Postural changes in blood pressure in the general population of Cantabria (northern Spain).

OBJECTIVE: To describe the postural changes in blood pressure and correlates among the general population of Cantabria, a region in the north of Spain. METHODS: Between 2002 and 2004 blood pressure measurements were taken in a seated position and after 1 and 3 min standing on a random sample of 1178 individuals aged 18 years and above, stratified by age and sex. RESULTS: The prevalence of orthostatic hypotension was 7%, whereas 30% of the participants presented an exaggerated increase in blood pressure when standing and 36% presented one of the two alterations (postural dysregulation in blood pressure syndrome). Sixteen percent of the nonhypertensive participants presented a blood pressure figure when standing that was above or equal to 140/90 mmHg (orthostatic hypertension). In logistic regression analysis the existence of a high level of blood pressure when sitting was the only variable related to orthostatic hypotension (odds ratio: 2.407; confidence interval: 1.413-4.099). CONCLUSION: When evaluating and treating hypertensive patients, it should be taken into account that orthostatic hypotension is more frequent among those individuals who present poor levels of control of their blood pressure figures. Postural dysregulation in blood pressure syndrome is frequent among the general population, and therefore it is worthy of detailed study.

[Prevalence of overweight and obesity in Cantabria [Spain]]. / Prevalencia de sobrepeso y obesidad en Cantabria.

OBJECTIVE: To estimate the prevalence of overweight and obesity in Cantabria (Spain). METHODS: In the framework of the CANHTABRIA study, carried out in 2002-2004, measurements of height and weight were performed on a representative sample of 1197 subjects aged 18 years or over. RESULTS: The overall prevalence of overweight was 37.6% (95%CI: 34.2-41); 43.8% (95%CI: 37.2-50.5) in males, and 32.4% (95%CI: 28.6-36.1) in females (p<0.01). Prevalence of obesity was 22.3% (95%CI: 19.1-25.5); 23.2% (95%CI: 16.9-29.5) in males, and 21.5% (95%CI: 18.3-24.8) in females. Compared to persons with higher education, individuals with lowest level of education had two-fold higher prevalence of overweight and obesity. CONCLUSIONS: The Increase in weight is a public health problem in Cantabria as it affects 6 out of 10 adults of the general population, mainly males and individuals with low educational level.

[Arterial hypertension prevalence, detection, treatment and control in Cantabria, Spain, 2002]. / Prevalencia, detección, tratamiento y control de la hipertensión arterial en Cantabria en 2002.

BACKGROUND: Hypertension is a major cardiovascular risk factor. The aim of this study was to establish the prevalence of high blood pressure in a European region in Northern Spain (Cantabria), and also levels of detection, treatment, and control. METHODS: On a random multi-stage sample of 1197 individuals aged 18 or over, stratified by sex and age, blood pressure measurements were taken and other general data were collected from 2002 to 2004. RESULTS: A prevalence of hypertension of 29% was found. The prevalence among males and females was similar, being 29% and 28%, respectively. Sixty five per cent of the hypertensive subjects were aware of their condition, 53% were undergoing treatment, and 22% presented readings below 140/90 mm Hg. CONCLUSIONS: Hypertension constitutes a public health problem in Cantabria, since it affects 1 in 3 of the adult population. Although levels of detection, treatment, and control are superior to those previously described in this region in 1989, the situation could clearly be improved.

Effects of weight loss after biliopancreatic diversion on metabolism and cardiovascular profile.

BACKGROUND: Obesity is associated with increased prevalence of cardiovascular risk factors. Biliopancreatic diversion (BPD) for morbid obesity has been reported to produce anemia and malnutrition in short-term follow-up. The aim of our study was to analyze the effect of weight reduction on cardiovascular profile, renal function and nutritional status. METHODS: 35 morbidly obese patients underwent BPD. We analyzed the presence of cardiovascular risk factors, renal status, proteinuria and nutritional status before and 1 year after BPD. RESULTS: Excess weight loss was 67% at 1 year after BPD. All cardiovascular risk factors (hypertension, diabetes, hyperlipidemia) improved during follow-up. We could not find any relevant signs of malnutrition in the patients. Microalbuminuria decreased and proteinuria disappeared after weight loss. We observed less urinary calcium and citrate excretion, with an increase in oxaluria, but these changes did not increase the incidence of renal stones. CONCLUSIONS: BPD was followed by improved cardiovascular profile and a lower pro-inflammatory state. BPD did not produce significant malnutrition, anemia or renal stone disease.

The risk of cardiovascular disease associated with proteinuria in renal transplant patients.

