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Sacramento-Pacheco J, Sánchez-Gómez MB, Gómez-Salgado J, Novo-Muñoz MM, Duarte-Clíments G. Prevalence of Cardiovascular Risk Factors in Spain: A Systematic Review. J Clin Med 2023; 12:6944. [PMID: 37959409 PMCID: PMC10650307 DOI: 10.3390/jcm12216944] [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: 10/16/2023] [Revised: 10/30/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
Cardiovascular diseases are the leading cause of death in Spain, according to data from the National Institute of Statistics, with the lack of control of cardiovascular risk factors (CVRF) being the main contributing factor. The CVRFs of greatest clinical interest are high blood pressure (HBP), smoking, diabetes mellitus (DM2), overweight, obesity, hypercholesterolaemia, and sedentary lifestyle. The main objective of this review was to compare the prevalence of the different CVRFs according to population-based studies carried out in Spain. For this, a systematic review based on publications assessing CVRFs in the adult population and estimating their national prevalence was conducted. Pubmed and Dialnet databases were consulted, and the selected articles were analysed using the Critical Appraisal Skills Programme Español (CASPe) tool for cohort studies and the Berra et al. tool for cross-sectional studies. A total of 33 studies were obtained from the autonomous regions of Andalusia, the Canary Islands, Castilla-Leon, Castilla-La Mancha, Catalonia, Extremadura, the Balearic Islands, Madrid, Murcia, and Navarra. In all the population-based studies, there was a greater representation of women in the sample. The most prevalent CVRFs differed across the studies according to the autonomous region targeted, with dyslipidaemia, sedentary lifestyle, high blood pressure, hypercholesterolaemia, overweight, and obesity standing out. Numerous differences exist between the studies included in this review, such as the age range, the CVRFs analysed and their prevalence, and remarkable aspects such as the over-representation of the female sex in all cases. It can be concluded that, based on the presented results, the prevalence of CVRFs in Spain varies according to the autonomous region, the sex of the individual, and the studied age range.
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Affiliation(s)
- Jennifer Sacramento-Pacheco
- Nuestra Señora de Candelaria Nursing University School, University of La Laguna, 38010 San Cristóbal de La Laguna, Spain
- Europa Sur Educational Centre (CESUR Tenerife), 38006 Santa Cruz de Tenerife, Spain
| | - María Begoña Sánchez-Gómez
- Cátedra de Enfermería, Universidad de La Laguna, 38200 San Cristóbal de La Laguna, Spain
- Cieza Este Health Centre, Area IX, Servicio Murciano de Salud, 30530 Murcia, Spain
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21071 Huelva, Spain
- Safety and Health Postgraduate Program, Universidad Espíritu Santo, Guayaquil 092301, Ecuador
| | - María Mercedes Novo-Muñoz
- Department of Nursing, Faculty of Health Sciences, University of La Laguna, 38200 San Cristóbal de La Laguna, Spain
| | - Gonzalo Duarte-Clíments
- Cátedra de Enfermería, Universidad de La Laguna, 38200 San Cristóbal de La Laguna, Spain
- Case Management, Area IX, Servicio Murciano de Salud, 30530 Murcia, Spain
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Zheng L, Cui C, Yue S, Yan H, Zhang T, Ding M, Sun Q, He C, Ren H. Longitudinal association between triglyceride glucose index and depression progression in middle-aged and elder adults: A national retrospective cohort study. Nutr Metab Cardiovasc Dis 2023; 33:507-515. [PMID: 36642610 DOI: 10.1016/j.numecd.2022.11.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/10/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Psychological symptoms are prevalent among individuals with non-communicable diseases, while the longitudinal association between triglyceride glucose (TyG) index, an indicator of metabolic health, and depression progression remains unclear yet. This study aims to investigate the association of baseline TyG index and depression progression in middle-aged and elder adults. METHODS AND RESULTS This retrospective cohort study enrolled 8287 participants aged 45 years or above from national China Health and Retirement Longitudinal Study in visit 1 (2011-2012), which were biennially followed for depression score until visit 4 (2017-2018). Multivariate-adjusted regression models were used to evaluate the association of baseline TyG index with the individual level change rate and slope of depression score. The mean age (±SD) of participants was 58.25 ± 9.10 years, and 3806 (45.9%) were men. There was no significant difference of depression score at baseline across TyG quartile groups (P = 0.228). Participants in the highest quartile of TyG index had a 0.124 (95% CI: 0.018-0.230) higher change rate of depression score, and a 0.127 (95% CI: 0.019-0.235) higher change slope, compared to those in the lowest. The observed associations were consistent in multiple sensitivity analyses, and stable in men, the elder, and overweight people. CONCLUSION TyG index is positively associated with depression progression especially in men, the elder and overweight people, which provides new insights for the primary prevention of depression disorder.
