[Cardiovascular preventive recommendations. PAPPS 2020 update]. / Recomendaciones preventivas cardiovasculares. Actualización PAPPS 2020.

The recommendations of the semFYC's Program for Preventive Activities and Health Promotion (PAPPS) for the prevention of cardiovascular diseases (CVD) are presented. The following sections are included: Epidemiological review, where the current morbidity and mortality of CVD in Spain and its evolution as well as the main risk factors are described; Cardiovascular (CV) risk tables and recommendations for the calculation of CV risk; Main risk factors such as arterial hypertension, dyslipidemia and diabetes mellitus, describing the method for their diagnosis, therapeutic objectives and recommendations for lifestyle measures and pharmacological treatment; Indications for antiplatelet therapy, and recommendations for screening of atrial fibrillation. The quality of testing and the strength of the recommendation are included in the main recommendations.

[Prevalence of obesity in immigrants in Madrid, Spain]. / Prevalencia de obesidad en inmigrantes en Madrid.

BACKGROUND AND OBJECTIVE: There are no studies in Spain on the extent of obesity in adult immigrants. The aim of this paper is to present the frequency and distribution of obesity among immigrants living in Madrid. PATIENTS AND METHOD: We selected subjects between 18 and 64 years of age. Body Mass Index was used as an estimator of obesity. Immigrant status was defined according to country of birth. The results show the unadjusted and adjusted prevalence of obesity for different immigrant groups. RESULTS: The percentage of obesity was higher in the immigrant population than in the Spanish population, except for the group of immigrants from western countries. According to gender, male immigrants from Eastern Europe and Latin America and women from Asia, Africa and Eastern Europe were the most obese. CONCLUSION: The highest prevalence of obesity among immigrants has also been observed in studies conducted in other countries. The prevalence of obesity among immigrants may be due to a more intense exposure to obesogenic factors both before arrival and during their residence in Spain.

[Determinants of the adherence to therapeutic plan in elderly Spaniards, over 60 years of age]. / Determinantes del cumplimiento terapéutico en personas mayores de 60 años en España.

OBJECTIVE: To identify factors associated with the adherence to a therapeutic plan of awareness of hypertension. MATERIAL AND METHODS: The data of the study "Arterial hypertension and other factors of risk in the elderly (> or = 60 years) Spanish population". This was a population-based survey of 4.009 older Spaniards. Information for this survey was obtained thorough household personal interviews to evaluate if these determining factors are independent of socio-demographic variables, the use of health system, lifestyles and the quality of life related to health. RESULTS: In men, the adherence to a therapeutic plan according to the regions studied (OR Rural = 3.9; OR Cantabrian = 1.9). Beside general health (OR = 1.01). With respect to the women, the ones that complied with the therapeutic plan more frequently had a low scholastic level (OR = 1.8), physical condition (OR = 1.02), and had more frequent home medical visits monthly (OR = 3.0). The women with poor adherence had two chronic illnesses (OR = 0.6) CONCLUSIONS: There are regional differences, gender, educational and to measure health-related quality of life. This demonstrates poor adherence, so the strategy should be directed toward in this variables mentioned.

[Factors associated the control of hypertension among older Spaniards, over 60 years of age]. / Factores asociados al control de la hipertension arterial en personas mayores de 60 años en España.

BACKGROUND: In the last decade, improvement has been observed in the control of arterial hypertension in Spain. Such control has an effect in the decrease of cardiovascular morbidity and mortality. The objective of the study was to identify factors associated to the control of arterial hypertension in awareness of hypertension among males and females who receive pharmacological treatment. METHODS: A cross-sectional analysis, made in basis of the following study data: "Arterial Hypertension and other risk factors in the population of 60 years old and more in Spain". The sample included 1461 hypertensive patients treated pharmacologically, selected by probabilistic and multistage sampling. The information recollected about the control of arterial hypertension, social and demographic variables, lifestyle, healthcare service usage, and life quality related to health, by residence interviewing. RESULTS: No differences between gender were observed in the control of hypertension (p = 0.09), In men control were significantly linked to: residence in rural areas (OR = 1.83; CI at 95%: 1.06-3.14); being single (OR = 3.40; CI at 95%: 1.32-8.74); and exercising (OR = 1.69; CI at 95%: 1.06-2.69). Women who consume alcohol in a moderate way controlled themselves more (OR = 1.63; CI at 95% 1.14-2.33). CONCLUSIONS: This research determines, according to gender, some factors related with the control of arterial hypertension in awareness of hypertension patients treated pharmacologically. In male patients the control is related to: living in rural areas, being single and physical activity. While in females control was associated with moderate alcohol consumption.

