Cross-sectional survey of the prevalence of reduced estimated glomerular filtration rate, albuminuria and cardiovascular risk in a native Spanish population.

OBJECTIVES: HERMEX is a population-based study which tries to evaluate the relative weight of cardiovascular risk factors in inhabitants of Extremadura, Spain. This report presents the data about chronic kidney disease (CKD) in a Spanish population sample. METHODS: For an observational cross-sectional population-based study, 3,402 subjects were randomly selected from health care system records. The final sample included 2,813 participants (mean age 51.2 years, 53.5% women). Renal function was estimated from serum creatinine using the 4-variable Modification of Diet in Renal Disease (MDRD-4) Study and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. Individual renal risk was calculated using the Kidney Disease Improving Global Outcomes (KDIGO) table. RESULTS: Using the CKD-EPI formula, 3.6% of participants had a glomerular filtration rate (GFR) <60 ml/min. MDRD-4 gave a result of 4.0%. Prevalence of albuminuria was 5.5%. Taken together, in patients with albuminuria and/or reduced GFR, the prevalence of renal disease was 8.1%. The KDIGO renal risk table suggested that 0.05% of patients were at high or very high risk of CKD progression and 1.6% at medium risk. CKD was more common in those who were obese, hypertensive, dyslipidemic or had diabetes. Multivariate analysis showed an independent negative association of CKD as dependent variable with systolic blood pressure and body mass index, but a positive correlation with diastolic blood pressure and male sex. CONCLUSIONS: A low frequency of abnormal GFR was detected in a randomly selected sample of the Spanish general population. This finding agreed with the low rates of cardiovascular mortality and morbidity observed in Spain in spite of a high prevalence of classic cardiovascular risk factors.

Prevalence of abnormal urinary albumin excretion in a population-based study in Spain: results from the HERMEX Study.

BACKGROUND: HERMEX is a population-based study which try to evaluate the relative weight of cardiovascular risk factors in the population of Extremadura. This report provides the data obtained about microalbuminuria in a large Spanish population. DESIGN AND METHODS: Observational, cross-sectional, population-based study. A total of 3402 subjects were randomly selected from the Health Care System of Extremadura. The final sample included 2813 subjects (mean age 51·2 years, 53·5% female). Urinary albumin excretion rate (UAER) in first morning urine sample was analysed. Microalbuminuria was diagnosed when UAER was ≥ 22 in men or ≥ 31 mg/g in women. RESULTS: Prevalence of abnormal UAER in general population was 5·5% (microalbuminuria: 4·7%; proteinuria 0·8%). Microalbuminuria grew slightly in patients between 65 and 74 years and showed a dramatic increase in subject older than 75 years (P < 0·001). Men showed a high prevalence of microalbuminuria (5·8% vs. women 3·6%; P = 0·006 chi-squared test). Increased UAER was more common in obese subjects (6·7% vs. 2·3%, P < 0·001), hypertensive patients (8·3% vs. 2·3%, P < 0·001) and diabetic ones (10·9% vs. 3·7%, P < 0·001). The multivariate analysis showed a positive correlation of abnormal UAER with body mass index (BMI), systolic blood pressure, plasma creatinine and triglyceride levels. CONCLUSIONS: A low frequency of abnormal UAER was detected in a randomly selected sample of Spanish general population. This finding agreed with the low rates of cardiovascular mortality and morbidity observed in Spain in spite of a high prevalence of classic cardiovascular risk factors.

[Prevalence of metabolic syndrome estimated with the new World Health Organization recommendations. The HERMEX study]. / Prevalencia de síndrome metabólico según las nuevas recomendaciones de la OMS. Estudio HERMEX.

OBJECTIVES: The unification of criteria for the diagnosis of metabolic syndrome, together with the subsequent World Health Organization (WHO) proposal to eliminate diabetes and cardiovascular diseases from the diagnostic criteria, will change estimates of the known prevalence of this syndrome. The aim of this study was to determine the prevalence of metabolic syndrome in a health area of Badajoz (Spain) using the latest consensus criteria and eliminating diabetes and cardiovascular disease. METHODS: We performed a cross-sectional population-wide study of randomly selected individuals aged between 25 and 79 years old in a health area of Badajoz. In all patients, data on their history of cardiovascular risk factors were gathered, waist circumference and blood pressure were measured and a fasting blood sample was collected. The prevalence of metabolic syndrome, following recent criteria, was compared by age and gender. RESULTS: We recruited 2,833 individuals (46.5% men). The mean age was 51.2 years The prevalence of metabolic syndrome was 33.6% and was significantly higher in men (36.7% vs 30.9%; p < 0.001). The prevalence of metabolic syndrome fell significantly after exclusion of patients with diabetes or cardiovascular disease (20.8%; p < 0.001). The difference in prevalence between the distinct criteria was significant for the whole population and by sex (p < 0.000). A significant difference in prevalence between genders was observed from the age of 45-54 years in men and 55-64 years in women CONCLUSIONS: The prevalence of metabolic syndrome in a health area of Badajoz is among the highest reported in population-based studies in Spain. Although estimates of the prevalence are decreased by the new international recommendations, a considerable proportion of the young population requires preventive measures.

[Prevalence, awareness, treatment and control of cardiovascular risk factors in the Extremadura population (Spain). HERMEX study]. / Prevalencia, detección, tratamiento y grado de control de los factores de riesgo cardiovascular en la población de Extremadura (España). Estudio HERMEX.

OBJECTIVE: To estimate the prevalence, detection, treatment and degree of control of cardiovascular risk factors in Extremadura. DESIGN: Cross-sectional study. SETTING: Population study in Don Benito-Villanueva de la Serena health area (Badajoz). PARTICIPANTS: A random sample of the people between 25 and 79 years, who lived in this area, was selected. METHODS: History of cardiovascular risk factors and its treatment were obtained by questionnaire. Blood pressure and blood sample were obtained for all participants. We calculated the prevalence of each variable standardized for age and gender for the population of Extremadura. RESULTS: Of the 3521 eligible, 2833 (80.5%) participants were included, mean age 51.2 years, male 46.5%. Adjusted prevalence of current smoking in men: 40.5% (37.8-43.2), hypertension 39.5% (37.3-41.7), hypercholesterolemia, 37.9% (35.4-40.4), obesity 36.5% (33.9-39.1), diabetes 13.7% (12.1-15.4). Adjusted prevalence of hypercholesterolemia in women: 35,0% (32.9-37.2), hypertension 33,0% (31.3-34.7), obesity 30.7% (28.6-32.8), current smoking 26,6% (24.5-28.7), diabetes 12,0% (10.5-13.5). The detection level of each factor was above 70%, and the degree of control among those treated of 51, 62.3 and 74.7% for hypertension, diabetes and hypercholesterolemia, respectively. CONCLUSIONS: Extremadura's population is highly exposed to major cardiovascular risk factors, especially men. Smoking, obesity and diabetes stand in the national context as the most prevalent in our community.