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Affiliation(s)
- Lan Zheng
- Department of Laboratory Medicine, China-Japan Union Hospital of Jilin University, Jilin University, China; Department of Laboratory Medicine, Hospital of Stomatology, Jilin University, China.
| | - Cancan Cui
- Department of Laboratory Medicine, China-Japan Union Hospital of Jilin University, Jilin University, China.
| | - Siqi Yue
- Department of Laboratory Medicine, China-Japan Union Hospital of Jilin University, Jilin University, China.
| | - Han Yan
- Department of Endocrinology and Metabolism, China-Japan Union Hospital of Jilin University, Jilin University, China.
| | - Te Zhang
- Department of Anesthesiology, China-Japan Union Hospital of Jilin University, Jilin University, China.
| | - Meng Ding
- Endoscopy Center, China-Japan Union Hospital of Jilin University, Jilin University, China.
| | - Qichao Sun
- Imaging and Nuclear Medicine, China-Japan Union Hospital of Jilin University, Jilin University, China.
| | - Chengyan He
- Department of Laboratory Medicine, China-Japan Union Hospital of Jilin University, Jilin University, China.
| | - Hui Ren
- Department of General Surgery, China-Japan Union Hospital of Jilin University, Jilin University, China.
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Li X, Sun M, Yang Y, Yao N, Yan S, Wang L, Hu W, Guo R, Wang Y, Li B. Predictive Effect of Triglyceride Glucose-Related Parameters, Obesity Indices, and Lipid Ratios for Diabetes in a Chinese Population: A Prospective Cohort Study. Front Endocrinol (Lausanne) 2022; 13:862919. [PMID: 35432185 PMCID: PMC9007200 DOI: 10.3389/fendo.2022.862919] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 02/25/2022] [Indexed: 11/16/2022] Open
Abstract
Objective The purpose of this study was to evaluate the association between triglyceride glucose (TyG) index and new-onset diabetes under different glycemic states and to compare the predictive value of TyG-related parameters, obesity indices, and lipid ratios for new-onset diabetes. Methods Data were collected from the China Health and Retirement Longitudinal Study (CHARLS), consisting of 6,258 participants aged ≥45 years. Participants were grouped according to their glycemic states. Cox proportional hazards models and restricted cubic spline regression were used to explore the association between TyG index and diabetes. Cox proportional hazard models were applied to confirm the predictive value of the optimal marker. Receiver operating characteristic (ROC) curves were used to compare the predictive value. Results TyG index was positively correlated with the risk of diabetes (hazard ratio (HR), 1.75; 95% confidence interval (CI), 1.56-1.97), and the linear association existed (p < 0.001). The highest correlation with diabetes was visceral adiposity index (VAI) (HR, 2.04; 95% CI, 1.44-2.90) in normal fasting glucose (NFG) group and TyG-body mass index (TyG-BMI) (HR, 2.53; 95% CI, 1.97-3.26) in impaired fasting glucose (IFG) group. The largest area under curve (AUC) was observed in TyG-waist-to-height ratio (TyG-WHtR) in the NFG group (AUC, 0.613; 95% CI, 0.527-0.700), and TyG-BMI had the highest AUC in the IFG group (AUC, 0.643; 95% CI, 0.601-0.685). Conclusion The association between TyG index and new-onset diabetes was positive and linear. TyG-WHtR was a clinically effective marker for identifying the risks of diabetes in the NFG group and TyG-BMI was an effective marker to predict diabetes in the IFG group.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
