Control lipídico y factores de riesgo asociados, antes del padecimiento del primer evento cardiovascular / Lipid control and associated risk factors, before suffering from the first cardiovascular event

Objetivos: Conocer el grado de control lipídico previo al primer accidente cardiovascular en población atendida durante 2013 en Atención Primaria. Analizar la distribución de dichos eventos según intervalos de control de colesterol LDL (LDL-col), colesterol HDL (HDL-col) y triglicéridos (TG). Método: Estudio descriptivo transversal multicéntrico. Sujetos: mayores de 18 años atendidos en centros del Servicio (SAP) Baix Llobregat Nord, que habían sufrido un primer evento (ECV) isquémico cardiaco (CI) o cerebral (CV) del 01/01/2013 al 31/12/2013. Mediciones: edad, sexo, tabaquismo, hipertensión arterial, diabetes, dislipemia, obesidad, colesterol total (col-tot), LDL-col, HDL-col, TG, presión arterial sistólica, diastólica, IMC, HbA1c, índices aterogénicos, REGICOR, fármacos. Resultados: Trescientos setenta y nueve sujetos afectos, 197 (52%) cardiaco y 182 (48%) cerebral. Doscientos veinticinco (59,4%) varones; edad media en el diagnóstico 68,9 años (DS 13,7), 71,2 (DS 14,4) en CV (p: 0,001). Hipertensión 214 (56,5%), diabetes 113 (29,8%), DLP 193 (50,9%). Casos en LDL < 100-159: 88%, HDL ≥ 40/50: 72,8%, TG < 150: 71,3%. Media col-tot: 198,3 mg/dl (DS 40,2); LDL-col 121 (DS 33,8), LDL-col < 130: 170 (58,6%). Media HDL-col: 52,5 mg/dl (DS 15,4) y TG: 130,9 mg/dl (DS 73,2) (CI: 139,5 [DS 84,2] vs. CV: 120,9 [DS 55,9] [p: 0,003]). col-tot/HDL-col óptimo 67%, TG/HDL-col óptimo 39,8%. CI: col-tot/HDL-col óptimo varón vs. mujer: 51,2 vs. 76,9% (p 0,002); TG/HDL-col óptimo varón vs. mujer: 28% vs. 53,8% (p 0,004). Conclusiones: La cuantía de eventos fue similar en ambos territorios, y la edad media en el diagnóstico algo mayor en CV. Hipertensión, DLP y obesidad son los FRCV más prevalentes, y su control en prevención primaria es susceptible de mejora. La mayor parte de los casos se agruparon en los intervalos lipídicos LDL < 100-159 mg/dl, HDL ≥ 40/50 mg/dl y TG < 150 mg/dl

Objective: To ascertain the degree of lipidic control before the first cardiovascular accident in population attended during 2013 at Primary Care. To analyze the distribution of these events depending on control intervals of cholesterol LDL (LDL-chol), cholesterol HDL (HDL-chol) and triglycerides (TG). Method: A multicentric cross-sectional, descriptive study on above 18-year-old people attended at the centres of the Primari Care Service (PCS) Baix Llobregat Nord, who had suffered a first cardiac or cerebral ischemic attack from 01/01/2013 to 31/12/2013. Variables collected included age,sex, smoking, high blood preassure,diabetes, dyslipidemia (DLP), obesity, total cholesterol (chol-tot), LDL-chol, HDL-chol, TG, systolic and diastolic blood preassure (SBP,DBP), IMC, HbA1c, atherogenic indices, REGICOR, drugs. Results: 379 affected people, among them 197 (52%) heart attack and 182 (48%) stroke (ictus). Two hundred and twenty-five (54.4%) males, diagnosis median age 68.9 years (DS 13.7), 71.2 (DS 14.4) in CV (p: .001). High blood preassure 214 (56.5%), diabetes 113 (29.8%), DLP 193 (50.9%). Cases in LDL< 100-159: 88%, HDL ≥ 40/50: 72.8%, TG < 150: 71.3%. chol-tot average: 198.3 mg/dl (DS 40.2), LDL-chol:121 (DS 33.8), LDL-chol < 130:170 (58.6%). HDL-chol average: 52.5 mg/dl (DS 15.4) and TG: 130.9 mg/dl (DS 73.2) (CI:139.5 [DS 84.2] vs. CV: 120.9 [DS 55.9] [p: .003]). Optimal chol-tot/HDL-chol 67%, optimal TG/HDL-chol 39.8%. CI:optimal chol-tot/HDL-chol male vs. female: 51.2% vs. 76.9% (p: .002); optimal TG/HDL-chol male vs. female: 28% vs. 53.8% (p: .004). Conclusions: The quantity of events was similar in both cardiac and cerebral territories, whereas the median age in the diagnosis was a little higher in CV. High blood preassure, DLP and obesity are the most prevalent FRCV, and its control at primary prevention is improvable. Most of the cases were grouped in the LDL lipid ranges < 100-159 mg/dl, HDL ≥ 40/50 mg/dl and TG < 150 mg/dl

Lipid control and associated risk factors, before suffering from the first cardiovascular event. / Control lipídico y factores de riesgo asociados, antes del padecimiento del primer evento cardiovascular.

