ABSTRACT
Objetivos: El conocimiento sobre la incidencia de enfermedad coronaria en nuestro país es escaso y sus fuentes poco comparables. Fue nuestro objetivo determinar la incidencia de cardiopatía isquémica en una cohorte poblacional con un seguimiento de 7 años y el riesgo asociado a los factores de riesgo cardiovascular clásicos. Métodos: Estudio de cohortes prospectivo en una muestra poblacional de 2833 sujetos, seleccionada por método aleatorio simple entre ciudadanos de 25 a 79 años del Área de Salud Don Benito Villanueva de la Serena (Badajoz), tasa de respuesta 80,5%. Se recogieron todos los episodios de angina de pecho, infarto de miocardio letal y no letal en individuos sin antecedentes previos de enfermedad cardiovascular. Se calcularon las incidencias acumuladas y las tasas de incidencia ajustadas por 100.000 personas-año por sexo y global. Resultados: De los 2833 participantes iniciales, se excluyeron 103 por antecedentes de enfermedad cardiovascular y 61 por pérdidas, completando el seguimiento 2669 (94,2%). La mediana de seguimiento fue de 6,9 años (RI 6,5 - 7,5), 56,4% mujeres; se registraron 59 eventos. La tasa de incidencia global de cardiopatía isquémica fue 327 casos/100.000 personas-año correspondiendo 470 casos/100.000 al sexo masculino y 211 casos/100.000 personas-año al femenino. Los factores de riesgo cardiovascular clásicos que se asociaron con mayor riesgo de presentar eventos en el seguimiento fueron la dislipemia y la HTA, además del sexo masculino y la edad. Conclusiones: La incidencia de cardiopatía isquémica en la población urbano-rural de Extremadura, es elevada. Los factores de riesgo cardiovascular clásicos más fuertemente asociados a su aparición fueron la dislipemia, y la hipertensión arterial (AU)
Objectives: Knowledge about the incidence of coronary heart disease in our country is scarce and its sources are not comparable. Our aim was to determine the incidence of ischemic heart disease in a population cohort in a 7 years of follow-up, as well as the risk associated with the different classical cardiovascular risk factors. Methods: Cohort study with a population sample of 2833 subjects, selected by the simple random method in a population between 25 and 79, from the Don Benito Villanueva de la Serena (Badajoz) health area, response rate was 80.5%. All episodes of angina pectoris, lethal and non-lethal myocardial infarction were collected in individuals with no previous history of cardiovascular disease. Cumulative incidences and incidence rates adjusted per 100,000 person-years by sex and overall were calculated. Results: From 2833 initial cohort participants, 103 were excluded due to a history of cardiovascular disease and 61 for losses, 2669 completed the follow-up (94.2%). The median follow-up was 6.9 years (IR 6.57.5), 56.4% women; 59 events were recorded. The overall incidence rate of ischemic heart disease was 327 cases/100,000 person-years, corresponding to 470 cases/100,000 for men and 211 cases/100,000 people-years for women. The classical cardiovascular risk factors that were associated with a higher risk of presenting events in the follow-up were dyslipidemia and arterial hypertension, in addition to male sex and age. Conclusions: The incidence of ischemic heart disease in the urbanrural population of Extremadura is high. The classical cardiovascular risk factors most strongly associated with events were dyslipidemia, and arterial hypertension (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Myocardial Ischemia/epidemiology , Incidence , Spain/epidemiology , Risk Factors , Prospective Studies , Cohort StudiesABSTRACT
OBJECTIVES: Knowledge about the incidence of coronary heart disease in our country is scarce and its sources are not comparable. Our aim was to determine the incidence of ischemic heart disease in a population cohort in a 7 years of follow-up, as well as the risk associated with the different classical cardiovascular risk factors. METHODS: Cohort study with a population sample of 2833 subjects, selected by the simple random method in a population between 25 and 79, from the Don Benito - Villanueva de la Serena (Badajoz) health area, response rate was 80.5%. All episodes of angina pectoris, lethal and non-lethal myocardial infarction were collected in individuals with no previous history of cardiovascular disease. Cumulative incidences and incidence rates adjusted per 100,000 person-years by sex and overall were calculated. RESULTS: From 2833 initial cohort participants, 103 were excluded due to a history of cardiovascular disease and 61 for losses, 2669 completed the follow-up (94.2%). The median follow-up was 6.9 years (IR 6.5-7.5), 56.4% women; 59 events were recorded. The overall incidence rate of ischemic heart disease was 327 cases/100,000 person-years, corresponding to 470 cases/100,000 for men and 211 cases/100,000 people-years for women. The classical cardiovascular risk factors that were associated with a higher risk of presenting events in the follow-up were dyslipidemia and arterial hypertension, in addition to male sex and age. CONCLUSIONS: The incidence of ischemic heart disease in the urban-rural population of Extremadura is high. The classical cardiovascular risk factors most strongly associated with events were dyslipidemia, and arterial hypertension.