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Cubas-Basterrechea G, Elío I, Sumalla-Cano S, Aparicio-Obregón S, González-Antón CT, Muñoz-Cacho P. The Regular Consumption of Nuts Is Associated with a Lower Prevalence of Abdominal Obesity and Metabolic Syndrome in Older People from the North of Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1256. [PMID: 35162277 PMCID: PMC8834977 DOI: 10.3390/ijerph19031256] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The aim of this study was to relate the adherence to nut consumption (30 g) three or more days per week to the prevalence of abdominal obesity and metabolic syndrome (MetS) in an elderly population from the north of Spain. METHODS The study consists of an observational, descriptive, cross-sectional, and correlational study conducted in 556 non-institutionalised individuals between 65 and 79 years of age. To define the consumption recommendation of nuts the indication of the questionnaire MEDAS-14 was followed. The diagnosis of MetS was conducted using the International Diabetes Federation (IDF) criteria. RESULTS In 264 subjects aged 71.9 (SD: ±4.2) years old, 39% of whom were men, the adherence to nut consumption recommendations was 40.2%. Of these individuals, 79.5% had abdominal obesity. The prevalence of MetS was 40.2%, being 47.6% in men and 35.4% in women (p < 0.05). A nut consumption lower than recommended was associated with a 19% higher prevalence of abdominal obesity (Prevalence Ratio: 1.19; 95% CI: 1.03-1.37; p < 0.05) and a 61% higher prevalence of MetS (Prevalence Ratio: 1.61; 95% CI: 1.16-2.25; p = 0.005) compared to a consumption of ≥3 servings per week. CONCLUSION An inverse relationship was established between nut consumption and the prevalence of abdominal obesity and metabolic syndrome.
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Affiliation(s)
| | - Iñaki Elío
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain; (I.E.); (S.S.-C.); (S.A.-O.)
- Department of Health, Nutrition and Sport, Iberoamerican Internarional University, Campeche 24560, Mexico
| | - Sandra Sumalla-Cano
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain; (I.E.); (S.S.-C.); (S.A.-O.)
- Department of Health, Nutrition and Sport, Iberoamerican Internarional University, Campeche 24560, Mexico
| | - Silvia Aparicio-Obregón
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain; (I.E.); (S.S.-C.); (S.A.-O.)
- Department of Health, Nutrition and Sport, Iberoamerican Internarional University, Campeche 24560, Mexico
| | | | - Pedro Muñoz-Cacho
- Teaching Department of Primary Care Management, Cantabrian Health Service, IDIVAL, 39011 Santander, Spain;
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Impaired Glucose Metabolism in Bipolar Patients: The Role of Psychiatrists in Its Detection and Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071132. [PMID: 30934836 PMCID: PMC6480108 DOI: 10.3390/ijerph16071132] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 12/12/2022]
Abstract
Bipolar patients have a higher risk of type 2 diabetes and obesity, which are associated with cardiovascular diseases as the leading cause of death in this group. Additionally, there is growing evidence that impaired glucose metabolism in bipolar patients is associated with rapid cycling, poor response to mood stabilizers and chronic course of illness. The aim of the study was to assess the prevalence of type 2 diabetes and other types of impaired glucose metabolism in bipolar patients along with an evaluation of the Fasting Triglycerides and Glucose Index (TyG) as a method of the insulin sensitivity assessment. The analysis of fasting glycemia, insulinemia and lipid profile in euthymic bipolar patients was performed, and the Homeostasis model assessment for insulin resistance (HOMA-IR) and TyG were computed. Type 2 diabetes was observed in 9% and insulin resistance with HOMA-IR in 48% of patients. The TyG and HOMA-IR indices were correlated (p < 0.0001), the TyG index value of 4.7 had the highest sensitivity and specificity for insulin resistance detection. The usefulness of TyG in the recognition of insulin resistance in bipolar patients was suggested. The significant role of psychiatrists in the detection and management of impaired glucose metabolism in bipolar patients was presented.
