Estudio del riesgo coronario y de ictus en pacientes hipertensos mayores de 54 años atendidos en Atención Primaria / Study of the stroke and coronary risks in hypertensive patients over 54 years of age in the primary care practice

Antecedentes y objetivos. La cuantificación del riesgocerebrovascular no es una práctica extendida enpacientes hipertensos atendidos en Atención Primaria.Métodos. Estudio epidemiológico transversal enpacientes hipertensos mayores de 54 añosatendidos en Atención Primaria en España. Secalculó el riesgo de ictus mediante la escalaFramingham-D’Agostino.Resultados. La población evaluable fue de 4.945pacientes (edad media: 66,8 años, 50,9% de mujeres).La presión arterial (PA) media fue de 145/86 mmHgen varones y de 143,7/84,7 mmHg en mujeres(p < 0,001). El 80,5% de los pacientes mostró uncontrol inadecuado de la PA a pesar de que el 89,6%recibía un tratamiento farmacológico antihipertensivo.El 41% de los pacientes era diabético. El riesgo globalde ictus en 10 años fue del 22,5%, superior envarones (28,6 frente al 16,8%; p < 0,001) y aumentócon la edad, de forma más pronunciada en mujeres.Los factores significativamente asociados a padecerictus, según su porcentaje de contribución, fueron laedad, la hipertrofia ventricular izquierda, laenfermedad cardiovascular, la PA sistólica, lafibrilación auricular, la diabetes, el hábito tabáquico, elcontrol de la PA, el sexo y el tratamientoantihipertensivo. El riesgo coronario medio estimadoen 10 años fue superior en varones (24,2 frente al16,0%; p < 0,001) y se correlacionósignificativamente con el de ictus (r = 0,626).Conclusiones. El riesgo estimado de ictus en estamuestra de población hipertensa fue alto ysignificativamente más elevado en varones, aunquecon la edad se incrementa proporcionalmente másen mujeres. Se observó una correlación linealmoderada, pero significativa, entre el riesgo de ictusy el riesgo coronario. Además de las variablesincluidas en la escala, el sexo, el control de la PA ytratamiento antihipertensivo influyeron significativa eindependientemente en el riesgo calculado de ictus

Background and objectives. Quantification of strokerisk is not always performed in hypertensive patientsin Primary Care.Methods. This was an epidemiological study inhypertensive patients aged 55 years and older attendingprimary care centres in Spain. The D’Agostino StrokeRisk Scale, using data from the Framingham Study, wasused for assessment of stroke risk.Results. We analysed 4,945 patients (mean age,66.8 years; 50.9% females). Mean blood pressure(BP) values were 145/86 mmHg in men and143.7/84.7 mmHg in women (p < 0.001). Themajority of patients (80.5%) showed high BP valuesthat were above the values recommended in theguidelines, despite most of them (89.6%) receivingpharmacological antihypertensive treatment. 41% ofpatients were diabetics. The 10-year global risk ofstroke was 22.5%, and was higher in men (28.6% vs.16.8%; P < 0.001). The risk of stroke increased withage, being more marked in women. Several riskfactors showed a statistically significant associationwith the risk of stroke. From higher to lowersignificance, these risk factors were: age, leftventricular hypertrophy (LVH), cardiovasculardisease, systolic BP, auricular fibrillation, diabetes,cigarette smoking, control of BP, gender, andantihypertensive treatment.The 10-year coronary risk was higher in men(24.2% vs. 16.0%; p < 0.001) and was significantlyrelated to the 10-year risk of stroke (r = 0.626).Conclusions. The risk of stroke in the Spanishhypertensive population is high, and is significantlyhigher in men, although it shows a larger age-relatedincrease in women. Linear regression analysis showeda moderate, but statistically significant, correlationbetween coronary risk and risk of stroke. Apart fromall the variables included in the Framingham StrokeRisk Model, gender, control of BP, andantihypertensive treatment accounted significantlyand independently as calculated risk factors forincidence of stroke

Patients' perception of cancer-related fatigue: results of a survey to assess the impact on their everyday life

PURPOSE: Fatigue is a cancer-related symptom with great impact on patients' daily lives, but often not discussed with their oncologists. This survey explored functional and psychological fatigue impact among different cancer symptoms according to patient's perception (pp). METHODS: A cross-sectional, self-administered survey was conducted in 10 oncologist services throughout Spain. Demographical data and tumour diagnoses were collected. Fatigue impact on functional and social activities (Likert scale) and on emotional well-being (visual analogue scale) was measured. The pp of oncologist's response to fatigue report was recorded. RESULTS: 505 surveyed cancer patients were analysed (55.2% women, aged 58.8 years +/-11.7), 97.8% remembered experiencing fatigue during treatment. 27.1% did not discuss their fatigue with their oncologist. Fatigue affected patient's daily routine (> or = 50% of times) included self-care (58.26%), entertainment activities (69.8%), and relationships (71.4%). Fatigue was the most bothersome symptom of cancer. CONCLUSIONS: Cancer patients perceive fatigue as the symptom with highest impact on their daily living and that substantially affects their emotional and social areas (AU)

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