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Puga M, Serrano JG, García EL, González Carracedo MA, Jiménez-Canino R, Pino-Yanes M, Karlsson R, Sullivan PF, Fregel R. El Hierro Genome Study: A Genomic and Health Study in an Isolated Canary Island Population. J Pers Med 2024; 14:626. [PMID: 38929847 PMCID: PMC11204744 DOI: 10.3390/jpm14060626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
El Hierro is the smallest and westernmost island of the Canary Islands, whose population derives from an admixture of different ancestral components and that has been subjected to genetic isolation. We established the "El Hierro Genome Study" to characterize the health status and the genetic composition of ~10% of the current population of the island, accounting for a total of 1054 participants. Detailed demographic and clinical data and a blood sample for DNA extraction were obtained from each participant. Genomic genotyping was performed with the Global Screening Array (Illumina). The genetic composition of El Hierro was analyzed in a subset of 416 unrelated individuals by characterizing the mitochondrial DNA (mtDNA) and Y-chromosome haplogroups and performing principal component analyses (PCAs). In order to explore signatures of isolation, runs of homozygosity (ROHs) were also estimated. Among the participants, high blood pressure, hypercholesterolemia, and diabetes were the most prevalent conditions. The most common mtDNA haplogroups observed were of North African indigenous origin, while the Y-chromosome ones were mainly European. The PCA showed that the El Hierro population clusters near 1000 Genomes' European population but with a shift toward African populations. Moreover, the ROH analysis revealed some individuals with an important portion of their genomes with ROHs exceeding 400 Mb. Overall, these results confirmed that the "El Hierro Genome" cohort offers an opportunity to study the genetic basis of several diseases in an unexplored isolated population.
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Affiliation(s)
- Marta Puga
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), 38200 La Laguna, Spain; (M.P.); (E.L.G.); (M.A.G.C.); (M.P.-Y.)
| | - Javier G. Serrano
- Evolution, Paleogenomics and Population Genetics Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), 38200 La Laguna, Spain;
| | - Elsa L. García
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), 38200 La Laguna, Spain; (M.P.); (E.L.G.); (M.A.G.C.); (M.P.-Y.)
| | - Mario A. González Carracedo
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), 38200 La Laguna, Spain; (M.P.); (E.L.G.); (M.A.G.C.); (M.P.-Y.)
- Genetics Laboratory, Institute of Tropical Diseases and Public Health of the Canary Islands (IUETSPC), Universidad de La Laguna (ULL), 38200 La Laguna, Spain
| | - Rubén Jiménez-Canino
- Genomics Service, Servicio General de Apoyo a la Investigación, Universidad de La Laguna (ULL), 38200 La Laguna, Spain;
| | - María Pino-Yanes
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), 38200 La Laguna, Spain; (M.P.); (E.L.G.); (M.A.G.C.); (M.P.-Y.)
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Tecnologías Biomédicas (ITB), Universidad de La Laguna (ULL), 38200 La Laguna, Spain
| | - Robert Karlsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden; (R.K.); (P.F.S.)
| | - Patrick F. Sullivan
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden; (R.K.); (P.F.S.)
- Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Rosa Fregel
- Evolution, Paleogenomics and Population Genetics Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), 38200 La Laguna, Spain;
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Arévalo-Lorido JC, Carretero-Gomez J, Rubini A, Félix-Redondo FJ, Robles Pérez Monteoliva NR, Hernández González M, Vázquez Jarén E, Cancho-Castellanos B, González Fernández R, Fernández-Bergés D. Temporal trends on the prevalence of renal disease and outcomes among patients with diabetes mellitus hospitalized by heart failure: findings from INCAex. Expert Rev Endocrinol Metab 2024:1-11. [PMID: 38866705 DOI: 10.1080/17446651.2024.2365769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 01/26/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND To assess 20-year time trends in the prevalence of diabetes mellitus (DM) among inpatients with heart failure (HF) and the influence of coexisting DM and kidney disease (KD) on outcomes. RESEARCH DESIGN AND METHODS A retrospective study of patients was admitted due to HF, during the period 2000/2019. The period of follow-up was divided into three intervals according to the European Medical Agency approval of newer hypoglycemic drugs. We analyzed in-hospital mortality and outcomes during the follow-up period. RESULTS A total of 4959 patients were included. Over time, prevalence of DM was significantly raising among women with HF (50 to 53.2%) and descending among men (50% to 46.8%, p = 0.02). Total mortality and readmissions were higher in patients with DM during the and second periods. However, no significant differences were found in the third-one (HR 1.14, 95% CI 0.94-1.39, p = 0.181). A protector role of oral hypoglycemic medications was observed in this last period. According to the presence of KD, the patients with both DM and KD were who presented most of the events. CONCLUSIONS Over the time analyzed, the prevalence of DM raised among women and decreased among men. DM influenced the prognosis of HF except in the third period when more protective hypoglycemic drugs started to be used.
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Affiliation(s)
| | | | - Alessia Rubini
- Servicio Extremeño de Salud, Unidad de Investigación Área Salud Don Benito-Villanueva, Villanueva de la Serena, Badajoz, Spain
- Unidad de investigaci'ón (GRIMEX), Villanueva de la Serena, Badajoz, Spain
| | - Francisco Javier Félix-Redondo
- Servicio Extremeño de Salud, Unidad de Investigación Área Salud Don Benito-Villanueva, Villanueva de la Serena, Badajoz, Spain
| | - Nicolás Roberto Robles Pérez Monteoliva
- Unidad de investigaci'ón (GRIMEX), Villanueva de la Serena, Badajoz, Spain
- Unidad de Hipertensión Arterial, Servicio de Nefrología, Hospital Universitario de Badajoz, Badajoz, Spain
| | - Miriam Hernández González
- Servicio Extremeño de Salud, Unidad de Investigación Área Salud Don Benito-Villanueva, Villanueva de la Serena, Badajoz, Spain
- Unidad de investigaci'ón (GRIMEX), Villanueva de la Serena, Badajoz, Spain
| | - Elena Vázquez Jarén
- Servicio Extremeño de Salud, Unidad de Investigación Área Salud Don Benito-Villanueva, Villanueva de la Serena, Badajoz, Spain
| | - Bárbara Cancho-Castellanos
- Unidad de investigaci'ón (GRIMEX), Villanueva de la Serena, Badajoz, Spain
- Unidad de Hipertensión Arterial, Servicio de Nefrología, Hospital Universitario de Badajoz, Badajoz, Spain
| | - Reyes González Fernández
- Unidad de investigaci'ón (GRIMEX), Villanueva de la Serena, Badajoz, Spain
- Servicio de Cardiología, Hospital Universitario de Badajoz, Badajoz, Spain
| | - Daniel Fernández-Bergés
- Servicio Extremeño de Salud, Unidad de Investigación Área Salud Don Benito-Villanueva, Villanueva de la Serena, Badajoz, Spain
- Unidad de investigaci'ón (GRIMEX), Villanueva de la Serena, Badajoz, Spain
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Camps-Vilaró A, Subirana I, Elosua R, Palomo I, Sanchis J, Tizón-Marcos H, Cainzos-Achirica M, Sala J, Masia R, Ramos R, Dégano IR, Marrugat J. Analysis of myocardial infarction incidence and case-fatality in the last three decades in the province of Girona. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2024; 77:450-458. [PMID: 37981192 DOI: 10.1016/j.rec.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/28/2023] [Indexed: 11/21/2023]
Abstract
INTRODUCTION AND OBJECTIVES Myocardial infarction (MI) incidence and case fatality trends are highly informative but relatively untested at the population level. The objective of this work was to estimate MI incidence and case fatality in the Girona population aged 35-74 years, and to determine their 30-year trends (1990-2019). METHODS The REGICOR (Girona Heart Registry) monitored MI incidence and case fatality rates from 1990 to 2008. For the period 2008 to 2019, we linked discharges from Girona hospitals (n=4 974 977) and mortality registry (n=70 405) during this period. Our linkage algorithm selected key MI diagnostic codes and removed duplicates. Estimates from the linkage algorithm and the REGICOR registry were compared using chi-square tests for overlapping years (2008-2009). We estimated the annual percent change (APC) of standardized MI incidence and 28-day case fatality, and analyzed their trends using joinpoint regression. RESULTS MI incidence and case fatality estimates were similar in the linkage algorithm and the REGICOR registry. We observed significant decreasing trends in the incidence of MI. The trend was APC, -0.96% (95% confidence interval (95%CI), -1.4 to -0.53) in women from 1990 to 2019 and -4.2% (95%CI, -5.5 to -3.0) in men from 1994 to 2019. The largest decrease in case fatality was -3.8% (95%CI, -5.1 to -2.5) from 1995 to 2003 in women and -2.4% (95%CI, -2.9 to -1.9) from 1995 to 2004 in men, mainly due to prehospital case fatality declines: -1.8% (95%CI, -2.6 to -1.1) in men and -3.2% (95%CI, -4.6 to -1.8) in women. CONCLUSIONS In Girona, MI incidence and case fatality decreased between 1990 and 2019. The incidence showed a slow but continuous decrease while case fatality only stabilized in the last decade, particularly in women.
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Affiliation(s)
- Anna Camps-Vilaró
- Grup d'Estudi REGICOR, Institut de Recerca Hospital del Mar (IMIM), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Doctoral College, University of Vic-Central University of Catalonia (Uvic-UCC), Vic, Barcelona, Spain
| | - Isaac Subirana
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Grup d'Epidemiologia i Genètica Cardiovascular, Institut de Recerca Hospital del Mar (IMIM), Barcelona, Spain
| | - Roberto Elosua
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Doctoral College, University of Vic-Central University of Catalonia (Uvic-UCC), Vic, Barcelona, Spain; Facultat de Medicina, Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Vic, Barcelona, Spain
| | - Iván Palomo
- Centro de Investigación en Trombosis, Departmento de Bioquímica Clínica e Inmunohematología, Escuela de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Juan Sanchis
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Cardiology Department, Hospital Clínic de Valencia, Valencia, Spain
| | - Helena Tizón-Marcos
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servei de Cardiologia, Hospital del Mar, Barcelona, Spain
| | | | - Joan Sala
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servei de Cardiologia, Hospital Universitari Josep Trueta, Girona, Spain
| | - Rafael Masia
- Servei de Cardiologia, Hospital Universitari Josep Trueta, Girona, Spain
| | - Rafel Ramos
- Unitat de Recerca de Medicina Familiar-de Girona, Institut de Recerca en Atenció Primària Jordi Gol, Barcelona, Spain
| | - Irene R Dégano
- Grup d'Estudi REGICOR, Institut de Recerca Hospital del Mar (IMIM), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Grup d'Epidemiologia i Genètica Cardiovascular, Institut de Recerca Hospital del Mar (IMIM), Barcelona, Spain; Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IRIS-CC), Vic, Barcelona, Spain.
| | - Jaume Marrugat
- Grup d'Estudi REGICOR, Institut de Recerca Hospital del Mar (IMIM), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
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Romero-Secin AA, Díez-Espino J, Prieto-Díaz MA, Pallares-Carratala V, Barquilla-García A, Micó-Pérez RM, Polo-García J, Velilla-Zancada SM, Martín-Sanchez V, Segura-Fragoso A, Ginel-Mendoza L, Arce-Vazquez VM, Cinza-Sanjurjo S. Prevalence, impact and management of hypertension-mediated organ damage in type 2 diabetes patients. Semergen 2024; 50:102220. [PMID: 38554607 DOI: 10.1016/j.semerg.2024.102220] [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: 12/19/2023] [Revised: 01/23/2024] [Accepted: 02/16/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVE To determine the prevalence, impact and management of hypertension-mediated organ damage (HMOD) according to the presence of type 2 diabetes (T2DM). METHODS IBERICAN is an ongoing multicenter, observational and prospective study, including outpatients aged 18-85 years who attended the Primary Care setting in Spain. In this study, the prevalence, impact and management of HMOD according to the presence of T2DM at baseline were analyzed. RESULTS At baseline, 8066 patients (20.2% T2DM, 28.6% HMOD) were analyzed. Among patients with T2DM, 31.7% had hypertension, 29.8% dyslipidemia and 29.4% obesity and 49.3% had ≥1 HMOD, mainly high pulse pressure (29.6%), albuminuria (16.2%) and moderate renal impairment (13.6%). The presence of T2DM significantly increased the risk of having CV risk factors and HMOD. Among T2DM population, patients with HMOD had more dyslipidemia (78.2% vs 70.5%; P=0.001), hypertension (75.4% vs 66.4%; P=0.001), any CV disease (39.6% vs 16.1%; P=0.001) and received more drugs. Despite the majority of types of glucose-lowering agents were more frequently taken by those patients with HMOD, compared to the total T2DM population, the use of SGLT2 inhibitors and GLP-1 receptor agonists was marginal. CONCLUSIONS In patients daily attended in primary care setting in Spain, one in five patients had T2DM and nearly half of these patients had HMOD. In patients with T2DM, the presence of HMOD was associated with a higher risk of CV risk factors and CV disease. Despite the very high CV risk, the use of glucose-lowering agents with proven CV benefit was markedly low.