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Sacramento-Pacheco J, Duarte-Clíments G, Gómez-Salgado J, Romero-Martín M, Sánchez-Gómez MB. Cardiovascular risk assessment tools: A scoping review. Aust Crit Care 2019; 32:540-559. [PMID: 30661867 DOI: 10.1016/j.aucc.2018.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 09/27/2018] [Accepted: 09/29/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES The objective of this review was to describe cardiovascular risk (CVR) assessment methods and to identify evidence-based practice recommendations when dealing with population at risk of developing cardiovascular diseases. REVIEW METHODS AND DATA SOURCES A literature review following the Arksey and O'Malley scoping review methodology was conducted. By using appropriate key terms, literature searches were conducted in PubMed, SciELO, Cochrane Library, Dialnet, ENFISPO, Medigraphic, ScienceDirect, Cuiden, and Lilacs databases. A complementary search on websites related to the area of interest was conducted. Articles published in English or Spanish in peer-review journals between 2010 and 2017. Critical appraisal for methodological quality was conducted. Data was extracted using ad-hoc tables and qualitatively synthesized. RESULTS After eliminating duplicates, 55325 records remained, and 1432 records were selected for screening. Out of these, 88 full-text articles were selected for eligibility criteria, and finally, 67 studies were selected for this review, and 25 studies were selected for evidence synthesis. In total, 23 CVR assessment tools have been identified, pioneered by the Framingham study. Qualitative findings were grouped into four thematic areas: assessment tools and scores, CVR indicators, comparative models, and evidence-based recommendations. CONCLUSIONS It is necessary to adapt the instruments to the epidemiological reality of the population. The most appropriate way to estimate CVR is to choose the assessment tool that best suits individual conditions, accompanied by a comprehensive assessment of the patient. More research is required to determine a single, adequate, and reliable tool.
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Affiliation(s)
- Jennifer Sacramento-Pacheco
- Polyclinic Centre of Canarias, Santa Cruz de Tenerife, Calle Alfonso Trujillo, s/n (Edificio Temait III), 38300, La Orotava, Santa Cruz de Tenerife, Spain.
| | - Gonzalo Duarte-Clíments
- Multiprofessional Teaching Unit of Family and Community Care, Canary Islands Health Service, Santa Cruz de Tenerife, Hospital Universitario Ntra. Sra. de Candelaria, Ctra. del Rosario, 145, 38010 Santa Cruz de Tenerife, Spain.
| | - Juan Gómez-Salgado
- University of Huelva, Department of Nursing, Facultad de Enfermería, Campus del Carmen, Avda. Tres de Marzo s/n, 21071, Huelva, Spain; Espíritu Santo University, Guayaquil, Ecuador.
| | - Macarena Romero-Martín
- Red Cross Nursing University Center, University of Sevilla, Avda Cruz Roja s/n. Dpdo, 41009, Sevilla, Spain.
| | - María Begoña Sánchez-Gómez
- University School of Nursing Nuestra Señora de Candelaria, University of La Laguna, Hospital Universitario Ntra. Sra. De Candelaria, Ctra. del Rosario, 145, 38010, Santa Cruz de Tenerife, Spain.
