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Bramajo O, Zueras P, Rentería E, Permanyer I. Decomposition of life expectancy differentials with (and without) conditions by educational attainment for major groups of causes in contemporary Spain: where is the advantage? GENUS 2024; 80:11. [PMID: 39027674 PMCID: PMC11252180 DOI: 10.1186/s41118-024-00220-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 07/03/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Healthy life expectancy is higher among individuals with higher socioeconomic standing. However, it is unclear whether such advantage is attributable to longer (i.e., mortality advantage) or to healthier (morbidity advantage) lifespans across different health conditions. Objective Estimate the contribution of mortality and morbidity components in differences in condition-free life expectancies (CFLE) and life expectancy with conditions (LEWC) for five major groups of conditions by sex and educational attainment, instead of using a global indicator of morbidity. Methods Using the Sullivan Method, we computed remaining life expectancies at age 40 and 65, CFLE, and LEWC and applied a stepwise decomposition technique, using national health surveys along with mortality data, in a cross-sectional analysis. Results An educational gradient was present in almost all conditions, with different intensities. For females, morbidity was the main contributor to educational differences in health expectancies, but mainly in the older age groups. For males, the drivers behind higher health expectancies for high-educated males were evenly distributed across mortality and morbidity between ages 40 and 65, but after that, the mortality gradient vanished between high-educated and middle-educated individuals. Discussion The changing contribution of the mortality and morbidity gradient for different conditions across age-groups brings evidence to adequately plan health policies to mitigate health gaps and improve quality of life of the populations in a lower social standing.
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Affiliation(s)
- Octavio Bramajo
- Universitat Autònoma de Barcelona, Bellaterra, Spain
- Centre d’Estudis Demogràfics, Bellaterra, Spain
- University of Texas Medical Branch, Galveston, USA
| | - Pilar Zueras
- Centre d’Estudis Demogràfics, Bellaterra, Spain
- Institute for Social and Economic Research, University of Essex, Essex, UK
| | | | - Iñaki Permanyer
- Centre d’Estudis Demogràfics, Bellaterra, Spain
- ICREA-Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
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Cordero A, Fernández Del Olmo MR, Cortez Quiroga GA, Romero-Menor C, Fácila L, Seijas-Amigo J, Fornovi A, Murillo JR, Rodríguez-Mañero M, Bello Mora MC, Valle A, Miriam S, Pamias RF, Bañeras J, García PB, Clemente Lorenzo MM, Sánchez-Alvarez S, López-Rodríguez L, González-Juanatey JR. Sex Differences in Low-Density Lipoprotein Cholesterol Reduction With PCSK9 Inhibitors in Real-world Patients: The LIPID-REAL Registry. J Cardiovasc Pharmacol 2022; 79:523-529. [PMID: 34983910 DOI: 10.1097/fjc.0000000000001205] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/24/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous evidence supports that monoclonal antibodies that inhibit the proprotein convertase subtilisin/kexin type 9 (PCSK9) reduce low-density lipoprotein cholesterol (LDLc) by 50%-65%, regardless of baseline treatments. We tested possible sex differences in a multicentre registry of real-world patients treated with PCSK9 inhibitors. METHODS This is a multicentre and retrospective study of 652 patients initiating treatment with any PCSK9 inhibitor in 18 different hospitals. Before-treatment and on-treatment LDLc and medical treatments, clinical indication, and clinical features were recorded. RESULTS Women represented 24.69% of the cohort. The use of statins was similar in both sexes, but women were receiving most frequently ezetimibe. Before-treatment median LDLc was 135 (interquartile range 115-166) mg, and it was higher in women. The median on-treatment LDLc was 57 (interquartile range 38-84) mg/dL, which represented a mean 54.5% reduction. On-treatment LDLc was higher in women, and the mean LDLc reduction was lower in women (47.4% vs. 56.9%; P = 0.0002) receiving evolocumab or alirocumab. The percentage of patients who achieved ≥50% LDLc reduction was higher in men (71.36% vs. 57.62%; P = 0.002). According to LDLc before-treatment quartiles, LDLc reduction was statistically lower in women in the 2 highest and a significant interaction of women and baseline LDLc >135 mg/dL was observed. Women were negatively associated with lower rates of LDLc treatment target achievement (odds ratio: 0.31). Differences were also observed in women with body mas index >25 kg/m2. Only 14 patients (2.14%) presented side effects. CONCLUSIONS This multicentre and retrospective registry of real-world patients treated with PCSK9 inhibitors highlights significant gender differences in LDLc reduction.
