Asociación entre salud cardiovascular ideal y longitud telomérica en una población de edad avanzada de la cohorte SUN / Association between ideal cardiovascular health and telomere length in participants older than 55 years old from the SUN cohort

Introducción y objetivos: Los telómeros son regiones no codificantes localizadas al final de los cromosomas de células eucariotas, y su acortamiento se ha visto relacionado con la enfermedad cardiovascular y sus factores de riesgo. El objetivo de este estudio es evaluar la asociación entre el índice de salud cardiovascular ideal y el riesgo de telómero corto en una población de sujetos de edad avanzada de la cohorte Seguimiento Universidad de Navarra (SUN). Métodos: Se valoró a 886 adultos mayores de 55 años (645 varones y 241 mujeres). La longitud telomérica se midió utilizando qPCR (quantitative protein chain reaction) en tiempo real y reacción única. El índice de salud cardiovascular «Life's simple 7» se definió según la American Heart Association mediante la puntuación de 7 ítems con valores de 0 a 2 para cada uno: tabaquismo, actividad física, dieta, índice de masa corporal, presión arterial, colesterol total y glucosa en sangre. La máxima puntuación del índice corresponde a 14 puntos. Se categorizó en terciles: pobre (0-9 puntos), intermedio (10-11 puntos) e ideal (12-14 puntos). El riesgo de telómero corto se definió como una longitud telomérica por debajo del percentil 20. Resultados: Sujetos con altos valores en el índice de salud cardiovascular ideal tenían menos riesgo de telómero corto (OR ajustada=0,60; IC95%, 0,34-1,05; p de tendencia lineal=0,052). Esta asociación fue significativa en varones (OR ajustada=0,37; IC95%, 0,17-0,83; p de tendencia lineal=0,025), pero no en mujeres. Conclusiones: En varones mayores de 55 años, existe una asociación inversa entre el índice de salud cardiovascular y el riesgo de tener telómeros cortos (AU)

Introduction and objectives: Telomeres are noncoding regions located at the end of chromosomes and their shortening has been associated with risk factors and cardiovascular disease. The aim of this study was to evaluate the association between ideal cardiovascular health (Life's simple 7) and the odds of having short telomeres in a subsample of participants older than 55 years from the Seguimiento Universidad de Navarra (SUN) study. Methods: We included 886 participants older than 55 years (645 men and 241 women). Telomere length was measured using a real-time quantitative polymerase chain reaction. Cardiovascular health score was defined by the American Heart Association as a composite score of 7 key risk factors (smoking status, physical activity, diet, body mass index, blood pressure, total cholesterol, and fasting blood glucose) with 0 to 2 points for each factor. We categorized this score in tertiles as poor (0-9 points), intermediate (10-11 points) and ideal (12-14 points). The odds of having short telomeres was defined as telomere length below the 20th percentile. Results: Individuals with higher ideal cardiovascular health had a lower prevalence of having short telomeres (adjusted OR, 0.60; 95%CI, 0.34-1.05; P trend=.052). This association was statistically significant in men (adjusted OR, 0.37; 95%CI, 0.17-0.83; P trend=.025) but not in women. Conclusions: An inverse association between cardiovascular health score and short telomeres was found especially for men older than 55 years in the SUN population (AU)

Association between ideal cardiovascular health and telomere length in participants older than 55 years old from the SUN cohort.

