¿Qué pasa con el deportista no de élite?, ¿y con su reconocimiento? / No disponible

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Mortalidad a largo plazo y reingreso hospitalario tras infarto agudo de miocardio: un estudio de seguimiento de ocho años / Long-term mortality and hospital readmission after acute myocardial infarction: an eight-year follow-up study

Introducción y objetivos. El infarto agudo de miocardio es en los países desarrollados la causa más importante de mortalidad, así como de un gran número de ingresos hospitalarios. Concretamente, en España cada año se producen alrededor de 140.000 muertes y 5 millones de hospitalizaciones a causa de infarto agudo de miocardio, lo cual corresponde a unos costes de asistencia sanitaria que suponen un 15% de los gastos totales. En este artículo se presenta, pues, un análisis exhaustivo del infarto agudo de miocardio y el pronóstico que comporta en cuanto a recurrencia y mortalidad. Métodos. Este estudio observacional se llevó a cabo en España. Los datos se obtuvieron de la Base de Datos Administrativa de Altas Hospitalarias para el periodo comprendido entre 2000 y 2007, ambos inclusive. Concretamente, se registraron 12.096 casos de infarto agudo de miocardio (8.606 mujeres y 3.490 varones) durante ese periodo, con un total de 2.395 reingresos por ese diagnóstico. Se analizó la frecuencia y la duración de los reingresos mediante regresión logística y con el modelo de supervivencia de Wang. La mortalidad se analizó mediante una regresión logística. Resultados. Las tasas de reingreso fueron del 50% en los pacientes de menos de 45 años y del 38% en los de más de 75 años (p<0,001). Los varones reingresaron con mayor frecuencia que las mujeres durante todo el periodo de seguimiento. Las variables relacionadas con la mortalidad hospitalaria por infarto agudo de miocardio fueron diabetes mellitus, antecedentes de cardiopatía isquémica y enfermedad cerebrovascular. Conclusiones. Los reingresos hospitalarios a medio plazo son muy frecuentes en los pacientes que sobreviven a un infarto agudo de miocardio. El sexo masculino, los antecedentes de enfermedad coronaria y el número de factores de riesgo cardiovascular clásicos son factores predictivos importantes del riesgo de reingreso. Nuestros resultados resaltan la necesidad de una mejora de la asistencia médica durante el ingreso por infarto agudo de miocardio, de manera integrada en los programas de prevención secundaria (AU)

Introduction and objectives. Acute myocardial infarction is responsible for most of the deaths in developed countries and for a very large number of hospital admissions. Specifically in Spain, each year about 140 000 deaths and 5 million hospital stays are due to acute myocardial infarction, corresponding to health care costs reaching 15% of total expenditure. Therefore, this paper presents an exhaustive analysis of acute myocardial infarction and the related prognosis, such as recurrence and mortality. Methods. This observational study was carried out in Spain. Data were obtained using the Hospital Discharge Administrative Database from 2000 through 2007, inclusive. Specifically, 12 096 cases of acute myocardial infarction (8606 women and 3490 men) were reported during this period, with 2395 readmissions for this diagnosis. Readmissions were analyzed for frequency and duration using logistic regression and the Wang survival model. Mortality was analyzed using logistic regression. Results. Readmission rates were 50% for patients younger than 45 years and 38% for those older than 75 years (P<.001). Men were readmitted more frequently than women throughout the follow-up period. Variables related to hospital mortality from acute myocardial infarction were the presence of diabetes, previous ischemic heart disease, and cerebrovascular disease. Conclusions. Mid-term hospital readmissions are highly frequent in acute myocardial infarction survivors. Male sex, previous coronary heart disease, and the number of classical cardiovascular risk factors are the major risk predictors of this readmission. Our results highlight the need for improved medical care during acute myocardial infarction admission, integrated into secondary prevention programs (AU)

Long-term mortality and hospital readmission after acute myocardial infarction: an eight-year follow-up study.

INTRODUCTION AND OBJECTIVES: Acute myocardial infarction is responsible for most of the deaths in developed countries and for a very large number of hospital admissions. Specifically in Spain, each year about 140,000 deaths and 5 million hospital stays are due to acute myocardial infarction, corresponding to health care costs reaching 15% of total expenditure. Therefore, this paper presents an exhaustive analysis of acute myocardial infarction and the related prognosis, such as recurrence and mortality. METHODS: This observational study was carried out in Spain. Data were obtained using the Hospital Discharge Administrative Database from 2000 through 2007, inclusive. Specifically, 12,096 cases of acute myocardial infarction (8606 women and 3490 men) were reported during this period, with 2395 readmissions for this diagnosis. Readmissions were analyzed for frequency and duration using logistic regression and the Wang survival model. Mortality was analyzed using logistic regression. RESULTS: Readmission rates were 50% for patients younger than 45 years and 38% for those older than 75 years (P<.001). Men were readmitted more frequently than women throughout the follow-up period. Variables related to hospital mortality from acute myocardial infarction were the presence of diabetes, previous ischemic heart disease, and cerebrovascular disease. CONCLUSIONS: Mid-term hospital readmissions are highly frequent in acute myocardial infarction survivors. Male sex, previous coronary heart disease, and the number of classical cardiovascular risk factors are the major risk predictors of this readmission. Our results highlight the need for improved medical care during acute myocardial infarction admission, integrated into secondary prevention programs.

