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.

[State of internal communication in primary care]. / Comunicación interna en atención primaria.

OBJECTIVES: To study internal communication between primary care health professionals DESIGN: Cross-sectional, descriptive. SETTING: Catalan Health Institute Costa de Ponent Primary Care Area, Spain. PARTICIPANTS: All workers in the area (n=3565). MEASUREMENTS: Three part questionnaire: a) sociodemographic questions; b) questions scoring from 0 to 10 the current importance and operation of certain aspects; and c) questions on new communication tools. RESULTS: Of those sent a questionnaire, 39% (n=1388) responded, with a mean age of 43.2 years (95% CI, 42.75- 43.65), 28.9% being male. The major differences between importance and current events were said to be "to be informed of projects before they appear in the communication media," "by official routes and not by rumour," and "to be aware of projects of other teams." The least communicated within teams. The doctors considered upward communication to be more important. Doctors are those who appreciate communication within teams better and the professionals of the users services unit (UAU) less so. Doctors are the ones who give more importance to being informed of projects at the time. 55% do not use the intranet, mainly due to lack of time. The second reason is that they find it difficult. Sixty-two per cent read e-mail >2-3 times per week. Eighty-nine per cent want an electronic bulletin. The older workers use new technologies less. CONCLUSIONS: Downward, upward, and sideways communication needs to be improved, particularly upwards by doctors, and that of the teams for the UAU professionals. Intranet tools must be provided that make the work easier and training in handling new technologies must be offered.

Comunicación interna en atención primaria / State of internal communication in primary care

Objetivos. Estudiar la comunicación interna entre los profesionales de la atención primaria. Diseño. Estudio descriptivo, transversal. Emplazamiento. Ámbito de Atención Primaria Costa de Ponent del Institut Català de la Salut. Participantes. Todos los trabajadores del ámbito (n = 3.565). Mediciones. Encuesta dividida en 3 partes: a) preguntas sociodemográficas; b) preguntas que valoraban del 0 al 10 la importancia y el funcionamiento actual de diferentes cuestiones, y c) preguntas sobre nuevas herramientas de comunicación. Resultados. Respondieron un 39% de los encuestados (n = 1.388), con una edad media de 43,2 años (intervalo de confianza [IC] del 95%, 42,75-43,65), y el 28,9% eran varones. Las mayores diferencias entre importancia y actualidad se dieron a «enterarse de los proyectos antes de que se publiquen en los medios de comunicación», «conocerlos por vía oficial y no por rumores» y «conocer los proyectos de otros equipos». Las menores diferencias se produjeron en la comunicación dentro de los equipos. Los médicos consideran más importante la comunicación ascendente. Los médicos son los que valoran mejor la comunicación dentro de los equipos, y los profesionales de la unidad de atención al usuario (UAU), los que la valoran peor. Los médicos son los que más importancia dan a enterarse a tiempo de los proyectos. El 55% de los encuestados no utiliza el servicio de intranet, la mayor parte por falta de tiempo. El segundo motivo de esta falta de uso es su dificultad. Un 62% lee el correo electrónico más de 2-3 veces por semana El 89% de los encuestados querría tener un boletín electrónico. Los trabajadores de más edad usan menos las nuevas tecnologías. Conclusiones. Es necesario mejorar la comunicación descendente, ascendente y transversal, especialmente la ascendente de los médicos, y la de los equipos para los profesionales de la UAU. Debe dotarse a la intranet de instrumentos que agilicen el trabajo y ofrecerse formación en el manejo de las nuevas tecnologías

Objectives. To study internal communication between primary care health professionals Design. Cross-sectional, descriptive. Setting. Catalan Health Institute Costa de Ponent Primary Care Area, Spain. Participants. All workers in the area (n=3565). Measurements. Three part questionnaire: a) sociodemographic questions; b) questions scoring from 0 to 10 the current importance and operation of certain aspects; and c) questions on new communication tools. Results. Of those sent a questionnaire, 39% (n=1388) responded, with a mean age of 43.2 years (95% CI, 42.75- 43.65), 28.9% being male. The major differences between importance and current events were said to be "to be informed of projects before they appear in the communication media," "by official routes and not by rumour," and "to be aware of projects of other teams." The least communicated within teams. The doctors considered upward communication to be more important. Doctors are those who appreciate communication within teams better and the professionals of the users services unit (UAU) less so. Doctors are the ones who give more importance to being informed of projects at the time. 55% do not use the intranet, mainly due lack of time. The second reason is that they find it difficult. Sixty-two per cent read e-mail >2-3 times per week. Eighty-nine per cent want an electronic bulletin. The older workers use new technologies less. Conclusions. Downward, upward, and sideways communication needs to be improved, particularly upwards by doctors, and that of the teams for the UAU professionals. Intranet tools must be provided that make the work easier and training in handling new technologies must be offered