarragona, España; Grupo de Trabajo de la Sociedad Española de Arteriosclerosis, España
| | - Alberto Cordero-Fort
- Sección de Riesgo Vascular y Rehabilitación, Sociedad Española de Cardiología, España; Hospital Universitario San Juan de Alicante, Alicante, España
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109
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Gil-Montalbán E, Martín-Ríos M, Ortiz-Marrón H, Zorrilla-Torras B, Martínez-Cortés M, Esteban-Vasallo M, López-de-Andrés A. Incidence of type 2 diabetes and associated factors in the adult population of the Community of Madrid. PREDIMERC cohort. Rev Clin Esp 2015. [DOI: 10.1016/j.rceng.2015.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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110
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Cardiovascular risk factors, lifestyle, and social determinants: a cross-sectional population study. Br J Gen Pract 2015; 64:e627-33. [PMID: 25267048 DOI: 10.3399/bjgp14x681793] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND The influence of socioeconomic development is often disregarded in epidemiological studies into the prevalence of cardiovascular risk factors. AIM To analyse the relationship between major cardiovascular risk factors and socioeconomic indicators. DESIGN AND SETTING Cross-sectional, population-wide study in primary care practices in the health area of Don Benito-Villanueva de la Serena, Badajoz, Extremadura, Spain. METHOD A total of 2833 people aged 25-79 years (mean age 51.2 years), representative of the population, participated in the study. The prevalence and odds ratios (ORs) were calculated for diabetes, arterial hypertension, obesity, hypercholesterolaemia, smoking, and sedentary behaviour, according to level of education and employment status. RESULTS A high prevalence of cardiovascular risk factors related to the level of education and employment status. Females who had not studied at university had a higher risk of obesity (OR = 2.5, 95% confidence interval [CI] = 1.5 to 4.2), smoking (OR 2.5, 95% CI = 1.7 to 3.7), and sedentary behaviour (OR = 2.5, 95% CI = 1.5 to 3.9) than females with a university education. Males who had not studied at university showed an increased risk of smoking (OR = 2.1, 95% CI = 1.4 to 3.1), arterial hypertension (OR = 1.5, 95% CI = 1.0 to 2.4), hypercholesterolaemia (OR = 1.5, 95% CI = 1.0 to 2.2), and obesity (OR = 1.5, 95% CI = 1.0 to 2.3) than males with a university education. The risk of obesity was higher in unemployed females than those in paid employment (OR =1.4, 95% CI = 1.1 to 1.9), but they showed a lower risk of smoking (OR = 0.7, 95% CI = 0.5 to 0.9). CONCLUSION The study results confirm an inverse association between the level of education and the prevalence of cardiovascular risk factors. Public health studies and interventions are needed to understand this association and develop interventions targeted at the population that is at greatest risk.
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111
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de la Sierra A, Pintó X, Guijarro C, Miranda JL, Callejo D, Cuervo J, Subirà R, Rubio M. Prevalence, Treatment, and Control of Hypercholesterolemia in High Cardiovascular Risk Patients: Evidences from a Systematic Literature Review in Spain. Adv Ther 2015; 32:944-61. [PMID: 26499178 PMCID: PMC4635180 DOI: 10.1007/s12325-015-0252-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Cardiovascular diseases (CVDs) represent a major Public Health burden. High serum cholesterol levels have been linked to major CV risk. The objectives of this study were to review the epidemiology of hypercholesterolemia in high risk CV patients from Spain, by assessing its prevalence, the proportion of diagnosed patients undergoing pharmacological treatment and the degree of attained lipid control. METHODS A systematic literature review was carried out using Medline and two Spanish databases. Manuscripts containing information on hypercholesterolemia in several high CV risk groups [diabetes mellitus (DM), Systematic COronary Risk Evaluation (SCORE) risk >5, or documented CVD], published between January 2010 and October 2014, were included. RESULTS Of the 1947 published references initially retrieved, a full-text review was done on 264 manuscripts and 120 were finally included. Prevalence of hypercholesterolemia ranged from 50 to 84% in diabetics, 30-60% in patients with DM or elevated SCORE risk, 64-74% with coronary heart disease, 40-70% in stroke patients, and 60-80% in those with peripheral artery disease. Despite the finding that most of them were on pharmacological treatment, acceptable control of serum lipids was very variable, ranging from 15% to 65%. Among those with heterozygous familial hypercholesterolemia, 95-100% received treatment but less than 50% achieved their therapeutic goals. CONCLUSIONS An elevated prevalence of hypercholesterolemia can be found in targeted groups at high CV risk. Although most patients are receiving pharmacological treatment, rates of lipid control continue to be low, both in primary and secondary prevention.
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Affiliation(s)
- Alex de la Sierra
- Department of Internal Medicine, University Hospital Mutua Terrassa, Barcelona, Spain.
| | - Xavier Pintó
- Lipid Unit, Internal Medicine Service, University Hospital of Bellvitge, Barcelona, Spain
| | - Carlos Guijarro
- Internal Medicine Service, University Hospital Alcorcón Foundation, Madrid, Spain
| | - José López Miranda
- Lipids and Atherosclerosis Unit, IMIBIC/Reina Sofıa University Hospital, University of Cordoba and CIBER Fisiopatologia Obesidad y Nutricion, Instituto de Salud Carlos III, Cordoba, Spain
- Reina Sofia University Hospital, IMIBIC/Fundacion para la Investigacion Biomedica de Cordoba, Cordoba, Spain
| | | | | | - Rudi Subirà
- Health Economics and Outcomes Research, Sanofi Iberia, Barcelona, Spain
| | - Marta Rubio
- Health Economics and Outcomes Research, Sanofi Iberia, Barcelona, Spain
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112
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Gil-Montalbán E, Martín-Ríos MD, Ortiz-Marrón H, Zorrilla-Torras B, Martínez-Cortés M, Esteban-Vasallo MD, López-de-Andrés A. Incidence of type 2 diabetes and associated factors in the adult population of the Community of Madrid. PREDIMERC cohort. Rev Clin Esp 2015; 215:495-502. [PMID: 26409707 DOI: 10.1016/j.rce.2015.07.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 05/20/2015] [Accepted: 07/30/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Determine the incidence and risk factors of type2 diabetes in the adult population of Madrid (Spain) and compare the predictive models of type2 diabetes based on the prediabetes criteria of the American Diabetes Association (ADA) and the World Health Organisation (WHO). MATERIAL AND METHODS A prospective study was conducted on a population cohort composed of 2048 individuals between 30 and 74years of age with no diabetes. At the start of the study, an epidemiological survey was performed, and baseline glycaemia, HbA1c, body mass index and waist circumference were measured. A follow-up of 6.4years was conducted. New cases of type2 diabetes were identified using the electronic primary care medical history. RESULTS The incidence of type2 diabetes was 3.5 cases/1000 person-years. In the multivariate analysis, the variables that were associated with the onset of type2 diabetes were age, family history of diabetes, baseline glycaemia (100-125mg/dL), HbA1c (5.7-6.4%) and waist circumference (≥94cm for men and ≥80cm for women). Of these, the most significantly associated variables were baseline glycaemia and HbA1c. The ADA and WHO criteria for defining prediabetes had the same predictive capacity. CONCLUSION The incidence of type2 diabetes measured in Madrid was lower than that found in other population studies, with the glucometabolic state the main factor associated with progression to type2 diabetes. There were no differences between the prediabetes defined by the ADA and the WHO for predicting the onset of the disease.
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Affiliation(s)
- E Gil-Montalbán
- Subdirección de Promoción de la Salud y Prevención, Consejería Sanidad, Comunidad de Madrid, Madrid, España.
| | - M D Martín-Ríos
- Servicio de Medicina Preventiva, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, España; Departamento Medicina y Cirugía, Psicología, Medicina Preventiva y Salud Pública e Inmunología Microbiología Médicas. Universidad Rey Juan Carlos, Alcorcón, Madrid, España
| | - H Ortiz-Marrón
- Subdirección de Promoción de la Salud y Prevención, Consejería Sanidad, Comunidad de Madrid, Madrid, España
| | - B Zorrilla-Torras
- Subdirección de Promoción de la Salud y Prevención, Consejería Sanidad, Comunidad de Madrid, Madrid, España
| | - M Martínez-Cortés
- Servicio de Prevención y Promoción de la Salud, Instituto de Salud Pública, Ayuntamiento de Madrid, Madrid, España
| | - M D Esteban-Vasallo
- Subdirección de Promoción de la Salud y Prevención, Consejería Sanidad, Comunidad de Madrid, Madrid, España
| | - A López-de-Andrés
- Departamento Medicina y Cirugía, Psicología, Medicina Preventiva y Salud Pública e Inmunología Microbiología Médicas. Universidad Rey Juan Carlos, Alcorcón, Madrid, España
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113
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Garzón G, Gil Á, Herrero AM, Jiménez F, Cerezo MJ, Domínguez C. [Achievement of cardiovascular goals in patients diagnosed with type 2 diabetes with and without cardiovascular disease]. GACETA SANITARIA 2015; 29:425-30. [PMID: 26342408 DOI: 10.1016/j.gaceta.2015.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 07/21/2015] [Accepted: 07/24/2015] [Indexed: 11/15/2022]
Abstract
AIMS To determine the proportion of patients with type 2 diabetes with and without cardiovascular disease achieving the main cardiovascular goals. METHODS DESIGN Cross-sectional study. SETTING A regional health district in a European country, Spain. Year: 2013. PARTICIPANTS Adult patients diagnosed with type 2 diabetes with and without cardiovascular disease. MEASUREMENTS Study using secondary data obtained from electronic records of clinical history. Haemoglobin A1c, blood pressure, LDL cholesterol, smoking and medication were covered. n=49,658 RESULTS: The proportion of patients with diabetes achieving cardiovascular goals (among those with recent measurement) was: haemoglobin A1c 68.8% (CI95%:68.2%-69.4%), blood pressure 74.3% (CI95%:73.9%-74.7%), LDL cholesterol 59.8% (CI95%:59.0%-60.6%), tobacco 80.2% (CI95%:79.6%-80.8%). Only 40%-67% of patients has recent measurement. Only 48.0% (CI95%: 46.6%-49.4%) of patients who needed statins were receiving them. Higher proportion of patients with cardiovascular disease were achiving goals. Differences were small but significant. CONCLUSIONS Cardiovascular goals were measured in around half of patients with diabetes. Proportion of patients achiving cardiovascular goals were similar to published and best in patients with cardiovascular disease but it could improve. This points to prioritising interventions in this group of patients at very high risk, improving the implementation of guidelines and patient adherence.