[Association of cardiovascular disease with overweight and obesity in Spain]. / Asociación de la enfermedad cardiovascular con el sobrepeso y la obesidad en España.

BACKGROUND: Our purpose was to examine the relationship of overweight and obesity with cardiovascular disorders. PATIENTS AND METHOD: Data from the 1993 Spanish National Health Survey (16,692 subjects with a body mass index [BMI] >= 18.5 kg/m2). RESULTS: After adjustment for age, residence city size and tobacco consumption, we observed a positive dose-response relationship (p linear trend < 0.05) of BMI >= 18.5 kg/m2 with hypertension, hypercholesterolemia and diabetes in both sexes, as well as with heart diseases in women. These associations decreased with age. CONCLUSIONS: Overweight and obesity are associated with a greater frequency of cardiovascular disorders in Spain.

[The obesity epidemic and related factors: the case of Spain]. / La epidemia de obesidad y sus factores relacionados: el caso de España.

The obesity epidemic is a global phenomenon that does not respect geographic or socio-demographic boundaries. Thus, research on factors related to the obesity epidemic has focused on social and economic characteristics of modern societies. This article discusses obesity in Spain and trends in several associated factors. Together with the increase in the prevalence of obesity, important changes in the population's dietary pattern have been observed, although total energy and fat intake appear to be stable. According to several indirect indicators, sedentary behavior predominates, although the percentage of the population reporting some leisure exercise is increasing. An increase in the amount of leisure time in modern societies is suggested as an explanation for this paradox. Factors related to energy expenditure could be as important as dietary factors in the genesis of the obesity epidemic.

[Demography, healht-related life style and history of tobacco consumption among occasional smokers in Spain]. / Características demográficas, hábitos de vida e historia del consumo de tabaco de los fumadores ocasionales en España.

BACKGROUND: This study describes the sociodemographic characteristics, health-related lifestyle, and history of tobacco consumption of the occasional smokers in Spain, and examines whether they show differences against daily smokers. METHODS: Data were obtained from the National Health Survey of Spain, carried out in 1993 through household interviews on a sample representative of the non-institutionalised population aged 16 year and older. Analyses were performed with logistic regression and adjusted for sociodemographic, health-state and life-style variables. RESULTS: Out of the 6,668 smokers in the survey, occasional smokers were 9.2%, while daily smokers of < or = 5 cigarettes and > 5 cigarettes were 9.9% and 80.9%, respectively. As compared with daily smokers of > 5 cigarettes, occasional smokers were more frequently women (odds ratio (0R): 2.12; CI95%: 1.72-2.61), younger (OR aged 25-44 versus 16-24 years: 0.75; 0.58-0.96), with lower alcohol consumption (p for linear trend: 0.0349), and higher leisure-time physical activity (p for linear trend: < 0.0001). On the day they smoke, occasional smokers used to consume less cigarettes than daily smokers (p < 0.0001). Occasional smokers were more frequent among young smokers (aged less than 20) with relatively short history of tobacco consumption (less than 20 years), and also among older smokers (aged 65 year and older) with longer history of consumption (over 50 years). Daily smokers of < or = 5 cigarettes showed characteristics midway between those of occasional and daily smokers of > 5 cigarettes. CONCLUSIONS: Occasional smokers show sociodemographic characteristics, health-related lifestyle, and history of tobacco consumption different from daily smokers. Such differences suggest that research and intervention programs specifically tailored to occasional smokers should be developed.