OBJECTIVE: To ascertain the degree of lipidic control before the first cardiovascular accident in population attended during 2013 at Primary Care. To analyze the distribution of these events depending on control intervals of cholesterol LDL (LDL-chol), cholesterol HDL (HDL-chol) and triglycerides (TG). METHOD: A multicentric cross-sectional, descriptive study on above 18-year-old people attended at the centres of the Primari Care Service (PCS) Baix Llobregat Nord, who had suffered a first cardiac or cerebral ischemic attack from 01/01/2013 to 31/12/2013. Variables collected included age,sex, smoking, high blood preassure,diabetes, dyslipidemia (DLP), obesity, total cholesterol (chol-tot), LDL-chol, HDL-chol, TG, systolic and diastolic blood preassure (SBP,DBP), IMC, HbA1c, atherogenic indices, REGICOR, drugs. RESULTS: 379 affected people, among them 197 (52%) heart attack and 182 (48%) stroke (ictus). Two hundred and twenty-five (54.4%) males, diagnosis median age 68.9 years (DS 13.7), 71.2 (DS 14.4) in CV (p: .001). High blood preassure 214 (56.5%), diabetes 113 (29.8%), DLP 193 (50.9%). Cases in LDL<100-159: 88%, HDL≥40/50: 72.8%, TG<150: 71.3%. chol-tot average: 198.3 mg/dl (DS 40.2), LDL-chol:121 (DS 33.8), LDL-chol<130:170 (58.6%). HDL-chol average: 52.5 mg/dl (DS 15.4) and TG: 130.9 mg/dl (DS 73.2) (CI:139.5 [DS 84.2] vs. CV: 120.9 [DS 55.9] [p: .003]). Optimal chol-tot/HDL-chol 67%, optimal TG/HDL-chol 39.8%. CI:optimal chol-tot/HDL-chol male vs. female: 51.2% vs. 76.9% (p: .002); optimal TG/HDL-chol male vs. female: 28% vs. 53.8% (p: .004). CONCLUSIONS: The quantity of events was similar in both cardiac and cerebral territories, whereas the median age in the diagnosis was a little higher in CV. High blood preassure, DLP and obesity are the most prevalent FRCV, and its control at primary prevention is improvable. Most of the cases were grouped in the LDL lipid ranges <100-159mg/dl, HDL ≥ 40/50mg/dl and TG <150mg/dl.

Síndrome metabólico y enfermedad arterial periférica: 2 enfermedades relacionadas / Metabolic syndrome and peripheral artery disease: Two related conditions

Objetivos: Conocer la prevalencia de síndrome metabólico (SM) en pacientes afectos de enfermedad arterial periférica (EAP) en el centro de Atención Primaria (AP) de Martorell. Analizar las diferencias de comorbilidad y factores de riesgo cardiovascular asociados (FRCV) en pacientes con EAP según presenten o no SM. Metodología: Estudio descriptivo transversal. Sujetos: pacientes diagnosticados de EAP según historia clínica informatizada de AP de Martorell. Mediciones: edad, sexo, hipertensión arterial (HTA), dislipidemia (DLP), diabetes (DM), tabaquismo, obesidad, enfermedad cardiovascular (ECV), disfunción eréctil (DE), insuficiencia renal (IR) y oligoalbuminuria. Análisis: frecuencias para variables discretas, medias y desviación típica (DS) para las variables continuas. Se realizó análisis bivariante que comparaba pacientes que presentaban EAP y SM con los que solo presentaban EAP. Resultados: Un total de 131 pacientes diagnosticados de EAP, 104 (79%) varones. De ellos, 63 (48,1%) presentaron SM, de los que 46 (73%) eran varones. Los pacientes que combinaban EAP y SM, en comparación con los que solo tenían EAP, presentaban mayor prevalencia de HTA (87,3 vs. 60,3%; p: 0,001), DLP (77,8 vs. 60,3%; p: 0,03), DM (69,8 vs. 30,9%; p < 0,001), obesidad (25,4 vs. 10,3%; p: 0,03), ECV (42,9 vs. 19,1%; p: 0,004), DE (81,3 vs. 54,3%; p: 0,02) e IR (40,3 vs. 17,9%; p: 0,006). Conclusiones: Los pacientes que combinan EAP y SM presentan una mayor prevalencia de HTA, DLP, DM y obesidad; padecen más eventos cardiovasculares a nivel cardiaco o cerebral, y se asocian, también de manera significativa a entidades patológicas tan relevantes desde el punto de vista del pronóstico cardiovascular como la DE y la enfermedad renal crónica (AU)

