Factores cardiometabólicos asociados y prevalencia de concentraciones bajas de colesterol HDL y de dislipidemia aterogénica. Estudio SIMETAP-DA / Related cardiometabolic factors and prevalence of low HDL-cholesterol levels and atherogenic dyslipidemia. SIMETAP-AD study

OBJETIVO: Determinar las prevalencias ajustadas por edad y sexo de concentraciones bajas de colesterol HDL (cHDL-bajo) y de dislipidemia aterogénica (DA), y valorar sus asociaciones con factores de riesgo cardiovascular, enfermedad renal crónica, enfermedades cardiovasculares y cardiometabólicas. MÉTODOS: Estudio observacional transversal de base poblacional realizado en atención primaria, con sujetos adultos seleccionados aleatoriamente. Se consideró DA si los pacientes tenían hipertrigliceridemia (triglicéridos≥150mg/dL) y cHDL-bajo (<40mg/dL [hombres],<50mg/dL [mujeres]). Se determinaron las tasas de prevalencia crudas y ajustadas por edad y sexo, y se realizó análisis univariado y multivariante para evaluar los factores cardiometabólicos relacionados. RESULTADOS: Población de estudio con 6.588 adultos (55,9% mujeres) con edad media de 55,1 (±17,5) años. Las medias de cHDL fueron 49,2 (±12,6) mg/dL en hombres y 59,2 (±14,7) mg/dL en mujeres. Las prevalencias crudas de cHDL-bajo y de DA fueron 30,8% (IC95%: 29,7-31,9), y 14,3% (IC95%: 13,5-15,2), respectivamente. Las prevalencias ajustadas de cHDL-bajo fueron 28% en hombres y 31% en mujeres, y de DA fueron 16,4% en hombres y 10,6% en mujeres. El 73% de la población con DA tenía riesgo cardiovascular alto o muy alto. Los factores independientes asociados con cHDL-bajo o con DA fueron diabetes, tabaquismo, obesidad abdominal y obesidad. Los principales factores asociados con cHDL-bajo y con DA fueron hipertrigliceridemia y diabetes, respectivamente. CONCLUSIONES: Casi un tercio de la población adulta presentaba cHDL-bajo y la mitad de ellos cumplía criterios de DA. Los factores cardiometabólicos se asociaban con cHDL-bajo y DA, destacando la hipertrigliceridemia con el cHDL-bajo, y la DM con la DA

AIM: To determine the crude and sex- and age-adjusted prevalence rates of atherogenic dyslipidemia (AD) and low HDL-cholesterol levels (low-HDLc), and to assess their associations with cardiovascular risk factors, chronic kidney disease, cardiovascular and cardiometabolic diseases. METHODS: Population-based cross-sectional study conducted in Primary Care, with randomly selected adult subjects. The AD was considered if the patients had hypertriglyceridemia (triglycerides≥150mg/dL) and low-HDLc (<40mg/dL [men];<50mg/dL [women]). Crude and sex- and age-adjusted prevalence rates were determined, and univariate and multivariate analysis were performed to assess related cardiometabolic factors. RESULTS: Study population with 6,588 adults (55.9% women) with mean age 55.1 (±17.5) years. The mean HDLc levels were 49.2 (±12.6) mg/dL in men and 59.2 (±14.7) mg/dL in women. The crude prevalence rates of low-HDLc and AD were 30.8% (95%CI: 29.7-31.9), and 14.3% (95%CI: 13.5-15.2), respectively. The adjusted prevalence rates of low-HDLc were 28.0% in men and 31.0% in women, and AD were 16.4% in men and 10.6% in women. Seventy-three percent of the population with AD had high or very high cardiovascular risk. The independent factors associated with low HDLc or with AD were diabetes, smoking, abdominal obesity, and obesity. The major factors associated with low HDLc and AD were hypertriglyceridemia and diabetes, respectively. CONCLUSIONS: Almost a third of the adult population had low HDL-C and half of them met AD criteria. Cardiometabolic factors were associated with low HDL-C and AD, highlighting hypertriglyceridemia with low HDLc, and DM with AD

Related cardiometabolic factors and prevalence of low HDL-cholesterol levels and atherogenic dyslipidemia. SIMETAP-AD study. / Factores cardiometabólicos asociados y prevalencia de concentraciones bajas de colesterol HDL y de dislipidemia aterogénica. Estudio SIMETAP-DA.