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Affiliation(s)
- Alberto Cordero
- Cardiology Department, Hospital Universitario de San Juan, Alicante, Spain
- Unidad de Investigación en Cardiología, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Comunidad Valenciana, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | | | | | - Cesar Romero-Menor
- Cardiology Department, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Lorenzo Fácila
- Cardiology Department, Consorcio Hospital General de Valencia, Valencia, Spain
| | - José Seijas-Amigo
- Cardiology Department, Complejo Hospitalario Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Aisa Fornovi
- Endocrinology Department, Hospital Vega Baja, Orihuela, Spain
| | - Juan R Murillo
- Cardiology Department, Hospital Universitario de Cabueñes, Gijón, Spain
| | - Moisés Rodríguez-Mañero
- Cardiology Department, Complejo Hospitalario Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Alfonso Valle
- Cardiology Department, Hospital Universitario de Denia, Denia, Spain
| | - Sandin Miriam
- Cardiology Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - Roman F Pamias
- Cardiology Department, Hospital Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, Spain
| | - Jordi Bañeras
- Cardiology Department, Hospital del Vall Hebrón, Barcelona, Spain
| | - Pedro B García
- Cardiology Department, Hospital Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, Spain
| | | | | | | | - José R González-Juanatey
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Cardiology Department, Complejo Hospitalario Universidad de Santiago de Compostela, Santiago de Compostela, Spain
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Mill-Ferreyra E, Cameno-Carrillo V, Saúl-Gordo H, Camí-Lavado MC. [Estimation of the percentage of body fat based on the body mass index and the abdominal circumference: Palafolls Formula]. Semergen 2018; 45:101-108. [PMID: 30268360 DOI: 10.1016/j.semerg.2018.04.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 04/03/2018] [Accepted: 04/06/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Overweight and obesity have the features of a worldwide epidemic, making it a public health problem. The traditional classification with the body mass index is a good start, but after the evidence of the biochemical activities of adipose tissue, its measurement is a necessity. There are multiple formulas for this purpose, but with little possibility of applying it in Primary Care. The following formulas are proposed for its use in this setting; Men=(body mass index [BMI/Abdominal Circumference [AC]*10)+BMI. Women=([BMI/AC]*10)+BMI+10. MATERIAL AND METHODS A descriptive, prospective study was conducted, including 505 women and 489 men aged between 30 and 90 years. Weight, height, and abdominal circumference were measured, and the body mass index, percentage of fat using the CUN BAE (Clínica Universidad de Navarra - Body Adiposity Estimator) and proposed formulas were calculated. RESULTS Comparative calculations were made between CUN BAE and formulas. No significant differences were observed in the descriptive values (Women χ2=1.1; P=.89. Men χ2=0.8; P=.93. The confidence interval and standard error p=1. The numerical correlation shows r=0.94; p=0.0001; R2=0.89. The relative error of the mean in men was 5.48% and -0.43% in women. The comparison of medians demonstrated Wilcoxon=0.8333. The study of sensitivity and specificity for cut-off points shows a ROC curve AUC=0.986; P=<.0001. CONCLUSIONS The lack of significant differences between the results of both formulas, makes it possible to be proposed for the calculation of the fat percentage in body weight in Primary Care Clinics.
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Affiliation(s)
- E Mill-Ferreyra
- Centro de Atención Primaria Malgrat-Palafolls. Corporació de Salut de Maresme i la Selva, Malgrat de Mar, España; Residencia Geríatrica Clivia, Blanes, Girona, España.