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Affiliation(s)
- Gerardo Garzón
- Área de Atención Primaria, Servicio Madrileño de Salud, Madrid, España.
| | - Ángel Gil
- Departamento de Medicina Preventiva y Salud Pública, Universidad Rey Juan Carlos, Madrid, España
| | - Ana María Herrero
- Área de Atención Primaria, Servicio Madrileño de Salud, Madrid, España
| | - Fernando Jiménez
- Área de Atención Primaria, Servicio Madrileño de Salud, Madrid, España
| | - María José Cerezo
- Área de Atención Primaria, Servicio Madrileño de Salud, Madrid, España
| | - Cristina Domínguez
- Servicio de Urgencias, Hospital de la Princesa, Servicio Madrileño de Salud, Madrid, España
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114
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Cosin Sales J, Fuentes Jiménez FJ, Mantilla Morató T, Ruiz E, Becerra V, Aceituno S, Ferrario MG, Lizán L, Gracia A. Coste-efectividad de rosuvastatina frente a simvastatina, atorvastatina y pitavastatina en pacientes con riesgo cardiovascular alto y muy alto en España. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2015; 27:228-38. [DOI: 10.1016/j.arteri.2014.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 10/30/2014] [Accepted: 11/05/2014] [Indexed: 10/24/2022]
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115
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Pérez-Manchón D, Álvarez-García GM, González-López E. [Perception of cardiovascular risk in an outpatient population of the Madrid Community]. HIPERTENSION Y RIESGO VASCULAR 2015; 32:100-4. [PMID: 26180033 DOI: 10.1016/j.hipert.2014.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 07/31/2014] [Accepted: 09/19/2014] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Cardiovascular diseases are responsible for the largest burden of global mortality. The study of the degree of knowledge of their population risk factors and cardiovascular risk is a priority preventive strategy. MATERIAL AND METHODS A cross-sectional study with 369 people was performed. The sociodemographic variables were cardiovascular risk and perception as well as physical and anthropometric factors. The risk was stratified with the SCORE table. RESULTS A total of 49.6% were men and 50.4% were women. The proportion of diagnosis was 23.8% in HTA, 39% in hypercholesterolemia, 31.4% in smoking, 26.3% in obesity and 4.6% in diabetes. Concordance between perceived and real cardiovascular risk was very weak. DISCUSSION The population has good knowledge about diabetes and acceptable knowledge about hypertension, and hypercholesterolemia but knowledge in prediabetic states and perception of the associated cardiovascular risk is low.
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Affiliation(s)
- D Pérez-Manchón
- Consultorio de Brunete, Centro de Salud Universitario Villanueva de la Cañada, Dirección asistencial noroeste del Servicio Madrileño de Salud (SERMAS), Madrid, España.
| | - G M Álvarez-García
- Centro de Salud Universitario Cerro del Aire, Dirección asistencial noroeste del Servicio Madrileño de Salud (SERMAS), Majadahonda, Madrid, España
| | - E González-López
- Centro de Salud Universitario Villanueva de la Cañada, Dirección asistencial noroeste del Servicio Madrileño de Salud (SERMAS), Facultad de Medicina de la Universidad Autónoma de Madrid, Villanueva de la Cañada, Madrid, España
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116
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García Iglesias A, Lozano Alonso J, Álamo Sanz R, Vega Alonso T. Evolución de los factores de riesgo cardiovascular entre 2004 y 2009 en la cohorte del estudio del Riesgo de Enfermedad Cardiovascular en Castilla y León (RECCyL). ANGIOLOGIA 2015. [DOI: 10.1016/j.angio.2014.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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117
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Oliveras V, Martín-Baranera M, Gracia M, Del Val JL, Plans M, Pujol-Moix N. [The relevance of the ankle-arm index to the reclassification of cardiovascular risk in asymptomatic hypertensive middle-aged males]. Med Clin (Barc) 2015; 144:435-9. [PMID: 24889750 DOI: 10.1016/j.medcli.2014.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 02/21/2014] [Accepted: 02/27/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND OBJECTIVE The ankle-brachial index allows for the detection of subclinical cardiovascular disease and risk, by diagnosing peripheral arterial disease and arterial calcification. Asymptomatic hypertensive men, between 45-55 years and with the suspicion of low risk, could be an important population group to benefit from this technique. The aim of the study was to compare the frequency of abnormal ankle-brachial index (subclinical peripheral arterial disease and arterial calcification) between asymptomatic hypertensive and non-hypertensive men, of the same age and suspicion of low risk. PATIENTS AND METHODS Two hundred and forty-four asymptomatic men (122 hypertensive and 122 non-hypertensive), between 45 and 55 years and an REGICOR index<10, were voluntarily recruited using consecutive sampling. Complete anamnesis, physical examination, laboratory tests and ankle-brachial index determination were carried out on all patients. RESULTS We detected abnormal ankle-brachial index values in 9.8% (12 cases) of the hypertensive subjects and in 1.6% (2 cases) of non-hypertensive subjects (P=.006). In the multivariate analysis, hypertension was significantly associated with an abnormal ankle-brachial index (P<.026) (odds ratio [OR] 5.9, 95% confidence interval [95% CI] 1.2-28.3), smoking (P=.018) (OR 2.7; 95% CI 1.2-6.2) and abdominal obesity (P=.005) (OR 2.8; 95% CI 1.3-5.9). CONCLUSIONS The population group analyzed in this study might be considered as an overriding segment for detecting subclinical cardiovascular disease and risk with the ankle-brachial index. Further studies are needed to establish the prevalence of abnormal ankle-brachial index in this population in order to assess its efficiency.
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Affiliation(s)
- Víctor Oliveras
- Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; Centro de Salud Adrià, Institut Català de la Salut, Barcelona, España.
| | - Montserrat Martín-Baranera
- Servicio de Epidemiología Clínica, Consorci Sanitari Integral, L'Hospitalet de Llobregat, Barcelona, España
| | - Maya Gracia
- Unitat de Risc Vascular, Clínica Sagrada Familia, Barcelona, España
| | - José Luís Del Val
- Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, España
| | - Miquel Plans
- Centro de Salud Verdaguer, Institut Català de la Salut, Sant Joan Despí, Barcelona, España
| | - Núria Pujol-Moix
- Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; Institut d'Investigació Biomèdica Sant Pau (IIRB), Barcelona, España
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118
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Hidalgo A, Pons-Lladó G. Usefulness of cardiac MRI in the prognosis and follow-up of ischemic heart disease. RADIOLOGIA 2015. [DOI: 10.1016/j.rxeng.2014.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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119
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Vega T, Gil M, Lozano J. Age and sex differences in the incidence of diabetes mellitus in a population-based Spanish cohort. J Diabetes 2015; 7:411-7. [PMID: 24981073 DOI: 10.1111/1753-0407.12183] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 05/20/2014] [Accepted: 06/03/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The prevalence of diabetes mellitus (DM) in Spain ranges between 10% and 20%. However, very little is known about the incidence of DM because of difficulties involved in estimating it and its apparent lack of usefulness in practice. The aim of the present study was to describe the incidence of type 1 and type 2 DM (T1DM and T2DM, respectively) in the Castilla y León diabetes cohort (CODICyL). METHODS New diabetes cases, were registered on a standard form that included diagnostic criteria, background, symptoms, results of clinical examination, complications, other cardiovascular risk factors, and treatment. There were 1 354 619 person-years monitored between 2000 and 2013. We estimated the incidence of DM and calculated the relative risks adjusted for age, gender, and year of diagnosis with Poisson regression models. RESULTS The incidence of DM in individuals aged ≥15 years was 196.9 per 100 000 person-years (95% confidence interval [CI] 188.4-205.7), whereas in those aged <15 years the incidence was 10.8 per 100 000 person-years (95% CI 7.8-14.8). Men had a 36% higher risk than women of developing T2DM (95% CI 25%-49%). The greatest incidence of T2DM was found in 55-64-year-old men and 65-69-year-old women. CONCLUSIONS The annual incidence of T2DM is approximately 2 per 1000 person-years, higher in men, and peaks in middle age. Although specific tests to differentiate between the two types of DM are not available in this study, the estimation of incidence in those <15 years of age (10.8 per 100 000 person-years) represents a close approximation of the incidence of T1DM.