Subject(s)
Cardiovascular Diseases , Myocardial Ischemia , Adult , Aged , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Cohort Studies , Female , Heart Disease Risk Factors , Humans , Incidence , Male , Middle Aged , Myocardial Ischemia/epidemiology , Myocardial Ischemia/etiology , Spain/epidemiologyABSTRACT
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Humans , Migraine Disorders/diagnosis , Neuroimaging , Psychometrics/instrumentation , Symptom AssessmentABSTRACT
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Humans , Female , Middle Aged , Hamartoma/complications , Hamartoma , Solitary Pulmonary Nodule/complications , Solitary Pulmonary Nodule , Biopsy/methods , Radiography, Thoracic/methods , Tomography, Spiral Computed/instrumentation , Tomography, Spiral Computed/methods , Tomography, Spiral ComputedSubject(s)
Humans , Male , Female , Mental Health Services/ethics , Mental Health Services/legislation & jurisprudence , Community Mental Health Centers/organization & administration , Mental Health/ethics , Mental Health/trends , Primary Health Care/methods , Primary Health Care/trends , Delivery of Health Care/organization & administration , Delivery of Health Care/standards , Primary Health Care/standards , Mental Health Services/statistics & numerical data , Mental Health Services/standards , Mental Health Services/trends , Mental Health Services , Community Mental Health Centers/economics , Primary Health Care/organization & administration , Primary Health CareABSTRACT
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Humans , Mental Disorders/prevention & control , Primary Health CareABSTRACT
INTRODUCCIÓN. Analizar la concordancia y validación a diez años de dos ecuaciones de riesgo coronario que utilizan la función de Framingham calibrada para población española (REGICOR y DORICA) en pacientes diabéticos tipo 2. PACIENTES Y MÉTODOS. Estudio descriptivo, longitudinal, de seguimiento de una cohorte durante 10 años. Un total de 131 pacientes diabéticos de un centro de salud urbano, de 35 a 64 años de edad, sin antecedentes de cardiopatía isquémica, a quienes se les pudo calcular el riesgo coronario antes del 1-01-1995. RESULTADOS. El porcentaje real de eventos coronarios fue del 9,9% (8,8% en varones y 11,1% en mujeres). El riesgo coronario global calculado en la ecuación de Framingham-REGICOR fue del 8,9%, ajustándose perfectamente al riesgo coronario en varones (8,8%) e infraestimándolo en mujeres (9,0%). En cambio, la ecuación de Framingham-DORICA sobreestimó el riesgo global de la cohorte (17,3% frente al 9,9% de eventos), tanto en varones (19,7%) como en mujeres (14,8%), siendo sus riesgos significativamente distintos (p < 0,05). La concordancia entre las dos funciones fue aceptable (índice Kappa = 0,5). La aplicación inicial de la función de Framingham-DORICA, con un umbral para riesgo coronario alto ≥ 10%, y posteriormente la de Framingham-REGICOR a los pacientes catalogados como de riesgo coronario no alto (< 10%), permitieron clasificar correctamente el riesgo coronario de los pacientes diabéticos. CONCLUSIONES. La concordancia entre las funciones de Framingham-REGICOR y DORICA es aceptable, siendo REGICOR la que más se aproximó al riesgo real de la cohorte. La aplicación secuencial de ambas ecuaciones clasifica correctamente el riesgo coronario de los pacientes diabéticos
INTRODUCTION. Analyze the concordance and validation at ten years of two coronary risk equations that use the calibrated Framingham function for Spanish population (REGICOR and DORICA) in type 2 diabetic patients. PATIENTS AND METHODS. Descriptive, longitudinal, follow-up study of a cohort over 10 years. A total of 131 diabetic patients from an urban health care center, from 35 to 65 years of age, without a background of ischemic heart disease, in whom coronary risk could be calculated before 1-01-1995. RESULTS. The real percentage of coronary events was 99% (8.8% in males and 11.1% in women). Global coronary risk calculated in the Framingham-REGICOR equation was 8.9%, it being perfectly adjusted to coronary risk in males (8.8%) and underestimated in women (9.0%). On the contrary, the Framingham-DORICA equation overestimated the global risk of the cohort (17.3% versus 9.9% of events) in both males (19.7%) and women (14.8%), their risks being significantly different (p < 0.05). Concordance between the two functions was acceptable (Kappa index = 0.5). Initial application of the Framingham-DORICA function with a threshold for high coronary risk ≥ 10% and then the Framingham-REGICOR to patients listed as not high coronary risk (< 10%) made it possible to correctly classify the coronary risk of the diabetic patients. CONCLUSIONS. Concordance between the Framingham-REGICOR and DORICA is acceptable, the REGICOR being that which approached the real risk of the cohort most. The sequential application of both equations correctly classified the coronary risk of diabetic patients
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Diabetes Mellitus/complications , Cardiovascular Diseases/epidemiology , Models, Cardiovascular , Risk Adjustment/methods , Risk Factors , Prospective StudiesABSTRACT
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Humans , Physicians, Family , Marriage , Physician's Role , Spouse Abuse , Domestic Violence , Family Characteristics , Family TherapySubject(s)
Domestic Violence/prevention & control , Mental Disorders/prevention & control , Adolescent , Adult , Age Factors , Aged , Battered Women/psychology , Cohort Studies , Cross-Sectional Studies , Family Practice , Female , Humans , Male , Mental Disorders/epidemiology , Pregnancy , Primary Health Care , Primary Prevention , Risk Factors , Sex Factors , Spouse Abuse/prevention & control , Spouse Abuse/psychology , Surveys and QuestionnairesSubject(s)
Family Practice , Pediatrics , Referral and Consultation , Child , Health Facilities , Humans , SpainABSTRACT
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