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Affiliation(s)
- A A Romero-Secin
- Specialist in Family and Community Medicine, Colloto Health Clinic, Principality of Asturias Health Service, Asturias, Spain; Fundacion redGEDAPS, Spain
| | - J Díez-Espino
- Fundacion redGEDAPS, Spain; Specialist in Family and Community Medicine, Tafalla Health Center, Tafalla, Navarrese Health Service, Navarra, Spain
| | - M A Prieto-Díaz
- Specialist in Family and Community Medicine, Vallobín-La Florida Health Center, Principality of Asturias Health Service, Asturias, Spain
| | | | - A Barquilla-García
- Specialist in Family and Community Medicine, Trujillo Health Center, Extremadura Health Service, Cáceres, Spain
| | - R M Micó-Pérez
- Specialist in Family and Community Medicine, Fontanars dels Alforins Health Center, Xàtiva-Ontinyent Department of Health, Valencia, Spain
| | - J Polo-García
- Specialist in Family and Community Medicine, Casar de Cáceres Health Center, Extremadura Health Service, Cáceres, Spain
| | - S M Velilla-Zancada
- Specialist in Family and Community Medicine, Joaquin Elizalde Health Center, Rioja Health Service, Logroño, La Rioja, Spain
| | - V Martín-Sanchez
- Institute of Biomedicine (IBIOMED), University of León, Epidemiology and Public Health Networking Biomedical Research Centre (CIBERESP), León, Spain
| | | | - L Ginel-Mendoza
- Specialist in Family and Community Medicine, Ciudad Jardín Health Center, Málaga, Spain
| | - V M Arce-Vazquez
- Centro de investigación en medicina molecular y enfermedades crónicas (CIMUS), Universidad de Santiago de Compostela, Galicia, Spain
| | - S Cinza-Sanjurjo
- Specialist in Family and Community Medicine, Milladoiro Health Centre, Health Area of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain; Networking Biomedical Research, Centre-Cardiovascular Diseases (CIBERCV), Santiago de Compostela, Spain
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5
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Martin-Gómez MA, Rodríguez Torres A, Espinosa Hernández M, Lopez Mendoza M, Sabio Sánchez JM, Martin Armada M, Martin Suarez I, Callejas Rubio JL, Castilla Castellano MM, Anglada Pintado JC, Barnosi Marín AC, Martinez Esteban MD, Castilla Guerra L, De Ramón Garrido E. Mortality and cardiovascular risk in vasculitis ANCA. Importance of hypertension and renal function. Experience from southern Spain. HIPERTENSION Y RIESGO VASCULAR 2024; 41:5-16. [PMID: 37517951 DOI: 10.1016/j.hipert.2023.06.001] [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: 09/12/2022] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Cardiovascular disease (CVD) is one of the principal causes of death in antineutrophil cytoplasmic antibody-(ANCA)-associated vasculitis (AAV). OBJECTIVES To evaluate the mortality and it's causes and CVD and its vascular risk factors (VRFs) in AAV patients in Andalusia. METHODS A multicenter cohort of 220 AAV patients followed-up from 1979 until June 2020 was studied in Andalussia, south of Spain. The information, including socio-demographic and clinical data was recorded retrospectively through chart review. Data was analysed using Chi2, ANOVA and Cox proportional hazards regresion as uni and multivariate test with a 95% confidence interval (CI). RESULTS During a mean ± standard deviation follow-up of 96.79 ± 75.83 months, 51 patients died and 30 presented at least one CVE. Independent prognostic factors of mortality were age (HR 1.083, p=0.001) and baseline creatinine (HR 4.41, p=0.01). Independent prognostic factors of CVE were age [hazard ratio (HR) 1.042, p=0.005] and the presence of hypertension (HTN) six months after diagnosis (HR 4.641, p=0.01). HTN, diabetes and renal failure, all of these important VRFs, are more prevalent in AAV patients than it is described in matched general population. CONCLUSIONS Age and baseline renal function, but not CVEs, are predictors of mortality and age and early HTN are independent predictors for having a CVE. CVD screening in AAV patients is demanded.
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Affiliation(s)
| | | | | | | | - J M Sabio Sánchez
- Internal Medicine Autoimmune Unit, Virgen de las Nieves Hospital, Granada, Spain
| | | | - I Martin Suarez
- Internal Medicine, Juan Ramón Jiménez Hospital, Huelva, Spain
| | | | | | | | | | | | | | - E De Ramón Garrido
- Internal Medicine, Andalussian Society of Autoimmune Diseases (AADEA), Spain
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Pallarés-Carratalá V, Ruiz-García A, Serrano-Cumplido A, Arranz-Martínez E, Divisón-Garrote JA, Moyá-Amengual A, Escobar-Cervantes C, Barrios V. Prevalence Rates of Arterial Hypertension According to the Threshold Criteria of 140/90 or 130/80 mmHg and Associated Cardiometabolic and Renal Factors: SIMETAP-HTN Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1846. [PMID: 37893564 PMCID: PMC10608132 DOI: 10.3390/medicina59101846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/29/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
Background and objectives: Arterial hypertension (HTN) is the leading preventable cause of atherosclerotic cardiovascular diseases (ASCVD) and death from all causes. This study aimed to determine the prevalence rates of HTN diagnosed according to the threshold diagnostic criteria 130/80 mmHg and 140/90 mmHg, to compare blood pressure (BP) control, and to evaluate their associations with cardiovascular diseases and cardiometabolic and renal risk factors. Materials and Methods: This was a cross-sectional observational study conducted in primary care with a population-based random sample: 6588 people aged 18.0-102.8 years. Crude and adjusted prevalence rates of HTN were calculated. BP control was compared in HTN patients with and without ASCVD or chronic kidney disease (CKD). Their associations with cardiovascular diseases and cardiometabolic and renal factors were assessed using bivariate and multivariate analysis. Results: Adjusted prevalence rates of HTN diagnosed according to 140/90 and 130/90 criteria were 30.9% (32.9% male; 29.7% female) and 54.9% (63.2% male; 49.3% female), respectively. BP < 130/80 mmHg was achieved in 60.5% of HTN patients without ASCVD or CKD according to 140/90 criterion, and 65.5% according to 130/80 criterion. This BP-control was achieved in 70% of HTN patients with ASCVD and 71% with CKD, according to both criteria. Coronary heart disease (CHD), heart failure, atrial fibrillation, stroke, diabetes, prediabetes, low glomerular filtration rate (eGFR), hyperuricemia, hypercholesterolemia, obesity, overweight, and increased waist-to-height ratio were independently associated with HTN according to both criteria. Conclusions: Almost a third of the adult population has HTN according to the 140/90 criterion, and more than half according to the 130/90 criterion, with a higher prevalence in men. The main clinical conditions associated with HTN were heart failure, diabetes, CHD, low eGFR, and obesity.
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Affiliation(s)
- Vicente Pallarés-Carratalá
- Health Surveillance Unit, Mutual Insurance Union, 12004 Castellon, Spain
- Department of Medicine, Jaume I University, 12006 Castellon, Spain
| | - Antonio Ruiz-García
- Lipids and Cardiovascular Prevention Unit, Pinto University Health Centre, Pinto, 28320 Madrid, Spain
- Department of Medicine, European University of Madrid, Villaviciosa de Odon, 28670 Madrid, Spain
| | | | | | | | | | | | - Vivencio Barrios
- Ramon y Cajal University Hospital, 28034 Madrid, Spain;
- Department of Medicine, Alcala University, 28801 Madrid, Spain
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7
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Cosín-Sales J, Campuzano Ruiz R, Díaz Díaz JL, Escobar Cervantes C, Fernández Olmo MR, Gómez-Doblas JJ, Mostaza JM, Pedro-Botet J, Plana Gil N, Valdivielso P. Impact of physician's perception about LDL cholesterol control in clinical practice when treating patients in Spain. Atherosclerosis 2023; 375:38-44. [PMID: 37245425 DOI: 10.1016/j.atherosclerosis.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND AND AIMS We aimed to understand the impact of physicians' perception about LDL-cholesterol (LDLc) control on the management of patients with dyslipidemia in Spain. METHODS We performed a cross-sectional and multicenter study, in which 435 healthcare professionals participated in face-to-face meetings, collecting qualitative and quantitative information related to hypercholesterolemia management. Additionally, aggregated anonymized data of the last 10 patients with hypercholesterolemia attended by each physician were collected. RESULTS A total of 4,010 patients (8%, 13%, 16% and 61% with low, moderate, high, and very high cardiovascular [CV] risk) were included. Physicians' perception was that 62% of their patients attained LDLc goals (66%, 63%, 61% and 56%, for low, moderate, high and very high CV risk, respectively). However, when looking into the data only 31% (vs 62% p<0.01) of patients attained the LDLc goals (47%, 36%, 22% and 25%, respectively). Overall, 33% of patients were taking high intensity statins, 32% statin/ezetimibe, 21% low/moderate intensity statins and 4% PCSK9 inhibitors. These numbers were 38%, 45%, 8% and 6% for very high risk patients and 44%, 21%, 21% and 4% for high CV risk patients. In 32% of patients, a change in lipid lowering therapy was performed after the visit, mainly combining statins/ezetimibe (55%). CONCLUSIONS In Spain, most patients with dyslipidemia do not achieve the recommended LDLc goals because of an insufficient intensification of lipid lowering therapy. On the one hand, this is in part due to physicians misperception on preventive LDLc control and the need for repeated advice to patient, and, on the other, to the lack of patient adherence.
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Affiliation(s)
- Juan Cosín-Sales
- Department of Cardiology, Hospital Arnau de Vilanova, Valencia, Spain.
| | | | - José Luis Díaz Díaz
- Department of Internal Medicine, Hospital Universitario A Coruña, A Coruña, Spain
| | | | | | - Juan José Gómez-Doblas
- Department of Cardiology, Hospital Universitario Virgen de la Victoria-IBIMA CIBERCV, Málaga, Spain
| | | | | | - Núria Plana Gil
- Department of Vascular Medicina and Metabolism, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
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Martín Pérez S, Arrobas Velilla T, Fabiani de la Iglesia J, Vázquez Rico I, Varo Sánchez G, León-Justel A. Geostatistical analysis from the clinical laboratory in cardiovascular prevention for primary care. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2023; 35:75-84. [PMID: 36184300 DOI: 10.1016/j.arteri.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/06/2022] [Accepted: 08/08/2022] [Indexed: 04/21/2023]
Abstract
INTRODUCTION AND OBJECTIVES Cardiovascular diseases continue to lead the ranking of mortality in Spain. The implementation of geostatistical analysis techniques in the clinical laboratory are innovative tools that allow the design of new strategies in primary prevention of cardiovascular disease. The aim of this study was to study the prevalence and geolocation of severe dyslipidemia in the health areas under study in order to implement prevention strategies in primary care. A retrospective cohort study of low-density protein-bound cholesterol, triglyceride and lipoprotein (a) levels in the years 2019 and 2020 were carried out. In addition, a geostatistical analysis was performed including representation in choropleth maps and the detection of clustering clusters, using geographic information in zip code format included in the demographic data of each analytic. RESULTS The analytical data included in the study were triglycerides (n=365,384), low density protein-bound cholesterol (n=289,594) and lipoprotein to lipoprotein (a) (n=502). Areas with the highest and lowest percentage of cases were identified for the established cut-off points of LDL-C>190mg/dL and TG>150mg/dL. Two clustering clusters with statistical significance were detected for cLDL>190mg/dL and a total of 6 clusters for TG values>150mg/dL. CONCLUSIONS The detection of clusters, as well as the representation of choropleth maps, can be of great help in detecting geographic areas that require greater attention to intervene and improve cardiovascular risk.
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Affiliation(s)
- Salomón Martín Pérez
- Laboratorio de Nutrición y Riesgo Cardiovascular, Unidad de Bioquímica Clínica, Hospital Universitario Virgen Macarena, Sevilla, España.
| | - Teresa Arrobas Velilla
- Laboratorio de Nutrición y Riesgo Cardiovascular, Unidad de Bioquímica Clínica, Hospital Universitario Virgen Macarena, Sevilla, España
| | | | - Ignacio Vázquez Rico
- Laboratorio de Análisis Clínicos, Unidad de Lípidos, Hospital Juan Ramón Jiménez, Huelva, España
| | - Gema Varo Sánchez
- Laboratorio de Análisis Clínicos, Hospital comarcal Riotinto, Huelva, España
| | - Antonio León-Justel
- Unidad de Bioquímica Clínica, Hospital Universitario Virgen Macarena, Sevilla, España
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9
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Ferraz-Amaro I, Genre F, Blanco R, Corrales A, Mazón IG, Portilla V, Aurrecoechea E, Mata C, Hernández-Hernández V, Quevedo-Abeledo JC, Rodríguez-Lozano C, Lopez-Medina C, Ladehesa-Pineda ML, Castañeda S, Vicente EF, Fernández-Carballido C, Martínez-Vidal MP, Castro-Corredor D, Anino-Fernández J, Peiteado D, Plasencia-Rodríguez C, Vivar MLG, Galíndez-Agirregoikoa E, Vegas-Revenga N, Urionagüena-Onaindia I, Perez EM, Díaz CF, González-Gay MÁ, Rueda-Gotor J. Sex differences in cardiovascular and disease-related features in axial spondyloarthritis. A multicenter study of 912 patients. Semin Arthritis Rheum 2023; 60:152198. [PMID: 37058848 DOI: 10.1016/j.semarthrit.2023.152198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/09/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVES To determine the potential impact of sex-specific disease-related characteristics on cardiovascular (CV) disease in axial spondyloarthritis (axSpA). METHODS Cross-sectional study of the Spanish AtheSpAin cohort to study CV disease in axSpA. Data on carotid ultrasound and CV disease and disease-related features were collected. RESULTS 611 men and 301 women were recruited. Classic CV risk factors were significantly less prevalent in women, who also showed a lower frequency of carotid plaques (p = 0.001), lower carotid intima-media thickness (IMT) values (p<0.001) and CV events (p = 0.008). However, after adjustment for classic CV risk factors, only the differences with respect to carotid IMT remained statistically significant. Women showed higher ESR at diagnosis (p = 0.038), and more active disease (ASDAS, p = 0.012, and BASDAI, p<0.001). They had shorter disease duration (p<0.001), lower prevalence of psoriasis (p = 0.008), less structural damage (mSASSS, p<0.001), and less mobility limitation (BASMI, p = 0.033). To establish whether these findings could lead to sex differences in CV disease burden, we compared the prevalence of carotid plaques in men and women with the same level of CV risk stratified according to the Systematic Coronary Risk Evaluation (SCORE). Men included in the low-moderate CV risk SCORE category had more carotid plaques (p = 0.050), along with longer disease duration (p = 0.004), higher mSASSS (p = 0.001) and psoriasis (p = 0.023). In contrast, in the high-very high-risk SCORE category, carotid plaques were observed more frequently in women (p = 0.028), who were characterized as having worse BASFI (p = 0.011), BASDAI (p<0.001) and ASDAS (p = 0.027). CONCLUSION Disease-related features may influence the expression of atherosclerosis in patients with axSpA. This may be especially applicable to women at high CV risk, characterized by greater disease severity and more severe subclinical atherosclerosis than men, suggesting a stronger interaction between disease activity and atherosclerosis in women with axSpA.
