Association of General and Abdominal Obesity With Hypertension, Dyslipidemia and Prediabetes in the PREDAPS Study

INTRODUCTION AND OBJECTIVES

Some anthropometric measurements show a greater capacity than others to identify the presence of cardiovascular risk factors. This study estimated the magnitude of the association of different anthropometric indicators of obesity with hypertension, dyslipidemia, and prediabetes (altered fasting plasma glucose and/or glycosylated hemoglobin).

METHODS

Cross-sectional analysis of information collected from 2022 participants in the PREDAPS study (baseline phase). General obesity was defined as body mass index ≥ 30kg/m² and abdominal obesity was defined with 2 criteria: a) waist circumference (WC) ≥ 102cm in men/WC ≥ 88cm in women, and b) waist-height ratio (WHtR) ≥ 0.55. The magnitude of the association was estimated by logistic regression.

RESULTS

Hypertension showed the strongest association with general obesity in women (OR, 3.01; 95%CI, 2.24-4.04) and with abdominal obesity based on the WHtR criterion in men (OR, 3.65; 95%CI, 2.66-5.01). Hypertriglyceridemia and low levels of high-density lipoprotein cholesterol showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.49; 95%CI, 1.68-3.67 and OR, 2.70; 95%CI, 1.89-3.86) and with general obesity in men (OR, 2.06; 95%CI, 1.56-2.73 and OR, 1.68; 95%CI, 1.21-2.33). Prediabetes showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.48; 95%CI, 1.85-3.33) and with abdominal obesity based on the WC criterion in men (OR, 2.33; 95%CI, 1.75-3.08).

CONCLUSIONS

Abdominal obesity indicators showed the strongest association with the presence of prediabetes. The association of anthropometric indicators with hypertension and dyslipidemia showed heterogeneous results.

[Is the availability of buprenorphine/naloxone therapy for opioid-dependent inmates a necessity? ]

Agonist therapy (OAT) programs in combination with a psychosocial approach are the most effective way to prevent relapse in opioid-dependent patients. These programs reduce morbidity and risk behaviours for HIV transmission and other infections, improve quality of life and retention in treatment, and have a positive impact on antisocial behaviour. They are therefore very useful for prisoners with a history of opiate use. OATs based on buprenorphine/naloxone (B/N), along with others using methadone, are currently available in Spain. Diversified treatment offers an alternative treatment for opioid dependence that is more personalized and tailored to the patient's characteristics. As regards effectiveness, both drugs are very similar, but B/N shows a better safety profile and fewer drug-drug interactions and can be dispensed in pharmacies once the patient is released, which can assist with the patient' social reintegration. B/N treatment is more expensive than methadone. It is advisable to have different modes of OAT. These should be prescribed according to the characteristics and needs of each case, without incarceration impeding the right to drug treatment, which should be similar to that performed outside prison.

[Preventive treatment of nonrheumatic atrial fibrillation: from the efficacy of clinical trials to the effectiveness of clinical practice]

OBJECTIVES

To know the percentage of patients with nonrheumatic atrial fibrillation treated with anticoagulants as an approach to the effectiveness of the prophylactic treatment of stroke.

DESIGN

Multicenter observational study.

SETTING

Six primary health centers from Barcelona.

PARTICIPANTS

465 patients with the diagnosed of AF were selected during the second semester of 1996. Patients that had suffered a hemorrhagic stroke, or with mitral stenosis, or with a prosthetic valve, or had hyperthyroidism, or receiving anticoagulant therapy were excluded.

MEASUREMENTS AND MAIN RESULTS

299 patients (64%) were finally included for the analysis. 15.8% of the patients were treated with acenocoumarin, and 35.4% were treated with aspirin. The percentage of patients treated improved for high risk patients (higher than 50%).

CONCLUSIONS

The percentage of patients with nonrheumatic AF treated with acenocoumarin or aspirin is low, and physicians might be reluctant to use them because of bleeding complications, compliance with the treatment, or problems of accessibility.

[Calibration and safety of sphygmomanometers in health centers of Murcia]

OBJECTIVE

To find the levels of calibration, safety and physical faults in the sphygmomanometers used in Health Centres.

DESIGN

A multi-centre, observational, descriptive and crossover study. SITE. 7 Health Centres in the urban zone of Murcia and nearby towns. All the sphygmomanometers in the 7 Health Centres, that is 80 aneroid and 62 mercury ones.

MAIN MEASUREMENTS AND RESULTS

It needs high-lighting that 43.7% of the aneroid sphygmomanometers and 12.3% of the mercury ones were wrongly calibrated. We noted that 20% of the measurements made with wrongly calibrated aneroid sphygmomanometers had a margin of error above +/- 8 mmHg, with a tendency towards under-registering. We found very significant differences between the average arterial pressure measured by aneroid instruments as against mercury ones (p < 0.001). The number of sphygmomanometers which show a margin of error greater than +/- 3 mmHg at every level of pressure is significantly greater in aneroid instruments than in mercury ones (p < 0.001). We found physical faults in 23.9% of the instruments.

CONCLUSIONS

We consider the number of wrongly calibrated aneroid sphygmomanometers to be excessively high. Therefore mercury ones should be used whenever possible and particularly during diagnosis and treatment. Both aneroid and mercury sphygmomanometers should be regularly checked, using a proper procedure. Mercury instruments set at zero are correctly calibrated and can be used as a model for checking aneroid ones.