Proteinuria in the general population has been shown to be associated with cardiovascular disease, which is the main cause of death in renal transplantation. We investigated the effect of proteinuria on cardiovascular disease after renal transplantation in 532 renal transplant patients with functioning grafts for more than 1 year. Patients were classified into two groups depending on the presence of persistent proteinuria. We analyzed graft and patient survival, posttransplantation cardiovascular disease, and main causes of graft loss and death. Five- and 10-year graft and patient survival rates were lower in the group with proteinuria. The main cause of death was vascular disease in both groups. The presence of posttransplantation cardiovascular disease was higher in the group with proteinuria. Persistent proteinuria was associated with graft loss (RR=4.18), patient death (RR=1.92), and cardiovascular disease (RR=2.45). In conclusion, persistent proteinuria was an independent risk factor for increased cardiovascular morbidity and mortality in renal transplant patients.

[Estimation of glomerular filtration rate using weight/creatinine formula]. / Valoración del filtrado glomerular mediante la fórmula peso/creatinina.

BACKGROUND AND OBJECTIVE: The correct management of patients with chronic renal disease depends on an early diagnosis. The aim of this study was to evaluate the usefulness, in the daily clinical practice, of the weight/creatinine formula as an indirect measurement of glomerular filtration. PATIENTS AND METHOD: 1,025 ambulatory patients were referred to the Nephrology Laboratory for basic blood and urine analysis. Creatinine clearance was calculated with the standard formula. RESULTS: A good correlation between the creatinine clearance adjusted for the corporal surface and that estimated by the weight/creatinine formula was observed, especially when creatinine levels were between 1.5-3 mg/dl and patients were older than 60 years. The mean difference between both methods was 6.3 (14.5) ml/min for males and 2.4 (10.5) ml/min for females. The weight/creatinine formula had a sensitivity of 91% and a specificity of 80% to detect a clearance below 50 ml/min. CONCLUSIONS: The weight/creatinine formula underestimates the clearance for normal creatinine values but fits quite well for creatinine levels between 1.5-3 mg/dl, mainly in patients older than 60 years. Although the estimation of clearance through this formula could be inaccurate, in most cases this is clinically irrelevant. Moreover, such a simple formula could avoid potential mistakes appearing at the time of evaluating renal function only by the serum creatinine.

Association between pulse pressure and cardiovascular disease in renal transplant patients.

Elevated pulse pressure in general population has been shown to be associated with cardiovascular disease, which is the main cause of death in renal transplant patients. We investigated the effect that a wider pulse pressure range may have on cardiovascular disease after renal transplantation in 532 transplant patients with functioning graft for more than 1 year. Patients were classified into two groups depending on 1-year pulse pressure (< or >/=65 mmHg) and we analyzed patient and graft survival, post-transplant cardiovascular disease and main causes of death. Higher pulse pressure was associated with older recipient age (40.8 +/- 10.8 vs. 50 +/- 11.3), higher systolic blood pressure (132.7 +/- 16.1 vs. 164.5 +/- 16), lower blood diastolic pressure (84.5 +/- 11.6 vs. 84.4 +/- 11.2), higher prevalence of diabetes (12% vs. 23%) and total cardiovascular disease (20.9% vs. 33.6%). Five- and 10-year patient survivals were lower in the group with higher pulse pressure, being vascular disease the main cause of death in both groups. In a Cox regression model increased pulse pressure was associated with higher cardiovascular disease (RR = 1.73, 95% CI: 1.13-2.32 p < 0.01). In conclusion, pulse pressure was an independent risk factor for increased cardiovascular morbidity and mortality in renal transplant patients.

Prevalencia de sobrepeso y obesidad en Cantabria / Prevalence of overweight and obesity in Cantabria [Spain]

Objetivo: Estimar la prevalencia del sobrepeso y la obesidaden Cantabria.Métodos: En el marco del estudio CANHTABRIA, se realizaron,entre los años 2002 y 2004, mediciones de peso y tallaa una muestra de1.197 sujetos 18 años de edad representativade la población general.Resultados: La prevalencia de sobrepeso fue del 37,6%(intervalo de confianza del 95% [IC95%]: 34,2-41), en hombresun 43,8% (IC95%: 37,2-50,5) y en mujeres un 32,4%(IC95%: 28,6-36,1; p < 0,01). La prevalencia de obesidad fuedel 22,3% (IC95%: 19,1-25,5), un 23,2% (IC95%: 16,9-29,5)en hombres y un 21,5% (IC95%: 18,3-24,8) en mujeres. Elsobrepeso y la obesidad fueron 2 veces más frecuentes enlas personas con menor nivel de estudios respecto a las demayor nivel.Conclusiones: El aumento de peso constituye un importanteproblema de salud pública en Cantabria, ya que afecta a6 de cada 10 adultos de su población general, especialmentehombres y personas con menor nivel educativo(AU)

