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Najar H, Karanti A, Pålsson E, Landén M. Cardiometabolic risk indicators in individuals with bipolar disorders: a replication study. Diabetol Metab Syndr 2023; 15:69. [PMID: 37009884 PMCID: PMC10069119 DOI: 10.1186/s13098-023-01044-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/26/2023] [Indexed: 04/04/2023] Open
Abstract
OBJECTIVES We recently conducted the first longitudinal study comparing cardiometabolic risk indicators (CMRIs) between a cohort of individuals with bipolar disorders (BDs) and controls from the general population. Here, we sought to validate the findings in that study using an independent case-control sample. METHODS We used data from the St. Göran project's Gothenburg cohort. The BDs group and the control group were examined at baseline and after a median of eight and seven years, respectively. Data collection occurred between March 2009 and June 2022. We used multiple imputation to handle missing data and linear mixed effects model to examine the annual change in CMRIs over the study period. RESULTS The baseline cohort included 407 individuals with BDs (mean age 40 years, 63% women) and 56 controls (mean age 43 years, 54% women). Of those, 63 persons with BDs and 42 controls participated at follow-up. At baseline, individuals with BDs had significantly higher mean values of body mass index (β = 0.14, p = 0.003) than controls. Over the study period, the difference in average annual change between the patient and the control group indicated an increase in patients relative to controls in waist-to-hip ratio (0.004 unit/year, p = 0.01), diastolic (0.6 mm Hg/year, p = 0.048), and systolic (0.8 mm Hg/year, p = 0.02) blood pressure. CONCLUSIONS This study replicated the main findings from our previous study and showed that central obesity and measures of blood pressure worsened over a relatively short time in individuals with BDs relative to controls. It is vital for clinicians to monitor CMRIs in persons with BDs and to be proactive in preventing cardiometabolic diseases in this high-risk group.
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Affiliation(s)
- Hemen Najar
- Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Blå stråket 15, Gothenburg, 413 45, Sweden.
| | - Alina Karanti
- Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Blå stråket 15, Gothenburg, 413 45, Sweden
| | - Erik Pålsson
- Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Blå stråket 15, Gothenburg, 413 45, Sweden
| | - Mikael Landén
- Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Blå stråket 15, Gothenburg, 413 45, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Prevalence of familial hypercholesterolemia phenotype and ten-year risk of cardiovascular events in a working population in primary prevention: The ICARIA study. Atherosclerosis 2021; 338:39-45. [PMID: 34785430 DOI: 10.1016/j.atherosclerosis.2021.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/07/2021] [Accepted: 11/04/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS We aimed to assess the prevalence of familial hypercholesterolaemia (FH) and to determine the incidence of cardiovascular events during a 10-year follow up in individuals with FH, compared to unaffected individuals in a working, middle-aged/young population. METHODS AND RESULTS 576,724 active workers (36 ± 10 years-old, 70% men) without cardiovascular disease were given regular health check-ups and followed for a median of 8.5 years (i.e., 4,123,927 person-years). The FH phenotype was defined according to validated low-density lipoprotein-cholesterol thresholds, adjusted for age and sex. The primary outcome was a first cardiovascular event, whether fatal or non-fatal. We found that 707 workers (0.12% or 1 in 816 individuals) met the criteria for a heterozygous FH phenotype. During the follow-up, cardiovascular events occurred in 23 of 707 (3.25%) subjects with the FH phenotype and in 3297 of 576,017 (0.57%) subjects without the FH phenotype (p<0.001). The hazard ratio (HR, assessed with a Cox regression model) for the primary outcome was 5.7 (99% CI 3.33-9.78), before adjustments, and 4.7 (99% CI 2.62-8.58) after adjusting for sex, age, smoking, blood pressure, and diabetes. The HRs were significant for both men and women, but the magnitude of the effect was greater for men than for women. CONCLUSIONS Our findings confirmed the high incidence of cardiovascular disease in individuals with untreated FH. We showed that regular health check-ups in an active, and mostly young, working population could contribute to the early identification of FH. Therefore, this approach may provide an opportunity for early treatment.
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Torres R, Silva JA, Vieira SS, Camilo de Carvalho PDT, Bocalini DS, Andrade E, Casarin C, Suzuki F, Antonio EL, Tucci PJF, Serra AJ. Cardiovascular risk and quality of life in supermarket cashiers: The role of physical activity. Work 2021; 67:459-465. [PMID: 33074209 DOI: 10.3233/wor-203295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Occupations might influence the employees' psychophysical conditions and an important issue is the human activity mechanization, which favors a hypokinetic work status and leads to several chronic diseases. One of the most hypokinetic occupations is the supermarket cashier, in which the individual may spend many hours a day in the same body position. OBJECTIVE The goal of this study was to evaluate the association between cardiovascular risk, quality of life and physical activity level in supermarket cashiers. METHODS This is a cross-sectional study which included 200 supermarket cashiers aged 20 to 41 years from São Paulo, Brazil. The following cardiovascular risk factors were evaluated: overweight, obesity, hypertension, diabetes mellitus, and tobacco smoking. Physical activity level and quality of life were assessed with the short-form of the International Physical Activity Questionnaire (IPAq) and World Health Organization Quality of Life (WHOQOL), respectively. Student t test and Chi-square were carried out to evaluate mean gender comparations and frequency, respectively. Logistic regression models were applied to determine the association between cardiovascular risk factors and physical activity level. RESULTS The prevalence for all cardiovascular risk factors was significantly high in the cashiers with a low physical activity level. However, there was a significant reduction in several risk factors in the groups with moderate and high physical activity levels. The odds ratio values were significantly reduced for the association between the cardiovascular risk factors and the moderate and high physical activity levels. The cashiers with moderate and high physical activity levels showed significantly higher quality of life scores for the social and environmental domain. CONCLUSIONS A high physical activity level is positively related to quality of life in supermarket cashiers.