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Affiliation(s)
- Iván Ferraz-Amaro
- Rheumatology Division, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Fernanda Genre
- IDIVAL, Research group on genetic epidemiology and atherosclerosis in systemic diseases and inmetabolic bone diseases of the musculoskeletal system, Santander, Spain
| | - Ricardo Blanco
- IDIVAL, Research group on genetic epidemiology and atherosclerosis in systemic diseases and inmetabolic bone diseases of the musculoskeletal system, Santander, Spain; Rheumatology Division, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Alfonso Corrales
- IDIVAL, Research group on genetic epidemiology and atherosclerosis in systemic diseases and inmetabolic bone diseases of the musculoskeletal system, Santander, Spain; Rheumatology Division, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Iñigo González Mazón
- Rheumatology Division, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Virginia Portilla
- Rheumatology Division, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - Cristina Mata
- Rheumatology Division, Hospital Comarcal de Laredo, Laredo, Spain
| | | | | | - Carlos Rodríguez-Lozano
- Rheumatology Division, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | | | | | - Santos Castañeda
- Rheumatology Division, Hospital Universitario de La Princesa, IIS-Princesa, Madrid, Spain
| | - Esther F Vicente
- Rheumatology Division, Hospital Universitario de La Princesa, IIS-Princesa, Madrid, Spain
| | | | - M Paz Martínez-Vidal
- Rheumatology Division, Hospital General Universitario de Alicante, Alicante, Spain
| | - David Castro-Corredor
- Rheumatology Division, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | | | - Diana Peiteado
- Rheumatology Division, Hospital Universitario La Paz, Madrid, Spain
| | | | | | | | | | | | | | | | - Miguel Ángel González-Gay
- IDIVAL and Department of Medicine and Psychiatry, School of Medicine, Universidad de Cantabria, Santander, Spain; Rheumatology Division, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Javier Rueda-Gotor
- IDIVAL, Research group on genetic epidemiology and atherosclerosis in systemic diseases and inmetabolic bone diseases of the musculoskeletal system, Santander, Spain; Rheumatology Division, Hospital Sierrallana, Torrelavega, Spain.
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10
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Fernández-Fernández L, Goujat-Salas J, Ceballos-Malagón C, Tejero-Mas M, Pérez-Caballero FL, Buitrago-Ramírez F. Prevalence by health areas of chronic kidney disease in the diabetic population of Extremadura in 2012, 2013 and 2014. An observational study. Nefrologia 2023; 42:704-713. [PMID: 36858876 DOI: 10.1016/j.nefroe.2023.02.005] [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: 10/22/2020] [Accepted: 04/25/2021] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Diabetes mellitus is the leading cause of chronic kidney disease (CKD) in our country. The objective was to estimate the global prevalence and by health areas of CKD in the diabetic population of Extremadura. METHODS Observational, longitudinal retrospective study in the diabetic population attended in the Extremadura Health System in 2012-2014. A total of 90,709 patients ≥18 years old were studied. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). The presence of CKD was was defined as follows: an eGFR <60ml/min/1.73m2 in a time period≥of three months or the presence of renal damage, as evaluated by an urine albumin-creatinine ratio (UACR) ≥30mg/g, with or without reduced eGFR, also in a time period ≥ of three months. RESULTS The overall prevalence of CKD was 15.6% (17.5% in women and 13.7% in men) and it was higher in the province of Cáceres (17.0%) than in Badajoz (14.8%, p<0.001), with the lowest prevalence in the Navalmoral de la Mata health area (13.0%) and the highest in Plasencia (17.8%, p<0.001). The prevalence of CKD defined without the need for confirmation of the sustainability of kidney damage or decreased eGFR was 26.1% (29.3% in women and 22.9% in men), which represents an overestimation of the prevalence of 67%. CONCLUSIONS The prevalence of CKD in Extremadura's diabetic population is lower than usually referred to and differs significantly between its health areas.
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Affiliation(s)
| | - Javier Goujat-Salas
- Centro de Salud Obispo Paulo (Urbano 3), Servicio Extremeño de Salud, Mérida, Badajoz, Spain.
| | - Carmen Ceballos-Malagón
- Centro de Salud Obispo Paulo (Urbano 3), Servicio Extremeño de Salud, Mérida, Badajoz, Spain.
| | - Manuel Tejero-Mas
- Centro de Salud de Don Benito Oeste, Servicio Extremeño de Salud, Don Benito, Badajoz, Spain.
| | | | - Francisco Buitrago-Ramírez
- Centro de Salud Universitario "La Paz", Servicio Extremeño de Salud, Facultad de Medicina, Universidad de Extremadura, Badajoz, Spain.
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11
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Dev R, Adams AM, Raparelli V, Norris CM, Pilote L. Sex and Gender Determinants of Vascular Disease in the Global Context. Can J Cardiol 2022; 38:1799-1811. [PMID: 35667597 DOI: 10.1016/j.cjca.2022.05.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/17/2022] [Accepted: 05/29/2022] [Indexed: 12/14/2022] Open
Abstract
Globally, vascular diseases are a leading cause of morbidity and mortality. Many of the most significant risk factors for vascular disease have a gendered dimension, and sex differences in vascular diseases incidence are apparent, worldwide. In this narrative review, we provide a contemporary picture of sex- and gender-related determinants of vascular disease. We illustrate key factors underlying sex-specific risk stratification, consider similarities and sex differences in vascular disease risk and outcomes with comparisons of data from the global North (ie, developed high-income countries in the Northern hemisphere and Australia) and the global South (ie, regions outside Europe and North America), and explore the relationship between country-level gendered inequities in vascular disease risk and the United Nation's gender inequality index. Review findings suggest that the rising incidence of vascular disease in women is partly explained by an increase in the prevalence of traditional risk factors linked to gender-related determinants such as shifting roles and relations related to the double burden of employment and caregiving responsibilities, lower educational attainment, lower socioeconomic status, and higher psychosocial stress. Social isolation partly explained the higher incidence of vascular disease in men. These patterns were apparent across the global North and South. Study findings emphasize the necessity of taking into account sex differences and gender-related factors in the determination of the vascular disease risk profiles and management strategies. As we move toward the era of precision medicine, future research is needed that identifies, validates, and measures gender-related determinants and risk factors in the global South.
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Affiliation(s)
- Rubee Dev
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada; Faculty of Applied Science, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alayne M Adams
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Colleen M Norris
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada; Faculty of Medicine and School of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada; Cardiovascular and Stroke Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada
| | - Louise Pilote
- Divisions of General Internal Medicine and Clinical Epidemiology, Department of Medicine, McGill University, Montreal, Quebec, Canada; Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, Quebec, Canada.
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12
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Ruiz-García A, Arranz-Martínez E, Morales-Cobos LE, García-Álvarez JC, Iturmendi-Martínez N, Rivera-Teijido M. Prevalence rates of overweight and obesity and their associations with cardiometabolic and renal factors. SIMETAP-OB study. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2022; 34:291-302. [PMID: 35618556 DOI: 10.1016/j.arteri.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Excess weight is a major health problem. Aims of this study were to determine the prevalence rates of overweight and obesity, and to compare their associations with cardiometabolic and renal risk factors between obese and non-obese populations, and between overweight and non-overweight populations. METHODS Cross-sectional observational study conducted in Primary Care. Population-based random sample: 6,588 study subjects between 18 and 102 years of age (response rate: 66%). Crude and sex- and age-adjusted prevalence rates of overweight and obesity were calculated, and their associations with cardiometabolic and renal variables were assessed by bivariate and multivariate analysis. RESULTS The age- and sex-adjusted prevalence rates of overweight and obesity were 36.0% (42.1% in men; 33.1% in women) and 25.0% (26.2% in men; 24.5% in women), respectively. These prevalences increased with age, and were higher in men than in women. Fifty-two percent (95%CI: 50.0-53.9) of the overweight population and 62.3% (95%CI: 60.1-64.5) of the obese population had a high or very high cardiovascular risk. Abdominal obesity, physical inactivity, prediabetes, hypertension, hypertriglyceridemia, and low HDL-C were independently associated with both entities. Furthermore, diabetes was independently associated with overweight and hypercholesterolemia with obesity. CONCLUSIONS The prevalence of overweight and obesity was 61.0% (68.4% in men and 59.0% in women). More than half of the overweight population and nearly two-thirds of the obese population had a high cardiovascular risk. Hyperglycemia, physical inactivity, hypertension, hypercholesterolemia, low HDL-C, and hypertriglyceridemia were independently associated with overweight and obesity.
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Affiliation(s)
- Antonio Ruiz-García
- Lipids and Cardiovascular Prevention Unit, Pinto University Health Center, Pinto, Madrid, Spain.
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13
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Cayuela A, Cayuela L, Ortega Belmonte MJ, Rodríguez-Domínguez S, Escudero-Martínez I, González A. Has stroke mortality stopped declining in Spain? Neurologia 2022; 37:550-556. [PMID: 31780318 DOI: 10.1016/j.nrl.2019.06.001] [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: 05/02/2018] [Revised: 05/06/2019] [Accepted: 06/20/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To analyse the changes in stroke mortality trends in Spain by autonomous community and by sex during the period 1980-2016, using joinpoint regression models. METHODS Mortality data were obtained from the Spanish National Statistics Institute. Crude and standardised rates were calculated for each Spanish autonomous community, and for each sex. Joinpoint analysis was used to identify the best-fitting points showing a statistically significant change in the trend. RESULTS Joinpoint analysis enabled us to differentiate between communities in which mortality rates showed a continuous decline throughout the study period in both sexes (Asturias, Cantabria, Castile and Leon, Ceuta, and Melilla) or in men only (Extremadura). In men, in all those communities in which changes in the trend were observed (all but Aragon, the Balearic Islands, and Murcia, where rates remained stable), we observed an initial period of decline (ranging from -3.4% in Catalonia and Extremadura, to -6.0% in Madrid) and a final period where the trends diverged: mortality rates continued to fall in Andalusia, Aragon, the Balearic Islands, and Madrid, but began to stabilise in Castile-La Mancha and Murcia and to increase in the Canary Islands. In women, in those communities where changes were observed (all but Aragon, Murcia, and the Basque Country, where rates remained stable), we observed an initial period of decline (ranging from -3.1% in Catalonia to -6.4% in Navarre) and a final period where divergent trends were observed: rates continued to decline in Andalusia, Aragon, Catalonia, Galicia, Madrid, and the Basque Country, but began to stabilise in Extremadura and Murcia and to increase in the Canary Islands. CONCLUSIONS Current data show that stroke mortality rates have decreased (in women in Andalusia), stabilised (in both sexes in Murcia, in men in Castile-La Mancha, and in women in Extremadura), and have even reversed (in both sexes in the Canary Islands). Further study is needed to identify the causes of these trends.