| | | | - H Saúl-Gordo
- Residencia Geríatrica Clivia, Blanes, Girona, España
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Tiric-Campara M, Tupkovic E, Denislic M, Biscevic M, Skopljak A, Zunic L, Djelilovic-Vranic J, Alajbegovic A. Gender Differences in Biochemical and Electroneurographic Parameters of Median and Ulnar Nerve. Acta Inform Med 2016; 23:360-3. [PMID: 26862246 PMCID: PMC4720820 DOI: 10.5455/aim.2015.23.360-363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION In this article are demonstrated differences in the aspects of the metabolic syndrome (MSy) between genders, as well as the association of MSy and neuropathy. THE AIM The aim of our study was that in patients with newly discovered metabolic syndrome of both sexes make comparison of fasting blood glucose levels and after oral glucose tolerance test, as well as neurophysiological parameters of n.medianus and n.ulnaris. PATIENTS AND METHODS All participants were examined dermatologically. The analysis included the 36 male and 36 female respondents with a newly discovered MSy. RESULTS The average age of men was 52.75±7.5 (40-65) years and women 52.1±7.7 (38-67) years. The average value of fasting blood glucose in women was 5.86±0.87 (4.5-8) mmol/L, and non significantly higher in men (p=0.0969) as 6.19±0.8 (4.7-8) mmol/L. Average values of blood sugar 120 minutes after oral glucose tolerance test were not significantly different (p=0.7052), and was 5.41±1.63 (3.3-9.7) mmol/L in women and 5.27±1.52 (2.7-9.8) mmol/L in men. Median motor velocity were significantly higher in women for n.medianus on the left (p=0.0024), n.ulnaris on the left (p=0.0081) and n.ulnaris on the right side (p=0.0293), and the median motor terminal latency were significantly longer in n.ulnaris on the left (p=0.0349) and n.ulnaris on the right side (p=0.011). There was no significant difference in the sensory conductivity velocity in n.medianus and n.ulnaris between the groups, but the amplitude with the highest peak of the sensory response was significantly higher in n.medianus on the left (p=0.0269) and n.ulnaris on the left side (p=0.0009) in female patients. CONCLUSION The results indicate that there are differences in neurophysiological parameters of the investigated nerves between the genders, and that tested nerve structures in the course of MSy are affected slightly more in men. There were no significant differences in skin changes between genders.
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Affiliation(s)
- Merita Tiric-Campara
- Clinic for Neurology, Clinical Center, University of Sarajevo, Bosnia and Herzegovina
| | - Emir Tupkovic
- Department for Neuropsychiatry, Primary Health Centre Tuzla, Bosnia and Herzegovina
| | | | - Mirza Biscevic
- Clinic for Orthopedics and Traumatology, Clinical Center, University of Sarajevo, Bosnia and Herzegovina
| | - Amira Skopljak
- Medical Faculty of Sarajevo University, Bosnia and Herzegovina
| | - Lejla Zunic
- Faculty for Health Sciences, University of Zenica, Zenica, Bosnia and Herzegovina
| | | | - Azra Alajbegovic
- Clinic for Neurology, Clinical Center, University of Sarajevo, Bosnia and Herzegovina
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Skaug EA, Madssen E, Aspenes ST, Wisløff U, Ellingsen Ø. Cardiovascular risk factors have larger impact on endothelial function in self-reported healthy women than men in the HUNT3 Fitness study. PLoS One 2014; 9:e101371. [PMID: 24991924 PMCID: PMC4081583 DOI: 10.1371/journal.pone.0101371] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 06/05/2014] [Indexed: 01/10/2023] Open
Abstract
Background Several studies suggest that cardiovascular risk factors comprising the metabolic syndrome have larger effects on the development of cardiovascular disease in women than in men. A recent study in self-reported healthy subjects demonstrated a marked gender difference in endothelial dysfunction that may be an important precursor of manifest cardiovascular disease. The aim of the present study was to determine whether the association between endothelial function and cardiovascular risk factors is different in self-reported healthy women compared to self-reported healthy men. Methods and Results Associations between endothelial function (flow mediated dilation, FMD, of the brachial artery measured by ultrasound), anthropometric variables, peak oxygen uptake (VO2peak), blood pressure, serum lipids, blood glucose and a questionnaire on general health and lifestyle including smoking status were studied by logistic and linear regression in 2 528 women and 2 211 men aged 20–89 years, free from self-reported cardiovascular disease. In women with hyperglycemia, endothelial dysfunction (FMD ≤0%) occurred twice as frequently as in male counterparts. The presence of the metabolic syndrome, high blood pressure and low VO2peak increased the prevalence of endothelial dysfunction more in women than in men. Conclusion Endothelial dysfunction is more strongly associated with cardiovascular risk factors in self-reported healthy women than in self-reported healthy men. This finding could explain why the metabolic syndrome, and especially hyperglycemia, is associated with higher cardiovascular risk and a worse prognosis in women.