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Affiliation(s)
- Tomás Vega
- Regional Health Department, Public Health Observatory, Castilla y León Health Sentinel Network, Valladolid, Spain
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120
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Roger VL, Gerber Y. Muertes por enfermedad coronaria: desde las cohortes de nacimiento a la prevención. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2014.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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121
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Efectos de la edad, el periodo de defunción y la cohorte de nacimiento en la mortalidad por enfermedad isquémica del corazón en el sur de España. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2014.07.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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122
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The role of population change in the increased economic differences in mortality: a study of premature death from all causes and major groups of causes of death in Spain, 1980-2010. BMC Public Health 2015; 15:321. [PMID: 25886044 PMCID: PMC4389922 DOI: 10.1186/s12889-015-1678-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 03/23/2015] [Indexed: 11/24/2022] Open
Abstract
Background An increase has been observed in differences in mortality between the richest and poorest areas of rich countries. This study assesses whether one of the proposed explanations, i.e., population change, might be responsible for this increase in Spain. Methods Observational study based on average income, population change and mortality at provincial level. The premature mortality rate (ages 0–74 years) was estimated for all causes and for cancer, cardiovascular disease and external causes across the period 1980–2010. In the years analysed, provinces were grouped into tertiles based on provincial income, with the mortality rate ratio (MMR) being estimated by taking the tertile of highest-income provinces as reference. Population change was then controlled for to ascertain whether it would modify the rate ratio. Results In all-cause mortality, the magnitude of the MRR for provinces in the poorest versus the richest tertile was 1.01 in 1980 and 1.12 in 2010; in cardiovascular mortality, the MMRs for these same years were 1.08 and 1.31 respectively; and in the case of cancer and external-cause mortality, MMR magnitude was similar in 1980 and 2010. The magnitude of the MMR remained unchanged in response to adjustment for population change, with the single exception of 1980, when it increased in all-cause and cardiovascular mortality. Conclusion The increase in the difference in premature mortality between the richest and poorest areas in Spain is due to the increased difference in cardiovascular mortality. This increase is not accounted for by population change. In rich countries, more empirical evidence is thus needed to test other alternative explanations for the increase in economic differences in mortality.
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123
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García Iglesias A, Lozano Alonso J, Álamo Sanz R, Vega Alonso T. Factores asociados al control de la presión arterial en la cohorte del estudio del Riesgo de Enfermedad Cardiovascular en Castilla y León (RECCyL). HIPERTENSION Y RIESGO VASCULAR 2015; 32:48-55. [DOI: 10.1016/j.hipert.2014.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 10/06/2014] [Accepted: 10/17/2014] [Indexed: 11/27/2022]
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124
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Salvador González B, Rodríguez Pascual M, Ruipérez Guijarro L, Ferré González A, Cunillera Puertolas O, Rodríguez Latre LM. [Chronic kidney disease in Primary Health Care: prevalence and associated risk factors]. Aten Primaria 2015; 47:236-45. [PMID: 25212720 PMCID: PMC6985625 DOI: 10.1016/j.aprim.2014.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 06/11/2014] [Accepted: 06/17/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the prevalence of chronic kidney disease and associated risk factors in subjects over 60 years of age, as well as its staging by determining the glomerular filtration rate (GFR). DESIGN Cross-sectional observational study. SETTING Primary Health Care. PARTICIPANTS Patients≥60 years of age who were seen in 40 Primary Health Care centres with serum creatinine measured in a central laboratory between January 1 and December 31, 2010. EXCLUSION CRITERIA kidney transplant, home care. MAIN MEASURES Social-demographic and anthropometric data, cardiovascular risk factors, and diseases established according to electronic clinical records. Serum creatinine was measured using standardised Jaffe kinetic method, and GFR estimated with MDRD-4-IDMS and CKD-EPI. RESULTS A total of 97,665 subjects (57.3% women, median age 70.0 years [Q1: 65.0, Q3: 77.0]). GFR-MDRD prevalence<60=15.1% (16.6% in women, 13.2% in men; P<.001) and increased with age. Multivariate analysis showed a positive association between GFR-MDRD<60 and age (OR=1.74; 95% CI 1.70 to 1.77), hypertension (OR=2.18; 95% CI 2.08 to 2.30), heart failure (OR=2.03; 95% CI 1.83 to 2.25), atrial fibrillation (OR=1.57; 95% CI 1.41 to 1.76), ischaemic heart disease (OR=1.40; 95% CI 1.30 to 1.50), peripheral arterial disease (OR=1.31; 95% CI 1.09 to 1.57), dyslipidaemia (OR=1.28; 95% CI 1.23 to 1.33), diabetes (OR=1.26; 95% CI 1.17 to 1.34), and stroke (OR=1.17; 95% CI 1.09 to 1.25). The GFR-CKD-EPI model showed an increase in OR with age and male sex, that became significant as a chronic kidney disease risk factor. CONCLUSIONS Chronic kidney disease has considerable prevalence in subjects≥60 years seen in Primary Health Care, more in women, and increasing with age. Hypertension, more than diabetes, was the main associated cardiovascular risk factor.
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Affiliation(s)
- Betlem Salvador González
- Equipo de Atención Primaria Florida Sud, Servei Atenció Primària Delta Llobregat, DAP Costa de Ponent, Institut Català de la Salut, L'Hospitalet de Llobregat, Barcelona, España; Grupo MACAP (Malaltia Cardiovascular en Atenció Primària), IDIAP Jordi Gol, Barcelona, España.
| | - Mercedes Rodríguez Pascual
- Equipo de Atención Primaria Viladecans 2, Servei d'Atenció Primària Delta Llobregat, DAP Costa de Ponent, Institut Català de la Salut, Viladecans, Barcelona, España
| | - Laura Ruipérez Guijarro
- Equipo de Atención Primaria Viladecans 2, Servei d'Atenció Primària Delta Llobregat, DAP Costa de Ponent, Institut Català de la Salut, Viladecans, Barcelona, España
| | - Antonia Ferré González
- Equipo de Atención Primaria Sant Vicençs dels Horts, Servei d'Atenció Primària Baix Llobregat Centre, DAP Costa de Ponent, Institut Català de la Salut, Sant Vicenç dels Horts, Barcelona, España
| | - Oriol Cunillera Puertolas
- Unidad de Soporte a la Investigación, IDIAP Jordi Gol, DAP Costa de Ponent, Institut Català de la Salut, Cornellà de Llobregat, Barcelona, España
| | - Luisa M Rodríguez Latre
- Servei d'Atenció Primària Baix Llobregat Centre, DAP Costa de Ponent, Institut Català de la Salut, Cornellà de Llobregat, Barcelona, España
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125
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Roger VL, Gerber Y. Coronary Disease Deaths: From Birth Cohorts to Prevention. ACTA ACUST UNITED AC 2015; 68:361-2. [PMID: 25770881 DOI: 10.1016/j.rec.2014.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 12/15/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Véronique L Roger
- Division of Cardiovascular Diseases, Department of Internal Medicine and Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States.
| | - Yariv Gerber
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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126
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Low mortality in the poorest areas of Spain: adults residing in provinces with lower per capita income have the lowest mortality. Eur J Epidemiol 2015; 30:637-48. [DOI: 10.1007/s10654-015-0013-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Accepted: 03/03/2015] [Indexed: 10/23/2022]
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127
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Hidalgo A, Pons-Lladó G. Usefulness of cardiac MRI in the prognosis and follow-up of ischemic heart disease. RADIOLOGIA 2015; 57:201-12. [PMID: 25648795 DOI: 10.1016/j.rx.2014.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 11/11/2014] [Accepted: 11/17/2014] [Indexed: 01/29/2023]
Abstract
Cardiac magnetic resonance imaging (MRI) is an important tool that makes it possible to evaluate patients with cardiovascular disease; in addition to infarction and alterations in myocardial perfusion, cardiac MRI is useful for evaluating other phenomena such as microvascular obstruction and ischemia. The main prognostic factors in cardiac MRI are ventricular dysfunction, necrosis in late enhancement sequences, and ischemia in stress sequences. In acute myocardial infarction, cardiac MRI can evaluate the peri-infarct zone and quantify the size of the infarct. Furthermore, cardiac MRI's ability to detect and evaluate microvascular obstruction makes it a fundamental tool for establishing the prognosis of ischemic heart disease. In patients with chronic ischemic heart disease, cardiac MRI can detect ischemia induced by pharmacological stress and can diagnose infarcts that can be missed on other techniques.