AIM: To determine the crude and sex- and age-adjusted prevalence rates of atherogenic dyslipidemia (AD) and low HDL-cholesterol levels (low-HDLc), and to assess their associations with cardiovascular risk factors, chronic kidney disease, cardiovascular and cardiometabolic diseases. METHODS: Population-based cross-sectional study conducted in Primary Care, with randomly selected adult subjects. The AD was considered if the patients had hypertriglyceridemia (triglycerides≥150mg/dL) and low-HDLc (<40mg/dL [men];<50mg/dL [women]). Crude and sex- and age-adjusted prevalence rates were determined, and univariate and multivariate analysis were performed to assess related cardiometabolic factors. RESULTS: Study population with 6,588 adults (55.9% women) with mean age 55.1 (±17.5) years. The mean HDLc levels were 49.2 (±12.6) mg/dL in men and 59.2 (±14.7) mg/dL in women. The crude prevalence rates of low-HDLc and AD were 30.8% (95%CI: 29.7-31.9), and 14.3% (95%CI: 13.5-15.2), respectively. The adjusted prevalence rates of low-HDLc were 28.0% in men and 31.0% in women, and AD were 16.4% in men and 10.6% in women. Seventy-three percent of the population with AD had high or very high cardiovascular risk. The independent factors associated with low HDLc or with AD were diabetes, smoking, abdominal obesity, and obesity. The major factors associated with low HDLc and AD were hypertriglyceridemia and diabetes, respectively. CONCLUSIONS: Almost a third of the adult population had low HDL-C and half of them met AD criteria. Cardiometabolic factors were associated with low HDL-C and AD, highlighting hypertriglyceridemia with low HDLc, and DM with AD.

Prevalence of erectile dysfunction in Spanish primary care setting and its association with cardiovascular risk factors and cardiovascular diseases. SIMETAP-ED study / Prevalencia de la disfunción eréctil en el ámbito de la atención primaria española y su asociación con factores de riesgo cardiovasculares y enfermedades cardiovasculares. Estudio SIMETAP-ED

Introduction: Few studies conducted in primary care setting report about age-adjusted prevalence rates of erectile dysfunction (ED). Aims of SIMETAP-ED study were to determine crude and age-adjusted prevalence rates of ED diagnosis, to compare these rates with other similar studies, and to compare prevalence rates of cardiovascular risk factors (CVRF), cardiovascular diseases (CVD), metabolic diseases and chronic kidney disease (CKD) between populations with and without ED. Methods: Cross-sectional observational study conducted in primary care setting. Population-based random sample: 2934 adult men. Response rate: 66%. A clinical interview was conducted to diagnose ED using a question derived from ED definition. The medical records of patients were reviewed to identify their CVRF and diseases associated with ED. The age-adjustments were standardized to Spanish population. Results: The prevalence rates of metabolic diseases, CVD, CVRF, and CKD in population with ED were higher than population without ED, highlighting the CVD. The crude prevalence of ED was 17.2% (95% confidence interval: 15.8-18.6). The age-adjusted prevalence rates of ED were 0.71% in men under 40 years, 12.4% in men over 18 years, 10.8% in men aged 40-69 years, 18.9% in men over 40 years, and 48.6% in men over 70 years. Conclusions: SIMETAP-ED study showed association of ED with metabolic diseases, CKD, CVRF, and highlighting CVD. The age-adjusted prevalence of ED was 12.4% in adult men, 19% in men over 40 years, and almost 50% in men over 70 years

Introducción: Existen pocos estudios realizados en atención primaria sobre prevalencias ajustadas por edad de la disfunción eréctil (ED, por sus siglas en inglés). Los objetivos del estudio SIMETAP-ED fueron determinar las prevalencias crudas y ajustadas por edad del diagnóstico de la ED, comparar estas tasas con otros estudios similares, y comparar las prevalencias de factores de riesgo cardiovasculares (FRCV), enfermedades cardiovasculares (ECV), enfermedades metabólicas y enfermedad renal crónica (ERC) entre las poblaciones con y sin ED. Métodos: Estudio observacional transversal realizado en atención primaria. Muestra aleatoria base poblacional: 2.934 varones adultos. Tasa de respuesta: 66%. Se realizó una entrevista clínica para diagnosticar ED mediante una pregunta derivada de la definición de ED. Se revisaron las historias clínicas de los pacientes para identificar sus FRCV y enfermedades asociadas con la ED. Los ajustes de tasas se estandarizaron con respecto a la población española. Resultados: Las prevalencias de enfermedades metabólicas, ECV, FRCV y ERC en la población con ED fueron más altas que en la población sin ED, destacando las ECV. La prevalencia cruda de la ED fue del 17,21% (intervalo de confianza del 95%: 15,86-18,63). Las tasas de prevalencia ajustadas por edad de la ED fueron del 0,71% en menores de 40 años, del 12,4% en mayores de 18 años, del 10,8% en varones entre 40 y 69 años, del 18,9% en mayores de 40 años y del 48,6% en mayores de 70 años. Conclusiones: El estudio SIMETAP-ED mostró asociación de la ED con las enfermedades metabólicas, ERC, FRCV y, sobre todo, con ECV. La prevalencia ajustada por edad de la ED fue del 12,4% en varones adultos, del 19% en mayores de 40 años y casi del 50% en mayores de 70 años

