[Effects of the intake of dairy products naturally enriched with selenium and omega-3 polyunsaturated fatty acids in a sample of postmenopausal women with metabolic syndrome: a randomized, triple-blind, placebo-controlled clinical trial]. / Efectos de la ingesta de lácteos enriquecidos de forma natural con selenio y omega-3 en una muestra de mujeres posmenopáusicas con síndrome metabólico: un ensayo clínico aleatorizado, triple ciego y controlado con placebo.

INTRODUCTION: Introduction: metabolic syndrome in postmenopausal women can improve with a healthy diet. Objectives: to evaluate whether a dietary intervention with dairy products naturally enriched with selenium and omega-3 polyunsaturated fatty acids increases selenium plasma levels and improves cardiovascular risk factors in postmenopausal women with metabolic syndrome. Material and methods: a randomized, triple-blind, controlled clinical trial carried out in GP surgeries. Recruitment: April 2018, 46 postmenopausal women with metabolic syndrome who were frequent dairy consumers. Randomization: 23 in control group and 23 in experimental group. Intervention: consumption of dairy products naturally enriched with selenium and omega-3 polyunsaturated fatty acids (milk, yogurt, fresh cheese) for three months. Controls took conventional dairy. Primary endpoint: plasma selenium levels; secondary endpoints: metabolic syndrome criteria. Registration number 2018/256, Galicia Ethics Committee. Results: in all, 23 women in the control group and 21 in the intervention group completed the trial. Selenium increased in the intervention group (7.2 µg/L, 95 % CI, 3.7/10.8) compared to the control group (-4.5 µg/L, 95 % CI, -8/-1) (p < 0.001) and very low-density lipoprotein cholesterol decreased (-2.3 mg/dL, 95 % CI, -5.6/1) compared to the control group (1.9 mg/dL, 95 % CI, -0.7/4.5) (p = 0.043). Waist circumference (p = 0.010), body mass index (p = 0.047) and high-density lipoprotein cholesterol (p < 0.001) in the experimental group improved in comparison to baseline measurements. Conclusions: an intervention with dairy products naturally enriched with selenium and omega-3 in a sample of postmenopausal women with metabolic syndrome can improve plasma selenium levels and very low-density lipoprotein cholesterol.

INTRODUCCIÓN: Introducción: el síndrome metabólico de las mujeres posmenopáusicas puede mejorar con una alimentación saludable. Objetivos: evaluar si una intervención alimentaria con productos lácteos enriquecidos en selenio y ácidos grasos poliinsaturados omega-3 aumenta los niveles de selenio y mejora los factores de riesgo cardiovascular en las mujeres posmenopáusicas con síndrome metabólico. Material y métodos: ensayo clínico aleatorizado, triple ciego y controlado, realizado en atención primaria. Captación: abril 2018, 46 mujeres posmenopáusicas con síndrome metabólico consumidoras habituales de lácteos. Aleatorización: 23 en el grupo de control y 23 en el grupo experimental. Intervención: consumo durante 3 meses de lácteos enriquecidos naturalmente con selenio y ácidos grasos poliinsaturados omega-3 (leche, yogur y queso fresco). Controles: consumo de lácteos convencionales. Variable principal: selenio en plasma; secundarias: criterios del síndrome metabólico. Número de registro 2018/256, Comité de Ética Galicia. Resultados: finalizaron 23 mujeres en el grupo de control y 21 en el grupo de intervención. Aumentó el selenio en el grupo de intervención (7,2 µg/L, IC del 95 %: 3,7/10,8) frente al grupo de control (-4,5 µg/L, IC del 95 %: -8/-1) (p < 0,001) y disminuyó el colesterol unido a lipoproteínas de muy baja densidad (-2,3 mg/dl, IC del 95 %: -5,6/1) respecto al grupo de control (1,9 mg/dl, IC del 95 %: -0,7/4,5) (p = 0,043). Las mujeres del grupo experimental mejoraron respecto a su medición basal en perímetro de cintura (p = 0,010), índice de masa corporal (p = 0,047) y colesterol unido a lipoproteínas de alta densidad (p < 0,001). Conclusiones: una intervención con lácteos enriquecidos naturalmente con selenio y omega-3 en mujeres posmenopáusicas con síndrome metabólico puede mejorar los niveles de selenio en plasma y de colesterol unido a lipoproteínas de muy baja densidad.

Rationale, design and preliminary results of the GALIPEMIAS study (prevalence and lipid control of familial dyslipidemia in Galicia, northwest Spain).

