[Cardiovascular disease epidemiology and risk factors in primary care]. / Epidemiología de las enfermedades cardiovasculares y factores de riesgo en atención primaria.

INTRODUCTION AND OBJECTIVES: To study the prevalence of and risk factors for cardiovascular disease in primary care. PATIENTS AND METHOD: A cross-sectional study was carried out at an urban health center in Barcelona, Spain. In total, 2248 patients > or =15 years old were selected randomly from medical records. The study investigated cardiovascular diseases such as ischemic heart disease, cerebrovascular disease and peripheral arterial disease, and cardiovascular risk factors such as age, sex, smoking, high blood pressure, hypercholesterolemia, hypertriglyceridemia, and diabetes mellitus. RESULTS: The patients' mean age was 49.1 (18.9) years and 53.5% were male. Cardiovascular risk factor prevalences were: smoking, 35.2%; high blood pressure, 33.7%; hypercholesterolemia, 21.9%; hypertriglyceridemia,12.7%; and diabetes mellitus, 15.8%. Overall, 57.9% of patients had at least 1 cardiovascular risk factor. Significantly more males presented with each risk factor (P<.05), apart from high blood pressure. The prevalence of all risk factors, except smoking, increased with age until 74 years and then stabilized, except high blood pressure, which continued to increase. Around 10% had cardiovascular disease, with myocardial ischemia in 5.5%, cerebrovascular disease in 3.7%, and peripheral arterial disease in 2.4%. All except cerebrovascular disease were significantly more common in males (P<.05). The prevalence of cardiovascular disease was low in individuals <55 years old, particularly women, and increased with age for all forms of disease. Some 68.3% were > or =65 years old. CONCLUSIONS: The high prevalence of cardiovascular risk factors was confirmed. Cardiovascular disease was more common in males and the elderly.

[Association between clustering of cardiovascular risk factors and the risk of cardiovascular disease]. / Asociación entre la agrupación (clustering) de factores de riesgo cardiovascular y el riesgo de enfermedad cardiovascular.

BACKGROUND: Cardiovascular diseases are the main cause of mortality in Spain. The aim of this work was to study the association between clustering of cardiovascular risk factors and the risk of suffering major cardiovascular events: ischemic cardiopathy, cerebrovascular disease and peripheral arteriopathy of the lower limbs. METHOD: A descriptive transversal study was carried out in a city health centre, with a total of 2248 patients selected by simple random sampling of the clinical records with a mean age of 15 years. The data were obtained by examining the clinical records and estimating Odds Ratios (OR) for any cardiovascular event (n = 224), ischemic cardiopathy (n = 123), cerebrovascular disease (n = 84) and peripheral arteriopathy (n = 55) in relation to the number of cardiovascular risk factors. The cardiovascular risk factors included in the study were smoking, arterial hypertension, hypercholesterolemia, hypertriglyceridemia, diabetes and obesity. The OR was adjusted for age and sex. RESULTS: The percentage of patients with 0, 1, 2, 3 and 4-6 cardiovascular risk factors was 39.1, 32.8, 17.5, 6.9 and 3.7 respectively. The OR for experiencing a cardiovascular event associated to 1, 2, 3 and 4-6 cardiovascular risk factors was 1.6 (CI95%: 0.9-2.7), 2.8 (CI95%: 1.7-4.7), 3.6 (CI95%: 1.9-6.5) and 5.6 (CI95%: 2.9-10.8), respectively. The OR for ischemic cardiopathy associated to the same risk levels were 2.3 (CI95%: 1.1-4.6), 2.5 (CI95%: 1.2-5.2), 5.3 (CI95%: 2.4-11.5) and 6.2 (CI95%: 2.7-14.3), respectively. For cardiovascular disease, the OR were 1.1 (CI95%: 0.5-2.5), 2.3 (CI95%: 1.2-5.3), 2.4 (CI95%: 1.0-5.9) and 5.6 (CI95%: 2.2-14.1), respectively. The OR for peripheral arteriopathy were 2.1 (CI95%: 0.8-5.9), 3.7 (CI95%: 1.3-10.5), 3.3 (CI95%: 1.0-11.1) and 6.1 (CI95%: 1.8-20.3), respectively. CONCLUSIONS: The addition of cardiovascular risk factors is associated with an increased risk of cardiovascular events. This finding emphasises the need for prevention of cardiovascular risk factors in primary care.