Prevalence of erectile dysfunction in Spanish primary care setting and its association with cardiovascular risk factors and cardiovascular diseases. SIMETAP-ED study.

INTRODUCTION: Few studies conducted in primary care setting report about age-adjusted prevalence rates of erectile dysfunction (ED). Aims of SIMETAP-ED study were to determine crude and age-adjusted prevalence rates of ED diagnosis, to compare these rates with other similar studies, and to compare prevalence rates of cardiovascular risk factors (CVRF), cardiovascular diseases (CVD), metabolic diseases and chronic kidney disease (CKD) between populations with and without ED. METHODS: Cross-sectional observational study conducted in primary care setting. Population-based random sample: 2934 adult men. Response rate: 66%. A clinical interview was conducted to diagnose ED using a question derived from ED definition. The medical records of patients were reviewed to identify their CVRF and diseases associated with ED. The age-adjustments were standardized to Spanish population. RESULTS: The prevalence rates of metabolic diseases, CVD, CVRF, and CKD in population with ED were higher than population without ED, highlighting the CVD. The crude prevalence of ED was 17.2% (95% confidence interval: 15.8-18.6). The age-adjusted prevalence rates of ED were 0.71% in men under 40 years, 12.4% in men over 18 years, 10.8% in men aged 40-69 years, 18.9% in men over 40 years, and 48.6% in men over 70 years. CONCLUSIONS: SIMETAP-ED study showed association of ED with metabolic diseases, CKD, CVRF, and highlighting CVD. The age-adjusted prevalence of ED was 12.4% in adult men, 19% in men over 40 years, and almost 50% in men over 70 years.

La salud de los médicos de familia: ¿practicamos lo que predicamos? / Health of family physicians: do we practice what we preach?

ObjetivosDescribir los estilos de vida de los médicos de Atención Primaria, detallar su adherencia a pruebas de cribado de cáncer y describir aspectos básicos de su salud laboral, mental y sexual.DiseñoEstudio descriptivo transversal.EmplazamientoAtención Primaria. Servicio Madrileño de Salud, Área 7.ParticipantesMédicos de familia.MétodoEstudio realizado mediante encuesta anónima y autorreferida que fue enviada a través del correo interno institucional. El cuestionario fue elaborado siguiendo en las recomendaciones de la Guía Europea de Prevención Cardiovascular, el Programa de Actividades Preventivas y de Promoción de la Salud y el documento de actividad física y salud de la Organización Mundial de la Salud. La escala de Hamilton se utilizó para medir la ansiedad.ResultadosParticiparon 114 médicos de familia en los que la media de años ejercidos fue de 18,29 años (DE: 8,2). La adherencia al cribado de enfermedad cardiovascular fue del 70%. La adherencia al cribado de cáncer cérvix, de mama y colorrectal fue del 73, 86 y 24% respectivamente. El calendario vacunal estuvo actualizado en el 51,8%. El 81,6% respondió tener pareja sexual estable y el 75,2% está satisfecho con sus relaciones sexuales. El método de barrera lo utiliza siempre el 21,1%. La escala de Hamilton fue patológica en el 74,3% de los participantes, aunque el 90,4% refiere sentirse bien o muy bien.ConclusionesLa adherencia al cribado cardiovascular y de cáncer femenino es adecuado, pero deficiente en el cáncer colorrectal. La vacunación entre los participantes se realiza de forma deficiente(AU)