Objetive: To estimate the prevalence of overweight and obesityin Cantabria (Spain).Methods: In the framework of the CANHTABRIA study, carriedout in 2002-2004, measurements of height and weightwere performed on a representative sample of 1197 subjectsaged 18 years or over.Results: The overall prevalence of overweight was 37.6%(95%CI: 34.2-41); 43.8% (95%CI: 37.2-50.5) in males, and32.4% (95%CI: 28.6-36.1) in females (p < 0.01). Prevalenceof obesity was 22.3% (95%CI: 19.1-25.5); 23.2% (95%CI: 16.9-29.5) in males, and 21.5% (95%CI: 18.3-24.8) in females. Comparedto persons with higher education, individuals with lowestlevel of education had two-fold higher prevalence of overweigthand obesity.Conclusions: The Increase in weight is a public health problemin Cantabria as it affects 6 out of 10 adults of the generalpopulation, mainly males and individuals with low educationallevel(AU)

Prevalencia, detección, tratamiento y control de la hipertensión arterial en Cantabria en 2002 / Arterial hypertension prevalence, detection, treatment and control in Cantabria, Spain, 2002

Fundamento: La hipertensión arterial es uno de los principales factores de riesgo cardiovascular. El objetivo de este estudio fue conocer en Cantabria la prevalencia de la hipertensión arterial, así como los grados de detección, tratamiento y control. Métodos: Entre 2002 y 2004 se realizaron mediciones de presión arterial y se recogieron otros datos generales en las personas de una muestra aleatoria de 1.197 individuos de 18 o más años de edad, elegida en varias etapas y estratificada por edad y sexo. Resultados: La prevalencia de hipertensión encontrada fue del 29%, siendo similar en hombres (29%) y en mujeres (28%). Entre las personas hipertensas el 65% conocía su situación, el 53% recibía tratamiento y el 22% presentaba cifras por debajo de 140/90 mm Hg. Conclusiones: La hipertensión arterial afecta a 1 de cada 3 sujetos adultos de la población cántabra. Aunque los niveles de detección, tratamiento y control son superiores a los descritos en esta Comunidad Autónoma en 1989, la situación es claramente mejorable

Background: Hypertension is a major cardiovascular risk factor. The aim of this study was to establish the prevalence of high blood pressure in a European region in Northern Spain (Cantabria), and also levels of detection, treatment, and control. Methods: On a random multi-stage sample of 1197 individuals aged 18 or over, stratified by sex and age, blood pressure measurements were taken and other general data were collected from 2002 to 2004. Results: A prevalence of hypertension of 29% was found. The prevalence among males and females was similar, being 29% and 28%, respectively. Sixty five per cent of the hypertensive subjects were aware of their condition, 53% were undergoing treatment, and 22% presented readings below 140/90 mm Hg. Conclusions: Hypertension constitutes a public health problem in Cantabria, since it affects 1 in 3 of the adult population. Although levels of detection, treatment, and control are superior to those previously described in this region in 1989, the situation could clearly be improved

Nefritis tubulointersticial aguda asociada a uveítis (síndrome TINU): descripción de dos casos / Acute tubulointerstitial nephritis and uveitis (TINU syndrome): description of two cases

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Valoración del filtrado glomerularmediante la fórmula peso/creatinina / Estimation of glomerular filtration rate using weight/creatinine formula

FUNDAMENTO Y OBJETIVO: El tratamiento adecuado de los pacientes con insuficiencia renal crónica depende de su diagnóstico temprano. El objetivo de este estudio fue evaluar la utilidad, en la práctica clínica diaria, de la fórmula peso/creatinina como medida indirecta del filtrado glomerular analizando el posible error cometido con la valoración exclusiva de la creatinina sérica. PACIENTES Y MÉTODO: Se incluyó a 1.025 pacientes ambulatorios remitidos al laboratorio de nefrología para la realización de una analítica básica en sangre y orina. El aclaramiento de creatinina se calculó mediante la fórmula estándar con recogida de orina de 24 h ajustado a la superficie corporal y por el estimado mediante la fórmula peso/creatinina. RESULTADOS: Se observó una buena correlación entre el aclaramiento de creatinina corregido por superficie corporal y el estimado por la fórmula de peso/creatinina especialmente para valores de creatinina entre 1,5 y 3 mg/dl y para pacientes mayores de 60 años. La diferencia promedio (DE) de ambos métodos fue de 6,3 (14,5) ml/min para varones y 2,4 (10,5) para mujeres. La fórmula peso/creatinina tuvo una sensibilidad del 91 por ciento y una especificidad del 80 por ciento para detectar un aclaramiento inferior a 50 ml/min. CONCLUSIONES: La fórmula peso/creatinina estima muy a la baja el aclaramiento para valores de creatinina considerados normales, pero se aproxima mucho para cifras de creatinina entre 1,5 y 3 mg/dl en sujetos mayores de 60 años. Aunque la estimación del aclaramiento por la fórmula puede ser inexacta, en la mayoría de los casos esto es clínicamente irrelevante y una fórmula tan sencilla permite evitar el error de valorar la función renal únicamente por la creatinina (AU)