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Affiliation(s)
- A Cayuela
- Unidad de Gestión Clínica de Salud Pública, Prevención y Promoción de la Salud, Hospital de Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, España.
| | - L Cayuela
- Departamento de Medicina Interna, Hospital Severo Ochoa, Leganés, Madrid, España
| | - M J Ortega Belmonte
- Unidad de Gestión Clínica de Salud Pública, Prevención y Promoción de la Salud, Hospital de Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, España
| | | | - I Escudero-Martínez
- Unidad de Ictus, Unidad de Gestión Clínica de Neurociencias, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - A González
- Servicio de Neurorradiología Intervencionista, Hospital Universitario Virgen del Rocío, Sevilla, España
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14
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Stable Gender Gap and Similar Gender Trend in Chronic Morbidities between 1997-2015 in Adult Canary Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159404. [PMID: 35954761 PMCID: PMC9368162 DOI: 10.3390/ijerph19159404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/24/2022] [Accepted: 07/29/2022] [Indexed: 01/25/2023]
Abstract
There is little information about the trend of the gender gap in chronic morbidities and whether the trend of expansion occurs equally in the age and gender groups. The objectives were to examine the consistency and stability of the gender gap in the main self-reported chronic morbidities in the general population, and, likewise, to analyze the trend of major chronic morbidities between 1997 and 2015 in men and women across age groups. The data were extracted from the Canary Health Survey, which uses a probabilistic sampling in the population >16 years of age, for the years 1997 (n = 2167), 2004 (n = 4304), 2009 (n = 4542), and 2015 (n = 4560). The data for the twelve most frequent chronic morbidities were analyzed using logistic regression, estimating the annual change ratio between 1997 and 2015, adjusting for age and educational level. The interaction of age with the period (1997−2015) was examined to analyze the rate of change for each morbidity in the age groups. Musculoskeletal diseases, headaches, anxiety and depression, and peripheral vascular diseases showed a stable gender gap across observed years. High cholesterol and high blood pressure tended to a gap reduction, while heart disease, diabetes, and respiratory disease did not show a significant gender gap along the period. The trend of the main chronic morbidities increased similarly in men and women in all age groups, but significantly in women older than 60 years and in men older than 45 years. Aging explained a substantial part of the trend of increasing prevalence of the main chronic morbidities, but not totally. Factors other than age and education are driving the increase in chronic morbidity in older age groups.
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15
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Martin-Baranera M. Cardiovascular research and population-based prospective cohort studies: as time goes by. HIPERTENSION Y RIESGO VASCULAR 2022; 39:101-104. [DOI: 10.1016/j.hipert.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 12/01/2022]
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16
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[Deprescription in old people: It's time to take action]. Aten Primaria 2022; 54:102367. [PMID: 35653980 PMCID: PMC9160471 DOI: 10.1016/j.aprim.2022.102367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 12/02/2022] Open
Abstract
El uso de fármacos conlleva innegables beneficios en las personas mayores, pero no está exento de efectos indeseables. La deprescripción es el proceso de revisión sistemática de la medicación con el objetivo de lograr la mejor relación riesgo-beneficio en base a la mejor evidencia disponible. Este proceso es especialmente importante en mayores polimedicados, sobretratados, frágiles, con enfermedades terminales y en el final de la vida. La deprescripción debe hacerse de forma escalonada, estableciendo un seguimiento estrecho por si aparecen problemas tras la retirada. En la toma de decisiones es muy importante contar con la opinión del paciente y de los cuidadores, valorando los objetivos del tratamiento según la situación clínica, funcional y social del enfermo. Existen múltiples herramientas para facilitar a los clínicos la tarea de seleccionar qué fármacos deprescribir (criterios Beers, STOPP-START…). Los grupos farmacológicos más susceptibles de intervención son: antihipertensivos, antidiabéticos, estatinas, benzodiacepinas, antidepresivos, anticolinérgicos, anticolinesterásicos y neurolépticos.
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Hypertension: The most common chronic health problem in Spain. A call to action. HIPERTENSION Y RIESGO VASCULAR 2022; 39:121-127. [DOI: 10.1016/j.hipert.2022.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 11/23/2022]
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18
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Camps-Vilaró A, Pérez-Fernández S, Subirana I, Teira R, Estrada V, Domingo P, Dégano IR, Marrugat J. Standardized Comparison of Cardiovascular Risk Factors Prevalence in Spanish Women and Men Living with HIV and in the General Population. J Pers Med 2021; 11:jpm11111085. [PMID: 34834438 PMCID: PMC8621654 DOI: 10.3390/jpm11111085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/20/2021] [Accepted: 10/23/2021] [Indexed: 11/16/2022] Open
Abstract
People living with HIV (PLWH) have an increased risk of cardiovascular (CV) disease, likely due to a higher prevalence of CV risk factors. We compared the age-standardized prevalence and management of CV risk factors in PLWH to that of the general population in Spain. Blood pressure, lipid, glucose, and anthropometric profiles were cross-sectionally compared along with the treatment of hypertension, dyslipidemia, and diabetes in a general population cohort and a PLWH cohort. Prevalence rates were standardized by the direct method by 10-year age groups in European standard populations and stratified by gender. We included 47,593 individuals aged 35 to 74 years, 28,360 from the general population cohort and 19,233 from the PLWH cohort. Compared to the general population, PLWH had a higher concentration of triglycerides (>35 mg/dL in women and >26 mg/dL in men) and a higher prevalence of smoking (>23% and >17%) and diabetes (>9.9% and >8.5%). The prevalence of treated diabetes, hypertension, and dyslipidemia were up to three-fold lower in both women and men living with HIV. There was a significant difference in PLWH compared to the general population in the lipid, glucose, and anthropometric profile. In addition, PLWH were less often treated for diagnosed diabetes, hypertension, and dyslipidemia.
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Affiliation(s)
- Anna Camps-Vilaró
- REGICOR Study Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona Biomedical Research Park (PRBB), Dr. Aiguader 88, 08003 Barcelona, Spain; (A.C.-V.); (S.P.-F.); (I.S.)
- CIBER of Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Silvia Pérez-Fernández
- REGICOR Study Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona Biomedical Research Park (PRBB), Dr. Aiguader 88, 08003 Barcelona, Spain; (A.C.-V.); (S.P.-F.); (I.S.)
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
| | - Isaac Subirana
- REGICOR Study Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona Biomedical Research Park (PRBB), Dr. Aiguader 88, 08003 Barcelona, Spain; (A.C.-V.); (S.P.-F.); (I.S.)
- CIBER of Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Ramon Teira
- Infectious Diseases Unit, Hospital Sierrallana, 39300 Torrelavega, Spain;
| | - Vicente Estrada
- Infectious Diseases Unit, Hospital Clínico San Carlos, 28040 Madrid, Spain;
| | - Pere Domingo
- Department of Infectious Diseases, Hospital de la Santa Creu i Sant Pau, Institut de Recerca del Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain;
| | - Irene R. Dégano
- REGICOR Study Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona Biomedical Research Park (PRBB), Dr. Aiguader 88, 08003 Barcelona, Spain; (A.C.-V.); (S.P.-F.); (I.S.)
- CIBER of Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Faculty of Medicine, University of Vic-Central University of Catalonia (UVic-UCC), 08500 Vic, Spain
- Correspondence: (I.R.D.); (J.M.); Tel.: +34-9-3316-0714 (I.R.D.); +34-9-3316-0733 (J.M.); Fax: +34-9-3316-0796 (I.R.D. & J.M.)
| | - Jaume Marrugat
- REGICOR Study Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona Biomedical Research Park (PRBB), Dr. Aiguader 88, 08003 Barcelona, Spain; (A.C.-V.); (S.P.-F.); (I.S.)
- CIBER of Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: (I.R.D.); (J.M.); Tel.: +34-9-3316-0714 (I.R.D.); +34-9-3316-0733 (J.M.); Fax: +34-9-3316-0796 (I.R.D. & J.M.)
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[Incidence of ischemic heart disease in the HERMEX study and its association with classical cardiovascular risk factors]. Semergen 2021; 48:88-95. [PMID: 34702607 DOI: 10.1016/j.semerg.2021.09.007] [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: 06/21/2021] [Revised: 09/06/2021] [Accepted: 09/11/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Knowledge about the incidence of coronary heart disease in our country is scarce and its sources are not comparable. Our aim was to determine the incidence of ischemic heart disease in a population cohort in a 7 years of follow-up, as well as the risk associated with the different classical cardiovascular risk factors. METHODS Cohort study with a population sample of 2833 subjects, selected by the simple random method in a population between 25 and 79, from the Don Benito - Villanueva de la Serena (Badajoz) health area, response rate was 80.5%. All episodes of angina pectoris, lethal and non-lethal myocardial infarction were collected in individuals with no previous history of cardiovascular disease. Cumulative incidences and incidence rates adjusted per 100,000 person-years by sex and overall were calculated. RESULTS From 2833 initial cohort participants, 103 were excluded due to a history of cardiovascular disease and 61 for losses, 2669 completed the follow-up (94.2%). The median follow-up was 6.9 years (IR 6.5-7.5), 56.4% women; 59 events were recorded. The overall incidence rate of ischemic heart disease was 327 cases/100,000 person-years, corresponding to 470 cases/100,000 for men and 211 cases/100,000 people-years for women. The classical cardiovascular risk factors that were associated with a higher risk of presenting events in the follow-up were dyslipidemia and arterial hypertension, in addition to male sex and age. CONCLUSIONS The incidence of ischemic heart disease in the urban-rural population of Extremadura is high. The classical cardiovascular risk factors most strongly associated with events were dyslipidemia, and arterial hypertension.
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Tendencias de mortalidad prematura por cardiopatía isquémica en España durante el periodo 1998-2018. Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Fernández-Fernández L, Goujat-Salas J, Ceballos-Malagón C, Tejero-Mas M, Pérez-Caballero FL, Buitrago-Ramírez F. Prevalencia por áreas sanitarias de enfermedad renal crónica en la población diabética de Extremadura durante los años 2012, 2013 y 2014. Un estudio observacional. Nefrologia 2021. [DOI: 10.1016/j.nefro.2021.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Cayuela A, Cayuela L, Ortega Belmonte MJ, Rodríguez-Domínguez S, Escudero-Martínez I, González A. Has stroke mortality stopped declining in Spain? NEUROLOGÍA (ENGLISH EDITION) 2021; 37:550-556. [PMID: 34521606 DOI: 10.1016/j.nrleng.2019.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 06/20/2019] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To analyse the changes in stroke mortality trends in Spain by autonomous community and by sex during the period 1980-2016, using joinpoint regression models. METHODS Mortality data were obtained from the Spanish National Statistics Institute. Crude and standardised rates were calculated for each Spanish autonomous community, and for each sex. Joinpoint analysis was used to identify the best-fitting points showing a statistically significant change in the trend. RESULTS Joinpoint analysis enabled us to differentiate between communities in which mortality rates showed a continuous decline throughout the study period in both sexes (Asturias, Cantabria, Castile and Leon, Ceuta, and Melilla) or in men only (Extremadura). In men, in all those communities in which changes in the trend were observed (all but Aragon, the Balearic Islands, and Murcia, where rates remained stable), we observed an initial period of decline (ranging from -3.4% in Catalonia and Extremadura, to -6.0% in Madrid) and a final period where the trends diverged: mortality rates continued to fall in Andalusia, Aragon, the Balearic Islands, and Madrid, but began to stabilise in Castile-La Mancha and Murcia and to increase in the Canary Islands. In women, in those communities where changes were observed (all but Aragon, Murcia, and the Basque Country, where rates remained stable), we observed an initial period of decline (ranging from -3.1% in Catalonia to -6.4% in Navarre) and a final period where divergent trends were observed: rates continued to decline in Andalusia, Aragon, Catalonia, Galicia, Madrid, and the Basque Country, but began to stabilise in Extremadura and Murcia and to increase in the Canary Islands. CONCLUSIONS Current data show that stroke mortality rates have decreased (in women in Andalusia), stabilised (in both sexes in Murcia, in men in Castile-La Mancha, and in women in Extremadura), and have even reversed (in both sexes in the Canary Islands). Further study is needed to identify the causes of these trends.
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Affiliation(s)
- A Cayuela
- Unidad de Gestión Clínica de Salud Pública, Prevención y Promoción de la Salud, Hospital de Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, Spain.
| | - L Cayuela
- Departamento de Medicina Interna, Hospital Severo Ochoa, Leganés, Madrid, Spain
| | - M J Ortega Belmonte
- Unidad de Gestión Clínica de Salud Pública, Prevención y Promoción de la Salud, Hospital de Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, Spain
| | | | - I Escudero-Martínez
- Unidad de Ictus, Unidad de Gestión Clínica de Neurociencias, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - A González
- Servicio de Neurorradiología Intervencionista, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Cayuela L, Gómez Enjuto S, Olivares Martínez B, Rodríguez-Domínguez S, Cayuela A. Is the pace of decline in cardiovascular mortality decelerating in Spain? REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2021; 74:750-756. [PMID: 33115628 DOI: 10.1016/j.rec.2020.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/16/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION AND OBJECTIVES To update the information on mortality from cardiovascular diseases and assess recent trends in Spain. METHODS Deaths from cardiovascular diseases (codes I20-I25, I50, I05-I09, I00-I02, I26-I49, I51, I52, I60-I69, I10-I15, and I70-I79 of the 10th revision of the International Classification of Diseases and Causes of Death) were obtained from the National Statistics Institute. Trends were analyzed using Joinpoint regression models. The results revealed the years (periods) composing each trend, as well as the annual percent change for each of them. The direction and magnitude of recent trends (last available 5-year period) were assessed by using the average annual percent change. RESULTS The decline in mortality rates from cardiovascular diseases slowed from -3.7% and -4.0% in 1999-2013 to -1.7% and -2.2% since 2013 in men and women, respectively. During the study period (1999-2018) all the analyzed causes decreased significantly. Nevertheless, recent trends differed according to age, sex, and the cause analyzed. Truncated rates (35-64 years) slowed (cardiovascular disease and stroke in men and ischemic heart disease in both sexes), stabilized (cardiovascular disease, stroke, and other heart diseases in women, and blood vessel disease in men), or increased (other diseases of the heart in men and diseases of the blood vessels in women). CONCLUSIONS In Spain, as in other countries, the reduction in mortality rates from cardiovascular diseases slowed (overall rates for both sexes and truncated in men) or stabilized (truncated rates in women) from 2014 to 2018.