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Affiliation(s)
- Renan Torres
- Programa de pós-graduação em biofotônica aplicada as ciências da saúde. Universidade Nove de Julho, São Paulo, Brazil
| | - José Antonio Silva
- Programa de pós-graduação em biofotônica aplicada as ciências da saúde. Universidade Nove de Julho, São Paulo, Brazil
| | - Stella Sousa Vieira
- Programa de pós-graduação em Cardiologia. Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Danilo Sales Bocalini
- Laboratorio de fisiologia e bioquimica experimental, centro de educacao fisica e deportos, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Erinaldo Andrade
- Programa de pós-graduação em biofotônica aplicada as ciências da saúde. Universidade Nove de Julho, São Paulo, Brazil
| | - Cezar Casarin
- Programa de pós-graduação em biofotônica aplicada as ciências da saúde. Universidade Nove de Julho, São Paulo, Brazil
| | - Frank Suzuki
- Programa de pós-graduação em biofotônica aplicada as ciências da saúde. Universidade Nove de Julho, São Paulo, Brazil
| | - Ednei Luiz Antonio
- Programa de pós-graduação em Cardiologia. Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Andrey Jorge Serra
- Programa de pós-graduação em biofotônica aplicada as ciências da saúde. Universidade Nove de Julho, São Paulo, Brazil.,Programa de pós-graduação em Cardiologia. Universidade Federal de São Paulo, São Paulo, Brazil
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Description of Main Predictors for Taking Sick Leave Associated with Work-Related Eye Injuries in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105157. [PMID: 34067993 PMCID: PMC8152250 DOI: 10.3390/ijerph18105157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 11/17/2022]
Abstract
Recent studies in Spain have shown that males, younger workers, and people involved in manual jobs had the highest risk of suffering a work-related eye injury (WREI). This study aims to assess the predictors of sick leave associated with WREI and to compare them with risk factors of initial injury. A retrospective and descriptive study of WREI that causes sick leave of one or more days among workers from an insurance labor mutual company in Spain was conducted over a period from 2008 to 2018. The variables of the study were sex, age, occupation, and type of injury. A total of 9352 (18.6% of 50,265 WREI) cases and 113,395 total days of sick leave were observed, with an estimated EUR 4,994,009.59 of associated labor cost. The main predictors of sick leave related to WREI were found to be female (highest incidence; 25.9 (95% CI (24.8–27.1))), >55 years of age (highest incidence; 20.5 (95% CI (19.3–21.7))), not working in the industry (lowest incidence; 13.8 (95% CI (13.3–14.2))), and not suffering “other disorders of conjunctiva” (lowest incidence; 5.7 (95% CI (4.7–6.8))). The consequences associated with WREI are worse for female and older workers, despite the main risk of suffering WREI being observed in males and younger workers.
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Calvo-Bonacho E, Catalina-Romero C, Fernández-Labandera C, Fernández-Meseguer A, González-Quintela A, Martínez-Muñoz P, Quevedo L, Valdivielso P, Sánchez-Chaparro MÁ. COVID-19 and Sick Leave: An Analysis of the Ibermutua Cohort of Over 1,651,305 Spanish Workers in the First Trimester of 2020. Front Public Health 2020; 8:580546. [PMID: 33194983 PMCID: PMC7604328 DOI: 10.3389/fpubh.2020.580546] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 08/31/2020] [Indexed: 12/29/2022] Open
Abstract
Objectives: The worldwide SARS-COV2 pandemic has impacted the health of workers and companies. The aim is to quantify it according to sick leave. Methods: Using ICD-9 codes, we analyzed Ibermutua records of all sick leaves during the first trimester of 2020, compared to during the same months of 2017, 2018, and 2019. We stratified the analysis by causes, patient sex, activity sectors, and regional data. All sick leaves were adjusted by the number of Ibermutua-affiliated persons in each period. Results: In March 2020, there was an unprecedented (116%) increase in total sick leaves, mainly due to infectious and respiratory diseases. Men and women were equally affected. All activity sectors were impacted, with the highest increase (457%) observed among health-related workers, especially due to contagious disease. The incidences of sick leaves were heterogeneous among different regions. Cost-analysis of sick leaves during the first trimester of 2020 compared with in previous years showed 40.3% increment (mean 2,813 vs. 2,005 € per 100 affiliated workers). Conclusions: The SARS-COV2 pandemic is having a huge impact on workers' health, as shown by data regarding sick leaves in March 2020. This is associated with greater economic burden for companies, both due to the cost associated with sick leaves and the losses in productivity due to confinement.
