RESUMO
One of the objectives of the Spanish Society of Arteriosclerosis is to contribute to better knowledge of vascular disease, its prevention and treatment. It is well known that cardiovascular diseases are the leading cause of death in our country and entail a high degree of disability and health care costs. Arteriosclerosis is a multifactorial disease and therefore its prevention requires a global approach that takes into account the different risk factors with which it is associated. Therefore, this document summarizes the current level of knowledge and includes recommendations and procedures to be followed in patients with established cardiovascular disease or at high vascular risk. Specifically, this document reviews the main symptoms and signs to be evaluated during the clinical visit, the laboratory and imaging procedures to be routinely requested or requested for those in special situations. It also includes vascular risk estimation, the diagnostic criteria of the different entities that are cardiovascular risk factors, and makes general and specific recommendations for the treatment of the different cardiovascular risk factors and their final objectives. Finally, the document includes aspects that are not usually referenced in the literature, such as the organization of a vascular risk consultation.
Assuntos
Arteriosclerose , Doenças Cardiovasculares , Arteriosclerose/complicações , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Fatores de Risco de Doenças Cardíacas , Humanos , Fatores de RiscoRESUMO
UNLABELLED: INTRODUCTION, BASES AND AIMS: Study the possible associations between any family history of early heart disease and variables expressive of heart disease, lesion or repercussion in subjects of high cardiovascular risk. MATERIAL AND METHODS: Nationwide cross-sectional study with 2264 consecutive patients in the Outpatient Clinic of Internal Medicine 18 years of age or older and with high or extremely high cardiovascular risk taken from the CIFARC (Integral Control of High Risk Cardiovascular Factors) study run by the SEMI (Spanish Internal Medicine Association) cardiovascular Risk Group. We have studied the relationship between the presence or lack of same in family histories of early heart disease (AFP-Family History of early heart disease, hereafter FH) and different variables in the factors concerning cardiovascular risk and target organ lesion. The statistical treatment (Chi-2, ANOVA and Pearson s linear regression) was performed using the STATISTIX programme. RESULTS AND DISCUSSION: We observed a significative increase (p<0.05) in the group with FH with a percentage of the following variables: Total cholesterol>250 mg/dl, HDL<40 mg/dl, LDL>130 mg/dl, LVH (left ventricular hypertrophy), creatinine 1.2-2mg/dl, retinopathy I-II, serious retinopathy, smoking, proteinuria>300 mg/dl, kidney insufficiency and peripheral vascular disease. This significative increase in the variables under study appeared in males of over 55 years of age and in females of over 65 years of age; nevertheless, this increase in the incidence rate is becoming more common as of age 50 in males, with a maximum in both sexes after the age of 70. No significative differences were noted with regard to sex, BMI (Body Mass Index), atheromatosis, ischemic cardiopathy and cerebrovascular disease. On the whole, subjects of both sexes of the FH group have come to the clinic 3 years earlier than those of the group without FH. CONCLUSIONS: Patients with FH show a greater incidence of certain factors concerning heart risk and target organ lesion.