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Affiliation(s)
- Eli-Anne Skaug
- Department of Circulation and Medical Imaging and KG Jebsen Center for Exercise in Medicine Norwegian University of Science and Technology, Trondheim, Norway
| | - Erik Madssen
- Department of Circulation and Medical Imaging and KG Jebsen Center for Exercise in Medicine Norwegian University of Science and Technology, Trondheim, Norway; Department of Cardiology, St Olavs Hospital, Trondheim, Norway
| | - Stian Thoresen Aspenes
- Department of Circulation and Medical Imaging and KG Jebsen Center for Exercise in Medicine Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging and KG Jebsen Center for Exercise in Medicine Norwegian University of Science and Technology, Trondheim, Norway
| | - Øyvind Ellingsen
- Department of Circulation and Medical Imaging and KG Jebsen Center for Exercise in Medicine Norwegian University of Science and Technology, Trondheim, Norway; Department of Cardiology, St Olavs Hospital, Trondheim, Norway
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Cabrera M, Sánchez-Chaparro MA, Valdivielso P, Quevedo-Aguado L, Catalina-Romero C, Fernández-Labandera C, Ruiz-Moraga M, González-Santos P, Calvo-Bonacho E. Prevalence of atherogenic dyslipidemia: association with risk factors and cardiovascular risk in Spanish working population. "ICARIA" study. Atherosclerosis 2014; 235:562-9. [PMID: 24956529 DOI: 10.1016/j.atherosclerosis.2014.05.960] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 05/22/2014] [Accepted: 05/30/2014] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of this study was to assess the prevalence of atherogenic dyslipidemia (AD) and the lipid triad (LT) in the working population in Spain, their associated variables and how far they are linked to cardiovascular risk (CVR). METHODS Observational cross-sectional study of 70,609 workers (71.5% male (M), 28.5% female (F), mean age 39.2 ± 10), who attended medical checkups and agreed to participate. Plasma samples were analysed in a central laboratory. AD definition used was: triglycerides ≥150 mg/dl and HDL cholesterol <40 mg/dl (M)/<50 mg/dl (F) and LT when LDL cholesterol > 160 mg/dl is further added. Univariate comparisons in the absence and presence of AD and LT and the probability of AD according to different parameters and their possible association with CVR were assessed. CVR was stratified following the European SCORE model for low risk-population. RESULTS 5.7% (95% CI 4.7-6.9) of the working population have AD and 1.1% (95% CI 1.0-1.2) LT. In univariate analysis, workers with AD and LT had a higher prevalence of obesity, hypertension, smoking and diabetes than those who had not (p < 0.001). In multivariate analysis, BMI, sex, age 40-49, diabetes, tobacco, uric acid, LDL or blood pressure significantly influenced the risk of AD. AD was significantly associated with CVR after adjusting for alcohol and obesity. However, most of the AD subjects (91.8%) were classified as low risk. CONCLUSIONS About 6% of the working population in Spain meets AD criteria. Assuming that these subjects have increased CVR, AD allows to identify additional 5% of subjects with increased CVR to that one the SCORE model detects, helping to improve cardiovascular risk stratification.
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Affiliation(s)
- M Cabrera
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
| | - M A Sánchez-Chaparro
- Department of Internal Medicine, University Hospital "Virgen de la Victoria" and University of Málaga, Campus de Teatinos, s/n, 29010 Málaga, Spain.
| | - P Valdivielso
- Department of Internal Medicine, University Hospital "Virgen de la Victoria" and University of Málaga, Campus de Teatinos, s/n, 29010 Málaga, Spain.
| | - L Quevedo-Aguado
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
| | - C Catalina-Romero
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
| | - C Fernández-Labandera
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
| | - M Ruiz-Moraga
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
| | - P González-Santos
- Department of Internal Medicine, University Hospital "Virgen de la Victoria" and University of Málaga, Campus de Teatinos, s/n, 29010 Málaga, Spain.
| | - E Calvo-Bonacho
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Ramírez de Arellano 27, 28043 Madrid, Spain.