AIMS: There is little information on the familial nature of dyslipidemias in the Spanish population. This knowledge could have potential diagnostic and treatment implications. The objective of the GALIPEMIAS study was to determine the prevalence of familial dyslipidemia in Galicia, as well as determine the degree of lipid control in the participants. Prevalence of atherosclerotic cardiovascular disease (ASCVD) was also estimated. This paper presents the design, methodology and selected preliminary results. METHODOLOGY: A cross-sectional study was performed in the population aged ≥18 years using cluster sampling and then random sampling. A sample of 1000 subjects was calculated and divided into three sequential phases with a specific methodology for each one. Phase I: selection of subjects from the general population and collection of informed consent documents; Phase II: collection of data from the digital clinical history to select subjects with dyslipidemia according to study criteria; Phase III: personal interview, blood analysis, family tree, and definitive diagnosis of dyslipidemia. Prevalence of different diseases and active medication was analysed. Corrected prevalence (to the reference population) of different risk factors and ASCVD was estimated. RESULTS: Phase I participation was 89.5%. We extracted complete information from 93% of the participants (Phase II). According to the study's own criteria, 56.5% (n = 527) of the participants had some form of dyslipidemia and almost 33.7% of them had familial dyslipidemia with autosomal dominant inherit pattern. The corrected prevalence of ASCVD was 5.1% (95% CI 3.1-7.2). CONCLUSIONS: Dyslipidemia was the most prevalent cardiovascular risk factor in our population with an autosomal dominant inheritance pattern in one out of every three dyslipidemia cases. Approximately, 5.1% of the sample population aged ≥18 has suffered an episode of ACVD.

Educational intervention on cardiovascular parameters in perimenopausal women with a cardiovascular risk factor. Randomised clinical trial. / Intervención educativa sobre parámetros cardiovasculares en mujeres perimenopáusicas con un factor de riesgo cardiovascular. Ensayo clínico aleatorizado.

BACKGROUND AND OBJECTIVE: Randomised clinical trial performed in two urban health centres in Spain. To evaluate if educational intervention in women of perimenopausal age with hypertension, diabetes mellitus and/or dyslipidaemia could achieve significant changes in the reduction of biochemical and haemodynamic risk parameters. PATIENTS AND METHODS: The study included 320 women aged between 45 and 60 years old who were diagnosed with hypertension, diabetes mellitus and/or dyslipidaemia. They were randomly assigned to the experimental group (n=160) and the control group (n=160). The intervention group received three educational sessions and the control group received an informative leaflet sent by mail. Haemodynamic and biochemical variables were evaluated at baseline and one year later in both groups. RESULTS: Women in the intervention group showed a decrease in low density lipoprotein (P=.034), (-5.89±29.8; 95% CI: -13.1/0.27) and an increase in high density lipoprotein (P=.013), (2.71±10.6; 95% CI: -1.36/6.20), as well as improvements in systolic blood pressure (P=.016), (-2.16±11.8; 95% CI: -4.4/0.01) and frequency (P=.003), (-1.46±10.3; 95% CI: -3.34/0.42) compared to women in the control group. Women in the control group significantly increased glucose (P=.04), (4.84±15.5; 95% CI: -0.75/31.3) and gamma-glutamyltranspeptidase (P=.031), (3.61±14.7; 95% CI: 0.87/6.36) levels more than those in the experimental group. CONCLUSIONS: An educational intervention can be an effective method of reducing the parameters associated with an increased likelihood of cardiovascular disease in women at perimenopausal age with hypertension, diabetes mellitus and/or dyslipidaemia.

[Metabolic syndrome and visceral fat in women with cardiovascular risk factor]. / Síndrome metabólico y grasa visceral en mujeres con un factor de riesgo cardiovascular.

INTRODUCTION: Cardiovascular diseases are the leading cause of death in women after menopause, since after this stage there are profound metabolic and hormonal changes which favor the development of metabolic syndrome. An increase in the percentage of visceral fat may be related to the onset of this syndrome. OBJECTIVE: To establish the relationship between visceral fat and parameters of the metabolic syndrome and to determine the optimal cut-off point for the variables related to obesity in women with a cardiovascular risk factor. METHOD: Cross-sectional descriptive study carried out in two urban health centers in Spain. We evaluated 320 women aged 45 to 60 years with hypertension, diabetes mellitus and/or dyslipidemia. Age, estrogenic activity, visceral fat and body fat measured through a bioimpedance device, body mass index, abdominal perimeter, systolic and diastolic blood pressure, triglycerides, high density lipoprotein, glucose and the presence or absence of syndrome metabolic were considered. RESULTS: There is a significant correlation between visceral fat and all metabolic syndrome defining parameters (p < 0.05). The optimum cut-offs for obesity-related variables were visceral fat (8 kg), abdominal perimeter (93.5 cm), body mass index (26.9 kg/m2 ) and total body fat (24.3 kg). CONCLUSIONS: Menopausal women showed more visceral fat. An association between visceral fat and the parameters that define the metabolic syndrome is observed. It would be advisable to perform a more complex research to study the utility of visceral fat as a possible screening parameter in the metabolic syndrome.