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Affiliation(s)
- Eva Calvo-Bonacho
- Departamento de Proyectos Sanitarios, Ibermutua, Mutua Colaboradora con la Seguridad Social 274, Madrid, Spain
| | - Carlos Catalina-Romero
- Departamento de Proyectos Sanitarios, Ibermutua, Mutua Colaboradora con la Seguridad Social 274, Madrid, Spain
| | - Carlos Fernández-Labandera
- Departamento de Proyectos Sanitarios, Ibermutua, Mutua Colaboradora con la Seguridad Social 274, Madrid, Spain
| | - Ana Fernández-Meseguer
- Departamento de Proyectos Sanitarios, Ibermutua, Mutua Colaboradora con la Seguridad Social 274, Madrid, Spain
| | - Arturo González-Quintela
- Departamento de Medicina Interna, Hospital Universitario, Universidad de Santiago de Compostela, A Coruña, Spain
| | - Paloma Martínez-Muñoz
- Departamento de Proyectos Sanitarios, Ibermutua, Mutua Colaboradora con la Seguridad Social 274, Madrid, Spain
| | - Luis Quevedo
- Departamento de Proyectos Sanitarios, Ibermutua, Mutua Colaboradora con la Seguridad Social 274, Madrid, Spain
| | - Pedro Valdivielso
- Servicio de Medicina Interna, Hospital Virgen de la Vic, Málaga, Spain
- Departamento de Medicina y Dermatología, Universidad de Málaga and Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | - Miguel Ángel Sánchez-Chaparro
- Servicio de Medicina Interna, Hospital Virgen de la Vic, Málaga, Spain
- Departamento de Medicina y Dermatología, Universidad de Málaga and Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
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Fernández-Labandera C, Calvo-Bonacho E, Valdivielso P, Quevedo-Aguado L, Martínez-Munoz P, Catalina-Romero C, Ruilope LM, Sánchez-Chaparro MA. Prediction of fatal and non-fatal cardiovascular events in young and middle-aged healthy workers: The IberScore model. Eur J Prev Cardiol 2019; 28:177–186. [PMID: 33838039 DOI: 10.1177/2047487319894880] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 11/18/2019] [Indexed: 11/15/2022]
Abstract
AIMS Our primary objective was to improve risk assessment for fatal and non-fatal cardiovascular events in a working population, mostly young and healthy. METHODS We conducted a prospective cohort study to derive a survival model to predict fatal and non-fatal 10-year cardiovascular risk. We recruited 992,523 workers, free of diagnosed cardiovascular disease at entry, over six years, from 2004-2009. We divided the sample into two independent cohorts: a derivation one (626,515 workers; from 2004-2006) and a temporal validation one (366,008 workers; over 2007-2009). Then, we followed both cohorts over 10 years and registered all fatal and non-fatal cardiovascular events. We built a new risk calculator using an estimation of cardiovascular biological age as a predictor and named it IberScore. There were remarkable differences between this new model and Systematic Coronary Risk Evaluation (SCORE) (in both the specification and the equation). RESULTS Over the 10-year follow-up, we found 3762 first cardiovascular events (6‰) in the derivation cohort. Most of them (80.3%) were non-fatal ischaemic events. If we had been able to use our model at the beginning of the study, we had classified in the 'high-risk' or 'very high-risk' groups 82% of those who suffered a cardiovascular event during the follow-up. All the post-estimation tests showed superior performance (true positive rate: 81.8% vs 11.8%), higher discrimination power and better clinical utility (standardised net benefit: 58% vs 13%) for IberScore when compared to SCORE. CONCLUSION Risk assessment of fatal and non-fatal cardiovascular events in young and healthy workers was improved when compared to the previously used model (SCORE). The latter was not reliable to predict cardiovascular risk in our sample. The new model showed superior clinical utility and provided four useful measures for risk assessment. We gained valuable insight into cardiovascular ageing and its predictors.
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Affiliation(s)
| | - Eva Calvo-Bonacho
- Ibermutuamur, Mutua Colaboradora con la Seguridad Social n° 274, Spain
| | - Pedro Valdivielso
- University Hospital 'Virgen de la Victoria', University of Malaga, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Spain
| | | | | | | | - Luis M Ruilope
- Hypertension Unit and Cardiorenal Translational Laboratory, University Hospital 12 de Octubre, Spain
| | - Miguel A Sánchez-Chaparro
- University Hospital 'Virgen de la Victoria', University of Malaga, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Spain
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Brotons C, Moral I, Fernández D, Puig M, Calvo Bonacho E, Martínez Muñoz P, Catalina Romero C, Quevedo Aguado LJ. Estimation of Lifetime Risk of Cardiovascular Disease (IBERLIFERISK): A New Tool for Cardiovascular Disease Prevention in Primary Care. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2019; 72:562-568. [PMID: 30097396 DOI: 10.1016/j.rec.2018.05.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 05/04/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION AND OBJECTIVES To develop a predictive function of lifetime cardiovascular risk, including morbidity and mortality, in a healthy working population in Spain. METHODS Retrospective cohort study. We selected healthy workers, aged 18 to 65 years, with no history of cardiovascular disease, who underwent a health assessment between 2004 and 2007. We used 70% of the cohort to develop the risk equation, and the remaining 30% to validate the equation. Four Cox proportional hazards models were constructed using cardiovascular events and competing events as dependent variables. The same models were replicated for men and women separately. Fatal and nonfatal events were assessed until 2014. RESULTS A total of 762 054 individuals were selected. The mean age was 35.48 years and 71.14% were men. Significant risk variables in the model included manual occupations, being a smoker or exsmoker, diabetes mellitus, antihypertensive treatment, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, and lipid-lowering treatment; in men, the model also included alcohol consumption, body mass index, a family history of early coronary disease in first-degree relatives, renal failure, and diastolic blood pressure. The area under the curve receiver operating characteristic was 0.84 (95%CI, 0.82-0.85) in men and 0.73 (95%CI, 0.66-0.80) in women. Calibration showed underestimation in low-risk deciles and overestimation in high-risk deciles. CONCLUSIONS The new lifetime cardiovascular risk model has satisfactory discrimination and calibration, with better results in men than in women.