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Affiliation(s)
- Lucía Cayuela
- Departamento de Medicina Interna, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - Sara Gómez Enjuto
- Servicio de Neurología, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | | | | | - Aurelio Cayuela
- Unidad de Salud Pública, Prevención y Promoción de la Salud, Área de Gestión Sanitaria Sur de Sevilla, Seville, Spain
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Cayuela L, Gómez Enjuto S, Olivares Martínez B, Rodríguez-Domínguez S, Cayuela A. ¿Se está desacelerando el ritmo de disminución de la mortalidad cardiovascular en España? Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.07.017] [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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Llisterri-Caro JL, Turégano-Yedro M, Cinza-Sanjurjo S, Segura-Fragoso A, Sánchez-Sánchez B, Cubelos-Fernández N, Velilla-Zancada S, Micó-Pérez RM, Martín-Sánchez V. [Factors associated with the optimum simultaneous control of diabetes, arterial hypertension and hypercholesterolemia in the diabetic population. BPC Diabetes study]. Semergen 2021; 48:225-234. [PMID: 34479796 DOI: 10.1016/j.semerg.2021.07.012] [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: 06/09/2021] [Revised: 07/12/2021] [Accepted: 07/26/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To know the degree of simultaneous optimal control of diabetes (DM), high blood pressure (BP) and hypercholesterolemia and determine the associated factors. MATERIAL AND METHOD Cross-sectional descriptive study in diabetic patients 18 years aged or older selected consecutively in primary care centers (PC). Patient data were obtained through access to electronical clinical history. Clinical and analytical variables of interest were registered. Good metabolic control was considered as HbA1c < 7%, good blood pressure control (PA) as values < 140/80 mmHg and good LDL cholesterol control (c-LDL) as values < 100 mg/dL. Bivariate analysis was performed and odds ratio were calculated in a logistic regression model. The study was approved by the San Carlos Clinical Hospital's Clinical Research Ethics Committee (CREC), in Madrid. RESULTS 1420 patients (55.8% male), with an average (SD) age of 70.6 (10.8) years were included. 75.9% were hypertensive patients, and 69.1% dyslipemic. HbA1c values were 6.9 (1.2) %, sistolic BP 135.0 (16.8) mmHg, diastolic BP 75.9 (10.6) mmHg and LDL-cholesterol 93.7 (32.8) mg/dL. Good metabolic control of DM was achieved at 63.0% (95% CI: 60.4-65.5), good control of HTA at 42.6% (95% CI: 40.0-45.2) and good LDL cholesterol control in 61.1% (95% IC: 58.4-63.7) of patients. Good simultaneous control of the three cardiovascular risk factors (CVRF) was reached at 16.1% (95% CI: 14.2-18.1). A positive and independent association (p<0.05) was observed between good simultaneous control of CVRF with age (OR: 1.017) and with personal history of cardiovascular disease (OR: 1.596). CONCLUSIONS The results of our study indicate that a small proportion, less than two out of 10 patients, meet the good control goals recommended by clinical practice guidelines. We found important differences between patients with and without cardiovascular disease.
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Affiliation(s)
| | | | - S Cinza-Sanjurjo
- Centro de Salud Porto do Son, Área Sanitaria de Santiago de Compostela, A Coruña, España
| | - A Segura-Fragoso
- Universidad de Castilla-La Mancha, Facultad de Ciencias de la Salud, Talavera de la Reina, Toledo, España
| | | | | | | | - R M Micó-Pérez
- Consultorio Fontanars dels Alforins, Departamento de Salud de Xàtiva-Ontinyent, Valencia, España
| | - V Martín-Sánchez
- Instituto de Biomedicina (IBIOMED), Universidad de León, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), León, España
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Muerte súbita relacionada con la actividad deportiva en España. Estudio poblacional multicéntrico forense de 288 casos. Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.05.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Aguilar-Palacio I, Malo S, Jarauta E, Moreno-Franco B, Maldonado L, Compés L, Rabanaque MJ, Casasnovas JA. Pharmacological Primary Cardiovascular Prevention and Subclinical Atherosclerosis in Men: Evidence from the Aragon Workers' Health Study. J Clin Med 2021; 10:jcm10050945. [PMID: 33804382 PMCID: PMC7957801 DOI: 10.3390/jcm10050945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/09/2021] [Accepted: 02/18/2021] [Indexed: 11/16/2022] Open
Abstract
The objective of this study is to describe the profile of primary preventive treatment for cardiovascular disease in adult males and to analyze the association between treatment profile and subclinical atherosclerosis. We selected male workers who had undergone ultrasound imaging and had no previous history of cardiovascular disease (n = 2138). Data on the consumption of primary cardiovascular drugs from the previous year were obtained. We performed bivariate analyses to compare patient characteristics according to cardiovascular treatment and the presence of subclinical atherosclerosis, and logistic regression models to explore the association between these two variables. Among participants with no personal history of cardiovascular disease, subclinical atherosclerosis was present in 77.7% and 31.2% had received some form of preventive treatment. Of those who received no preventive treatment, 73.6% had subclinical atherosclerosis. Cardiovascular preventive treatment was associated only with CACS > 0 (odds ratio (OR), 1.37; 95% confidence interval (95% CI), 1.06-1.78). Statin treatment was associated with a greater risk of any type of subclinical atherosclerosis (OR, 1.73) and with CACS > 0 (OR, 1.72). Subclinical atherosclerosis existed in almost 75% of men who had no personal history of cardiovascular disease and had not received preventive treatment for cardiovascular disease.
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Affiliation(s)
- Isabel Aguilar-Palacio
- Preventive Medicine and Public Health Department, University of Zaragoza, 50009 Zaragoza, Spain; (I.A.-P.); (B.M.-F.); (M.J.R.)
- Instituto Aragonés de Ciencias de Salud, IIS Aragón, 50009 Zaragoza, Spain; (E.J.); (J.A.C.)
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA) IIS Aragón, 50009 Zaragoza, Spain;
| | - Sara Malo
- Preventive Medicine and Public Health Department, University of Zaragoza, 50009 Zaragoza, Spain; (I.A.-P.); (B.M.-F.); (M.J.R.)
- Instituto Aragonés de Ciencias de Salud, IIS Aragón, 50009 Zaragoza, Spain; (E.J.); (J.A.C.)
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA) IIS Aragón, 50009 Zaragoza, Spain;
- Correspondence:
| | - Estibaliz Jarauta
- Instituto Aragonés de Ciencias de Salud, IIS Aragón, 50009 Zaragoza, Spain; (E.J.); (J.A.C.)
- Hospital Universitario Miguel Servet, IIS Aragón, 50009 Zaragoza, Spain
| | - Belén Moreno-Franco
- Preventive Medicine and Public Health Department, University of Zaragoza, 50009 Zaragoza, Spain; (I.A.-P.); (B.M.-F.); (M.J.R.)
- Instituto Aragonés de Ciencias de Salud, IIS Aragón, 50009 Zaragoza, Spain; (E.J.); (J.A.C.)
| | - Lina Maldonado
- Department of Economic Structure, Economic History and Public Economics, University of Zaragoza, 50009 Zaragoza, Spain;
| | - Luisa Compés
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA) IIS Aragón, 50009 Zaragoza, Spain;
- Dirección General de Salud Pública, Gobierno de Aragón, 50009 Zaragoza, Spain
| | - Mª José Rabanaque
- Preventive Medicine and Public Health Department, University of Zaragoza, 50009 Zaragoza, Spain; (I.A.-P.); (B.M.-F.); (M.J.R.)
- Instituto Aragonés de Ciencias de Salud, IIS Aragón, 50009 Zaragoza, Spain; (E.J.); (J.A.C.)
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA) IIS Aragón, 50009 Zaragoza, Spain;
| | - José Antonio Casasnovas
- Instituto Aragonés de Ciencias de Salud, IIS Aragón, 50009 Zaragoza, Spain; (E.J.); (J.A.C.)
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Calvo-Hueros JI, Cañón-Barroso L, Morales-Gabardino JA, Buitrago F. Cardiovascular risk and validation of cardiovascular risk prediction functions in a cohort of patients with type 2 diabetes followed for 10 years in Badajoz (SPAIN). AN observational study. Prim Care Diabetes 2021; 15:115-120. [PMID: 32811775 DOI: 10.1016/j.pcd.2020.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/22/2020] [Accepted: 07/26/2020] [Indexed: 11/19/2022]
Abstract
AIMS To analyse whether diabetes behaves as an equivalent of coronary risk and assess the performance of the original and REGICOR Framingham functions in a cohort of patients with type 2 diabetes observed for 10 years in primary care practices in Badajoz, Spain. METHODS Observational, longitudinal study. A total of 643 patients (mean age 64.0 years, 55.7% women), without evidence of cardiovascular disease were studied. We assessed the incidence of cardiovascular events and the patients' 10-year coronary risk predicted-values at the time of their recruitment. RESULT The actual incidence rate of coronary events was 14.5% (15.1% in women and 13.7% in men, p = 0.616). Patients who suffered coronary events were older (66.3 vs 63.6 years, p < 0.05), had higher total cholesterol (236.3 vs 219.5 mg/dl, p < 0.01), fasting plasma glucose levels (177.6 vs 159.8 mg/dl, p < 0.01), glycated haemoglobin (7.3 vs 6.7%, p < 0.05) and also higher prevalence of high blood pressure, dyslipidemia and chronic renal disease. The original Framingham equation overpredicted risk by 88%, whereas the REGICOR Framingham function underpredicted risk by 24%. CONCLUSIONS Diabetes in our cohort does not behave as a coronary heart disease equivalent and both the original and REGICOR Framingham coronary risk functions have little utility in a diabetic population.
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Affiliation(s)
| | | | | | - Francisco Buitrago
- Centro de Salud Universitario "La Paz", Unidad Docente de Medicina Familiar y Comunitaria, Facultad de Medicina, Universidad de Extremadura, Servicio Extremeño de Salud, Badajoz, Spain.
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Trends in premature mortality due to ischemic heart disease in Spain from 1998 to 2018. ACTA ACUST UNITED AC 2021; 74:838-845. [PMID: 33402321 DOI: 10.1016/j.rec.2020.09.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 09/15/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION AND OBJECTIVES Ischemic heart disease (IHD) is the leading cause of death and one of the leading causes of disability. The aim of this study was to analyze trends in premature mortality due to IHD in patients younger than 75 years in Spain from 1998 to 2018 by region. METHODS Observational study of temporal trends in premature mortality due to IHD in Spain by region and sex from 1998 to 2018. The study population included resident citizens aged between 0 and 74 years. The data sources were the continuous population register and the mortality registry of the National Institute of Statistics. We calculated age-adjusted mortality rates and their average annual percent change estimated by Poisson models. RESULTS During the study period, mortality rates due to IHD decreased, both in the country as a whole and by provinces (53% in men and 61% in women), with an average annual percent change of -3.92% and -5.07%, respectively. In the first year (1998), mortality was unequally distributed among provinces, with higher mortality in the south of Spain. CONCLUSIONS Premature mortality due to IHD significantly decreased in Spain during the study period in both sexes to roughly half of initial cases. This decrease was statistically significant in almost all regions. Interprovincial differences in mortality and their variation also decreased in recent years.
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Ruiz-García A, Arranz-Martínez E, García-Fernández ME, Cabrera-Vélez R, García-Pliego RA, Morales-Cobos LE, Sanz-Pozo B, Gómez-Díaz E, Rodríguez-de-Mingo E, Rico-Pérez MR, Migueláñez-Valero A, Calderín-Morales MP, Sandín-de-Vega E, Hombrados-Gonzalo MP, Luna-Ramírez S, Sánchez-Ramos MC, Mora-Casado C, Moreno-Muñoz MS, González-Escobar P, Ruiz-Díaz L, Caballero-Ramírez N, Zamora-Gómez MM, Iturmendi-Martínez N, Holgado-Catalán MS, Álvarez-Benedicto R, Sanchidriá-Fernández PL, Benito-Alonso E, Fernández-Vicente T, Hernández-López RM, Doria-Carlin NA, Frías-Vargas MJ. Related cardiometabolic factors and prevalence of low HDL-cholesterol levels and atherogenic dyslipidemia. SIMETAP-AD study. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2021; 33:19-29. [PMID: 33082056 DOI: 10.1016/j.arteri.2020.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/05/2020] [Accepted: 06/15/2020] [Indexed: 06/11/2023]
Abstract
AIM To determine the crude and sex- and age-adjusted prevalence rates of atherogenic dyslipidemia (AD) and low HDL-cholesterol levels (low-HDLc), and to assess their associations with cardiovascular risk factors, chronic kidney disease, cardiovascular and cardiometabolic diseases. METHODS Population-based cross-sectional study conducted in Primary Care, with randomly selected adult subjects. The AD was considered if the patients had hypertriglyceridemia (triglycerides≥150mg/dL) and low-HDLc (<40mg/dL [men];<50mg/dL [women]). Crude and sex- and age-adjusted prevalence rates were determined, and univariate and multivariate analysis were performed to assess related cardiometabolic factors. RESULTS Study population with 6,588 adults (55.9% women) with mean age 55.1 (±17.5) years. The mean HDLc levels were 49.2 (±12.6) mg/dL in men and 59.2 (±14.7) mg/dL in women. The crude prevalence rates of low-HDLc and AD were 30.8% (95%CI: 29.7-31.9), and 14.3% (95%CI: 13.5-15.2), respectively. The adjusted prevalence rates of low-HDLc were 28.0% in men and 31.0% in women, and AD were 16.4% in men and 10.6% in women. Seventy-three percent of the population with AD had high or very high cardiovascular risk. The independent factors associated with low HDLc or with AD were diabetes, smoking, abdominal obesity, and obesity. The major factors associated with low HDLc and AD were hypertriglyceridemia and diabetes, respectively. CONCLUSIONS Almost a third of the adult population had low HDL-C and half of them met AD criteria. Cardiometabolic factors were associated with low HDL-C and AD, highlighting hypertriglyceridemia with low HDLc, and DM with AD.