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Affiliation(s)
- A Hidalgo
- Sección de Radiología Cardiotorácica. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España.
| | - G Pons-Lladó
- Unidad de Imagen Cardíaca, Departamento de Cardiología, Universitat Autònoma de Barcelona, Barcelona, España
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128
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Barrios V, Escobar C, Llisterri J, Rodríguez Roca G, Badimón J, Vergara J, Prieto M, Serrano A, Cinza S, Murillo C. Características clínicas basales y manejo de los pacientes incluidos en el estudio IBERICAN. Semergen 2015; 41:3-12. [DOI: 10.1016/j.semerg.2014.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 09/29/2014] [Indexed: 12/18/2022]
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129
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Immune-Mediated Inflammatory Diseases and Other Comorbidities in Patients With Psoriasis: Baseline Characteristics of Patients in the AQUILES Study. ACTAS DERMO-SIFILIOGRAFICAS 2015. [DOI: 10.1016/j.adengl.2014.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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130
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Cataño Bedoya JU, Duque Botero J, Naranjo González CA, Rúa Molina DC, Rosique Gracia J, García Pineda AF, Gómez Isaza LF, Cardona Arias JA, Caro MA, Bedoya Berrío G, Pizano Ramírez ND. Prevalencia de factores de riesgo cardiovascular en indígenas embera-chamí de Cristianía (Jardín), Antioquia. IATREIA 2014. [DOI: 10.17533/udea.iatreia.18535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Estudiamos la prevalencia de los factores de riesgo cardiovascular en 488 individuos mayores de 14 años, en el resguardo indígena Karmata Rúa de Cristianía. se encontraron las siguientes frecuencias: hipertensión arterial (HTA) 18,1%; antecedente personal de diabetes mellitus 3,3%; glucemia mayor de 126 mg/dL 0,7%; hábito de fumar 15%; sobrepeso 40,2%; obesidad 8,0%; hipercolesterolemia 21,4%; hipertrigliceridemia 33,3% y dislipidemia 56,2%. El índice de masa corporal y los valores de colesterol total, glucemia, perímetro de la cintura, índice cintura/ cadera y presión arterial sistólica y diastólica presentaron correlación positiva y significativa con la edad. El grado de escolaridad mostró correlación negativa con el perímetro de la cintura, el índice cintura/cadera, la glucemia y la presión arterial. Al comparar con poblaciones indígenas y no indígenas de Colombia y de otros países, se encontró una prevalencia entre tres y cuatro veces menor de diabetes mellitus; en la población estudiada hay menos HTA aunque existe tendencia al sobrepeso. No se encontraron diferencias significativas en otros factores de riesgo; todos ellos fueron más frecuentes en mujeres, en personas de escolaridad baja y en individuos mayores. Los factores que contribuyen a estas diferencias son genéticos (homogeneidad étnica) y ambientales, como la mayor actividad física de los hombres, la dieta y la estructura demográfica.
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Ortiz H, Galán I, Zorrilla B, Martínez-Cortés M. [Factors associated with overweight, general obesity and abdominal obesity in the Madrid Community's adult population. Study PREDIMERC]. Med Clin (Barc) 2014; 143:560-2. [PMID: 24286812 DOI: 10.1016/j.medcli.2013.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 09/19/2013] [Accepted: 09/19/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Honorato Ortiz
- Servicio de Epidemiología, Dirección General de Atención Primaria, Consejería de Sanidad, Madrid, España.
| | - Iñaki Galán
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España
| | - Belén Zorrilla
- Servicio de Epidemiología, Dirección General de Atención Primaria, Consejería de Sanidad, Madrid, España
| | - Mercedes Martínez-Cortés
- Servicio de Prevención y Sanidad Ambiental, Instituto de Salud Pública, Madrid-Salud, Ayuntamiento de Madrid, Madrid, España
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Ocaña-Riola R, Mayoral-Cortés JM, Fernández-Ajuria A, Sánchez-Cantalejo C, Martín-Olmedo P, Blanco-Reina E. Age, Period, and Cohort Effects on Mortality From Ischemic Heart Disease in Southern Spain. ACTA ACUST UNITED AC 2014; 68:373-81. [PMID: 25482342 DOI: 10.1016/j.rec.2014.07.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 07/11/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION AND OBJECTIVES Ischemic heart disease is the leading cause of death and one of the top 4 causes of burden of disease worldwide. The aim of this study was to evaluate age-period-cohort effects on mortality from ischemic heart disease in Andalusia (southern Spain) and in each of its 8 provinces during the period 1981-2008. METHODS A population-based ecological study was conducted. In all, 145 539 deaths from ischemic heart disease were analyzed for individuals aged between 30 and 84 years who died in Andalusia in the study period. A nonlinear regression model was estimated for each sex and geographical area using spline functions. RESULTS There was an upward trend in male and female mortality rate by age from the age of 30 years. The risk of death for men and women showed a downward trend for cohorts born after 1920, decreasing after 1960 with a steep slope among men. Analysis of the period effect showed that male and female death risk first remained steady from 1981 to 1990 and then increased between 1990 and 2000, only to decrease again until 2008. CONCLUSIONS There were similar age-period-cohort effects on mortality in all the provinces of Andalusia and for Andalusia as a whole. If the observed cohort and period effects persist, male and female mortality from ischemic heart disease will continue to decline.
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Affiliation(s)
- Ricardo Ocaña-Riola
- Escuela Andaluza de Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria de Granada, Granada, Spain.
| | - José María Mayoral-Cortés
- Servicio de Epidemiología y Salud Laboral, Consejería de Salud de la Junta de Andalucía, Seville, Spain
| | - Alberto Fernández-Ajuria
- Escuela Andaluza de Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Carmen Sánchez-Cantalejo
- Escuela Andaluza de Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Piedad Martín-Olmedo
- Escuela Andaluza de Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria de Granada, Granada, Spain
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133
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[Patients with subarachnoid haemorrhage in poor grade neurological status: Study of prognostic factors]. Neurocirugia (Astur) 2014; 26:32-8. [PMID: 25455762 DOI: 10.1016/j.neucir.2014.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 07/31/2014] [Accepted: 09/22/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate and predict factors influencing prognosis and/or clinical outcome at 6 months in patients with spontaneous subarachnoid haemorrhage, World Federation of Neurosurgical Societies (WFNS) grades iv and v. MATERIAL AND METHODS This was a retrospective study of a consecutive series of 394 patients admitted to our hospital with clinical and radiological diagnosis of spontaneous subarachnoid haemorrhage, from 1 January 1999 to 30 June 2009. We selected 121 patients who met the criteria of being in WFNS grades iv or v before treatment; 3 patients were excluded due to loss of tracking. The outcome variable was assessed 6 months after the event using the Glasgow Outcome Scale. A P value<.05 was considered statistically significant. RESULTS One hundred and twenty-one patients were included in the statistical analysis. The average age of the patients in the series was 54 years (14-92). Patients who had a mean Glasgow Coma Scale lower than 7 points (P<.0001), those who were grade v (P<.0001) in the pre-treatment WFNS scale and those with pupillary disorder (P=.002) had a worse clinical outcome. Likewise, those with associated intraparenchymal hematoma (P=.020) and those not receiving any treatment (P=.020) were also associated with a poor clinical outcome. These results were statistically significant. CONCLUSIONS Patients admitted with a WFNS grade v and/or presenting pupil disorder and/or intraparenchymal hematoma were associated with worse clinical outcomes.
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Baena-Díez J, Grau M, Forés R, Fernández-Bergés D, Elosua R, Sorribes M, Félix-Redondo F, Segura A, Rigo F, Cabrera de León A, Sanz H, Marrugat J, Sala J. Prevalencia de fibrilación auricular y factores asociados en España, análisis de seis estudios de base poblacional. Estudio DARIOS. Rev Clin Esp 2014; 214:505-12. [DOI: 10.1016/j.rce.2014.06.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 04/26/2014] [Accepted: 06/09/2014] [Indexed: 02/05/2023]
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Prevalence of atrial fibrillation and its associated factors in Spain: An analysis of six population-based studies. DARIOS Study. Rev Clin Esp 2014. [DOI: 10.1016/j.rceng.2014.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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136
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Vázquez LA, Rodríguez Á, Salvador J, Ascaso JF, Petto H, Reviriego J. Relationships between obesity, glycemic control, and cardiovascular risk factors: a pooled analysis of cross-sectional data from Spanish patients with type 2 diabetes in the preinsulin stage. BMC Cardiovasc Disord 2014; 14:153. [PMID: 25361574 PMCID: PMC4228158 DOI: 10.1186/1471-2261-14-153] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 10/24/2014] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Obesity is associated with the onset of type 2 diabetes mellitus (T2D), but reports conflict regarding the association between obesity and macrovascular complications. In this study, we investigated associations between cardiovascular risk factors and body mass index (BMI) and glycemic control in non-insulin-treated patients with T2D. METHODS Authors gathered cross-sectional data from five observational studies performed in Spain. Generalized logit models were used to analyze the relationship between cardiovascular risk factors (independent variables) and 5 BMI strata (<25 kg/m2, 25 to <30 kg/m2, 30 to <35 kg/m2, 35 to <40 kg/m2, ≥40 kg/m2) and 5 glycated hemoglobin (HbA1c) strata (≤6.5%, >6.5-7%, >7-8%, >8-9%, >9%) (dependent outcomes). RESULTS In total, data from 6442 patients were analyzed. Patients generally had mean values of investigated cardiovascular risk factors outside recommended thresholds. Younger patients had higher BMI, triglyceride levels and HbA1c than their older counterparts. Diastolic blood pressure, systolic blood pressure and triglyceride levels were directly correlated with BMI strata, whereas an inverse correlation was observed between BMI strata and high-density lipoprotein cholesterol (HDL-C) levels, patient age, and duration of T2D. Increased duration of T2D and total cholesterol levels, and decreased HDL-C levels were associated with a higher HbA1c category. BMI and HbA1c levels were not associated with each other. CONCLUSIONS As insulin-naïve patients with T2D became more obese, cardiovascular risk factors became more pronounced. Higher BMI was associated with younger age and shorter duration of T2D, consistent with the notion that obesity at an early age may be key to the current T2D epidemic. Glycemic control was independent of BMI but associated with abnormal lipid levels. Further efforts should be done to improve modifiable cardiovascular risk factors.
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Affiliation(s)
- Luis A Vázquez
- Department of Clinical Research, Lilly, S,A,, Avda, de la Industria, 30 28108 Alcobendas, Spain.