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Affiliation(s)
- Carlos Brotons
- Unidad de Investigación, Equipo de Atención Primaria Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain.
| | - Irene Moral
- Unidad de Investigación, Equipo de Atención Primaria Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain
| | - Diana Fernández
- Unidad de Investigación, Equipo de Atención Primaria Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain
| | - Mireia Puig
- Unidad de Investigación, Equipo de Atención Primaria Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain
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Brotons C, Moral I, Fernández D, Puig M, Calvo Bonacho E, Martínez Muñoz P, Catalina Romero C, Quevedo Aguado LJ. Estimación del riesgo cardiovascular de por vida (IBERLIFERISK): una herramienta nueva en prevención primaria de las enfermedades cardiovasculares. Rev Esp Cardiol 2019. [DOI: 10.1016/j.recesp.2018.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Catalina-Romero C, Sanchez Chaparro MA, Valdivielso P, Quevedo-Aguado L, Brotons C, Ruilope LM, Calvo-Bonacho E. Estimating the impact of obesity and metabolic phenotype on sickness absence. Results from the ICARIA study. Nutr Metab Cardiovasc Dis 2019; 29:383-389. [PMID: 30803866 DOI: 10.1016/j.numecd.2018.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 11/05/2018] [Accepted: 12/17/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS To assess the impact of obesity and being overweight on sickness absence (SA) as a function of healthy/unhealthy metabolic phenotype. METHODS AND RESULTS A total of 173 120 healthy workers who underwent a routine check-up, consisting of a structured interview, anthropometric measurements and blood pressure and fasting blood analysis, were included as the study sample (67.1% males; 49.2% manual workers; mean age 40.6 ± 21.9 years). Workers were classified according to their body mass index (BMI) and metabolic phenotype. A metabolically unhealthy phenotype was defined as the presence of three or more of the following criteria: glycaemia ≥110 mg/dL or previously diagnosed type I/II diabetes or treatment for diabetes; triglycerides ≥150 mg/dL or lipid-lowering therapy; HDL <40/50 mg/dL M/F; blood pressure ≥130/85 mmHg or previously diagnosed hypertension or antihypertensive therapy; waist circumference >102/88 cm M/F. A one-year follow-up was conducted to evaluate the incidence of work-related and non-work-related SA (WRSA/NWRSA). The association of BMI with SA was tested using Poisson regression (standard error correction), segmenting on the basis of metabolic phenotype. The overall percentages of workers who were overweight, obese and/or had a metabolically unhealthy phenotype were 37.7%, 16.3% and 8.8%, respectively. BMI was associated with increased incidence of NWRSA in both phenotypes. It was also associated with WRSA in subjects with a BMI in the range of 35-39.99 kg/m2 and in metabolically healthy individuals. WRSA was lower in subjects with a BMI ≥40 kg/m2 and among metabolically unhealthy individuals. CONCLUSION Obesity is associated with health problems that have a significant impact on SA.
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Affiliation(s)
- C Catalina-Romero
- Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain.
| | - M A Sanchez Chaparro
- Department of Internal Medicine, University Hospital "Virgen de la Victoria", and University of Malaga, Malaga, Spain
| | - P Valdivielso
- Department of Internal Medicine, University Hospital "Virgen de la Victoria", and University of Malaga, Malaga, Spain
| | - L Quevedo-Aguado
- Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain
| | - C Brotons
- Research Unit, Sardenya Primary Health Care Centre-Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - L M Ruilope
- Research Institute Hospital 12 de Octubre, Madrid, Spain
| | - E Calvo-Bonacho
- Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain
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10
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Rodríguez-Capitán J, Fernández-Meseguer A, García-Pinilla JM, Calvo-Bonacho E, Jiménez-Navarro M, García-Margallo T, Cabrera-Bueno F, Echeverria-Lucotti I, Gómez-Doblas JJ, De Teresa-Galván E. Frequency of different electrocardiographic abnormalities in a large cohort of Spanish workers. Europace 2017; 19:1855-1863. [PMID: 28339570 DOI: 10.1093/europace/euw283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 08/13/2016] [Indexed: 11/13/2022] Open
Abstract
Aims Our aim was to describe the electrocardiographic findings of a large sample of Spanish workers from several different employment sectors. Methods and results Between May 2008 and November 2010, 13 495 consecutive 12-lead resting electrocardiograms (ECGs) were obtained during health examinations of working adults aged 16-74 years in 5 cities in different regions of Spain. Of those, 13 179 ECGs suitable for interpretation were included in this study. All tracings were classified by the same cardiologist, according to the Minnesota Code criteria. The mean age of the sample was 40 years, and 73.4% were male. Frequencies of complete right bundle branch block, complete left bundle branch block, and left ventricular hypertrophy were 1.1, 0.2, and 3.6%, respectively. Major Q wave abnormalities were observed in 1.7% of the subjects, T wave abnormalities in 0.7%, early repolarization in 2.4%, and other ST segment abnormalities in 0.2%. Atrial fibrillation was present in 0.08% of the workers and atrial flutter in 0.02%. Frequencies of the Wolff-Parkinson-White pattern, Brugada pattern, long QT pattern, and short QT pattern were 0.2, 0.068, 0.038, and 0.015%, respectively. Conclusion This study shows the electrocardiographic findings of a large sample of Spanish workers from several different employment sectors. The frequencies of many ECG patterns related to an adverse prognosis (left ventricular hypertrophy, complete left bundle branch block, T wave abnormalities, ST segment abnormalities, and atrial fibrillation) were low.