INTRODUCTION AND OBJECTIVES: Telomeres are noncoding regions located at the end of chromosomes and their shortening has been associated with risk factors and cardiovascular disease. The aim of this study was to evaluate the association between ideal cardiovascular health (Life's simple 7) and the odds of having short telomeres in a subsample of participants older than 55 years from the Seguimiento Universidad de Navarra (SUN) study. METHODS: We included 886 participants older than 55 years (645 men and 241 women). Telomere length was measured using a real-time quantitative polymerase chain reaction. Cardiovascular health score was defined by the American Heart Association as a composite score of 7 key risk factors (smoking status, physical activity, diet, body mass index, blood pressure, total cholesterol, and fasting blood glucose) with 0 to 2 points for each factor. We categorized this score in tertiles as poor (0-9 points), intermediate (10-11 points) and ideal (12-14 points). The odds of having short telomeres was defined as telomere length below the 20th percentile. RESULTS: Individuals with higher ideal cardiovascular health had a lower prevalence of having short telomeres (adjusted OR, 0.60; 95%CI, 0.34-1.05; P trend=.052). This association was statistically significant in men (adjusted OR, 0.37; 95%CI, 0.17-0.83; P trend=.025) but not in women. CONCLUSIONS: An inverse association between cardiovascular health score and short telomeres was found especially for men older than 55 years in the SUN population. The SUN project was registered at ClinicalTrials.gov (Identifier: NCT02669602).

Concordancia entre el índice de salud cardiovascular ideal y el índice Fuster-BEWAT / Concordance between the ideal cardiovascular health score and the Fuster-BEWAT score

RESUMEN Introducción: Cinco indicadores de salud cardiovascular: presión arterial, actividad física, índice de masa corporal, consumo de fruta y verdura y fumar tabaco, pueden ser suficientes para predecir el riesgo cardiovascular en individuos sanos a través del índice de Fuster BEWAT. Objetivo: Comparar los resultados de los índices de Fuster BEWAT y el de salud cardiovascular ideal para determinar la salud. Método: Se realizó un estudio descriptivo transversal en el servicio de Atención Primaria del Hospital Manuel Fajardo Rivero de Santa Clara, en el período enero-junio de 2019, se valoró el estado de salud cardiovascular de 347 individuos sanos, sin antecedentes de enfermedad cardiovascular con edades comprendidas entre 40 y 59 años. Se usó el índice de Kappa de Cohen para determinar la concordancia entre el índice de salud cardiovascular ideal y el índice Fuster-BEWAT. Resultados: La escasa actividad física (79,8%), la dieta no balanceada (74,9 %) y la presión arterial no controlada fueron los peores marcadores encontrados. Solo un 15,3% de los hombres y mujeres analizados cumplían con el estado ideal para todos los marcadores del índice de Fuster BEWAT y 17,8% del índice de salud cardiovascular ideal. La concordancia obtenida entre ambos índices, a través del coeficiente Kappa de Cohen (0.935), demostró una relación casi perfecta. Conclusiones: Las puntuaciones de los dos índices mostraron valores similares. El índice Fuster-BEWAT es más sencillo y no requiere resultados analíticos; puede considerarse la primera opción en contextos en los que el acceso a análisis de laboratorio es limitado.

ABSTRACT Introduction: The following five indicators of cardiovascular health: blood pressure, physical activity, body mass index, fruit and vegetable consumption and tobacco smoking, may be sufficient to predict cardiovascular risk in healthy individuals through the Fuster-BEWAT score. Objective: To compare the results of the Fuster-BEWAT score and the ideal cardiovascular health score to determine health. Method: A cross-sectional descriptive study was carried out in the Primary Care Service of the Hospital Manuel Fajardo Rivero in Santa Clara, from January to June 2019, evaluating the cardiovascular health status of 347 healthy individuals without a history of cardiovascular disease, between the ages of 40 and 59 years old. Cohen's kappa coefficient was used to determine the concordance between the ideal cardiovascular health score and the Fuster-BEWAT score. Results: Low physical activity (79.8%), unbalanced diet (74.9%), and uncontrolled blood pressure were the worst markers found. Only 15.3% of the analyzed men and women met the ideal condition for all markers of the Fuster-BEWAT score and 17.8% of the ideal cardiovascular health score. The concordance obtained between both scores, through Cohen's kappa coefficient (0.935), showed an almost perfect relationship. Conclusions: Both scores showed similar values. The Fuster-BEWAT score is simpler and does not require analytical results; it can be considered as a first option in contexts where access to laboratory tests is limited.