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Affiliation(s)
- Antonio Ruiz-García
- Unidad de Lípidos y Prevención Cardiovascular, C.S. Universitario Pinto, Pinto, España.
| | | | | | | | | | | | | | | | | | - María R Rico-Pérez
- Unidad de Lípidos y Prevención Cardiovascular, C.S. Universitario Pinto, Pinto, España
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Zueras P, Rentería E. Trends in disease-free life expectancy at age 65 in Spain: Diverging patterns by sex, region and disease. PLoS One 2020; 15:e0240923. [PMID: 33175856 PMCID: PMC7657566 DOI: 10.1371/journal.pone.0240923] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 10/05/2020] [Indexed: 11/28/2022] Open
Abstract
Life expectancy in Spain is among the highest in the world. Nevertheless, we do not know if improvements in health conditions at older ages have followed postponements of death. Previous studies in Spain show a stable trend in years lived in ill health in the past. In this paper we investigate changes between 2006, 2012 and 2017 in life expectancy with and without disease at age 65 in Spain and, for the first time, in Spanish regions, which have autonomous powers of health planning, public health and healthcare. Results show that, at the country level, disease-free life expectancy reduced between 2006 and 2017 in Spain. This was explained by an expansion of most diseases except for some cardiovascular and respiratory chronic conditions. However, at the regional level the evolution was different, especially regarding each disease and sex. First, regional differences reduced between 2006 and 2012 but largely widened in 2017, suggesting that not all regions had the same ability to recover after the 2008 financial crisis that caused government cuts to health services. Second, regional analysis also highlighted diverging trends by sex. While men experienced expansion of morbidity in most regions, women experienced a compression in about half of them, ending up with women showing higher disease-free life expectancies than men in 9 out of the 17 regions considered. This study, then, calls attention to the importance of focusing the analysis of health surveillance to more disaggregated levels, more in accordance with the level of health management, as regional trends showed heterogeneity in the prevalence of diseases and different progresses in the relationship between sexes.
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Affiliation(s)
- Pilar Zueras
- Centre d'Estudis Demogràfics, Bellaterra, Barcelona, Spain
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Caro-Codón J, López-Fernández T, Álvarez-Ortega C, Zamora Auñón P, Rodríguez IR, Gómez Prieto P, Buño Soto A, Canales Albendea M, Albaladejo A, Mediavilla G, Feliu Batlle J, Rodríguez Fraga O, Martínez Monzonis A, González-Costello J, Serrano Antolín JM, Cadenas Chamorro R, González-Juanatey JR, López-Sendón J. Cardiovascular risk factors during cancer treatment. Prevalence and prognostic relevance: insights from the CARDIOTOX registry. Eur J Prev Cardiol 2020; 29:859-868. [DOI: 10.1093/eurjpc/zwaa034] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/29/2020] [Accepted: 07/30/2020] [Indexed: 12/21/2022]
Abstract
Abstract
Aims
The actual usefulness of cardiovascular (CV) risk factor assessment in the prognostic evaluation of cancer patients treated with cardiotoxic treatment remains largely unknown. Prospective multicentre study in patients scheduled to receive anticancer therapy related with moderate/high cardiotoxic risk.
Methods and results
A total of 1324 patients underwent follow-up in a dedicated cardio-oncology clinic from April 2012 to October 2017. Special care was given to the identification and control of CV risk factors. Clinical data, blood samples, and echocardiographic parameters were prospectively collected according to protocol, at baseline before cancer therapy and then at 3 weeks, 3 months, 6 months, 1 year, 1.5 years, and 2 years after initiation of cancer therapy. At baseline, 893 patients (67.4%) presented at least one risk factor, with a significant number of patients newly diagnosed during follow-up. Individual risk factors were not related with worse prognosis during a 2-year follow-up. However, a higher Systemic Coronary Risk Estimation (SCORE) was significantly associated with higher rates of severe cardiotoxicity (CTox) and all-cause mortality [hazard ratio (HR) 1.79 (95% confidence interval, CI 1.16–2.76) for SCORE 5–9 and HR 4.90 (95% CI 2.44–9.82) for SCORE ≥10 when compared with patients with lower SCORE (0–4)].
Conclusions
This large cohort of patients treated with a potentially cardiotoxic regimen showed a significant prevalence of CV risk factors at baseline and significant incidence during follow-up. Baseline CV risk assessment using SCORE predicted severe CTox and all-cause mortality. Therefore, its use should be considered in the evaluation of cancer patients.
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Affiliation(s)
- Juan Caro-Codón
- Cardiology Department, University Hospital La Paz, UAM, IdiPaz, CiberCV, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Teresa López-Fernández
- Cardiology Department, University Hospital La Paz, UAM, IdiPaz, CiberCV, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Carlos Álvarez-Ortega
- Cardiology Department, University Hospital La Paz, UAM, IdiPaz, CiberCV, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Pilar Zamora Auñón
- Oncology Department, University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Isabel Rodríguez Rodríguez
- Oncoradiotherapy Department University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Pilar Gómez Prieto
- Hematology Department University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Antonio Buño Soto
- Clinical Analytics Department University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Miguel Canales Albendea
- Hematology Department University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Ainara Albaladejo
- Cardiology Department, University Hospital La Paz, UAM, IdiPaz, CiberCV, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Guiomar Mediavilla
- Cardiology Department, University Hospital La Paz, UAM, IdiPaz, CiberCV, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Jaime Feliu Batlle
- Oncology Department, University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Olaia Rodríguez Fraga
- Clinical Analytics Department University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Amparo Martínez Monzonis
- Department of Cardiology, University Hospital of Santiago de Compostela, CiberCV, Rúa da Choupana, s/n, 15706 Santiago de Compostela, A Coruña, Spain
| | - José González-Costello
- Department of Cardiology, University Hospital of Bellvitge, Carrer de la Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain
| | - José María Serrano Antolín
- Department of Cardiology, University Hospital of Fuenlabrada, Camino del Molino, 2, 28942 Fuenlabrada, Madrid, Spain
| | - Rosalía Cadenas Chamorro
- Department of Cardiology, University Hospital Infanta Sofia, Paseo de Europa, 34, 28703 San Sebastián de los Reyes, Madrid, Spain
| | - José R González-Juanatey
- Department of Cardiology, University Hospital of Santiago de Compostela, CiberCV, Rúa da Choupana, s/n, 15706 Santiago de Compostela, A Coruña, Spain
| | - José López-Sendón
- Cardiology Department, University Hospital La Paz, UAM, IdiPaz, CiberCV, Paseo de la Castellana 261, Madrid 28046, Spain
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Orozco-Beltrán D, Brotons Cuixart C, Alemán Sánchez JJ, Banegas Banegas JR, Cebrián-Cuenca AM, Gil Guillen VF, Martín Rioboó E, Navarro Pérez J. [Cardiovascular preventive recommendations. PAPPS 2020 update]. Aten Primaria 2020; 52 Suppl 2:5-31. [PMID: 33388118 PMCID: PMC7801219 DOI: 10.1016/j.aprim.2020.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 08/14/2020] [Indexed: 12/16/2022] Open
Abstract
The recommendations of the semFYC's Program for Preventive Activities and Health Promotion (PAPPS) for the prevention of cardiovascular diseases (CVD) are presented. The following sections are included: Epidemiological review, where the current morbidity and mortality of CVD in Spain and its evolution as well as the main risk factors are described; Cardiovascular (CV) risk tables and recommendations for the calculation of CV risk; Main risk factors such as arterial hypertension, dyslipidemia and diabetes mellitus, describing the method for their diagnosis, therapeutic objectives and recommendations for lifestyle measures and pharmacological treatment; Indications for antiplatelet therapy, and recommendations for screening of atrial fibrillation. The quality of testing and the strength of the recommendation are included in the main recommendations.
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Affiliation(s)
- Domingo Orozco-Beltrán
- Unidad de Investigación CS Cabo Huertas, Departamento San Juan de Alicante, Departamento de Medicina Clínica. Universidad Miguel Hernández, España.
| | | | | | | | | | | | - Enrique Martín Rioboó
- Instituto Maimónides de Investigación Biomédica de Córdoba IMIBIC Hospital Reina Sofía. Unidad de gestión clínica Poniente. Distrito sanitario Córdoba Guadalquivir, Córdoba, España
| | - Jorge Navarro Pérez
- Hospital Clínico Universitario, Departamento de Medicina, Universidad de Valencia, Instituto de Investigación INCLIVA, Valencia, España
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Menéndez Torre EL, Ares Blanco J, Conde Barreiro S, Rojo Martínez G, Delgado Alvarez E. Prevalence of diabetes mellitus in Spain in 2016 according to the Primary Care Clinical Database (BDCAP). ENDOCRINOLOGIA, DIABETES Y NUTRICION 2020; 68:109-115. [PMID: 32988801 DOI: 10.1016/j.endinu.2019.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/29/2019] [Accepted: 12/04/2019] [Indexed: 12/25/2022]
Abstract
The prevalence of type 2 diabetes mellitus is increasing worldwide, including in Spain, and this disease has become a major challenge for health care. In Spain, the computerization of medical records in primary care, in the Primary Care Clinical Database (BDCAP), has made possible the diagnoses of diabetes in a representative sample of the nation as a whole. This article analyzes the prevalence of diabetes recorded in this database and compares the data of the different autonomous communities. The prevalence of diabetes in Spain is 6.66% of the total population assigned to primary care in the National Health System, is higher in men than in women (7.27% vs. 6.06%), and increases with age up to 80 years. There are significant differences in the adjusted prevalence of diabetes between autonomous communities, with lower prevalence rates in North and Central Spain and higher rates in the South and East, as well as the islands. The lowest prevalence is seen in Castile and Leon (4.51%), and the highest in the Canary Islands (9.72%).
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Affiliation(s)
- Edelmiro Luis Menéndez Torre
- Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, España.
| | - Jessica Ares Blanco
- Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, España
| | | | - Gemma Rojo Martínez
- Servicio de Endocrinología y Nutrición, Hospital Regional de Málaga, IBIMA, Málaga, España
| | - Elías Delgado Alvarez
- Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, España
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Effects of Eradication of HCV on Cardiovascular Risk and Preclinical Atherosclerosis in HIV/HCV-Coinfected Patients. J Acquir Immune Defic Syndr 2020; 83:292-300. [PMID: 31913996 DOI: 10.1097/qai.0000000000002260] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND To assess the effects of eradication of hepatitis C virus (HCV) on cardiovascular risk (CVR) and preclinical atherosclerosis in HIV/HCV-coinfected patients. SETTING Prospective cohort study. METHODS We assessed serum lipids, 10-year Framingham CVR scores, pulse wave velocity, carotid intima-media thickness, and biomarkers of inflammation and endothelial dysfunction (BMKs) at baseline and 96 weeks (wk) after initiation of anti-HCV therapy (Rx) in HIV/HCV-coinfected patients. RESULTS A total of 237 patients were included. Anti-HCV therapy comprised pegylated interferon and ribavirin plus 1 direct-acting antiviral in 55.2%, pegylated interferon and ribavirin in 33.8%, and all-oral direct-acting antiviral in 11.0%. A total of 147 (62.0%) patients achieved sustained viral response (SVR). Median increases in low-density lipoprotein cholesterol in patients with and without SVR were 14 mg/dL and 0 mg/dL (P = 0.024), respectively. Increases in CVR categories were found in 26.9% of patients with SVR (P = 0.005 vs. baseline) and 8.1% of patients without SVR (P = 0.433). This resulted in a significant interaction between SVR and CVR over time (P < 0.001). No significant effect of SVR was observed for pulse wave velocity (P = 0.446), carotid intima-media thickness (P = 0.320), and BMKs of inflammation and endothelial dysfunction. CONCLUSIONS In coinfected patients, eradication of HCV had no effect on markers of preclinical atherosclerosis and BMKs of inflammation and endothelial dysfunction but was associated with a clinically relevant rise in serum low-density lipoprotein cholesterol. Evaluation of CVR should be an integral part of care after the cure of chronic hepatitis C in patients with HIV.