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Affiliation(s)
| | | | - José Manuel García-Pinilla
- Unidad de Gestión Clínica del Corazón, Hospital Clínico Universitario Virgen de la Victoria de Málaga Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | | | - Manuel Jiménez-Navarro
- Unidad de Gestión Clínica del Corazón, Hospital Clínico Universitario Virgen de la Victoria de Málaga Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | | | - Fernando Cabrera-Bueno
- Unidad de Gestión Clínica del Corazón, Hospital Clínico Universitario Virgen de la Victoria de Málaga Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | | | - Juan José Gómez-Doblas
- Unidad de Gestión Clínica del Corazón, Hospital Clínico Universitario Virgen de la Victoria de Málaga Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Eduardo De Teresa-Galván
- Unidad de Gestión Clínica del Corazón, Hospital Clínico Universitario Virgen de la Victoria de Málaga Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
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Calvo-Bonacho E, Catalina-Romero C, Cabrera M, Fernández-Labandera C, Sánchez Chaparro MÁ, Brotons C, Ruilope LM. Asociación entre la mejora en el perfil de riesgo cardiovascular y los cambios en la incapacidad temporal: resultados del estudio ICARIA. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2017.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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12
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Calvo-Bonacho E, Catalina-Romero C, Cabrera M, Fernández-Labandera C, Sánchez Chaparro MÁ, Brotons C, Ruilope LM. Association Between Improvement in Cardiovascular Risk Profile and Changes in Sickness Absence: Results of the ICARIA Study. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2017; 70:941-951. [PMID: 28291729 DOI: 10.1016/j.rec.2017.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 02/02/2017] [Indexed: 06/06/2023]
Abstract
INTRODUCTION AND OBJECTIVES The purpose of this study was to investigate whether changes in cardiovascular risk (CVR) are associated with the length and cost of sickness absence. METHODS A prospective cohort of 179 186 participants was evaluated. Each participant's CVR (SCORE) was assessed on 2 consecutive medical examinations, approximately 1 year apart (365 ± 90 days). Cardiovascular risk was categorized as < 4% or ≥ 4%, and participants were divided into 4 groups according to changes in their risk between the 2 assessments. After the second CVR estimate, a 1-year follow-up was carried out to assess sickness absence. Differences between the 4 groups in terms of the total count of sickness absence days during the follow-up period were tested using Poisson regression models. RESULTS After adjustment for covariates, participants who showed an improvement in CVR had a lower count of sickness absence days compared with both those who showed a worsening in risk and those who remained stable at ≥ 4% (RR, 0.91; 95%CI, 0.84-0.98). In comparison with participants whose CVR did not improve, more of the participants whose risk did improve had quit smoking (+17.2%; P < .001), and had controlled their blood pressure (+26.0%, P < .001), total cholesterol (+9.3%; P < .001), low-density lipoprotein cholesterol (+14.9%; P < .001), and triglyceride levels (+14.6%; P < .001). CONCLUSIONS Our results suggest that an improvement in CVR profile is accompanied by a decrease in sickness absence during a 1-year follow-up.
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Affiliation(s)
- Eva Calvo-Bonacho
- Departamento de Proyectos Sanitarios, Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain
| | - Carlos Catalina-Romero
- Departamento de Proyectos Sanitarios, Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain.