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Herrero A, Garzón G, Gil A, García I, Vargas E, Torres N. [Control of cardiovascular risk factors among patients with diabetes with and without cardiovascular disease]. Semergen 2014; 41:354-61. [PMID: 25163908 DOI: 10.1016/j.semerg.2014.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 06/13/2014] [Accepted: 07/09/2014] [Indexed: 11/30/2022]
Abstract
INTRODUCTION There is evidence that cardiovascular goals are beneficial in diabetes. OBJECTIVE To determine the distribution of cardiovascular risk levels in patients with diabetes and the clinical interventions they have received. DESIGN Descriptive cross-sectional study. SETTING SERMAS (Madrid) 2010. SUBJECTS All patients with diabetes. (n=41,096). MAIN MEASUREMENTS Patients in primary or secondary prevention, metabolic and cardiovascular risk factors control, pharmacological and non-pharmacological interventions. Patient and professional variables. RESULTS Around one-fifth (21.5%) (95%CI: 21.1% -21.9%) in secondary prevention (very high cardiovascular risk). HbA1c was under control in 31% (95%CI: 30.1%-32%), with 49.9% (95%CI: 48.8%-50.9%) with BP under control, and 39.4% (95% CI: 38.4%-40.4%) with LDL controlled. Only 8.9% (95%CI: 8.3%-9.5%) had a well-controlled HdA1c, BP and LDL, and in 19.8% (95%CI: 19%-20.6%) none of these were under control. Of those with an uncontrolled BP, 23.6% (95% CI: 23.2%-24%) had antihypertensive drugs. There was better control in patients older than 70 years, and those who lived in an urban center, or a lower number of patients per day. CONCLUSION In diabetic patients with very high cardiovascular risk (secondary prevention), just half of them had good control of cardiovascular risk factors (BP and LDL). An association was found between better control and older than 70, urban center or lower number of patients per day. This suggests developing strategies to promote a comprehensive control of cardiovascular risk factors in diabetic patients in secondary prevention.
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Affiliation(s)
- A Herrero
- Centro de Salud Federica Montseny, Servicio Madrileño de Salud, Madrid, España.
| | - G Garzón
- Centro de Salud Federica Montseny, Servicio Madrileño de Salud, Madrid, España
| | - A Gil
- Departamento de Medicina Preventiva y Salud Pública, Universidad Rey Juan Carlos, Madrid, España
| | - I García
- Centro de Salud Federica Montseny, Servicio Madrileño de Salud, Madrid, España
| | - E Vargas
- Centro de Salud Federica Montseny, Servicio Madrileño de Salud, Madrid, España
| | - N Torres
- Centro de Salud Federica Montseny, Servicio Madrileño de Salud, Madrid, España
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Vanaclocha F, Crespo-Erchiga V, Jiménez-Puya R, Puig L, Sánchez-Carazo JL, Ferrán M, Sancho C, Juliá B, Cea-Calvo L, Marín-Jiménez I, García-Vicuña R. Immune-mediated inflammatory diseases and other comorbidities in patients with psoriasis: baseline characteristics of patients in the AQUILES study. ACTAS DERMO-SIFILIOGRAFICAS 2014; 106:35-43. [PMID: 25091923 DOI: 10.1016/j.ad.2014.06.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 05/26/2014] [Accepted: 06/01/2014] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Patients with psoriasis often have comorbidities, including other immune-mediated inflammatory diseases (IMIDs), and cardiovascular risk factors. In this article we describe the baseline prevalence of comorbidities-including other IMIDs-in a cohort of patients with psoriasis. PATIENTS AND METHODS AQUILES was a prospective observational multicenter study of 3 patient cohorts (patients with psoriasis, spondyloarthritis, or inflammatory bowel disease) undertaken to investigate the prevalence of comorbidities, including other IMIDs, in these settings. The psoriasis cohort comprised patients aged at least 18 years who were seen in hospital dermatology clinics. A predefined protocol was used to collect demographic and clinical data. RESULTS The study enrolled 528 patients with psoriasis (60.2% men and 39.8% women). Mean age was 46.7 years; 89.8% of the participants had plaque psoriasis, and the median Psoriasis Area Severity Index score (PASI) was 3.2 (1.5-7.4). Comorbid IMIDs were present in 82 (15.5%) of the patients (CI 95%, 12.7%-18.9%). Spondyloarthritis was observed in 14% of patients (95% CI, 11.3%-17.2%), mostly in the form of psoriatic arthritis, for which the overall prevalence was 13.1% (95% CI, 10.5%-16.2%). Inflammatory bowel disease was present in 1.3% (95% CI, 0.6%-2.7%) and uveitis in .2% (95% CI, 0.1%-1.4%). Psoriatic arthritis was associated with male sex (odds ratio, 1.75 [.98-2.98]) and a disease duration of over 8 years (OR, 4.17 [1.84-9.44] vs a duration of < 4 years). In 73.1%, at least 1 cardiovascular risk factor was identified: smoking (40.5%), obesity (26.0%), dyslipidemia (24.8%), hypertension (24.3%), and diabetes mellitus (12.3%). CONCLUSION In patients with psoriasis the prevalence of other IMIDs was 15.5%, a level slightly higher than that found in the general population. Nearly three-quarters of these patients had at least 1 cardiovascular risk factor.
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Affiliation(s)
- F Vanaclocha
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - V Crespo-Erchiga
- Servicio de Dermatología, Hospital Regional Universitario Carlos Haya, Málaga, España
| | - R Jiménez-Puya
- Servicio de Dermatología, Hospital Universitario Reina Sofía, Córdoba, España
| | - L Puig
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - J L Sánchez-Carazo
- Servicio de Dermatología, Hospital General Universitario, Valencia, España
| | - M Ferrán
- Servicio de Dermatología, Hospital del Mar, Barcelona, España
| | - C Sancho
- Medical Affairs, Merck Sharp & Dohme, España
| | - B Juliá
- Medical Affairs, Merck Sharp & Dohme, España.
| | - L Cea-Calvo
- Medical Affairs, Merck Sharp & Dohme, España
| | - I Marín-Jiménez
- Servicio de Gastroenterología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - R García-Vicuña
- Servicio de Reumatología, Hospital Universitario La Princesa, IISP, Madrid, España
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139
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Perfil metabólico-inflamatorio en la transición obesidad, síndrome metabólico y diabetes mellitus en población mediterránea. Estudio DARIOS Inflamatorio. Rev Esp Cardiol 2014. [DOI: 10.1016/j.recesp.2013.10.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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140
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Usefulness of the ankle-brachial index as a survey method for subclinical vascular disease in patients with rheumatoid arthritis. REUMATOLOGIA CLINICA 2014; 10:268-9. [PMID: 24361194 DOI: 10.1016/j.reuma.2013.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 11/09/2013] [Indexed: 11/24/2022]
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141
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Valdés S, García-Torres F, Maldonado-Araque C, Goday A, Calle-Pascual A, Soriguer F, Castaño L, Catalá M, Gomis R, Rojo-Martínez G. Prevalencia de obesidad, diabetes mellitus y otros factores de riesgo cardiovascular en Andalucía. Comparación con datos de prevalencia nacionales. Estudio Di@bet.es. Rev Esp Cardiol 2014. [DOI: 10.1016/j.recesp.2013.09.031] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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142
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Rojo-Martínez G, Valdés S, Colomo N, Lucena MI, Gaztambide S, Gomis R, Casamitjana R, Carmena R, Catalá M, Martínez-Larrad MT, Serrano-Ríos M, Castaño L, Vendrell J, Girbés J, Franch J, Vázquez JA, Mora-Peces I, Urrutia I, Pascual-Manich G, Ortega E, Menéndez E, Delgado E, Bordiú E, Castell C, López-Alba A, Goday A, Calle A, Bosch-Comas A, Soriguer F. Use of drugs related to the treatment of diabetes mellitus and other cardiovascular risk factors in the Spanish population. The Di@bet.es study. ACTA ACUST UNITED AC 2014; 66:854-63. [PMID: 24773992 DOI: 10.1016/j.rec.2013.05.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 05/31/2013] [Indexed: 01/10/2023]
Abstract
INTRODUCTION AND OBJECTIVES To assess the patterns of use of 8 therapeutic drug groups for the treatment of diabetes mellitus and other cardiovascular risk factors, and to identify sociodemographic and health determinants of their use in the overall Spanish population. METHODS A representative sample of the Spanish population within the Di@bet.es study, a cross-sectional population-based survey, was included. STUDY VARIABLES sociodemographic, clinical, and lifestyle data; physical examination, and an oral glucose tolerance test in patients without known diabetes mellitus. Furthermore, patients were systematically queried about current medication use, and 8 pharmacotherapeutic groups were evaluated: lipid-lowering therapy, antihypertensives, oral hypoglycemic agents, insulin, thyroid hormone, uricosurics, psychoactive drugs, and nonsteroidal anti-inflammatory drugs. RESULTS Sixty-six percent of the Spanish population was taking at least one medication. Therapeutic drug use was associated with age, independently of the higher prevalence of diabetes mellitus, hypertension, or hyperlipidemia in older patients. Sex disparities were found in the use of lipid-lowering agents, allopurinol, levothyroxine, nonsteroidal anti-inflammatory drugs, and psychoactive drugs. Use of psychoactive drugs was related to education level, work status, physical activity, smoking, and alcohol consumption. Almost 30% of patients with diabetes mellitus were taking 6 or more medications daily. Diabetes mellitus was associated with greater use of antihypertensives, lipid-lowering agents, and nonsteroidal anti-inflammatory drugs. CONCLUSIONS Age and sex are the most important factors determining therapeutic drug use. Lifestyle patterns and sociocultural factors have an impact only on psychoactive drug use. Diabetes mellitus is associated with greater use of antihypertensives, lipid-lowering agents, and nonsteroidal anti-inflammatory drugs.
