Lipid control and associated risk factors, before suffering from the first cardiovascular event. / Control lipídico y factores de riesgo asociados, antes del padecimiento del primer evento cardiovascular.

OBJECTIVE: To ascertain the degree of lipidic control before the first cardiovascular accident in population attended during 2013 at Primary Care. To analyze the distribution of these events depending on control intervals of cholesterol LDL (LDL-chol), cholesterol HDL (HDL-chol) and triglycerides (TG). METHOD: A multicentric cross-sectional, descriptive study on above 18-year-old people attended at the centres of the Primari Care Service (PCS) Baix Llobregat Nord, who had suffered a first cardiac or cerebral ischemic attack from 01/01/2013 to 31/12/2013. Variables collected included age,sex, smoking, high blood preassure,diabetes, dyslipidemia (DLP), obesity, total cholesterol (chol-tot), LDL-chol, HDL-chol, TG, systolic and diastolic blood preassure (SBP,DBP), IMC, HbA1c, atherogenic indices, REGICOR, drugs. RESULTS: 379 affected people, among them 197 (52%) heart attack and 182 (48%) stroke (ictus). Two hundred and twenty-five (54.4%) males, diagnosis median age 68.9 years (DS 13.7), 71.2 (DS 14.4) in CV (p: .001). High blood preassure 214 (56.5%), diabetes 113 (29.8%), DLP 193 (50.9%). Cases in LDL<100-159: 88%, HDL≥40/50: 72.8%, TG<150: 71.3%. chol-tot average: 198.3 mg/dl (DS 40.2), LDL-chol:121 (DS 33.8), LDL-chol<130:170 (58.6%). HDL-chol average: 52.5 mg/dl (DS 15.4) and TG: 130.9 mg/dl (DS 73.2) (CI:139.5 [DS 84.2] vs. CV: 120.9 [DS 55.9] [p: .003]). Optimal chol-tot/HDL-chol 67%, optimal TG/HDL-chol 39.8%. CI:optimal chol-tot/HDL-chol male vs. female: 51.2% vs. 76.9% (p: .002); optimal TG/HDL-chol male vs. female: 28% vs. 53.8% (p: .004). CONCLUSIONS: The quantity of events was similar in both cardiac and cerebral territories, whereas the median age in the diagnosis was a little higher in CV. High blood preassure, DLP and obesity are the most prevalent FRCV, and its control at primary prevention is improvable. Most of the cases were grouped in the LDL lipid ranges <100-159mg/dl, HDL ≥ 40/50mg/dl and TG <150mg/dl.

Metabolic syndrome and peripheral artery disease: Two related conditions. / Síndrome metabólico y enfermedad arterial periférica: 2 enfermedades relacionadas.

AIMS: To ascertain the prevalence of metabolic syndrome (MS) in patients with peripheral artery disease (PAD) at the Martorell primary care (PC) center. To analyze the differences in comorbidities and cardiovascular risk factors between patients with PAD with and without MS. METHODS: A cross-sectional, descriptive study on patients diagnosed with PAD according to computerized clinical records of the Martorell PC center. Variables collected included age, sex, high blood pressure (HBP), dyslipidemia (DLP), diabetes (DM), smoking, obesity, cardiovascular disease (CVD), erectile dysfunction (ED), renal failure (RF), and oligoalbuminuria. An analysis comparing patients with and without MS was performed. RESULTS: There were 131 patients diagnosed with PAD, 104 (79%) of whom were male. Sixty-three (48.1%) also had MS. Patients with both PAD and MS had, as compared to those with PAD only, a higher prevalence of HBP (87.3 vs. 60.3%, P: 0.001), DLP (77.8 vs. 60.3%, P: 0.03), DM (69.8 vs. 30.9%, P<.001), obesity (25.4 vs. 10.3%, P: 0.03), CVD (42.9 vs. 19.1%); P: 0.004), ED (81.3 vs. 54.3%, P: 0.02), and RF (40.3 vs. 17.9%, P: 0.006). CONCLUSION: Patients with both PAD and MS had a higher prevalence of HBP, DLP, DM, and obesity. They also had more cardiovascular events and were significantly associated with pathological conditions highly relevant for cardiovascular prognosis such as erectile dysfunction and chronic kidney disease.

[Relationship between blood pressure and mortality at 4 years of follow up in a cohort of individuals aged over 80 years]. / Relación entre presión arterial y mortalidad a los 4 años de seguimiento en una cohorte de individuos mayores de 80 años.

BACKGROUND AND OBJECTIVES: To study the association between blood pressure and mortality in a cohort of over 80 years olders of the community after four years of follow up. PATIENTS AND METHODS: An observational study cohort of 323 individuals aged over 80 years the population of Martorell. We collected sociodemographic data, comorbidity, evaluation of the basic activities of daily living and the average blood pressure. The mortality and its causes were evaluated after four years of follow up. The association between blood pressure and mortality was investigated using Cox survival analysis. RESULTS: One hundred and thirty-five (41.8%) patients died, resulting in a mortality rate of 14.5% for year. In 60% of cases the cause of death was of cardiovascular origin. Subjects with systolic blood pressure (SBP) < 130 mm Hg had a mortality of 63.5% compared to those in the range of SBP = 140-159 mm Hg, who had a mortality of 25.5% (Hazard Ratio [HR]: 0.39; 95% CI: 0.21-0.72; p = 0.003). Female gender (HR: 0.62, 95% CI 0.39-0.97, p < 0.036), age (HR: 1.11, 95% CI: 1.04-1.18, p < 0.001), ischemic heart disease (HR: 2.14, 95% CI 1.23-3.70, p < 0.006), orthostatic hypotension (HR: 3.78, 95% CI: 1.88-7.60, p < 0.001), Barthel Index (HR: 0.97, 95% CI: 0.96-0.98, p < 0.001), and SBP = 140-159 mm Hg (HR: 0.31, 95% CI: 0.13-0.72; p = 0.007) were independent factors associated with mortality at 4 years of follow up. CONCLUSIONS: There is a high cardiovascular mortality in people aged more than 80 years. The risk factors associated with mortality are being female, older age, history of heart disease, presence of orthostatic hypotension and worse function. SBP below 130 mm Hg is associated with increased mortality.