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Arrebola-Moreno A, Marfil-Alvarez R, Catena A, García-Retamero R, Arrebola J, Melgares-Moreno R, Ramirez-Hernández J, Kaski J. Body mass index and myocardium at risk in patients with acute coronary syndrome. Rev Clin Esp 2014. [DOI: 10.1016/j.rceng.2013.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Arrebola-Moreno AL, Marfil-Alvarez R, Catena A, García-Retamero R, Arrebola JP, Melgares-Moreno R, Ramirez-Hernández JA, Kaski JC. Body mass index and myocardium at risk in patients with acute coronary syndrome. Rev Clin Esp 2014; 214:113-20. [PMID: 24560733 DOI: 10.1016/j.rce.2013.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 11/18/2013] [Accepted: 12/01/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Whilst traditional studies have shown that obese individuals are at a higher risk of cardiovascular events compared to lean subjects, recent studies in patients with acute myocardial infarction (AMI) have suggested that obesity may exert protective effects (the "obesity paradox"). We sought to assess the relationship between body mass index (BMI) and the BARI score (BARIsc), a validated tool used to assess myocardium at risk, in patients with acute coronary syndrome. PATIENTS AND METHODS Participants were 116 consecutive patients (mean age, 60.6 years; 97 men) with AMI (68 ST elevated myocardial infarction, STEMI; 48 non-ST elevated myocardial infarction, NSTEMI). Demographics, BMI, risk factors, biochemistry data, left ventricular function, angiographic data and the BARIsc were assessed in every patient. RESULTS Multiple linear regression analyses showed that BMI significantly correlated with BARIsc; β=.23, p<0.02. This was found only in the overweight/obese patients, β=.27, p<0.01, but not in patients with normal BMIs, β=0.08, p=0.71. CONCLUSIONS An increased body weight is associated with an increased area of myocardium at risk in patients with ACS.
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Affiliation(s)
- A L Arrebola-Moreno
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain; Cardiovascular Sciences Research Centre, St George's University of London, London, United Kingdom.
| | - R Marfil-Alvarez
- Department of Experimental Psychology, University of Granada, Granada, Spain
| | - A Catena
- Department of Experimental Psychology, University of Granada, Granada, Spain
| | - R García-Retamero
- Department of Experimental Psychology, University of Granada, Granada, Spain
| | - J P Arrebola
- Department of Experimental Psychology, University of Granada, Granada, Spain
| | - R Melgares-Moreno
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | - J C Kaski
- Cardiovascular Sciences Research Centre, St George's University of London, London, United Kingdom
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Cordero A, Bertomeu-Martínez V, Mazón P, Fácila L, Cosín J, Bertomeu-González V, Rodriguez M, Andrés E, Galve E, Lekuona I, González-Juanatey JR. Patients with cardiac disease: Changes observed through last decade in out-patient clinics. World J Cardiol 2013; 5:288-294. [PMID: 24009818 PMCID: PMC3761182 DOI: 10.4330/wjc.v5.i8.288] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 05/05/2013] [Accepted: 08/06/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To describe current profile of patients with cardiovascular disease (CVD) and assessing changes through last decade.
METHODS: Comparison of patients with established CVD from two similar cross-sectional registries performed in 1999 (n = 6194) and 2009 (n = 4639). The types of CVD were coronary heart disease (CHD), heart failure (HF) and atrial fibrillation (AF). Patients were collected from outpatient clinics. Investigators were 80% cardiologist and 20% primary care practitioners. Clinical antecedents, major diagnosis, blood test results and medical treatments were collected from all patients.
RESULTS: An increase in all risk factors, except for smoking, was observed; a 54.4% relative increase in BP control was noted. CHD was the most prevalent CVD but HF and AF increased significantly, 41.5% and 33.7%, respectively. A significant reduction in serum lipid levels was observed. The use of statins increased by 141.1% as did all cardiovascular treatments. Moreover, the use of angiotensin-renin system inhibitors in patients with HF, beta-blockers in CHD patients or oral anticoagulants in AF patients increased by 83.0%, 80.3% and 156.0%, respectively (P < 0.01).
CONCLUSION: The prevalence of all cardiovascular risk factors has increased in patients with CVD through last decade. HF and AF have experienced the largest increases.