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Affiliation(s)
- Gemma Rojo-Martínez
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Sergio Valdés
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Natalia Colomo
- Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - M Isabel Lucena
- Departamento de Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Facultad de Medicina, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Sonia Gaztambide
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Grupo de Investigación de Diabetes, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
| | - Ramón Gomis
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Unidad de Endocrinología y Diabetes, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Roser Casamitjana
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Centro de Diagnóstico Biomédico, Hospital Clínic, Barcelona, Spain
| | - Rafael Carmena
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Departamento de Medicina y Endocrinología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Miguel Catalá
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Departamento de Medicina y Endocrinología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - María T Martínez-Larrad
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Manuel Serrano-Ríos
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Luis Castaño
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Grupo de Investigación de Diabetes, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
| | - Joan Vendrell
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Joan XXIII, Institut d'Investigacions Sanitàries Pere Virgili, Tarragona, Spain
| | - Juan Girbés
- Unidad de Diabetes, Hospital Arnau de Vilanova, Valencia, Spain
| | - Josep Franch
- EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Atención Primaria, Unitat de Suport a la Recerca (IDIAP-Fundació Jordi Gol), Barcelona, Spain
| | - José A Vázquez
- Plan Nacional de Diabetes, Ministerio de Sanidad, Madrid, Spain
| | | | - Inés Urrutia
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Grupo de Investigación de Diabetes, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
| | - Gemma Pascual-Manich
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - Emilio Ortega
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Unidad de Endocrinología y Diabetes, Hospital Clínic, Barcelona, Spain
| | - Edelmiro Menéndez
- Departamento de Medicina-Endocrinología y Nutrición, Hospital Universitario Central de Asturias (HUCA), Universidad de Oviedo, Oviedo, Asturias, Spain
| | - Elias Delgado
- Departamento de Medicina-Endocrinología y Nutrición, Hospital Universitario Central de Asturias (HUCA), Universidad de Oviedo, Oviedo, Asturias, Spain
| | - Elena Bordiú
- Laboratorio de Endocrinología, Hospital Universitario San Carlos, Madrid, Spain
| | - Conxa Castell
- Departament de Salut Pública, Conselleria de Sanitat, Generalitat de Catalunya, Barcelona, Spain
| | | | - Alberto Goday
- Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, Spain
| | - Alfonso Calle
- Servicio de Endocrinología y Nutrición, Hospital Universitario San Carlos, Madrid, Spain
| | - Anna Bosch-Comas
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Federico Soriguer
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain.
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Fernández-Bergés D, Consuegra-Sánchez L, Peñafiel J, Cabrera de León A, Vila J, Félix-Redondo FJ, Segura-Fragoso A, Lapetra J, Guembe MJ, Vega T, Fitó M, Elosua R, Díaz O, Marrugat J. Metabolic and inflammatory profiles of biomarkers in obesity, metabolic syndrome, and diabetes in a Mediterranean population. DARIOS Inflammatory study. ACTA ACUST UNITED AC 2014; 67:624-31. [PMID: 25037541 DOI: 10.1016/j.rec.2013.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 10/23/2013] [Indexed: 02/02/2023]
Abstract
INTRODUCTION AND OBJECTIVES There is a paucity of data regarding the differences in the biomarker profiles of patients with obesity, metabolic syndrome, and diabetes mellitus as compared to a healthy, normal weight population. We aimed to study the biomarker profile of the metabolic risk continuum defined by the transition from normal weight to obesity, metabolic syndrome, and diabetes mellitus. METHODS We performed a pooled analysis of data from 7 cross-sectional Spanish population-based surveys. An extensive panel comprising 20 biomarkers related to carbohydrate metabolism, lipids, inflammation, coagulation, oxidation, hemodynamics, and myocardial damage was analyzed. We employed age- and sex-adjusted multinomial logistic regression models for the identification of those biomarkers associated with the metabolic risk continuum phenotypes: obesity, metabolic syndrome, and diabetes mellitus. RESULTS A total of 2851 subjects were included for analyses. The mean age was 57.4 (8.8) years, 1269 were men (44.5%), and 464 participants were obese, 443 had metabolic syndrome, 473 had diabetes mellitus, and 1471 had a normal weight (healthy individuals). High-sensitivity C-reactive protein, apolipoprotein B100, leptin, and insulin were positively associated with at least one of the phenotypes of interest. Apolipoprotein A1 and adiponectin were negatively associated. CONCLUSIONS There are differences between the population with normal weight and that having metabolic syndrome or diabetes with respect to certain biomarkers related to the metabolic, inflammatory, and lipid profiles. The results of this study support the relevance of these mechanisms in the metabolic risk continuum. When metabolic syndrome and diabetes mellitus are compared, these differences are less marked.
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Affiliation(s)
- Daniel Fernández-Bergés
- Unidad de Investigación Cardiovascular GRIMEX, Programa de Investigación Cardiovascular (PERICLES), Villanueva de la Serena, Badajoz, Spain; Hospital Don Benito-Villanueva, Gerencia de Área de Salud Don Benito-Villanueva, Don Benito, Badajoz, Spain.
| | - Luciano Consuegra-Sánchez
- Unidad de Investigación Cardiovascular GRIMEX, Programa de Investigación Cardiovascular (PERICLES), Villanueva de la Serena, Badajoz, Spain; Servicio de Cardiología, Hospital Universitario de Santa Lucía, Cartagena, Murcia, Spain
| | - Judith Peñafiel
- Grupo de Epidemiología y Genética Cardiovascular, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Antonio Cabrera de León
- Unidad de Investigación de Atención Primaria y del Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain; Área de Medicina Preventiva y Salud Pública, Universidad de La Laguna, La Laguna, Santa Cruz de Tenerife, Spain
| | - Joan Vila
- Grupo de Epidemiología y Genética Cardiovascular, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER de Epidemiología y Salud Pública, Barcelona, Spain
| | - Francisco Javier Félix-Redondo
- Unidad de Investigación Cardiovascular GRIMEX, Programa de Investigación Cardiovascular (PERICLES), Villanueva de la Serena, Badajoz, Spain; Centro de Salud Villanueva Norte, Villanueva de la Serena, Badajoz, Spain
| | - Antonio Segura-Fragoso
- Instituto de Ciencias de la Salud de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
| | - José Lapetra
- Centro de Salud Universitario San Pablo, Distrito Sanitario de Atención Primaria Sevilla, Servicio Andaluz de Salud, Seville, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Spain
| | - María Jesús Guembe
- Servicio de Investigación, Innovación y Formación Sanitaria, Departamento de Salud, Gobierno de Navarra, Pamplona, Navarra, Spain; Grupo de Investigación Riesgo Vascular en Navarra (RIVANA), Spain
| | - Tomás Vega
- Dirección General de Salud Pública, Consejería de Sanidad, Junta de Castilla y León, Valladolid, Spain
| | - Montse Fitó
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Spain; Grupo de Riesgo Cardiovascular y Nutrición, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Roberto Elosua
- Grupo de Epidemiología y Genética Cardiovascular, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Oscar Díaz
- Grupo de Riesgo Cardiovascular y Nutrición, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; Programa de Doctorat en Biomedicina, Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
| | - Jaume Marrugat
- Grupo de Epidemiología y Genética Cardiovascular, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
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Marrugat J, Subirana I, Ramos R, Vila J, Marín-Ibañez A, Guembe MJ, Rigo F, Tormo Díaz MJ, Moreno-Iribas C, Cabré JJ, Segura A, Baena-Díez JM, de la Cámara AG, Lapetra J, Grau M, Quesada M, Medrano MJ, González Diego P, Frontera G, Gavrila D, Aicua EA, Basora J, García JM, García-Lareo M, Gutierrez JA, Mayoral E, Sala J, D'Agostino R, Elosua R. Derivation and validation of a set of 10-year cardiovascular risk predictive functions in Spain: the FRESCO Study. Prev Med 2014; 61:66-74. [PMID: 24412897 DOI: 10.1016/j.ypmed.2013.12.031] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 12/26/2013] [Accepted: 12/31/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To derive and validate a set of functions to predict coronary heart disease (CHD) and stroke, and validate the Framingham-REGICOR function. METHOD Pooled analysis of 11 population-based Spanish cohorts (1992-2005) with 50,408 eligible participants. Baseline smoking, diabetes, systolic blood pressure (SBP), lipid profile, and body mass index were recorded. A ten-year follow-up included re-examinations/telephone contact and cross-linkage with mortality registries. For each sex, two models were fitted for CHD, stroke, and both end-points combined: model A was adjusted for age, smoking, and body mass index and model B for age, smoking, diabetes, SBP, total and HDL cholesterol, and for hypertension treatment by SBP, and age by smoking and by SBP interactions. RESULTS The 9.3-year median follow-up accumulated 2973 cardiovascular events. The C-statistic improved from model A to model B for CHD (0.66 to 0.71 for men; 0.70 to 0.74 for women) and the combined CHD-stroke end-points (0.68 to 0.71; 0.72 to 0.75, respectively), but not for stroke alone. Framingham-REGICOR had similar C-statistics but overestimated CHD risk. CONCLUSIONS The new functions accurately estimate 10-year stroke and CHD risk in the adult population of a typical southern European country. The Framingham-REGICOR function provided similar CHD prediction but overestimated risk.