[Epidemiology of hypertension in the elderly population of Spain]. / Epidemiología de la hipertensión arterial en personas mayores de 60 años en España.

About 68% of the Spanish elderly are hypertensives (> or = 140/90 mmHg). About 65% are aware hypertensives, 55% are treated with antihypertensives, and only 16% are controlled. Among treated hypertensives, systolic control (32%) is much lower than diastolic control (82.3%). Control is lower in males, the oldest, and those of lowest educational level. About 57% of uncontrolled treated hypertensives are undergoing monotherapy. Losing weight is the least followed advice. Overall, hypertension is an important public health problem in the Spanish elderly.

Recomendaciones preventivas cardiovasculares. Actualización PAPPS 2018 / No disponible

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Recomendaciones preventivas cardiovasculares. PAPPS 2016 / No disponible

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Recomendaciones preventivas cardiovasculares / Recommendations on prevention of cardiovascular disease

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Effectiveness and equity of serum cholesterol and blood pressure testing: a population-based study in Spain.

BACKGROUND: This study examined the effectiveness and equity of serum cholesterol and blood pressure testing in Spain. METHODS: Data were taken from a household survey of 3680 persons of the Basque Country, a region in northern Spain. Analyses were performed using logistic regression, controlling for need, equity, and predisposing factors for serum cholesterol and blood pressure testing. Proxies for need were age, subjective health and cardiovascular risk factors, such as tobacco and alcohol consumption, physical activity at work and at leisure time, and body mass index. Proxies for equity were sex, educational level, and province of residence, and predisposing factors for testing were the marital status and the number of medical visits in the preceding year. RESULTS: The percentage of subjects that had their cholesterol measured rose with age and worse subjective health, but showed no association with any cardiovascular risk factor except body mass index, for which a positive association was observed (P for linear trend, 0.0351). The percentage of subjects with serum cholesterol checked also rose with educational level (P for linear trend, 0.0024). Moreover, women were less likely to have their cholesterolemia tested than men (OR, 0.79; 95% CI, 0.67-0.94). Educational and sex differences in cholesterol testing increased after adjustment for the number of medical visits. Similar results were obtained for blood pressure testing. CONCLUSIONS: Serum cholesterol and blood pressure testing are not performed according to cardiovascular risk, which compromise its effectiveness. Moreover, there are social inequalities in testing, to which healthcare professionals could be contributing.

Surgical site infection of 7301 traumatologic inpatients (divided in two sub-cohorts, study and validation): modifiable determinants and potential benefit.

The widespread use of peri-surgical chemoprophylaxis is decreasing the incidence of surgical site infection in Traumatology, which nevertheless remains as a problem amenable to further reduction. We have tried to identify modifiable determinants of the avoidable incidence of surgical site infection, and to estimate the potential benefit from implementing adequate measures targeting those determinants. In a firts sub-cohort of 5320 traumatologic patients with a post-surgical stay of more than 2 days, in Madrid's La Paz Hospital, between 1991 and 1996. The epidemiological surveillance was prospective during their hospital stay but also includes data on readmissions due to infection so as to analyse the actual incidence of surgical site infection, both before and after discharge. Bivariate and multivariate (multiple logistic regression model) analyses of risk factors for surgical site infections have been performed. In this sub-cohort, 212 patients (3.9%) suffered some type of nosocomial infection. The incidence of surgical site infection before discharge in cases of clean surgery was 1.6%, rising to 2% when cases readmitted for infection after discharge were considered. The multivariate analysis of risk factors for surgical site infection identified the following: contaminated ('dirty') surgery (OR: 10.5), inadequate chemoprophylaxis (OR: 1.5) and a pre-surgical stay of more than 4 days (OR: 1.6). Next, a second sub-cohort, consisting of 1981 patients, treated between 1997 and 1999, was analysed to validate the results of the first multivariate analysis. The validation model (and the global cohort with 7301 patients) corroborates the importance of the same three factors. Last, we calculated that controlling two modifiable factors, pre-surgical stay and peri-surgical chemoprophylaxis, could avoid 56% of surgical site infections.