| | - Martha Cabrera
- Departamento de Proyectos Sanitarios, Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain
| | - Carlos Fernández-Labandera
- Departamento de Proyectos Sanitarios, Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain
| | | | - Carlos Brotons
- Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Luis Miguel Ruilope
- Instituto de Investigación, Hospital Universitario 12 de Octubre, Madrid, Spain
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Depression and cardiovascular disease: Time for clinical trials. Atherosclerosis 2017; 257:250-252. [DOI: 10.1016/j.atherosclerosis.2017.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 01/11/2017] [Indexed: 11/16/2022]
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Gordois AL, Toth PP, Quek RG, Proudfoot EM, Paoli CJ, Gandra SR. Productivity losses associated with cardiovascular disease: a systematic review. Expert Rev Pharmacoecon Outcomes Res 2016; 16:759-769. [PMID: 27831848 DOI: 10.1080/14737167.2016.1259571] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION People with cardiovascular disease (CVD) often require time off work to recover from illness or surgery; for example, following a myocardial infarction (MI) or stroke. These individuals incur income losses, work-related productivity is reduced for employers, and output is reduced for the wider economy. Productivity impacts to the economy also arise due to CVD-related mortality. Areas covered: A systematic literature review was conducted to identify and collate studies that report the magnitude of work-related productivity losses associated with CVD generally or specific cardiovascular (CV) events or conditions (coronary heart disease, MI, stroke, transient ischemic attack, angina, heart failure, peripheral artery disease, coronary revascularization). The search was conducted using Medline, Embase, the Cochrane Library, and Google to find studies published from January 2004 to January 2015. In total, 60 studies were identified, including 20 studies conducted in the USA, 25 studies conducted in Europe, and 18 studies conducted in other countries (three studies were conducted in multiple regions). The studies differed by the scope of losses assessed (absenteeism, presenteeism, early retirement, premature mortality) and CVD conditions/events included. Studies reported either average patient or population losses, and generally used a human capital rather than friction cost method. Outcomes were standardized and adjusted to 2015 US dollars where possible. Expert commentary: The review demonstrates that CVD imposes substantial morbidity- and mortality-related productivity costs. The studies identified in the review may be used to inform and populate societal economic evaluations in CVD, with the most appropriate source study being that most closely matching the context of the evaluation.
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Affiliation(s)
- Adam L Gordois
- a Covance Market Access Services Inc. , Sydney , Australia
| | - Peter P Toth
- b University of Illinois College of Medicine , Peoria , IL , USA.,c Ciccarone Center for the Prevention of Cardiovascular Disease , Johns Hopkins University School of Medicine , Baltimore , MD , USA
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Estimating the glomerular filtration rate in the Spanish working population: chronic kidney disease prevalence and its association with risk factors. J Hypertens 2016; 32:1970-8; discussion 1978. [PMID: 25023154 DOI: 10.1097/hjh.0000000000000267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aims to investigate the influence of estimated glomerular filtration rate (eGFR) with two equations (and by one or two separate measurements), on the prevalence of chronic kidney disease (CKD) and its association with blood pressure, and cardiovascular and metabolic risk factors. METHODS Between January 2010 and October 2011, the Ibermutuamur CArdiovascular RIsk Assessment project included 128 588 workers (77.2% men, mean age 39.3 years, range 16-75), who underwent two consecutive yearly medical check-ups and had information for eGFR according to the MDRD-IDMS and CKD-EPI equations (serum creatinine was measured by a isotope-dilution mass spectrometry traceable method in a single central laboratory). CKD was defined by an eGFR less than 60 ml/min per 1.73 m. Subclinical (occult) renal disease was defined as an eGFR less than 60 ml/min per 1.73 m in patients with serum creatinine below 1.3 mg/dl and below 1.2 mg/dl in men and women, respectively. RESULTS In this working population, prevalence of CKD was very low, but two to six times lower when two separate eGFRs below 60 ml/min per 1.73 m were used. The prevalence of CKD was significantly lower with the CKD-EPI compared to the MDRD-IDMS equation. The same applies to occult CKD. In male workers, occult CKD was practically nonexistent.Multivariate analyses show that blood pressure, total serum cholesterol, and serum glucose (positively), and high-density lipoprotein and low-density lipoprotein (negatively) were associated with CKD, with both equations. Another metabolic factor (waist circumference) was only associated (positively) with CKD defined by the CKD-EPI equation, which appears to be associated with most components of the metabolic syndrome. CONCLUSIONS The CKD-EPI formula, calculated on the basis of two reported blood samples, may provide the most specific definition of CKD.
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Reviriego J, Vázquez LA, Goday A, Cabrera M, García-Margallo MT, Calvo E. Prevalence of impaired fasting glucose and type 1 and 2 diabetes mellitus in a large nationwide working population in Spain. ACTA ACUST UNITED AC 2016; 63:157-63. [PMID: 26948542 DOI: 10.1016/j.endonu.2015.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 12/09/2015] [Accepted: 12/09/2015] [Indexed: 12/14/2022]
Abstract
INTRODUCTION To report the prevalence of impaired fasting glucose (IFG), undiagnosed and diagnosed diabetes, and their association to occupational categories in a representative sample of working population in Spain. MATERIALS AND METHODS A cross-sectional study of workers who attended routine medical check-ups from January 2007 to December 2007. A structured questionnaire was completed, and physical examinations and routine serum biochemical tests were performed. IFG was defined as fasting glucose levels ranging from 100 to 125 mg/dl with no diagnosis of T1DM or T2DM; T1DM was defined as previous diagnosis of T1DM; and T2DM as previous diagnosis of T2DM, treatment with oral antidiabetic drugs or insulin or fasting glucose levels ≥126 mg/dl, according to ADA criteria. RESULTS Of the 371,997 participants (median age 35 [interquartile range 29-44] years), 72.4% were male. Raw prevalence rates (95% CI) of IFG, undiagnosed (UKDM), and previously known type 2 (KDM2) and type 1 (KDM1) diabetes were 10.4% (10.3-10.5%), 1.3% (1.2-1.3%), 1.1% (1.1-1.2%), and 0.3% (0.3-0.3%), respectively. With the exception of KDM1, prevalence of these conditions increased with age and was greater among manual/blue-collar workers (12.1%, 1.5%, 1.3% and 0.3%, respectively) as compared to non-manual/white-collar workers (7.3%, 0.8%, 0.8% and 0.3%, respectively). Age- and sex-adjusted prevalence rates of IFG, UKDM and KDM2 were 13.1%, 2.0% and 2.4%, respectively. DISCUSSION In this sample of Spanish working population, impaired glycemic profiles were common. Prevalence rates of IFG and T2DM were high among blue-collar workers (except for T1DM). These data emphasize the need for earlier structured preventive schemes.