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Affiliation(s)
- Jaume Marrugat
- Research Group on Cardiovascular Epidemiology and Genetics, IMIM, Barcelona, Spain.
| | - Isaac Subirana
- Research Group on Cardiovascular Epidemiology and Genetics, IMIM, Barcelona, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain
| | - Rafel Ramos
- Unitat de Recerca d'Atenció Primària, Instituto de Investigación en Atención Primaria Jordi Gol. Instituto de Investigación de Girona, Spain
| | - Joan Vila
- Research Group on Cardiovascular Epidemiology and Genetics, IMIM, Barcelona, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain
| | | | - María Jesús Guembe
- Grupo de Investigación Riesgo Vascular en Navarra (RIVANA), Departamento de Salud, Gobierno de Navarra, Pamplona, Spain; Servicio de Investigación, Innovación y Formación, Departamento de Salud, Gobierno de Navarra, Pamplona, Spain
| | - Fernando Rigo
- Grupo Cardiovascular de Baleares de la REDIAP IBSALUT, Palma de Mallorca, Spain
| | - María José Tormo Díaz
- CIBER de Epidemiología y Salud Pública, CIBERESP FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain; Consejería de Sanidad y Consumo de la Región de Murcia, Murcia, Spain
| | - Conchi Moreno-Iribas
- CIBER de Epidemiología y Salud Pública, CIBERESP FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain; Grupo de Investigación Riesgo Vascular en Navarra (RIVANA), Departamento de Salud, Gobierno de Navarra, Pamplona, Spain; Instituto de Salud Pública de Navarra, Departamento de Salud, Gobierno de Navarra, Pamplona, Spain
| | - Joan Josep Cabré
- Unitat de Recerca d'Atenció Primària, Institut Català de la Salut, Tarragona-Reus, Spain
| | - Antonio Segura
- Instituto de Ciencias de la Salud, Consejería de Salud y Asuntos Sociales, Junta de Comunidades de Castilla - La Mancha, Talavera de la Reina, Spain
| | | | - Agustín Gómez de la Cámara
- CIBER de Epidemiología y Salud Pública, CIBERESP FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain; Unidad de Investigación Clínica, Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain
| | - José Lapetra
- Centro de Salud Universitario "San Pablo", Distrito Sanitario Atención Primaria Sevilla, Servicio Andaluz de Salud, Sevilla, Spain; CIBER de Fisiopatología de la Obesidad y la Nutrición, CIBEROBN FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain
| | - María Grau
- Research Group on Cardiovascular Epidemiology and Genetics, IMIM, Barcelona, Spain
| | - Miquel Quesada
- Unitat de Recerca d'Atenció Primària, Instituto de Investigación en Atención Primaria Jordi Gol. Instituto de Investigación de Girona, Spain
| | - María José Medrano
- Instituto de Salud Carlos III, Centro Nacional de Epidemiología, Madrid, Spain
| | - Paulino González Diego
- Grupo de Investigación Riesgo Vascular en Navarra (RIVANA), Departamento de Salud, Gobierno de Navarra, Pamplona, Spain
| | - Guiem Frontera
- Grupo Cardiovascular de Baleares de la REDIAP IBSALUT, Palma de Mallorca, Spain
| | - Diana Gavrila
- CIBER de Epidemiología y Salud Pública, CIBERESP FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain; Consejería de Sanidad y Consumo de la Región de Murcia, Murcia, Spain
| | - Eva Ardanaz Aicua
- CIBER de Epidemiología y Salud Pública, CIBERESP FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain; Grupo de Investigación Riesgo Vascular en Navarra (RIVANA), Departamento de Salud, Gobierno de Navarra, Pamplona, Spain; Instituto de Salud Pública de Navarra, Departamento de Salud, Gobierno de Navarra, Pamplona, Spain
| | - Josep Basora
- Unitat de Recerca d'Atenció Primària, Institut Català de la Salut, Tarragona-Reus, Spain; CIBER de Fisiopatología de la Obesidad y la Nutrición, CIBEROBN FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain
| | - José María García
- Instituto de Ciencias de la Salud, Consejería de Salud y Asuntos Sociales, Junta de Comunidades de Castilla - La Mancha, Talavera de la Reina, Spain
| | | | | | - Eduardo Mayoral
- CIBER de Fisiopatología de la Obesidad y la Nutrición, CIBEROBN FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain; Plan Integral de Diabetes de Andalucía, Servicio Andaluz de Salud, Sevilla, Spain
| | - Joan Sala
- Department of Cardiology, Hospital Universitari Dr. Josep Trueta, Girona, Spain
| | | | - Roberto Elosua
- Research Group on Cardiovascular Epidemiology and Genetics, IMIM, Barcelona, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain
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Grau M, Subirana I, Vila J, Elosua R, Ramos R, Sala J, Dégano IR, Tresserras R, Bielsa O, Marrugat J. Validation of a population coronary disease predictive system: the CASSANDRA model. J Epidemiol Community Health 2014; 68:1012-9. [PMID: 24619990 DOI: 10.1136/jech-2013-203516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The use of validated multivariate cardiovascular predictive models in a population setting is of interest for public health policy makers. We aimed to validate the estimations of the CASSANDRA model (coronary heart disease (CHD) incidence and CHD risk distribution), considering the population changes in age, sex and CHD risk factors prevalence in a 10-year period. METHODS We compared the projected CHD incidence estimated with CASSANDRA with that observed in the Girona Heart Registry (REGICOR) for 1995-2004 and 2000-2009 in the population of Girona (Spain) aged 35-74 years. We used official age and sex distributions for this population. Baseline cardiovascular risk factors prevalence and the distribution of cardiovascular risk were obtained from three cross-sectional studies performed in 1995, 2000 and 2005. To validate the future distribution of cardiovascular risk, we tested the yearly CHD risk variance over the study period. RESULTS No significant differences between the estimated and observed annual CHD incidence per 100 000 men were found in 1995-2004 (CASSANDRA=457.8 and REGICOR=420.3, incidence rate ratio (IRR) (95% CI)=0.92 (0.89 to 0.96)) and in 2000-2009 (441.4 and 409.6, respectively, IRR=0.93 (0.90 to 0.96)). However, overpredictions of 18% and 22%, respectively, were observed in women (198.8 and 160.4, IRR=0.82 (0.77 to 0.86), and 197.1 and 152.8, IRR=0.78 (0.74 to 0.83), respectively). No significant differences were found in the CHD risk variance in the three different cross-sectional studies. CONCLUSIONS The CASSANDRA model produces valid estimates, particularly in men, of the future burden of disease and in the distribution of cardiovascular risk in individuals aged 35-74 years.
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Affiliation(s)
- Maria Grau
- Cardiovascular Epidemiology and Genetics Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Isaac Subirana
- Cardiovascular Epidemiology and Genetics Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain CIBER Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Joan Vila
- Cardiovascular Epidemiology and Genetics Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain CIBER Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Roberto Elosua
- Cardiovascular Epidemiology and Genetics Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Rafel Ramos
- Docent and Research Unit of Family Medicine, IDIAP Jordi Gol (University Institute in Primary Care Research Jordi Gol), Girona, Spain Departament of Medicine, University of Girona, Girona, Spain
| | - Joan Sala
- Cardiology Unit, University Hospital Josep Trueta, Girona, Spain
| | - Irene R Dégano
- Cardiovascular Epidemiology and Genetics Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | - Oscar Bielsa
- Department of Urology, Hospital del Mar, Barcelona, Spain
| | - Jaume Marrugat
- Cardiovascular Epidemiology and Genetics Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
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Sánchez DP, Guillén JJ, Torres AM, Sánchez FI. [Analysis of medications dispensed to control the main cardiovascular risks in the Murcia Region: are there gender differences?]. Aten Primaria 2014; 46:147-55. [PMID: 24210690 PMCID: PMC6985612 DOI: 10.1016/j.aprim.2013.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 09/05/2013] [Accepted: 09/09/2013] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To estimate the use of cardiovascular medicines and its distribution by age and sex. DESIGN Observational study. SETTING Region of Murcia. MAIN MEASUREMENTS Daily doses of cardiovascular drugs prescribed and dispensed in all the pharmacies of the Region per 1,000 inhabitants-day (DHD). A comparison was made of consumption rates (DHD) by age and sex. RESULTS The probability of receiving antiplatelet drugs increases with age, with the proportion of men being higher. The use of beta-blockers and angiotensin II increases with age up to 79 years, with an increased consumption in men up to 65 years. The probability of receiving treatment with calcium channel blockers, ACE inhibitors, or statins, linearly increases with age, and the proportion of men under treatment exceeds that of women in the early ages, tending to equalize beyond 80 years. CONCLUSIONS This study shows that the cardiovascular disease prevention focuses on people aged 40 to 74 years. Access by women to cardiovascular therapy occurs with a delay of 3-5 years, depending on the treatment subgroup. Changes should be promoted to encourage rational and equitable access and use of the drugs.