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Andrés E, Cordero A, León M, Alcalde V, Laclaustra M, Casasnovas JA. Escala para la predicción de la aparición de hipertensión arterial en población activa masculina. Med Clin (Barc) 2013. [DOI: 10.1016/j.medcli.2012.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fabbian F, Bedani PL, Rizzioli E, Molino C, Pala M, De Giorgi A, Menegatti AM, Bagnaresi I, Portaluppi F, Manfredini R. Risk factors for renal disease and urinary abnormalities in men and women: data from the World Kidney Day in the province of Ferrara, Italy. Ren Fail 2013; 35:440-445. [PMID: 23438092 DOI: 10.3109/0886022x.2013.766571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a worldwide health problem due to its morbidity and mortality, and cost. World Kidney Day (WKD) has been planned to improve disease prevention. The aim of this study was to evaluate CKD risk factors and urinary abnormalities, collected on WKD along several years, in men and women. PATIENTS AND METHODS Between 2006 and 2012, 1980 subjects, of whom 1012 women, from general population living in Ferrara area, a town in the north-east of Italy, were investigated. For each participant age, sex, smoking, hypertensive and diabetic status, body mass index (BMI), waist circumference (WC), and blood pressure (BP) were obtained. Moreover, body shape index (BSI) was calculated. All subjects underwent dipstick urinalysis. RESULTS Men had higher BMI, WC, and BP than women. Women had higher prevalence of abdominal obesity and higher BSI (0.0951 ± 0.0105 vs. 0.0920 ± 0.0071 m(11/6)kg(-2/3)), while men had higher prevalence of overweight. In women, hematuria and leukocyturia were more prevalent (16.9% vs. 12.8%; OR 95%CI 1.161 (1.042-1.294); p = 0.012; 18.5% vs. 7% OR 95%CI 1.538 (1.403-1.676); p < 0.001, respectively), while glycosuria was less frequent (4.2% vs. 8.8% OR 95%CI 0.642 (0.501-0.822); p < 0.001) than in men. Frequency of proteinuria was similar in the two sexes. Venn diagrams indicate a different overlap of urinary abnormalities in the two sexes. CONCLUSIONS Risk factors for CKD collected during the WKD appear to be different in the two sexes, and urinary abnormalities overlap differently. Data collected during the WKD are related to sex, and women deserve greater attention.
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Affiliation(s)
- Fabio Fabbian
- Clinica Medica, Department of Internal Medicine, Azienda Ospedaliera-Universitaria S. Anna, Ferrara, Italy.
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Short-term metabolic changes achieved by weight loss in hypertensive patients. Int J Cardiol 2011; 153:286-90. [DOI: 10.1016/j.ijcard.2010.08.051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Revised: 07/13/2010] [Accepted: 08/17/2010] [Indexed: 10/19/2022]
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González-Juanatey JR, Cordero A, Vitale GC, González-Timón B, Mazón P, Bertomeu V. [Magnitude and characteristics of residual lipid risk in patients with a history of coronary revascularization: the ICP-bypass study]. Rev Esp Cardiol 2011; 64:862-8. [PMID: 21835533 DOI: 10.1016/j.recesp.2011.05.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 05/24/2011] [Indexed: 10/17/2022]
Abstract
INTRODUCTION AND OBJECTIVES Residual lipid risk has been defined as the excess of cardiovascular events observed in patients with adequate control of low-density lipoprotein cholesterol and has been mainly attributed to high-density lipoprotein cholesterol and triglycerides. The aim of our study was to describe the clinical features and the magnitude and characteristics associated with residual lipid risk in patients with a history of coronary revascularization. METHODS Multicenter, observational, cross-sectional study of patients with a history of coronary revascularization. Residual lipid risk was defined as the presence of high-density lipoprotein cholesterol <40 mg/dL and/or triglycerides >150 mg/dL in patients with low-density lipoprotein cholesterol <100 mg/dL. RESULTS We included 2292 patients with a mean age of 65.5 (12.4) years; 94.1% were receiving no statin therapy and 4.8% no lipid therapy. Statin-only therapy (74%) was the most common strategy, followed by combination with ezetimibe (17%). The prevalence of high-density lipoprotein cholesterol <40 mg/dL was 35.8%, hypertriglyceridemia 38.9%, and low-density lipoprotein cholesterol >100 mg/dL 44.9%; the residual lipid risk group included 29.9% of all patients. This patient group had a similar clinical profile except for slightly lower mean age, higher incidence of diabetes, and higher proportion of men. Multivariate analysis identified positive associations of diabetes and male sex with residual lipid risk; current smoking, male sex, and fibrate therapy were associated with high-density lipoprotein cholesterol <40 mg/dL; current smoking, abdominal obesity, and fibrate therapy were associated with hypertriglyceridemia. CONCLUSIONS In daily clinical practice, almost one-third of patients with a history of coronary revascularization have low-density lipoprotein cholesterol <100 mg/dL plus low high-density lipoprotein cholesterol and/or hypertriglyceridemia, a concept known as residual lipid risk.