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Affiliation(s)
- Jesús Reviriego
- Department of Clinical Research, Lilly, S.A., Alcobendas, Spain
| | | | - Albert Goday
- Endocrinology and Nutrition Unit, Hospital del Mar, Barcelona, Spain; Department of Medicine, Autonomous University of Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; CiberOBN CIBER Fisiopatología Nutrición y Obesidad, ISCIII, Spain
| | | | | | - Eva Calvo
- Ibermutuamur, Mutual of Work-Related Accidents and Diseases Social Security No. 274, Madrid, Spain
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Promoción de la salud desde el lugar de trabajo. HIPERTENSION Y RIESGO VASCULAR 2015; 32:97-9. [DOI: 10.1016/j.hipert.2015.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 06/11/2015] [Indexed: 11/18/2022]
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Brotons C, Calvo-Bonacho E, Moral I, Puig M, Garcia-Margallo MT, Cortés-Arcas MV, Catalina-Romero C, Quevedo-Aguado L, Ruilope LM. Comparison of application of different methods to estimate lifetime cardiovascular risk. Eur J Prev Cardiol 2015; 23:564-71. [PMID: 25827686 DOI: 10.1177/2047487315579616] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 03/10/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recent guidelines recommend assessment of lifetime cardiovascular risk on the basis of traditional risk factors in adults who are not at high short-term risk. The aim of this study is to determine the implications of estimating the lifetime cardiovascular risk in individuals in a large occupational cohort in Spain. DESIGN National cross-sectional study in an occupational cohort with an in-person interview including laboratory tests. METHODS Volunteer workers who were examined between January 2011 and December 2011 were included. A total of 580,236 workers were eligible during this year and 259,834 were examined (participation rate of 44.7%). Short-term (10-year) and lifetime cardiovascular risk were estimated using the American College of Cardiology (ACC) and the American Heart Association (AHA) tool and the QRISK2 and QRISK. RESULTS Sixty-eight per cent were male, mean age was 39 years, with an age range of 16 to 75 years. Total number of individuals included in this study was 258,676. The percentage of patients at high short-term risk was 6.85% (95% confidence interval (CI) 6.75%-6.95% and 20.83% (95% CI 20.60%-21.07%) with the QRISK2, and the ACC/AHA risk equations, respectively. Of the percentage of patients classified as not at high risk with the different tools 1.61% (95% CI 1.55%-1.66%) were high lifetime risk on QRISK, and 27.41% (95% CI 27.11%-27.70%) on ACC/AHA risk. CONCLUSIONS Application of lifetime cardiovascular risk engages greater numbers of individuals at high risk with substantial differences between the different methods available. These differences can have important clinical implications specifically in the percentage of candidates for lifestyle changes and eventually lipid lowering drugs.
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Affiliation(s)
- Carlos Brotons
- Research Unit, Sardenya Primary Health Care Centre-Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain Teaching Unit of Family Medicine ACEBA, Barcelona, Spain
| | | | - Irene Moral
- Research Unit, Sardenya Primary Health Care Centre-Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain Teaching Unit of Family Medicine ACEBA, Barcelona, Spain
| | - Mireia Puig
- Research Unit, Sardenya Primary Health Care Centre-Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain Teaching Unit of Family Medicine ACEBA, Barcelona, Spain
| | | | | | | | | | - Luis M Ruilope
- Instituto de Investigación, Hospital Universitario Doce de Octubre, Madrid, Spain
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Catalina-Romero C, Ruilope LM, Sánchez-Chaparro MA, Valdivielso P, Cabrera-Sierra M, Fernández-Labandera C, Ruiz-Moraga M, Gonzalez-Quintela A, Calvo-Bonacho E. Factors influencing return-to-work after cerebrovascular disease: the importance of previous cardiovascular risk. Eur J Prev Cardiol 2014; 22:1220-7. [PMID: 25059932 DOI: 10.1177/2047487314544961] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 07/07/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND The role of prior cardiovascular risk (CVR) in the multifactorial process of returning to work after a cerebrovascular event has not been adequately investigated. Therefore, the objective of the present study was to analyse the association between previous CVR level, cardiovascular risk factors (CVRFs) and return-to-work (RTW) following cerebrovascular disease. DESIGN This was a prospective observational study. METHODS We analysed a cohort of 348 patients who had experienced an episode of cerebrovascular disease-related work absence. These individuals were selected from the ICARIA study (Ibermutuamur CArdiovascular RIsk Assessment). Global CVR was assessed using the SCORE system. We investigated the association between demographics, work-related variables, CVRFs and RTW following a cerebrovascular event. RESULTS We found that a total of 254 individuals (73.0%; 95% CI: 68.3-77.7) returned to work after cerebrovascular disease. Also, we observed a median loss of 12 working years due to disability. Moreover, adjusting for potential confounders revealed that low CVR level and the absence of the following CVRFs was associated with a higher likelihood of RTW: low vs moderate-to-high CVR level (OR: 2.55; 95% CI: 1.42-4.57), no hypertension before stroke (OR: 1.95; 95% CI: 1.11-3.41), non-smoker status (OR: 2.26; 95% CI: 1.30-3.93) and no previous diabetes (OR: 2.46; 95% CI: 1.26-4.79). CONCLUSIONS Low CVR, along with the absence of several CVRFs, can be used to predict RTW rates following cerebrovascular events. Therefore, controlling hypertension, tobacco consumption and diabetes might contribute to the effectiveness of multidisciplinary rehabilitation and/or secondary/tertiary prevention programs for cerebrovascular disease.