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Production of Vegetables and Artichokes Is Associated with Lower Cardiovascular Mortality: An Ecological Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186583. [PMID: 32927601 PMCID: PMC7558224 DOI: 10.3390/ijerph17186583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/01/2020] [Accepted: 09/05/2020] [Indexed: 11/16/2022]
Abstract
Mortality due to cardiovascular disease (CVD), including cerebrovascular disease (CED) and ischaemic heart disease (IHD), was considerably different in eight municipalities of the province of Castellón, Community of Valencia (Spain) during the period of 1991-2011. In addition, these villages showed differences in agricultural practices and production. Since high vegetable consumption has been linked to decreased all-cause, CVD, and CED mortalities, we hypothesized that the diversity in vegetable and artichoke production, used as proxies for their consumption, could be associated with the diversity of mortality rates. In order to test our hypothesis, we estimated the smoothed standardized mortality ratios (SMRs) of CVD, CED, and IHD mortalities and a directed, age-adjusted mortality rate (AMR). We used a multilevel linear regression analysis to account for the ecological nature of our study. After adjustment, the CVD and CED SMRs were inversely associated with vegetable and artichoke production, with a reduction in SMRs for CVD: -0.19 (95% Confidence Interval [CI] -0.31 to -0.07) and -0.42 (95% CI -0.70 to -0.15) per hectare/103 inhabitants, respectively. The SMRs for CED also decreased: -0.68 (95% CI -1.61 to -0.19) and -1.47 (95% CI -2.57 to -0.36) per hectare/103 inhabitants, respectively. The SMRs for IHD were not associated with vegetal and artichoke production. When the directed AMR was used, CED mortality was consistent with the previous results, whereas the CVD mortality association was lost. Our results indicate that vegetable and artichoke production may act as protective factors of CED and CVD mortalities.
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Morentin B, Suárez-Mier MP, Monzó A, Ballesteros J, Molina P, Lucena J. Sports-related sudden cardiac death in Spain. A multicenter, population-based, forensic study of 288 cases. ACTA ACUST UNITED AC 2020; 74:225-232. [PMID: 32920001 DOI: 10.1016/j.rec.2020.05.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 05/29/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION AND OBJECTIVES To determine the incidence of sports-related sudden cardiac death in Spain, and to identify the clinical-pathological characteristics, substance abuse, and sports activity associated with this entity. METHODS Retrospective, population-based, multicenter study of forensic autopsies conducted in 25 provinces during an 8-year period (2010-2017). RESULTS We investigated 288 cases (98.6% occurred in men with a mean age of 43.8±14.4 years). The incidence in the general population was 0.38 cases out of 100 000 inhabitants per year (0.82 among regular athletes), and most cases (54%) occurred in persons aged between 35 and 54 years. The most frequent sports (96% recreational) were cycling (28%), football (18%), and jogging (17%). Death was of cardiovascular origin in 99%. The main causes were ischemic heart disease (63%), cardiomyopathies (21%), and sudden arrhythmic death syndrome (6%). In young people, cardiomyopathies (38%) and ischemic heart disease (30%), present after the age of 20 years, were the most prevalent. The disease was diagnosed during life in 23 cases, relevant clinical antecedents were observed in 30 cases, and cardiovascular risk factors, mainly obesity, in 95 cases. Toxicological analysis detected cardiotoxic substances in 7%, highlighting the association between cannabis and acute ischemic heart disease. CONCLUSIONS Sports-related sudden cardiac death in Spain has a very low incidence and affects middle-aged men practicing recreational sports, mainly cycling, football, and jogging. This entity is of cardiovascular origin with early onset of ischemic heart disease. Clinical data and substance abuse should be taken into account to develop preventive strategies.
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Affiliation(s)
- Benito Morentin
- Servicio de Patología Forense, Instituto Vasco de Medicina Legal y Ciencias Forenses, Bilbao, Vizcaya, Spain; Instituto de Investigación Biosanitaria Biocruces, Bilbao, Vizcaya, Spain; Departamento de Especialidades Médico-Quirúrgicas, Universidad del País Vasco/Euskal Herriko Unibertsitatea, Bilbao, Vizcaya, Spain
| | - M Paz Suárez-Mier
- Servicio de Histopatología, Instituto Nacional de Toxicología y Ciencias Forenses, Las Rozas de Madrid, Madrid, Spain
| | - Ana Monzó
- Servicio de Patología Forense, Instituto Medicina Legal y Ciencias Forenses, Valencia, Spain
| | - Javier Ballesteros
- Departamento de Neurociencias, Universidad del País Vasco/Euskal Herriko Unibertsitatea, Bilbao, Vizcaya, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Bilbao, Vizcaya, Spain
| | - Pilar Molina
- Servicio de Patología Forense, Instituto Medicina Legal y Ciencias Forenses, Valencia, Spain
| | - Joaquín Lucena
- Servicio de Patología Forense, Instituto Medicina Legal y Ciencias Forenses, Sevilla, Spain.
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Prevalence of hypertriglyceridemia in adults and related cardiometabolic factors. SIMETAP-HTG study. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2020; 32:242-255. [PMID: 32534728 DOI: 10.1016/j.arteri.2020.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/11/2020] [Accepted: 04/22/2020] [Indexed: 12/11/2022]
Abstract
AIM To determine in the adult population the crude and the sex- and age-adjusted prevalence rates of hypertriglyceridaemia (HTG) and to assess its association with cardiovascular risk factors, chronic kidney disease, cardiovascular and cardiometabolic diseases. METHODS Cross-sectional observational study conducted in Primary Care, with 6,588 adult study subjects, randomly selected on base-population. Patients had HTG if the triglyceride level was≥150mg/dL (≥1.7mmol/L), or were on lipid-lowering therapy to lower triglyceride. Associations were assessed by univariate and multivariate analysis, and crude and sex- and age-adjusted prevalence rates were determined. RESULTS The arithmetic and geometric means of triglyceride levels were respectively 120.5 and 104.2mg/dL in global population, 135.7 and 116.0mg/dL in men, and 108.6 and 95.7mg/dL in women. The crude HTG prevalence rates were 29.6% in global population, 36.9% in men and 23.8% in women. The sex- and age-adjusted HTG prevalence rates were 27.0% in global population, 34.6% in men and 21.4% in women. The independent variables that were most associated with HTG were hypercholesterolemia (OR: 4.6), low HDL-C (OR: 4.1), hepatic steatosis (OR: 2.8), diabetes (OR: 2.0), and obesity (OR: 1.9). CONCLUSIONS The means of triglyceride levels and HTG prevalence rates are intermediate between those of other national and international studies. A fifth of the female adult population and more than a third of the male population had HTG. The independent factors associated with HTG were hypercholesterolemia and low HDL-C, and the cardiometabolic variables diabetes, hepatic steatosis and obesity.
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39
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Risk of cardiovascular disease in patients with HIV infection undergoing antiretroviral therapy. Rev Clin Esp 2020. [DOI: 10.1016/j.rceng.2019.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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40
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Estrada D, Sierra C, Soriano RM, Jordán AI, Plaza N, Fernández C. Grado de conocimiento de la hipertensión en pacientes hipertensos. ENFERMERIA CLINICA 2020; 30:99-107. [DOI: 10.1016/j.enfcli.2018.11.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 11/28/2018] [Indexed: 01/07/2023]
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Rojo-Martínez G, Valdés S, Soriguer F, Vendrell J, Urrutia I, Pérez V, Ortega E, Ocón P, Montanya E, Menéndez E, Lago-Sampedro A, González-Frutos T, Gomis R, Goday A, García-Serrano S, García-Escobar E, Galán-García JL, Castell C, Badía-Guillén R, Aguilera-Venegas G, Girbés J, Gaztambide S, Franch-Nadal J, Delgado E, Chaves FJ, Castaño L, Calle-Pascual A. Incidence of diabetes mellitus in Spain as results of the nation-wide cohort di@bet.es study. Sci Rep 2020; 10:2765. [PMID: 32066839 PMCID: PMC7026031 DOI: 10.1038/s41598-020-59643-7] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 01/28/2020] [Indexed: 12/22/2022] Open
Abstract
Our aim was to determine the incidence of type 2 diabetes mellitus in a nation-wide population based cohort from Spain (di@bet.es study). The target was the Spanish population. In total 5072 people older than 18 years,were randomly selected from all over Spain). Socio-demographic and clinical data, survey on habits (physical activity and food consumption) and weight, height, waist, hip and blood pressure were recorder. A fasting blood draw and an oral glucose tolerance test were performed. Determinations of serum glucose were made. In the follow-up the same variables were collected and HbA1c was determined. A total of 2408 subjects participated in the follow-up. In total, 154 people developed diabetes (6.4% cumulative incidence in 7.5 years of follow-up). The incidence of diabetes adjusted for the structure of age and sex of the Spanish population was 11.6 cases/1000 person-years (IC95% = 11.1–12.1). The incidence of known diabetes was 3.7 cases/1000 person-years (IC95% = 2.8–4.6). The main risk factors for developing diabetes were the presence of prediabetes in cross-sectional study, age, male sex, obesity, central obesity, increase in weight, and family history of diabetes. This work provides data about population-based incidence rates of diabetes and associated risk factors in a nation-wide cohort of Spanish population.
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Affiliation(s)
- G Rojo-Martínez
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain. .,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain.
| | - S Valdés
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | - F Soriguer
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | - J Vendrell
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Department of Endocrinology and Nutrition, University Hospital Joan XXIII, Pere Virgili Institute (IISPV), Rovira I Virgili University, Tarragona, Spain
| | - I Urrutia
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Cruces University Hospital, Biocruces Bizkaia Health Research Institute, UPV/EHU, Barakaldo, Spain.,Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain
| | - V Pérez
- General Laboratory. Regional University Hospital of Malaga, Malaga, Spain
| | - E Ortega
- Department of Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute - IDIBAPS, Hospital Clínic of Barcelona, Barcelona, Spain.,Spanish Biomedical Research Network in physiopathology of obesity and Nutrition (CIBEROBN), Barcelona, Spain
| | - P Ocón
- General Laboratory. Regional University Hospital of Malaga, Malaga, Spain
| | - E Montanya
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, Bellvitge University Hospital, Barcelona, Spain
| | - E Menéndez
- Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain.,Department of Endocrinology and Nutrition, Central University Hospital of Asturias/University of Oviedo, Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
| | - A Lago-Sampedro
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | - T González-Frutos
- Cruces University Hospital, Biocruces Bizkaia Health Research Institute, UPV/EHU, Barakaldo, Spain
| | - R Gomis
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Department of Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute - IDIBAPS, Hospital Clínic of Barcelona, Barcelona, Spain
| | - A Goday
- Spanish Biomedical Research Network in physiopathology of obesity and Nutrition (CIBEROBN), Barcelona, Spain.,Department of Endocrinology and Nutrition, Hospital del Mar, IMIM. Universitat Autònoma, Barcelona, Spain
| | - S García-Serrano
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | - E García-Escobar
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | - J L Galán-García
- Department of Applied Mathematics, Malaga University, Malaga, Spain
| | - C Castell
- Department of Health, Public Health Agency of Catalonia, Barcelona, Spain
| | - R Badía-Guillén
- Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | | | - J Girbés
- Diabetes Unit, Hospital Arnau of Vilanova, Valencia, Spain
| | - S Gaztambide
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain.,Department of Endocrinology and Nutrition, Cruces University Hospital, Biocruces Bizkaia Health Research Institute, UPV/EHU, Barakaldo, Spain
| | - J Franch-Nadal
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,EAP Raval Sud, Catalan Institute of Health, GEDAPS Network, Primary Care, Research support unit (IDIAP - Jordi Gol Foundation), Barcelona, Spain
| | - E Delgado
- Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain.,Department of Endocrinology and Nutrition, Central University Hospital of Asturias/University of Oviedo, Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
| | - F J Chaves
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Genomic and Genetic Diagnosis Unit, Research Foundation of Valencia University Clinical Hospital-INCLIVA, Valencia, Spain
| | - L Castaño
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Cruces University Hospital, Biocruces Bizkaia Health Research Institute, UPV/EHU, Barakaldo, Spain.,Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain
| | - A Calle-Pascual
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Department of Endocrinology and Nutrition, University Hospital S. Carlos of Madrid, Madrid, Spain
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Rodríguez Pérez MDC, Chines C, Pedrero García AJ, Sousa D, Cuevas Fernández FJ, Marcelino-Rodríguez I, Domínguez Coello S, Cabrera de León A. Major amputations in type 2 diabetes between 2001 and 2015 in Spain: regional differences. BMC Public Health 2020; 20:54. [PMID: 31937275 PMCID: PMC6961258 DOI: 10.1186/s12889-019-8137-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 12/30/2019] [Indexed: 11/20/2022] Open
Abstract
Background To analyze the trend of lower extremity major amputations (MA) among patients with type 2 diabetes mellitus (T2DM) in the Regions of Spain from year 2001 until 2015. Methods Descriptive study of 40,392 MA. Data were obtained from the national hospital discharge database in patients with T2DM. The incidence rate was calculated in each Region, in addition to the incidence ratios (IR) between annual incidence and incidence of the year 2001. The length of hospital stay and mortality risks were analyzed using regression models adjusted for sex, age and smoking. Results The major amputations incidence rate per 100,000 person-years was 0.48 in Spain; Canary Islands showed the highest incidence (0.81). The trend was a slight decrease or stability of the incidence in all Regions except in the Canary Islands (IR2015 = 2.0 [CI95% = 1.5, 2.6]) and in Madrid (IR2015 = 0.1 [CI95% = 0.1, 0.2]). Mortality after major amputations was 10% in Spain; Cantabria suffered the highest risk of death [1.7 (CI95% = 1.4; 2.1), p < 0.001] and La Rioja the lowest risk (0.5 [CI95% = 0.2; 0.9]; p = 0.026). The longest hospital stay was registered in the Canary Islands [(CI95% = 11.4;13.3], p < 0.001)], and the shortest in the Valencian Community [(CI95% = − 7.3; − 5.8), p < 0.001)]. Conclusion MA in T2DM followed a growing trend in the Canary Islands, which diverged from the downward trend in Spain. The variability of mortality and hospital stay, suggest to review the clinical management in some Regions. Sudden incidence decrease in Madrid suggests checking the record procedures of hospital discharges.
