Intervención clínica sobre los principales factores de riesgo vascular (estudio RIVANA) / Clinical interventions on the major vascular risk factors (RIVANA study)

Fundamento. El objetivo es describir la frecuencia de diagnósticode los factores clásicos de riesgo vascular y de lasintervenciones dietéticas y terapéuticas, así como su control.Sujetos y métodos. Dentro del proyecto Riesgo Vascular deNavarra (RIVANA), se lleva a cabo el estudio transversal enuna muestra aleatoria de 4.354 personas entre 35 y 84 años,recogiendo por encuesta antecedentes y realizando exploraciónclínica y analítica. Los sujetos se han clasificado paracada factor de riesgo en: diagnosticados por información –cuando el personal sanitario le había informado de que presentabael factor de riesgo–; por intervención –cuando tomamedicación para ello–; y por detección en personas asintomáticas.Se identifican las variables de intervención porárboles dicotómicos expresadas por frecuencias relativas.Resultados. El 45,3% de los sujetos son hipertensos: 27%diagnosticados previamente y 18,3% en el momento de laexploración. El 39% son hipercolesterolémicos: 33,4% diagnosticadospreviamente y 5,6% en el momento de la exploración.El 21,2% presentaban hiperglucemia: 9,7% diagnosticadospreviamente y 11,6% en el momento de la exploración.El 65,6% fue diagnosticado de sobrepeso u obesidad: 25,9%previamente y el 39,6% en el momento de la exploración.Recibían consejo dietético y tratamiento farmacológicorespectivamente: el 79,8% y el 70,3% de los hipertensos; el75,4% y el 35% de los hipercolesterolémicos; el 83,1% y 47,4%de los que presentaban hiperglucemia y el 68,5% y 4% de losque presentaban sobrepeso u obesidad.Conclusiones. La frecuencia de los factores de riesgo cardiovasculares elevada. Existe un margen de mejora importante enla detección, intervención y control de los factores de riesgo(AU)

Background. To describe the diagnostic frequency of classicalvascular risk factors, dietary and therapeutic interventionsand their control.Methods. Within the project Vascular Risk in Navarre (RIVANA),a transversal study was made of a random sampleof 4,354 people between the ages of 35 and 84; antecedentswere gathered by interview and clinical and analytical explorationwas carried out. The subjects were classifiedfor each risk factor into: diagnosed by information –whenhealth personnel had informed them that they presented arisk factor–; by intervention –when they take medication forit–; and by detection in asymptomatic people. The variablesof intervention were identified by dichotomic trees expressedby relative frequencies.Results. Forty-five point three percent of the subjects are hypertense:27% previously diagnosed and 18.3% at the time ofthe exploration. Thirty-nine percent are hypercholesterolemic:33.4% previously diagnosed and 5.6% at the time of theexploration. Twenty-one point two percent presented hyperglycemia:9.7% previously diagnosed and 11.6% at the time ofthe exploration. Sixty-five point six percent were diagnosed asoverweight or obese: 25.9% previously and 39.6% at the timeof the exploration.They received dietary counselling and pharmacologicaltreatment respectively: 79.8% and 70.3% of the hypertense;75.4% and 35% of the hypercholesterolemic; 83.1% and47.4% of those who presented hyperglycemia and 68.5% and4% of those who showed overweight or obesity.Conclusions. The frequency of cardiovascular risk factorsis high. There is a margin for significant improvement in thedetection, intervention and control of the risk factors(AU)

[Clinical interventions on the major vascular risk factors (RIVANA study)]. / Intervención clínica sobre los principales factores de riesgo vascular (estudio RIVANA).

BACKGROUND: To describe the diagnostic frequency of classical vascular risk factors, dietary and therapeutic interventions and their control. METHODS: Within the project Vascular Risk in Navarre (RIVANA), a transversal study was made of a random sample of 4,354 people between the ages of 35 and 84; antecedents were gathered by interview and clinical and analytical exploration was carried out. The subjects were classified for each risk factor into: diagnosed by information--when health personnel had informed them that they presented a risk factor; by intervention--when they take medication for it; and by detection in asymptomatic people. The variables of intervention were identified by dichotomic trees expressed by relative frequencies. RESULTS: Forty-five point three percent of the subjects are hypertense: 27% previously diagnosed and 18.3% at the time of the exploration. Thirty-nine percent are hypercholesterolemic: 33.4% previously diagnosed and 5.6% at the time of the exploration. Twenty-one point two percent presented hyperglycemia: 9.7% previously diagnosed and 11.6% at the time of the exploration. Sixty-five point six percent were diagnosed as overweight or obese: 25.9% previously and 39.6% at the time of the exploration. They received dietary counselling and pharmacological treatment respectively: 79.8% and 70.3% of the hypertense; 75.4% and 35% of the hypercholesterolemic; 83.1% and 47.4% of those who presented hyperglycemia and 68.5% and 4% of those who showed overweight or obesity. CONCLUSIONS: The frequency of cardiovascular risk factors is high. There is a margin for significant improvement in the detection, intervention and control of the risk factors.