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Affiliation(s)
- Carlos Catalina-Romero
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Madrid, Spain
| | - Luis Miguel Ruilope
- Hypertension Unit, Department of Nephrology, Hospital 12 de Octubre, Madrid, Spain
| | - Miguel Angel Sánchez-Chaparro
- Department of Internal Medicine. University Hospital "Virgen de la Victoria", and University of Malaga, Malaga, Spain
| | - Pedro Valdivielso
- Department of Internal Medicine. University Hospital "Virgen de la Victoria", and University of Malaga, Malaga, Spain
| | - Martha Cabrera-Sierra
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Madrid, Spain
| | - Carlos Fernández-Labandera
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Madrid, Spain
| | - Montserrat Ruiz-Moraga
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Madrid, Spain
| | - Arturo Gonzalez-Quintela
- Department of Internal Medicine, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Eva Calvo-Bonacho
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Madrid, Spain
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Cabrera M, Sánchez-Chaparro MA, Valdivielso P, Quevedo-Aguado L, Catalina-Romero C, Fernández-Labandera C, Ruiz-Moraga M, González-Santos P, Calvo-Bonacho E. Prevalence of atherogenic dyslipidemia: association with risk factors and cardiovascular risk in Spanish working population. "ICARIA" study. Atherosclerosis 2014; 235:562-9. [PMID: 24956529 DOI: 10.1016/j.atherosclerosis.2014.05.960] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 05/22/2014] [Accepted: 05/30/2014] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of this study was to assess the prevalence of atherogenic dyslipidemia (AD) and the lipid triad (LT) in the working population in Spain, their associated variables and how far they are linked to cardiovascular risk (CVR). METHODS Observational cross-sectional study of 70,609 workers (71.5% male (M), 28.5% female (F), mean age 39.2 ± 10), who attended medical checkups and agreed to participate. Plasma samples were analysed in a central laboratory. AD definition used was: triglycerides ≥150 mg/dl and HDL cholesterol <40 mg/dl (M)/<50 mg/dl (F) and LT when LDL cholesterol > 160 mg/dl is further added. Univariate comparisons in the absence and presence of AD and LT and the probability of AD according to different parameters and their possible association with CVR were assessed. CVR was stratified following the European SCORE model for low risk-population. RESULTS 5.7% (95% CI 4.7-6.9) of the working population have AD and 1.1% (95% CI 1.0-1.2) LT. In univariate analysis, workers with AD and LT had a higher prevalence of obesity, hypertension, smoking and diabetes than those who had not (p < 0.001). In multivariate analysis, BMI, sex, age 40-49, diabetes, tobacco, uric acid, LDL or blood pressure significantly influenced the risk of AD. AD was significantly associated with CVR after adjusting for alcohol and obesity. However, most of the AD subjects (91.8%) were classified as low risk. CONCLUSIONS About 6% of the working population in Spain meets AD criteria. Assuming that these subjects have increased CVR, AD allows to identify additional 5% of subjects with increased CVR to that one the SCORE model detects, helping to improve cardiovascular risk stratification.
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Affiliation(s)
- M Cabrera
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
| | - M A Sánchez-Chaparro
- Department of Internal Medicine, University Hospital "Virgen de la Victoria" and University of Málaga, Campus de Teatinos, s/n, 29010 Málaga, Spain.
| | - P Valdivielso
- Department of Internal Medicine, University Hospital "Virgen de la Victoria" and University of Málaga, Campus de Teatinos, s/n, 29010 Málaga, Spain.
| | - L Quevedo-Aguado
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
| | - C Catalina-Romero
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
| | - C Fernández-Labandera
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
| | - M Ruiz-Moraga
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
| | - P González-Santos
- Department of Internal Medicine, University Hospital "Virgen de la Victoria" and University of Málaga, Campus de Teatinos, s/n, 29010 Málaga, Spain.
| | - E Calvo-Bonacho
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
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Hernández Díaz FJ, Ruilope LM. ¿Es útil calcular el riesgo cardiovascular a 30 años? Med Clin (Barc) 2014; 142:540-1. [DOI: 10.1016/j.medcli.2014.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 01/23/2014] [Indexed: 10/25/2022]
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Affiliation(s)
- Stefan Agewall
- Department of Cardiology, Oslo University Hospital, Ullevål and Institute of Clinical Medicine, University of Oslo, Norway
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