AimsTo describe the lifestyle of primary care physicians, their adherence to cancer screening tests and to describe basic aspects of occupational, mental and sexual health.DesignCross-sectional study.SettingPrimary Care. Health Area 7, Madrid.ParticipantsFamily Physicians.MethodsAn anonymous survey sent through the internal mail was completed by the participants. The questionnaire was based on the Cardiovascular Disease Prevention European Guidelines, Health Prevention and Promotion Activities Program (Programa de Actividades Preventivas y de Promoción de la Salud) and the World Health Organisation document on physical activity and health. The Hamilton Anxiety Scale was used to measure anxiety.ResultsA total of 114 primary care physicians participated in the study. The average years of medical practice was 18.29 years (SD: 8.2). Adherence to cardiovascular screening was 70%. Adherence to cervix, breast and colorectal cancer screening was of 73%, 86% and 24%, respectively. Vaccination records were up to date in 51.8% of the participants. A total of 81.6% had a stable sexual partner and 75.2% were satisfied with their sexual relationships. The condom was always used by just 21.1% of the participants. Hamilton¿s anxiety scale was abnormal in 74.3% of the physicians, but 90.4% reported to feel good or very good.ConclusionsAdherence to cardiovascular and female cancer screening is adequate, but insufficient in colorectal cancer. Vaccination among the participants was adequate(AU)

Sesiones docentes en Atención Primaria. Experiencia en los centros de un Área de Madrid / Teaching sessions in primary care. Experience in health centres in an area of Madrid

Existe la percepción por parte de los responsables de docencia de los diferentesequipos de Atención Primaria del Área 7 de Madrid de una importante disparidad en la organizaciónde las sesiones docentes. Por esta razón, la Comisión de Docencia e Investigación delÁrea 7 de Madrid organizó una jornada de puesta en común. Este artículo pretende mostrar lasdiferentes formas organizativas, modelos de sesiones, ventajas de las sesiones docentes, problemaspercibidos y propuestas de mejora. Finalmente, se plantea un decálogo que pueda servircomo guía para la organización de las sesiones docentes en los centros de Atención Primaria(AU)

Those responsible for teaching of primary care teams of Area 7 of Madrid have noteda significant disparity in the organisation of teaching sessions. Therefore, the Madrid Area 7Commission for Teaching and Research organised an idea-sharing day. This article aims to showthe different organisational forms, model sessions, the benefits of education sessions, perceivedproblems and suggestions for improvement. Finally there is a decalogue, which can serve as aguide for organising teaching sessions in primary care(AU)

[Teaching sessions in primary care. Experience in health centres in an area of Madrid]. / Sesiones docentes en Atención Primaria. Experiencia en los centros de un Área de Madrid.

Those responsible for teaching of primary care teams of Area 7 of Madrid have noted a significant disparity in the organisation of teaching sessions. Therefore, the Madrid Area 7 Commission for Teaching and Research organised an idea-sharing day. This article aims to show the different organisational forms, model sessions, the benefits of education sessions, perceived problems and suggestions for improvement. Finally there is a decalogue, which can serve as a guide for organising teaching sessions in primary care.

[Health of family physicians: do we practice what we preach?]. / La salud de los médicos de familia: ¿practicamos lo que predicamos?

AIMS: To describe the lifestyle of primary care physicians, their adherence to cancer screening tests and to describe basic aspects of occupational, mental and sexual health. DESIGN: Cross-sectional study. SETTING: Primary Care. Health Area 7, Madrid. PARTICIPANTS: Family Physicians. METHODS: An anonymous survey sent through the internal mail was completed by the participants. The questionnaire was based on the Cardiovascular Disease Prevention European Guidelines, Health Prevention and Promotion Activities Program (Programa de Actividades Preventivas y de Promoción de la Salud) and the World Health Organisation document on physical activity and health. The Hamilton Anxiety Scale was used to measure anxiety. RESULTS: A total of 114 primary care physicians participated in the study. The average years of medical practice was 18.29 years (SD: 8.2). Adherence to cardiovascular screening was 70%. Adherence to cervix, breast and colorectal cancer screening was of 73%, 86% and 24%, respectively. Vaccination records were up to date in 51.8% of the participants. A total of 81.6% had a stable sexual partner and 75.2% were satisfied with their sexual relationships. The condom was always used by just 21.1% of the participants. Hamiltons anxiety scale was abnormal in 74.3% of the physicians, but 90.4% reported to feel good or very good. CONCLUSIONS: Adherence to cardiovascular and female cancer screening is adequate, but insufficient in colorectal cancer. Vaccination among the participants was adequate.