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Affiliation(s)
- María Del Cristo Rodríguez Pérez
- Research Unit, Canarian Health Service, Ntra. Sra. de Candelaria University Hospital and Primary Care Authority, 38010, Santa Cruz de Tenerife, Spain
| | - Chiara Chines
- Preventive Medicine and Public Health, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | - Arturo J Pedrero García
- Research Unit, Canarian Health Service, Ntra. Sra. de Candelaria University Hospital and Primary Care Authority, 38010, Santa Cruz de Tenerife, Spain
| | - Djeniffer Sousa
- Preventive Medicine and Public Health, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | | | - Itahisa Marcelino-Rodríguez
- Research Unit, Canarian Health Service, Ntra. Sra. de Candelaria University Hospital and Primary Care Authority, 38010, Santa Cruz de Tenerife, Spain
| | | | - Antonio Cabrera de León
- Research Unit, Canarian Health Service, Ntra. Sra. de Candelaria University Hospital and Primary Care Authority, 38010, Santa Cruz de Tenerife, Spain. .,Preventive Medicine and Public Health, Universidad de La Laguna, Santa Cruz de Tenerife, Spain.
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43
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Banegas JR. El Proyecto IBERICAN. Progresando en el conocimiento del riesgo cardiovascular en atención primaria en España. Semergen 2020; 46:1-3. [DOI: 10.1016/j.semerg.2019.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 10/25/2022]
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Hernández-Yumar A, Abásolo Alessón I, González López-Valcárcel B. Economic crisis and obesity in the Canary Islands: an exploratory study through the relationship between body mass index and educational level. BMC Public Health 2019; 19:1755. [PMID: 31888574 PMCID: PMC6937794 DOI: 10.1186/s12889-019-8098-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 12/17/2019] [Indexed: 11/11/2022] Open
Abstract
Background The Canary Islands is one of the Spanish Regions with the highest obesity prevalence, and one of the Autonomous Communities that was hit hard by the economic crisis that arrived to Spain in 2008. This research studies the education-related inequalities in adult obesity in the Canary Islands and their evolution in recent years, considering the possible impact of the economic recession. Methods A repeated cross-sectional analysis is carried out with data obtained from the Canary Islands Health Surveys of 2004, 2009 and 2015. Obesity is measured through the body mass index (BMI). The analysis is performed using linear regression models for the general population and by gender, adjusting by age, educational attainment and island of residence. Likewise, the models also include dummy variables for each year and the corresponding interactions between the years and the education variable. Results The results show a decrease in the obesity prevalence in 2015 compared to 2009 (from 19.54 to 18.64%). An increase in the BMI of the population and that of women (+ 0.33 and + 0.59 units, respectively) in 2009, as well as a decline in the BMI of women with medium education (− 0.21 units) are also observed. Besides, there is an inverse correlation between education and BMI, and statistically significant differences among some islands. Conclusions Obesity figures in the Canary Islands have decreased and women have been more greatly affected by the changes in BMI during the economic crisis. Due to the fact that educational attainment is a protective factor in general (and for women with medium education levels in times of crisis, in particular), regional authorities should implement actions that promote access to education and healthy lifestyles, paying attention to territorial disparities.
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Affiliation(s)
- Aránzazu Hernández-Yumar
- Departamento de Economía Aplicada y Métodos Cuantitativos, Facultad de Economía, Empresa y Turismo, Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain.
| | - Ignacio Abásolo Alessón
- Departamento de Economía Aplicada y Métodos Cuantitativos, Facultad de Economía, Empresa y Turismo, Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
| | - Beatriz González López-Valcárcel
- Departamento de Métodos Cuantitativos en Economía y Gestión, Universidad de Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria, Spain
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Ten-Year Follow-Up of Clinical Governance Implementation in Primary Care: Improving Screening, Diagnosis and Control of Cardiovascular Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214299. [PMID: 31694294 PMCID: PMC6862228 DOI: 10.3390/ijerph16214299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/02/2019] [Accepted: 11/04/2019] [Indexed: 02/03/2023]
Abstract
Current improvement strategies for the control of cardiovascular risk factors (CRFs) in Europe are based on quality management policies. With the aim of understanding the effect of interventions delivered by primary healthcare systems, we evaluated the impact of clinical governance on cardiovascular health after ten years of implementation in Catalonia. A cohort study that included 1878 patients was conducted in 19 primary care centres (PCCs). Audits that comprised 13 cardiovascular health indicators were performed and general practitioners received periodic (annual, biannual or monthly) feedback about their clinical practice. We evaluated improvement in screening, diagnosis and control of the main CRFs and the effects of the feedback on cardiovascular risk (CR), incidence of cardiovascular disease (CVD) and mortality, comparing baseline data with data at the end of the study (after a 10-year follow-up). The impact of the intervention was assessed globally and with respect to feedback frequency. General improvement was observed in screening, percentage of diagnoses and control of CRFs. At the end of the study, few clinically significant differences in CRFs were observed between groups. However, the reduction in CR was greater in the group receiving high frequency feedback, specifically in relation to smoking and control of diabetes and cholesterol (Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL)). A protective effect of having a cardiovascular event (hazard ratio (HR) = 0.64, 95% confidence interval (CI) = 0.44-0.94) or death (HR = 0.55, 95% CI = 0.35-0.88) was observed in patients from centres where general practitioners received high frequency feedback. Additionally, these PCCs presented improved cardiovascular health indicators and lower incidence and mortality by CVD, illustrating the impact of this intervention.
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Estrada V, Domingo P, Suarez-Lozano I, Gutiérrez F, Knobel H, Palacios R, Antela A, Blanco JR, Refoyo E. Risk of cardiovascular disease in patients with HIV infection undergoing antiretroviral therapy. Rev Clin Esp 2019; 220:149-154. [PMID: 31690452 DOI: 10.1016/j.rce.2019.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 05/12/2019] [Accepted: 05/14/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND The increased survival of patients with HIV infection thanks to antiretroviral therapy (ART) is accompanied by a higher rate of cardiovascular disease (CVD). We analysed the prevalence of the cardiovascular risk factors (CRFs) and estimated the risk of CVD in a cohort of patients with HIV in Spain. METHODS We conducted a cross-sectional, observational study of CRFs in the Spanish VACH cohort of patients with HIV who undergo ART. RESULTS The study assessed 15,559 patients with HIV (76% men; mean age, 46 years). Some 3.7% had experienced at least 1 CVD event. The prevalence of CRFs was high (hyperlipidaemia, 64%; tobacco use, 47%; arterial hypertension, 22%; and diabetes, 16%). According to the Framingham scale, 10.9% of the patients presented a high CVD risk, and 28.8% presented a moderate risk. Of the patients with a high CVD risk, 49% took protease inhibitors and 43% took abacavir. Fifty-three percent of the patients diagnosed with arterial hypertension took antihypertensive drugs, and 2.6% of the patients with diabetes took antidiabetic agents. CONCLUSIONS Classical CRFs are common in patients with HIV undergoing ART in Spain, and a large proportion of them have a moderate-high risk of CVD. Therefore, controlling the modifiable CRFs in patients with HIV should be improved, and the use of drugs with a better cardiovascular risk profile should be assessed.
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Affiliation(s)
- V Estrada
- Hospital Clínico San Carlos-IdiSSC, Universidad Complutense de Madrid, Madrid, España.
| | - P Domingo
- Hospital Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
| | | | - F Gutiérrez
- Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche, Alicante, España
| | - H Knobel
- Hospital del Mar, Barcelona, España
| | - R Palacios
- Hospital Universitario Virgen de la Victoria, Málaga, España
| | - A Antela
- Hospital Clínico Universitario, Santiago de Compostela, España
| | - J R Blanco
- Hospital San Pedro-CIBIR, Logroño, España
| | - E Refoyo
- Hospital Universitario La Paz, Madrid, España
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Baena Díez JM, Carrera Morodo M, Corral Roca M, Calatayud Subías E, Flores Jiménez I, de la Arada Acebes AM. Impact of the new criteria of the ACC/AHA on the diagnostic prevalence of hypertension. Med Clin (Barc) 2019; 154:254-256. [PMID: 31481243 DOI: 10.1016/j.medcli.2019.06.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/03/2019] [Accepted: 06/06/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To study the impact on the prevalence of hypertension with the criteria (2017) of the American College of Cardiology/American Heart Association (ACC/AHA). PATIENTS AND METHODS Cross-sectional study, including 370 patients ≥18 years, randomly selected in a Health Centre, with at least one visit and a measurement of systolic (SBP) and diastolic blood pressure (DBP) recorded the last 2 years. Previous hypertension was considered if the diagnosis was confirmed or they had an SBP ≥140 or DBP ≥90mmHg and as ACC/AHA AHT criteria in any of these cases or an SBP between 130-139mmHg or DBP between 80-89mmHg. RESULTS The average age was 52.3 years (58.6% women). Forty-one point nine percent had previous hypertension, increasing to 67.8% with the ACC/AHA criteria (p <.05). Pharmacological treatment was received by 32.2% of the population, increasing to 38.4% with the ACC/AHA criteria (p>.05). The newly diagnosed patients (p <.05) were younger (mean difference 19.6 years) and less obese (23% vs. 41.4%). CONCLUSIONS The ACC/AHA criteria would represent an increase of 25.9% in the prevalence of hypertension, considering 2 out of 3 adults hypertensive.
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Affiliation(s)
- José Miguel Baena Díez
- Centro de Salud La Marina, SAP Esquerra Barcelona, Institut Catalá de la Salut, Barcelona, España; IDIAP Jordi Gol, Institut Catalá de la Salut , Barcelona, España.
| | - María Carrera Morodo
- Centro de Salud La Marina, SAP Esquerra Barcelona, Institut Catalá de la Salut, Barcelona, España
| | - Miriam Corral Roca
- Centro de Salud La Marina, SAP Esquerra Barcelona, Institut Catalá de la Salut, Barcelona, España
| | - Eva Calatayud Subías
- Centro de Salud La Marina, SAP Esquerra Barcelona, Institut Catalá de la Salut, Barcelona, España
| | - Iris Flores Jiménez
- Centro de Salud La Marina, SAP Esquerra Barcelona, Institut Catalá de la Salut, Barcelona, España
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de Gonzalo-Calvo D, Elosua R, Vea A, Subirana I, Sayols-Baixeras S, Marrugat J, Llorente-Cortés V. Soluble low-density lipoprotein receptor-related protein 1 as a biomarker of coronary risk: Predictive capacity and association with clinical events. Atherosclerosis 2019; 287:93-99. [DOI: 10.1016/j.atherosclerosis.2019.06.904] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 05/10/2019] [Accepted: 06/14/2019] [Indexed: 10/26/2022]
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Barquilla García A, Sánchez Vega J, Romero Vigara JC, Fernández L, Gamero Samino MJ, Buitrago F. Prevalence of diabetes and frequency of glycated haemoglobin monitoring in Extremadura (Spain) during 2012, 2013 and 2014: An observational study. Prim Care Diabetes 2019; 13:324-329. [PMID: 30630669 DOI: 10.1016/j.pcd.2018.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 12/14/2018] [Accepted: 12/28/2018] [Indexed: 11/27/2022]
Abstract
AIMS To analyze the prevalence of diabetes and the frequency of haemoglobin A1C (HbA1C) monitoring in the population with diabetes in Extremadura (Spain). METHODS Observational, longitudinal retrospective study in the population attended in the Extremadura Health System in 2012-2014. A total of 403,644 glycated haemoglobin determinations in 189,466 subjects (52.4% female) were studied. All patients with a prescription of antidiabetic drugs and those who, despite not having treatment, had any determination of HbA1C ≥6.5% were considered as people with diabetes. All patients without treatment but with HbA1C ≥5.7% and <6.5% were considered prediabetes patients. RESULTS The prevalence rate of diabetes was 8.3% and the frequency of HbA1C monitoring was 0.9/patient/year in the diabetic population. 48.2% of the patients with monitoring of HbA1C had diabetes, 21.2% had prediabetes, and 30.6% did not meet the criteria for diabetes or prediabetes. 12.7% of people with diabetes did not have determinations of HbA1C and only 11.8% have had ≥6 determinations in the period analyzed. CONCLUSIONS The frequency of HbA1C monitoring in the diabetic population is lower than that usually recommended. Moreover, there is an inadequate use of HbA1C determinations, since one out of every 3 patients does not meet the criteria for diabetes or prediabetes.
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Affiliation(s)
| | - Javier Sánchez Vega
- Centro de Salud de Losar de la Vera, Servicio Extremeño de Salud, Cáceres, Spain.
| | | | - Leandro Fernández
- Centro de Salud de Zafra, Servicio Extremeño de Salud, Badajoz, Spain.
| | | | - Francisco Buitrago
- Centro de Salud Universitario "La Paz", Unidad Docente de Medicina Familiar y Comunitaria, Servicio Extremeño de Salud, Badajoz, Spain.
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Mate Redondo C, Rodríguez-Pérez MC, Domínguez Coello S, Pedrero García AJ, Marcelino Rodríguez I, Cuevas Fernández FJ, Almeida González D, Brito Díaz B, Rodríguez Esteban M, Cabrera de León A. Mortalidad hospitalaria de 415.798 pacientes con IAM: 4 años antes en Canarias que en el conjunto de España. Rev Esp Cardiol 2019. [DOI: 10.1016/j.recesp.2018.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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