Aims: To ascertain the prevalence of metabolic syndrome (MS) in patients with peripheral artery disease (PAD) at the Martorell primary care (PC) center. To analyze the differences in comorbidities and cardiovascular risk factors between patients with PAD with and without MS. Methods: A cross-sectional, descriptive study on patients diagnosed with PAD according to computerized clinical records of the Martorell PC center. Variables collected included age, sex, high blood pressure (HBP), dyslipidemia (DLP), diabetes (DM), smoking, obesity, cardiovascular disease (CVD), erectile dysfunction (ED), renal failure (RF), and oligoalbuminuria. An analysis comparing patients with and without MS was performed. Results: There were 131 patients diagnosed with PAD, 104 (79%) of whom were male. Sixty-three (48.1%) also had MS. Patients with both PAD and MS had, as compared to those with PAD only, a higher prevalence of HBP (87.3 vs. 60.3%, P: 0.001), DLP (77.8 vs. 60.3%, P: 0.03), DM (69.8 vs. 30.9%, P<.001), obesity (25.4 vs. 10.3%, P: 0.03), CVD (42.9 vs. 19.1%); P: 0.004), ED (81.3 vs. 54.3%, P: 0.02), and RF (40.3 vs. 17.9%, P: 0.006). Conclusion: Patients with both PAD and MS had a higher prevalence of HBP, DLP, DM, and obesity. They also had more cardiovascular events and were significantly associated with pathological conditions highly relevant for cardiovascular prognosis such as erectile dysfunction and chronic kidney disease (AU)

Metabolic syndrome and peripheral artery disease: Two related conditions. / Síndrome metabólico y enfermedad arterial periférica: 2 enfermedades relacionadas.

AIMS: To ascertain the prevalence of metabolic syndrome (MS) in patients with peripheral artery disease (PAD) at the Martorell primary care (PC) center. To analyze the differences in comorbidities and cardiovascular risk factors between patients with PAD with and without MS. METHODS: A cross-sectional, descriptive study on patients diagnosed with PAD according to computerized clinical records of the Martorell PC center. Variables collected included age, sex, high blood pressure (HBP), dyslipidemia (DLP), diabetes (DM), smoking, obesity, cardiovascular disease (CVD), erectile dysfunction (ED), renal failure (RF), and oligoalbuminuria. An analysis comparing patients with and without MS was performed. RESULTS: There were 131 patients diagnosed with PAD, 104 (79%) of whom were male. Sixty-three (48.1%) also had MS. Patients with both PAD and MS had, as compared to those with PAD only, a higher prevalence of HBP (87.3 vs. 60.3%, P: 0.001), DLP (77.8 vs. 60.3%, P: 0.03), DM (69.8 vs. 30.9%, P<.001), obesity (25.4 vs. 10.3%, P: 0.03), CVD (42.9 vs. 19.1%); P: 0.004), ED (81.3 vs. 54.3%, P: 0.02), and RF (40.3 vs. 17.9%, P: 0.006). CONCLUSION: Patients with both PAD and MS had a higher prevalence of HBP, DLP, DM, and obesity. They also had more cardiovascular events and were significantly associated with pathological conditions highly relevant for cardiovascular prognosis such as erectile dysfunction and chronic kidney disease.

Relación entre presión arterial y mortalidad a los 4 años de seguimiento en una cohorte de individuos mayores de 80 años / Relationship between blood pressure and mortality at 4years of follow up in a cohort of individuals aged over 80 years