[Study of vascular risk in Navarre: objectives and design. Prevalence of metabolic syndrome and of vascular risk factors]. / Estudio de riesgo vascular en Navarra: objetivos y diseño. Prevalencia del síndrome metabólico y de los factores mayores de riesgo vascular.

BACKGROUND: To determine in a representative sample of the population the prevalence of risk factors and metabolic syndrome; their association with sub-clinical atherosclerotic lesions and their impact on cardiocerebrovascular disease 10 years after. MATERIAL AND METHODS: (Phase 1) Cross sectional survey of a random sample stratified by age and sex of the population of Navarre aged between 35 and 84. Antecedents, risk factors, physical and analytical exploration. (Phase II) Ten year follow-up cohort study, in 500 exposed to MS and 500 not exposed persons, aged between 45 and 74 years; with an 82.25% power to detect a risk ratio of 2; with analytical and image markers of sub-clinical atherosclerosis. (Phase III) Follow up of vascular events at ten years. RESULTS: The subjects recruited were 6,553; excluded or not found 871; the final sample was 5,682 (2,644 men and 3,038 women); 4,168 (73,4%) took part in the study. The prevalence of MS was 22.1% (95%CI 20.5 - 23.7) for men and 17,2% (95%CI 15.8 - 18.5) for women. The main cardiovascular RF were high compared to other geographical areas except for HDL cholesterol. The rate was 8.5% (95%CI 7.4 - 9.6) for men and 1.7% (95%CI 1.3 - 2.2) CONCLUSIONS: There are important differences in risk between sex, being worst for men. The high figures for HDL cholesterol and the low prevalence of MS might mean a lower risk of vascular events in Navarra.

Estudio de riesgo vascular en Navarra: objetivos y diseño. Prevalencia del síndrome metabólico y de los factores mayores de riesgo vascular / Study of vascular risk in Navarre: objectives and design. Prevalence of metabolic syndrome and of vascular risk factors

Fundamento. Determinar en una muestra poblacional la prevalencia de los factores de riesgo y del síndrome metabólico, su asociación con las lesiones arterioscleróticas subclínicas y su impacto sobre la enfermedad cardiovascular y cerebrovascular a los 10 años. Material y métodos. (Fase I) Estudio transversal en una muestra aleatoria estratificada por edad y sexo de la población de Navarra entre 35 y 84 años, por encuesta sobre antecedentes vasculares, factores de riesgo, exploración física y analítica. (Fase II) Estudio de cohortes de 10 años de seguimiento, en 500 expuestos y 500 no expuestos al SM, entre 45 y 74 años seleccionados para una razón de riesgo de 2, y una potencia del 82,25%, con exploración de marcadores de arteriosclerosis subclínica por imagen y analíticos. (Fase III) Seguimiento de eventos de enfermedad vascular a los 10 años de la muestra poblacional y de la cohorte prospectiva. Resultados. (Fase 1) Los sujetos requeridos fueron 6.553; excluidos y no localizados 871; la muestra efectiva 5.682 (2.644 hombres y 3.038 mujeres) y completaron el estudio 4.168 sujetos, (73,4%). La prevalencia del síndrome metabólico entre 35 y 84 años fue de 22,1 por 100 (IC95% 20,5-23,7) en hombres y de 17,2% (IC95% 15,8-18,5) en mujeres. Los factores mayores de riesgo vascular presentan prevalencias altas esperadas respecto a otras áreas geográficas excepto la del HDL colesterol bajo que lo fue de 8,5 por 100 (IC95% 7,4-9,6) en hombres y de 1,7% (IC95% 1,3-2,2). Conclusiones. Existen diferencias importantes de riesgo entre sexos en detrimento de los hombres. Las altas cifras promedio de HDL colesterol y la baja prevalencia de síndrome metabólico pueden justificar el menor riesgo de eventos vasculares en Navarra

Background. To determine in a representative sample of the population the prevalence of risk factors and metabolic syndrome; their association with sub-clinical atherosclerotic lesions and their impact on cardiocerebrovascular disease 10 years after. Material and Methods. (Phase 1) Cross sectional survey of a random sample stratified by age and sex of the population of Navarre aged between 35 and 84. Antecedents, risk factors, physical and analytical exploration. (Phase II) Ten year follow-up cohort study, in 500 exposed to MS and 500 not exposed persons, aged between 45 and 74 years; with an 82.25% power to detect a risk ratio of 2; with analytical and image markers of subclinical atherosclerosis. (Phase III) Follow up of vascular events at ten years. Results. The subjects recruited were 6,553; excluded or not found 871; the final sample was 5,682 (2,644 men and 3,038 women); 4,168 (73,4%) took part in the study. The prevalence of MS was 22.1% (95%CI 20.5 - 23.7) for men and 17,2% (95%CI 15.8 - 18.5) for women. The main cardiovascular RF were high compared to other geographical areas except for HDL cholesterol. The rate was 8.5% (95%CI 7.4 - 9.6) for men and 1.7% (95%CI 1.3 - 2.2) Conclusions. There are important differences in risk between sex, being worst for men. The high figures for HDL cholesterol and the low prevalence of MS might mean a lower risk of vascular events in Navarra