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Affiliation(s)
- José Ramón González-Juanatey
- Servicio de Cardiología, Complejo Hospitalario Universitario Clínico de Santiago de Compostela, Santiago de Compostela, A Coruña, España.
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Factors Associated With Uncontrolled Hypertension in Patients With and Without Cardiovascular Disease. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.rec.2011.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Cordero A, Bertomeu-Martínez V, Mazón P, Fácila L, Bertomeu-González V, Cosín J, Galve E, Núñez J, Lekuona I, González-Juanatey JR. [Factors associated with uncontrolled hypertension in patients with and without cardiovascular disease]. Rev Esp Cardiol 2011; 64:587-93. [PMID: 21640460 DOI: 10.1016/j.recesp.2011.03.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 03/04/2011] [Indexed: 01/13/2023]
Abstract
INTRODUCTION AND OBJECTIVES Hypertension is one of the most prevalent and poorly controlled risk factors, especially in patients with established cardiovascular disease (CVD). The aim of this study was to describe the rate of blood pressure (BP) control and related risk factors. METHODS Multicenter, cross-sectional and observational registry of patients with hypertension recruited from cardiology and primary care outpatient clinics. Controlled BP defined as <140/90 mmHg. RESULTS 55.4% of the 10 743 patients included had controlled BP and these had a slightly higher mean age. Patients with uncontrolled BP were more frequently male, with a higher prevalence of active smokers, obese patients, and patients with diabetes. The rate of controlled BP was similar in patients with or without CVD. Patients with uncontrolled BP had higher levels of blood glucose, total cholesterol, low density lipoproteins and uric acid. Patients with uncontrolled BP were receiving a slightly higher mean number of antihypertensive drugs compared to patients with controlled BP. Patients with CVD were more frequently receiving a renin-angiotensin-aldosterone axis inhibitor: 83.5% vs. 73.2% (P<.01). Multivariate analysis identified obesity and current smoking as independently associated with uncontrolled BP, both in patients with or without CVD, as well as relevant differences between the two groups on other factors. CONCLUSIONS Regardless of the presence of CVD, 55% of hypertensive patients had controlled BP. Lifestyle and diet, especially smoking and obesity, are independently associated with lack of BP control. Full English text available from: www.revespcardiol.org.
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Affiliation(s)
- Alberto Cordero
- Departamento de Cardiología, Hospital Universitario de San Juan, 3550 Sant Joan d'Alacant, Alicante, Spain.
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[Cardiovascular risk factors and lifestyle associated with premature myocardial infarction diagnosis]. Rev Esp Cardiol 2011; 64:527-9. [PMID: 21507545 DOI: 10.1016/j.recesp.2010.09.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Accepted: 09/19/2010] [Indexed: 11/22/2022]
Abstract
Young and old patients with acute myocardial infarction have different risk factor profiles, clinical presentation, angiographic findings and prognosis. In the present study we investigated the clinical profile of patients aged <46 years with acute myocardial infarction.