Fundamento y objetivos: Estudiar la asociación entre las cifras de presión arterial y la mortalidad en una cohorte de personas mayores de 80 años de la comunidad.Pacientes y métodos: Estudio analítico observacional de una cohorte de 323 individuos mayores de 80 años de la población de Martorell. Se recogieron datos sociodemográficos, comorbilidad, actividades básicas de la vida diaria y la media de la presión arterial. La mortalidad y sus causas fueron evaluadas después de 4 años de seguimiento. La asociación entre presión arterial y mortalidad se investigó mediante el análisis de supervivencia de Cox. Resultados:Ciento treinta y cinco (41,8%) individuos fallecieron, resultando una tasa de mortalidad de 14,5%/año. En el 60% de los casos la causa del fallecimiento fue cardiovascular. Los sujetos con presión arterial sistólica (PAS) < 130mmHg presentaron una mortalidad de 63,5%, frente a los situados en el intervalo de PAS=140-159mmHg con una mortalidad del 25,5% (Hazard Ratio [HR]: 0,39; IC95%: 0,21-0,72; p=0,003). El género femenino (HR: 0,62; IC95%: 0,39-0,97; p < 0,036), la edad al inicio del estudio (HR: 1,11; IC95%: 1,04-1,18; p<0,001), cardiopatía isquémica (HR: 2,14; IC95%: 1,23-3,70; p<0,006), hipotensión ortostática (HR: 3,78; IC95%: 1,88-7,60; p<0,001) e Índice de Barthel (HR: 0,97; IC95%: 0,96-0,98; p<0,001) fueron factores independientes asociados a mortalidad a los 4 años. Conclusiones: Existe una elevada mortalidad cardiovascular en personas mayores de 80 años. Son factores de riesgo asociados a mayor mortalidad, la edad, ser mujer, cardiopatía isquémica, hipotensión ortostática y peor funcionalidad. Una PAS inferior a 130mmHg se asoció con mayor mortalidad (AU)

Background and objectives: To study the association between blood pressure and mortality in a cohort of over 80years olders of the community after four years of follow up. Patients and methods: An observational study cohort of 323 individuals aged over 80years the population of Martorell. We collected sociodemographic data, comorbidity, evaluation of the basic activities of daily living and the average blood pressure. The mortality and its causes were evaluated after four years of follow up. The association between blood pressure and mortality was investigated using Cox survival analysis. Results: One hundred and thirty-five (41.8%) patients died, resulting in a mortality rate of 14.5% for year. In 60% of cases the cause of death was of cardiovascular origin. Subjects with systolic blood pressure (SBP) < 130mmHg had a mortality of 63.5% compared to those in the range of SBP=140-159mmHg, who had a mortality of 25.5% (Hazard Ratio [HR]: 0.39; 95% CI: 0.21-0.72; p=0.003). Female gender (HR: 0.62, 95% CI 0.39-0.97, p<0.036), age (HR: 1.11, 95% CI: 1.04-1.18, p<0.001), ischemic heart disease (HR: 2.14, 95% CI 1.23-3.70, p<0.006), orthostatic hypotension (HR: 3.78, 95% CI: 1.88-7.60, p<0.001), Barthel Index (HR: 0.97, 95% CI: 0.96-0.98, p<0.001), and SBP=140-159mmHg (HR: 0.31, 95% CI: 0.13-0.72; p=0.007) were independent factors associated with mortality at 4years of follow up.Conclusions: There is a high cardiovascular mortality in people aged more than 80years. The risk factors associated with mortality are being female, older age, history of heart disease, presence of orthostatic hypotension and worse function. SBP below 130mmHg is associated with increased mortality (AU)

[Relationship between blood pressure and mortality at 4 years of follow up in a cohort of individuals aged over 80 years]. / Relación entre presión arterial y mortalidad a los 4 años de seguimiento en una cohorte de individuos mayores de 80 años.

BACKGROUND AND OBJECTIVES: To study the association between blood pressure and mortality in a cohort of over 80 years olders of the community after four years of follow up. PATIENTS AND METHODS: An observational study cohort of 323 individuals aged over 80 years the population of Martorell. We collected sociodemographic data, comorbidity, evaluation of the basic activities of daily living and the average blood pressure. The mortality and its causes were evaluated after four years of follow up. The association between blood pressure and mortality was investigated using Cox survival analysis. RESULTS: One hundred and thirty-five (41.8%) patients died, resulting in a mortality rate of 14.5% for year. In 60% of cases the cause of death was of cardiovascular origin. Subjects with systolic blood pressure (SBP) < 130 mm Hg had a mortality of 63.5% compared to those in the range of SBP = 140-159 mm Hg, who had a mortality of 25.5% (Hazard Ratio [HR]: 0.39; 95% CI: 0.21-0.72; p = 0.003). Female gender (HR: 0.62, 95% CI 0.39-0.97, p < 0.036), age (HR: 1.11, 95% CI: 1.04-1.18, p < 0.001), ischemic heart disease (HR: 2.14, 95% CI 1.23-3.70, p < 0.006), orthostatic hypotension (HR: 3.78, 95% CI: 1.88-7.60, p < 0.001), Barthel Index (HR: 0.97, 95% CI: 0.96-0.98, p < 0.001), and SBP = 140-159 mm Hg (HR: 0.31, 95% CI: 0.13-0.72; p = 0.007) were independent factors associated with mortality at 4 years of follow up. CONCLUSIONS: There is a high cardiovascular mortality in people aged more than 80 years. The risk factors associated with mortality are being female, older age, history of heart disease, presence of orthostatic hypotension and worse function. SBP below 130 mm Hg is associated with increased mortality.