[Coronary disease risk attributable to cardiovascular risk factors in the Spanish population]. / Riesgo coronario atribuible a los factores de riesgo cardiovascular en población española.

INTRODUCTION AND OBJECTIVES: The proportion of the ischemic heart disease (IHD) burden attributable to cardiovascular risk factors in Spain has traditionally been extrapolated from populations in other countries. The aim of this study was to estimate the IHD risk attributable to smoking, hypercholesterolemia, hypertension, diabetes and excess weight using data from studies carried out in the Spanish population. METHODS: Data on the prevalence of cardiovascular risk factors in the general population were obtained from a meta-analysis of 48 cross-sectional studies carried out in Spain, and data on corresponding prevalences among IHD patients were derived from the PRIAMHO II and PREVESE II multicenter hospital registries. Crude and adjusted relative risks of IHD were obtained from follow-up data collected over 5 years in a primary-care cohort of 6124 adults without cardiovascular disease. The crude and adjusted population attributable fractions for various risk factors were calculated for both sexes combined and for men and women separately. RESULTS: Among men, 42.5% (95% confidence interval [CI] 6.8%-59.6%) of the adjusted incidence of IHD was attributable to overweight, 33.9% (95% CI 22.6%-41.0%) to smoking, 19.4% (95% CI 8.2%-26.5%) to hypercholesterolemia, and 15.5% (95% CI 1.6%-24.6%) to hypertension. Among women, 36.5% (95% CI -8.0%-56.3%) of IHD cases were attributable to overweight, 24.8% (95% CI 12.0%-31.9%) to diabetes, and 20.1% (95% CI 6.1%-28.6%) to hypercholesterolemia. CONCLUSIONS: The cardiovascular risk factors found to contribute most to IHD in the Spanish population were excess weight in both sexes, followed by smoking in men.

Riesgo coronario atribuible a los factores de riesgo cardiovascular en población española / Coronary disease risk attributable to cardiovascular risk factors in the spanish population

Introducción y objetivos. La carga de enfermedad coronaria atribuible a los factores de riesgo cardiovascular en España ha sido extrapolada tradicionalmente de otras poblaciones. Este estudio pretende estimar el riesgo coronario atribuible al tabaquismo, la hipercolesterolemia, la hipertensión, la diabetes y el sobrepeso, utilizando datos procedentes de poblaciones Españolas. Métodos. Las prevalencias de los factores de riesgo en la población general se obtuvieron de un metaanálisis de 48 estudios transversales realizados en España, y las prevalencias en enfermos coronarios se tomaron de los registros hospitalarios multicéntricos PRIAMHO II y PREVESE II. Los riesgos relativos brutos y ajustados de enfermedad coronaria se obtuvieron del seguimiento durante 5 años de una cohorte de atención primaria de 6.124 personas adultas libres de enfermedad cardiovascular. Las fracciones atribuibles brutas y ajustadas se calcularon para ambos sexos y para varones y mujeres por separado. Resultados. En los varones, el 42,5% (intervalo de confianza [IC] del 95%, 6,8%-59,6%) de la incidencia ajustada de enfermedad coronaria se atribuyó al sobrepeso; el 33,9% (IC del 95%, 22,6%-41%), al tabaquismo, el 19,4% (IC del 95%, 8,2%-26,5%), a la hipercolesterolemia, y el 15,5% (IC del 95%, 1,6%-24,6%), a la hipertensión. En las mujeres, el 36,5% (IC del 95%, ­8%-56,3%) de los casos de cardiopatía isquémica se atribuyeron al sobrepeso, el 24,8% (IC del 95%, 12%-31,9%), a la diabetes y el 20,1% (IC del 95%, 6,1%-28,6%), a la hipercolesterolemia. Conclusiones. El sobrepeso y el tabaquismo en varones son los factores de riesgo cardiovascular a los que cabe atribuir un mayor impacto poblacional en la enfermedad coronaria (AU)

Introduction and objectives. The proportion of the ischemic heart disease (IHD) burden attributable to cardiovascular risk factors in Spain has traditionally been extrapolated from populations in other countries. The aim of this study was to estimate the IHD risk attributable to smoking, hypercholesterolemia, hypertension, diabetes and excess weight using data from studies carried out in the Spanish population. Methods. Data on the prevalence of cardiovascular risk factors in the general population were obtained from a meta-analysis of 48 cross-sectional studies carried out in Spain, and data on corresponding prevalences among IHD patients were derived from the PRIAMHO II and PREVESE II multicenter hospital registries. Crude and adjusted relative risks of IHD were obtained from follow-up data collected over 5 years in a primary-care cohort of 6124 adults without cardiovascular disease. The crude and adjusted population attributable fractions for various risk factors were calculated for both sexes combined and for men and women separately. Results. Among men, 42.5% (95% confidence interval [CI] 6.8%­59.6%) of the adjusted incidence of IHD was attributable to overweight, 33.9% (95% CI 22.6%­41.0%) to smoking, 19.4% (95% CI 8.2%­26.5%) to hypercholesterolemia, and 15.5% (95% CI 1.6%­24.6%) to hypertension. Among women, 36.5% (95% CI ­8.0%­56.3%) of IHD cases were attributable to overweight, 24.8% (95% CI 12.0%­31.9%) to diabetes, and 20.1% (95% CI 6.1%­28.6%) to hypercholesterolemia. Conclusions. The cardiovascular risk factors found to contribute most to IHD in the Spanish population were excess weight in both sexes, followed by smoking in men (AU)