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Marrachelli VG, Rentero P, Mansego ML, Morales JM, Galan I, Pardo-Tendero M, Martinez F, Martin-Escudero JC, Briongos L, Chaves FJ, Redon J, Monleon D. Genomic and Metabolomic Profile Associated to Clustering of Cardio-Metabolic Risk Factors. PLoS One 2016; 11:e0160656. [PMID: 27589269 PMCID: PMC5010244 DOI: 10.1371/journal.pone.0160656] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 07/22/2016] [Indexed: 12/11/2022] Open
Abstract
Background To identify metabolomic and genomic markers associated with the presence of clustering of cardiometabolic risk factors (CMRFs) from a general population. Methods and Findings One thousand five hundred and two subjects, Caucasian, > 18 years, representative of the general population, were included. Blood pressure measurement, anthropometric parameters and metabolic markers were measured. Subjects were grouped according the number of CMRFs (Group 1: <2; Group 2: 2; Group 3: 3 or more CMRFs). Using SNPlex, 1251 SNPs potentially associated to clustering of three or more CMRFs were analyzed. Serum metabolomic profile was assessed by 1H NMR spectra using a Brucker Advance DRX 600 spectrometer. From the total population, 1217 (mean age 54±19, 50.6% men) with high genotyping call rate were analysed. A differential metabolomic profile, which included products from mitochondrial metabolism, extra mitochondrial metabolism, branched amino acids and fatty acid signals were observed among the three groups. The comparison of metabolomic patterns between subjects of Groups 1 to 3 for each of the genotypes associated to those subjects with three or more CMRFs revealed two SNPs, the rs174577_AA of FADS2 gene and the rs3803_TT of GATA2 transcription factor gene, with minimal or no statistically significant differences. Subjects with and without three or more CMRFs who shared the same genotype and metabolomic profile differed in the pattern of CMRFS cluster. Subjects of Group 3 and the AA genotype of the rs174577 had a lower prevalence of hypertension compared to the CC and CT genotype. In contrast, subjects of Group 3 and the TT genotype of the rs3803 polymorphism had a lower prevalence of T2DM, although they were predominantly males and had higher values of plasma creatinine. Conclusions The results of the present study add information to the metabolomics profile and to the potential impact of genetic factors on the variants of clustering of cardiometabolic risk factors.
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Affiliation(s)
- Vannina G. Marrachelli
- Metabolomic and Molecular Image Lab, Health Research Institute, INCLIVA, Valencia, Spain
| | - Pilar Rentero
- Genotyping and Genetic Diagnosis Unit, Health Research Institute, INCLIVA, Valencia, Spain
| | - María L. Mansego
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain
| | - Jose Manuel Morales
- Metabolomic and Molecular Image Lab, Health Research Institute, INCLIVA, Valencia, Spain
| | - Inma Galan
- Genotyping and Genetic Diagnosis Unit, Health Research Institute, INCLIVA, Valencia, Spain
| | - Mercedes Pardo-Tendero
- Metabolomic and Molecular Image Lab, Health Research Institute, INCLIVA, Valencia, Spain
| | | | | | - Laisa Briongos
- INCLIVA Research Institute, University of Valencia, Valencia, Spain
| | - Felipe Javier Chaves
- Genotyping and Genetic Diagnosis Unit, Health Research Institute, INCLIVA, Valencia, Spain
- CIBERDem, Health Institute Carlos III, Madrid, Spain
| | - Josep Redon
- INCLIVA Research Institute, University of Valencia, Valencia, Spain
- CIBERObn, Health Institute Carlos III, Madrid, Spain
- * E-mail:
| | - Daniel Monleon
- Metabolomic and Molecular Image Lab, Health Research Institute, INCLIVA, Valencia, Spain
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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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Esteban MR, Montero SM, Sánchez JJA, Hernández HP, Pérez JJG, Afonso JH, Pérez DCR, Díaz BB, de León AC. Acute coronary syndrome in the young: clinical characteristics, risk factors and prognosis. Open Cardiovasc Med J 2014; 8:61-7. [PMID: 25152777 PMCID: PMC4141177 DOI: 10.2174/1874192401408010061] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 05/20/2014] [Accepted: 06/06/2014] [Indexed: 12/18/2022] Open
Abstract
Background: To describe the characteristics of patients ≤40 years of age hospitalized for acute coronary syndrome, analyze the risk factors and identify the variables associated with prognosis. Methods: Case series of patients admitted between 2003 and 2012 inclusive in a tertiary hospital (123 consecutive cases admitted between 2003 and 2012), and case-control study (369 controls selected from the general population matched for sex and age with cases, at a ratio of 3:1). Outcome variables: Mortality, likelihood of survival without readmission for heart-related problems, extent of coronary disease as determined by coronary angiography and cardiovascular risk factors. Results: Mean age was 35.4±4.8 years and 83.7% of the participants were men. Myocardial infarction with abnormal Q wave (48%) and single-vessel involvement (44.7%) predominated. Intrahospital mortality was 1.6%. For the 108 patients eventually included in the follow-up, likelihood of readmission-free survival after 60 months was 69.3±4.8%. In the case group 36% of the patients admitted to using cocaine. Compared to controls, the prevalence in patients was higher for smoking (74.8 vs 33.1%, p<0001), diabetes (14.6% vs 5.1%, p=0.001), low HDL-cholesterol (82.9 vs 34.1%, p<0.001) and obesity (30.0 vs 20.3%, p=0.029). Decreased left ventricular ejection fraction (odds ratio=2.2, p=0.033) and smoking (odds ratio=7.8, p=0.045) were associated with readmission for coronary syndrome. Conclusion: Acute coronary syndrome in people younger than 40 years is associated with diabetes and unhealthy lifestyle: smoking, sedentary behavior (low HDL-cholesterol), cocaine use and obesity. The readmission rate is high, and readmission is associated with smoking and decreased ejection fraction.
