[Detection of cardiovascular risk in healthcare workers on the basis of WHO/JNC 7/ATP III criteria]. / Detección de riesgo cardiovascular en trabajadores del sector salud con base en los criterios OMS/JNC 7/ATP III.

BACKGROUND: Anthropometric and blood pressure measurements are significant parameters in the assessment of cardiovascular risk (CVR). The aim was to establish the distribution of clinical-anthropometric parameters in health care workers according to the criteria established by WHO/JNC 7/ATP III. METHODS: Observational, cross-sectional study in 350 workers of a general hospital. Definitions of anthropometric alterations were made considering the criteria established by WHO and the Asian ATP III, while altered blood pressure was defined by criteria JNC 7 and ATP III. RESULTS: The average age of workers was 34 years. The prevalence of obesity, abdominal obesity, and impaired waist-hip ratio (WHR) was higher according to the ATP III criteria. The distribution of obesity prevailed in females, administrative personnel, and nursing according to WHO criteria, but there were no differences according to ATP III criteria. The WHR predominated in females and impaired blood pressure in males. 50% showed impaired capillary glucose. The number of anthropometric and clinical abnormalities, as well as its combinations, varied; most often it was found in one and three alterations with WHO and ATP III criteria, respectively. CONCLUSIONS: The prevalence of CVR factors in health workers is high, which is why we suggest to implement immediate action strategies to reduce its comorbidities and the institutional and personal costs related to these factors; we also encourage to apply the ATP criteria to decrease the subdiagnostic of CVR in this population.

Introducción: las medidas antropométricas y de presión arterial son parámetros significativos para evaluar el riesgo cardiovascular (RCV). Comparamos la distribución de alteraciones clínico-antropométricas en trabajadores del área de la salud según criterios de la OMS/JNC 7/ATP III. Métodos: estudio observacional y transversal en 350 trabajadores de un hospital general. Las alteraciones antropométricas se definieron según los criterios establecidos por la OMS y el ATP III modificado; la tensión arterial alterada, según los criterios del JNC-7 y el ATP III. Resultados: el promedio de edad fue de 34 años. La prevalencia de obesidad, obesidad abdominal e ICC alterado fue mayor según el ATP III. La distribución de la obesidad predominó en el género femenino, el personal administrativo, el auxiliar y el de enfermería según criterios de la OMS, pero no hubo diferencias significativas según el ATP III. El ICC alterado predominó en el género femenino y la tensión arterial alterada en el género masculino. El 50% presentó glucosa capilar alterada. Se presentó con mayor frecuencia la alteración de un parámetro con criterios OMS y de tres parámetros con criterios ATP III. Conclusión: la prevalencia de factores de RCV en estos trabajadores es elevada, por lo que se sugieren estrategias de intervención inmediata que reduzcan las comorbilidades y los gastos personales e institucionales en su atención; además, se recomienda implementar los criterios ATP III para disminuir el subdiagnóstico de los factores de RCV en esta población.

[Pregnancy and Fallot tetralogy without surgical correction: report of a case]. / Embarazo y tetralogía de Fallot sin corrección quirúrgica Reporte de un caso.

Tetralogy of Fallot is the most common cyanotic congenital heart disease. Women with this condition may become pregnant, and it is important to detect the disease to prevent cardiovascular complications and to reduce maternal and fetal death. The purpose of this paper is to report the case of a pregnant patient with no previous diagnosis of uncorrected tetralogy of Fallot, who reached the end of pregnancy with added diagnoses of severe preeclampsia and HELLP syndrome. For accurate information about the natural history of tetralogy of Fallot it is necessary to review the literature of the past 30 years because there is no recently published series. It is common for patients with tetralogy of Fallot and pregnancy to suffer a gradual increase in the severity of pulmonary stenosis, with exacerbation of symptoms and increased cyanosis. The long-term prognosis is extremely poor in the absence of correction, with a mortality of 10%.