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Affiliation(s)
- Diego P Sánchez
- Departamento de Ciencias Sociosanitarias, Facultad de Medicina, Universidad de Murcia, Murcia, España.
| | - José J Guillén
- Departamento de Ciencias Sociosanitarias, Facultad de Medicina, Universidad de Murcia, Murcia, España
| | - Alberto M Torres
- Departamento de Ciencias Sociosanitarias, Facultad de Medicina, Universidad de Murcia, Murcia, España
| | - Fernando I Sánchez
- Departamento de Economía Aplicada, Facultad de Economía y Empresa, Universidad de Murcia, Murcia, España
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Valdés S, García-Torres F, Maldonado-Araque C, Goday A, Calle-Pascual A, Soriguer F, Castaño L, Catalá M, Gomis R, Rojo-Martínez G. Prevalence of obesity, diabetes and other cardiovascular risk factors in Andalusia (southern Spain). Comparison with national prevalence data. The Di@bet.es study. ACTA ACUST UNITED AC 2014; 67:442-8. [PMID: 24863592 DOI: 10.1016/j.rec.2013.09.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 09/20/2013] [Indexed: 10/25/2022]
Abstract
INTRODUCTION AND OBJECTIVES The aim of this study was to compare the prevalences of obesity, diabetes and other cardiovascular risk factors in the region of Andalusia with those in the rest of Spain. METHODS The Di@bet.es study is a national, cross-sectional, population-based survey of cardiometabolic risk factors and their association with lifestyle. The sample consisted of 5103 participants ≥ 18 years. The variables analyzed were clinical, demographic and lifestyle survey, physical examination, and oral glucose tolerance test. The prevalence of cardiovascular risk factors in Andalusia (n=1517) was compared with that for the rest of Spain (n=3586). RESULTS In data adjusted to the Spanish population, the prevalence of diabetes (World Health Organization, 1999), hypertension (blood pressure ≥ 140/90 mmHg), high-sensitivity CRP levels (≥ 3 mg/L) and obesity (body mass index ≥ 30 kg/m(2)) were 16.3%, 43.9%, 32.0%, and 37.0% in Andalusia compared with 12.5%, 39.9%, 28.3%, and 26.6% in the rest of Spain (P<.001 for differences except P=.01 for the difference in high-sensitivity CRP levels). The corresponding figures for the Andalusia data adjusted to the Andalusian population were 15.3%, 42.3%, 31.4%, and 34.0%, respectively. Differences in diabetes, hypertension and high-sensitivity CRP were not significant in models adjusted for age, sex, and adiposity measurements. Differences in obesity were not significant in models adjusted for age, sex, educational level, marital status, work status, and physical activity (P=.086) CONCLUSIONS: This study contributes information from a national study perspective and shows a higher prevalence of cardiovascular risk factors in southern Spain, in close relation to obesity, a sedentary lifestyle, and markers of socioeconomic disadvantage.
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Affiliation(s)
- Sergio Valdés
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.
| | - Francisca García-Torres
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Cristina Maldonado-Araque
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Albert Goday
- Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, Spain
| | - Alfonso Calle-Pascual
- Servicio de Endocrinología y Nutrición, Hospital Universitario San Carlos, Madrid, Spain
| | - Federico Soriguer
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Luis Castaño
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Unidad de Investigación, Hospital Universitario Cruces, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Baracaldo, Vizcaya, Spain
| | - Miguel Catalá
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Departamento de Medicina y Endocrinología, Hospital Universitario de Valencia, Valencia, Spain
| | - Ramon Gomis
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Gemma Rojo-Martínez
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
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Tauler P, Bennasar-Veny M, Morales-Asencio JM, Lopez-Gonzalez AA, Vicente-Herrero T, De Pedro-Gomez J, Royo V, Pericas-Beltran J, Aguilo A. Prevalence of premorbid metabolic syndrome in Spanish adult workers using IDF and ATPIII diagnostic criteria: relationship with cardiovascular risk factors. PLoS One 2014; 9:e89281. [PMID: 24586656 PMCID: PMC3930690 DOI: 10.1371/journal.pone.0089281] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Accepted: 01/19/2014] [Indexed: 01/29/2023] Open
Abstract
Background Metabolic Syndrome (MetS) is a complex disorder defined as a cluster of interconnected risk factors such as hypertension, dyslipidemia, obesity and high blood glucose levels. Premorbid metabolic syndrome (PMetS) is defined by excluding patients with previously diagnosed cardiovascular disease or diabetes mellitus from those suffering MetS. We aimed to determine the prevalence of PMetS in a working population, and to analyse the relationship between the diagnostic criteria of the International Diabetes Federation (IDF) and of the National Cholesterol Education Program Adult Treatment Panel III (ATPIII). The relationship between the presence of PMetS and cardiovascular risk factors was also analysed. Research Methodology/Findings A cross-sectional study was conducted in 24,529 male and 18,736 female Spanish (white western European) adult workers (20–65 years) randomly selected during their work health periodic examinations. Anthropometrics, blood pressure and serum parameters were measured. The presence of MetS and PMetS was ascertained using ATPIII and IDF criteria. Cardiovascular risk was determined using the Framingham-REGICOR equation. The results showed MetS had an adjusted global prevalence of 12.39% using ATPIII criteria and 16.46% using IDF criteria. The prevalence of PMetS was slightly lower (11.21% using ATPIII criteria and 14.72% using IDF criteria). Prevalence in males was always higher than in females. Participants with PMetS displayed higher values of BMI, waist circumference, blood pressure, glucose and triglycerides, and lower HDL-cholesterol levels. Logistic regression models reported lower PMetS risk for females, non-obese subjects, non-smokers and younger participants. Cardiovascular risk determined with Framingham-REGICOR was higher in participants with PMetS. Conclusions PMetS could be a reliable tool for the early identification of apparently healthy individuals who have a significant risk for developing cardiovascular events and type 2 diabetes.
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Affiliation(s)
- Pedro Tauler
- Fundamental Biology and Health Sciences Department, Universitat Illes Balears, Palma, Spain
| | - Miquel Bennasar-Veny
- Research Group on Evidence, Lifestyles & Health, Universitat Illes Balears, Palma, Spain
- * E-mail:
| | | | - Angel A. Lopez-Gonzalez
- Prevention of Occupational Risks in Health Services, Balearic Islands Health Service, Palma, Spain
| | | | - Joan De Pedro-Gomez
- Research Group on Evidence, Lifestyles & Health, Universitat Illes Balears, Palma, Spain
| | - Vanessa Royo
- Gastroenterology Services, Manacor Hospital, Manacor, Spain
| | - Jordi Pericas-Beltran
- Research Group on Evidence, Lifestyles & Health, Universitat Illes Balears, Palma, Spain
| | - Antoni Aguilo
- Research Group on Evidence, Lifestyles & Health, Universitat Illes Balears, Palma, Spain
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Medrano MJ, Alcalde-Cabero E, Ortíz C, Galán I. Effect of cardiovascular prevention strategies on incident coronary disease hospitalisation rates in Spain; an ecological time series analysis. BMJ Open 2014; 4:e004257. [PMID: 24534258 PMCID: PMC3927998 DOI: 10.1136/bmjopen-2013-004257] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To assess the overall population impact of primary prevention strategies (promotion of healthy lifestyles, prevention of smoking and use of vascular risk drug therapy) of coronary disease in Spain. DESIGN Ecological time series analysis, 1982-2009. SETTING All public and private hospitals in Spain. PARTICIPANTS General population. OUTCOME Incident coronary disease hospitalisation as derived from official hospital discharge data. METHODS Annual hospitalisation rates were modelled according to nationwide use of statins, antihypertensive, antidiabetic and antiplatelet drugs, and prevalences of smoking, obesity and overweight. Additive generalised models and mixed Poisson regression models were used for the purpose, taking year as the random-effect variable and adjusting for age, sex, prevalence of vascular risk factors and the number of hospital beds in intensive and coronary care units. RESULTS Across 28 years and 671.5 million person-years of observation, there were 2 986 834 hospitalisations due to coronary disease; of these, 1 441 980 (48.28%) were classified as incident. Hospitalisation rates increased from 1982 to 1996, with an inflection point in 1997 and a subsequent 52% decrease until 2009. Prevalences of smoking, obesity, overweight and use of vascular risk drug therapy were significantly associated with hospitalisation rates (p<0.001): incidence rates ratios (95% CI) for the fourth versus the first quartile were 1.46 (1.42 to 1.50), 1.80 (1.78 to 1.83), 1.58 (1.55 to 1.60) and 0.57 (0.51 to 0.63), respectively. These variables accounted for 92% of interannual variability. CONCLUSIONS After decades of continuous rises, hospitalisation due to incident ischaemic heart disease has been cut by half, an achievement associated with the decline in smoking and the increase in vascular risk drug therapy. These results indicate that these two primary prevention strategies have been effective at a population level, thanks to an appropriate balance between financial and health goals, something that should be left intact despite the current economic crisis. Future strategies ought to lay special stress on excessive body weight prevention.
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Affiliation(s)
- María José Medrano
- National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
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Martínez-Ortega AJ, Aliaga-Verdugo A, Pereira-Cunill JL, Jiménez-Varo I, Romero-Lluch AR, Sobrino-Rodríguez S, Belda-Laguna O, García-Luna PP. [Intraluminal/endoscopic procedures in the treatment of obesity]. ACTA ACUST UNITED AC 2014; 61:264-73. [PMID: 24508068 DOI: 10.1016/j.endonu.2013.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 10/26/2013] [Accepted: 10/29/2013] [Indexed: 02/07/2023]
Abstract
Few effective therapeutic tools are currently available to fight the increasing prevalence of obesity and its associated comorbidities. Bariatric surgery is the only treatment with proven long-term effectiveness, but is associated to a high surgical risk and significant economic costs because of its technical complexity and the characteristics of patients. This is leading to development of new endoscopic procedures with less clinical risks and economic costs, while maintaining the benefits in terms of morbidity and mortality, which could even serve as a bridging element before surgery in cases where this is unavoidable, allowing for preoperative weight loss and control of comorbidities in order to improve anesthetic risks and possible complications. The purpose of this review was to analyze the most relevant and promising endoscopic techniques currently available.
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Affiliation(s)
| | - Alberto Aliaga-Verdugo
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - José Luis Pereira-Cunill
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Ignacio Jiménez-Varo
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Ana R Romero-Lluch
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Salvador Sobrino-Rodríguez
- Sección de Endoscopia, Servicio de Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, España
| | | | - Pedro Pablo García-Luna
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España.
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