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Affiliation(s)
| | - Sara M Montero
- Unidad de Medicina Intensiva, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
| | - José J A Sánchez
- Unidad de Investigación de Atención Primaria y del Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain ; Red de Investigación Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | | | - Del C R Pérez
- Unidad de Investigación de Atención Primaria y del Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain ; Red de Investigación Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
| | - Buenaventura B Díaz
- Unidad de Investigación de Atención Primaria y del Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain ; Red de Investigación Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio C de León
- Unidad de Investigación de Atención Primaria y del Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain ; Red de Investigación Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain ; Área de Medicina Preventiva y Salud Pública, Universidad de La Laguna, La Laguna, Spain
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Via-Sosa MA, Toro C, Travé P, March MA. Screening premorbid metabolic syndrome in community pharmacies: a cross-sectional descriptive study. BMC Public Health 2014; 14:487. [PMID: 24885099 PMCID: PMC4042002 DOI: 10.1186/1471-2458-14-487] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 05/06/2014] [Indexed: 11/10/2022] Open
Abstract
Background Premorbid metabolic syndrome (pre-MetS) is a cluster of cardiometabolic risk factors characterised by central obesity, elevated fasting glucose, atherogenic dyslipidaemia and hypertension without established cardiovascular disease or diabetes. Community pharmacies are in an excellent position to develop screening programmes because of their direct contact with the population. The main aim of the study was to determine the prevalence of pre-MetS in people who visited community pharmacies for measurement of any of its five risk factors to detect the presence of other risk factors. The secondary aims were to study the presence of other cardiovascular risk factors and determine patients’ cardiovascular risk. Methods Cross-sectional, descriptive, multicentre study. Patients meeting selection criteria aged between 18 and 65 years who visited participating community pharmacies to check any of five pre-MetS diagnostic factors were included.The study involved 23 community pharmacies in Catalonia (Spain). Detection criteria for pre-MetS were based on the WHO proposal following IDF and AHA/NHBI consensus. Cardiovascular risk (CVR) was calculated by Regicor and Score methods. Other variables studied were smoking habit, physical activity, body mass index (BMI), and pharmacological treatment of dyslipidemia and hypertension. The data were collected and analysed with the SPSS programme. Comparisons of variables were carried out using the Student’s T-test, Chi-Squared test or ANOVA test. Level of significance was 5% (0.05). Results The overall prevalence of pre-MetS was 21.9% [95% CI 18.7-25.2]. It was more prevalent in men, 25.5% [95% CI 22.1-28.9], than in women, 18.6% [95% CI 15.5-21.7], and distribution increased with age. The most common risk factors were high blood pressure and abdominal obesity. About 70% of people with pre-MetS were sedentary and over 85% had a BMI ≥25 Kg/m2. Some 22.4% had two metabolic criteria and 27.2% of patients with pre-MetS had no previous diagnosis. Conclusions The prevalence of pre-MetS in our study (21.9%) was similar to that found in other studies carried out in Primary Care in Spain. The results of this study confirm emergent cardiometabolic risk factors such as hypertension, obesity and physical inactivity. Our study highlights the strategic role of the community pharmacy in the detection of pre-MetS in the apparently healthy population.
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Affiliation(s)
- Maria Angeles Via-Sosa
- Unit of Practice Pharmacy, Unidad de Prácticas Tuteladas, Faculty of Pharmacy, University of Barcelone, Catalonia, 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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