INTRODUCCIÓN: las enfermedades cardiovasculares son la primera causa de muerte en las mujeres tras la menopausia, ya que después de esta etapa se producen profundos cambios metabólicos y hormonales que favorecen el desarrollo de síndrome metabólico. Un aumento en el porcentaje de la grasa visceral puede estar relacionado con la aparición de dicho síndrome. OBJETIVO: establecer la relación entre la grasa visceral y los parámetros del síndrome metabólico y determinar el punto de corte óptimo para las variables relacionadas con la obesidad, en mujeres con un factor de riesgo cardiovascular. MÉTODO: estudio descriptivo transversal realizado en dos centros de salud urbanos de España. Fueron evaluadas 320 mujeres de edades comprendidas entre 45 y 60 años con hipertensión, diabetes mellitus y/o dislipemia. Se estudiaron edad, actividad estrogénica, grasa visceral y grasa corporal medida a través de un dispositivo de bioimpedancia, índice de masa corporal, perímetro abdominal, presión arterial sistólica y diastólica, triglicéridos, lipoproteínas de alta densidad, glucosa y presencia o no de síndrome metabólico. RESULTADOS: las mujeres menopáusicas presentaban mayor cantidad de grasa visceral (p = 0,011). Se observó una correlación significativa entre la grasa visceral y todos los parámetros definitorios del síndrome metabólico (p < 0,05). El punto de corte óptimo para las variables relacionadas con la obesidad fue: grasa visceral (8 kg), perímetro abdominal (93,5 cm), índice de masa corporal (26,9 kg/m2) y grasa corporal total (24,3 kg). CONCLUSIONES: mostraron mayor cantidad de grasa visceral las mujeres menopáusicas. Se observa una asociación entre la grasa visceral y los parámetros que definen el síndrome metabólico. Sería recomendable realizar un estudio más complejo que estudiase la utilidad de la grasa visceral como posible parámetro de cribado en el síndrome metabólico.

Morbidity and mortality among heart failure patients in Galicia, N.W. Spain: the GALICAP Study.

OBJECTIVE: Characterization of current morbidity and mortality among heart failure (HF) outpatients in Galicia (N.W. Spain), together with their main determinants. DESIGN: Prospective multicentre study involving 149 primary care physicians. SETTING: Primary care physicians selected randomly from among all (1959) primary care physicians in Galicia. PATIENTS: Clinical and epidemiological information for 1195 outpatients with HF were collected in 2006, with a mean follow-up of 6.5+/-1.5 months. MAIN OUTCOME MEASURES: Survival rates were calculated by Cox's proportional hazard model. RESULTS: Mean patient age was 76 years, 48% were male, 82% had a history of arterial hypertension, and 32% ischaemic cardiopathy. Echocardiography had been performed in 67%, showing preserved systolic function in 61%. Ninety-two (8%) died during follow-up [74 (80%) of them from cardiac causes], and 313 (29%) were re-admitted to hospital [230 (73%) of them for cardiac reasons]. Multivariate analysis identified the following independent predictors of cardiovascular death and/or readmission: ischaemic cardiopathy [hazard ratio (HR) 1.76, 95% confidence interval (CI) 1.29-4.40], stroke (HR 1.79, CI 1.18-2.73), oedema (HR 1.49, CI 1.10-2.03), anaemia (HR 1.66, CI 1.21-2.27), deteriorated systolic function (HR 1.62, CI 1.19-2.20), and previous cardiovascular admissions (HR 2.33, CI 1.67-3.24). Residence in the Barbanza district was identified as an independent predictor of survival free from cardiovascular admission (HR 0.56, CI 0.37-0.86). CONCLUSION: Morbidity and mortality are currently high among Galician HF patients, and their best single predictor is previous hospitalization for cardiovascular reasons.

[Galician study of heart failure in primary care (GALICAP Study)]. / Estudio gallego de insuficiencia cardiaca en atención primaria (estudio GALICAP).

INTRODUCTION AND OBJECTIVES: Heart failure (HF) is an important public health concern. Our aim was to evaluate the characteristics of HF patients in Galicia, Spain. METHODS: This descriptive, cross-sectional, multicenter study involved 149 primary care physicians and recorded the characteristics of 1195 patients diagnosed with HF. RESULTS: Some 48% of patients were male, and their mean age was 76 years, though women were older (P<.001). Disease history included hypertension in 82%, hyperlipidemia in 47%, diabetes in 31%, atrial fibrillation in 49%, valvular disease in 35%, and ischemic heart disease in 32%. Mean systolic and diastolic blood pressures were 131 mm Hg and 76 mm Hg, respectively. Pressure was controlled (