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CLARK C, SMITH W, LOCHNER A, DU TOIT EF. The Effects of Gender and Obesity on Myocardial Tolerance to Ischemia. Physiol Res 2011; 60:291-301. [DOI: 10.33549/physiolres.931999] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Obesity is increasing at an alarming rate globally. Several studies have shown that premenopausal women have a reduced risk of CV disease and a reduced myocardial susceptibility to ischemia/reperfusion injury. The effect of obesity on myocardial tolerance to ischemia in women has not been established. To determine how obesity affects myocardial susceptibility to ischemia/reperfusion injury in both males and females, we fed male and female Wistar rats a high caloric diet (HCD) or a control rat chow diet (CD) for 18 weeks. Rats were subsequently fasted overnight, anesthetized and blood was collected. In separate experiments, 18-week-fed (HCD and CD) rats underwent 45 min in vivo coronary artery ligation (CAL) followed by 2 hours reperfusion. Hearts were stained with TTC and infarct size determined. Both male and female HCD fed rats had increased body and visceral fat weights. Homeostasis model assessment (HOMA) index values were 13.95±3.04 for CD and 33.58±9.39 for HCD male rats (p<0.01) and 2.98±0.64 for CD and 2.99±0.72 for HCD fed female rats. Male HCD fed rats had larger infarct sizes than CD fed littermates (43.2±9.3 % vs. 24.4±7.6 %, p<0.05). Female HCD and CD diet fed rats had comparable infarct sizes (31.8±4.3 % vs. 23.9±3.3 %). We conclude that male rats on the HCD became viscerally obese, dyslipidemic and insulin-resistant, while female HCD fed rats became viscerally obese without developing dyslipidemia or insulin resistance. Obesity increased myocardial infarct size in males but not the females.
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Affiliation(s)
| | | | | | - E. F. DU TOIT
- School of Medical Science, Griffith University, Gold Coast Campus, QLD, Australia
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Grima-Serrano A, García-Porrero E, Luengo-Fernández E, León Latre M. Cardiología preventiva y rehabilitación cardiaca. Rev Esp Cardiol 2011; 64 Suppl 1:66-72. [DOI: 10.1016/s0300-8932(11)70009-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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García-Porrero E, Andrés-Esteban E, de Pablo-Zarzosa C, León-Latre M. Cardiología preventiva y rehabilitación. Rev Esp Cardiol 2010; 63 Suppl 1:40-8. [DOI: 10.1016/s0300-8932(10)70139-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cordero A, Fácila L, Galve E, Mazón P. Novedades en hipertensión arterial y diabetes mellitus. Rev Esp Cardiol 2010; 63 Suppl 1:101-15. [DOI: 10.1016/s0300-8932(10)70144-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Cordero A, Andrés E, Ordoñez B, León M, Laclaustra M, Grima A, Luengo E, Moreno J, Bes M, Pascual I, Civeira F, Pocoví M, Alegría E, Casasnovas JA. Usefulness of triglycerides-to-high-density lipoprotein cholesterol ratio for predicting the first coronary event in men. Am J Cardiol 2009; 104:1393-7. [PMID: 19892056 DOI: 10.1016/j.amjcard.2009.07.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Revised: 07/02/2009] [Accepted: 07/02/2009] [Indexed: 01/27/2023]
Abstract
Overweight and obesity potentiate the development of cardiovascular risk factors but many doubts have arisen recently regarding their role in coronary events. We evaluated the predictive value of a surrogate maker of insulin resistance, the ratio of triglyceride (TG) to high-density lipoprotein (HDL), for the incidence of a first coronary event in men workers according to body mass index (BMI). We designed a case-control study of active subjects collected from a single factory through their annual health examination and medical reports. Case subjects included those with myocardial infarction, unstable angina pectoris, or subclinical myocardial ischemia detected through electrocardiographic abnormalities. The sample was constituted by 208 case and 2,080 control subjects (mean age 49.9 years, 49.6 to 50.2). General characteristics of case and control subjects were well matched. The TG/HDL ratio was significantly higher in case subjects compared to controls. Stratification of the sample revealed an increasing prevalence of case subjects and mean TG/HDL in each category of BMI. Multivariable analysis, adjusted by smoking, demonstrated that TG/HDL increased 50% the risk of a first coronary event (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.26 to 1.71), whereas low-density lipoprotein cholesterol values indicated a more moderate increased risk (OR 1.01, 95% CI 1.005 to 1.012); metabolic syndrome (OR 1.76, 95% CI 0.94 to 3.30) and hypertension (OR 1.50, 95% CI 0.81 to 2.79) did not reach statistical significance. The TG/HDL ratio was associated with a first coronary event in all categories of BMI. In conclusion, the TG/HDL ratio has a high predictive value of a first coronary event regardless of BMI.
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