Comentarios a las guías de práctica clínica sobre manejo de las dislipemias de la Sociedad Europea de Cardiología y la Sociedad Europea de Aterosclerosis 2011. Un informe del Grupo de Trabajo del Comité de Guías de Práctica Clínica de la Sociedad Española de Cardiología / Comments on the ESC/EAS guidelines for the management of dyslipidaemias 2011. A report of the Task Force of the Clinical Practice Guidelines Committee of the Spanish Society of Cardiology

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Factores de riesgo cardiovascular y estilo de vida asociados a la aparición prematura de infarto agudo de miocardio / Cardiovascular risk factors and lifestyle associated with premature myocardial infarction diagnosis

Los pacientes jóvenes diagnosticados de infarto agudo de miocardio tienen diferente perfil de riesgo cardiovascular, presentación clínica, hallazgos angiográficos y pronóstico que los demás pacientes. En este estudio se analizan las características y la evolución de los pacientes diagnosticados de infarto agudo de miocardio con edad < 46 años (AU)

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 (AU)

[Cardiovascular risk factors and lifestyle associated with premature myocardial infarction diagnosis]. / Factores de riesgo cardiovascular y estilo de vida asociados a la aparición prematura de infarto agudo de miocardio.

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.

Relationship between metabolic syndrome and ischemic heart disease mortality in Spain.

Morbidity and mortality due to ischemic heart disease (IHD) is subject to wide geographic variation both between and within countries. The aim of this study was to determine whether geographic variations exist in the prevalence of metabolic syndrome in the Spanish working population or in its relationship with IHD mortality. We analyzed clinical and laboratory data obtained during health check-ups carried out in Spanish workers (n=17,837) during 2003. The prevalence of metabolic syndrome was 17% in men and 6.5% in women. However, there was a heterogeneous distribution across the different regions studied. The prevalence in southern and western regions (e.g., in men: 22.15% in Extremadura and 20.6% in Galicia) was double that observed in central and northern zones (e.g., in the Basque Country and Castile and León). This research indicates that there is a significant association between IHD mortality and the prevalence of metabolic syndrome in workers from different Spanish regions.

Relación entre el síndrome metabólico y la mortalidad por cardiopatía isquémica en España / Relationship between metabolic syndrome and ischemic heart disease mortality in Spain

La mortalidad y morbilidad de la cardiopatía isquémica siguen una distribución geográfica heterogénea entre diferentes países e incluso dentro de cada país. El objetivo del presente estudio es analizar si hay diferencias en la distribución geográfica del síndrome metabólico en la población laboral española y su relación con la mortalidad por cardiopatía isquémica. Analizamos datos clínicos y analíticos (n = 17.837) procedentes de los exámenes de salud realizados a trabajadores durante el año 2003. La prevalencia del síndrome metabólico es del 17% en varones y el 6,5% en mujeres. Sin embargo, su distribución es heterogénea en las diferentes comunidades estudiadas. Las regiones del sur y el oeste muestran prevalencias (Extremadura, 22,15%; Galicia, 20,6% en varones) que duplican las de las zonas del centro y el norte: País Vasco y Castilla y León. Nuestro trabajo señala una asociación significativa entre la mortalidad por cardiopatía isquémica y la frecuencia de síndrome metabólico en trabajadores de las diferentes provincias españolas (AU)

Morbidity and mortality due to ischemic heart disease (IHD) is subject to wide geographic variation both between and within countries. The aim of this study was to determine whether geographic variations exist in the prevalence of metabolic syndrome in the Spanish working population or in its relationship with IHD mortality. We analyzed clinical and laboratory data obtained during health check-ups carried out in Spanish workers (n=17,837) during 2003. The prevalence of metabolic syndrome was 17% in men and 6.5% in women. However, there was a heterogeneous distribution across the different regions studied. The prevalence in southern and western regions (e.g., in men: 22.15% in Extremadura and 20.6% in Galicia) was double that observed in central and northern zones (e.g., in the Basque Country and Castile and León). This research indicates that there is a significant association between IHD mortality and the prevalence of metabolic syndrome in workers from different Spanish regions (AU)

Usefulness of triglycerides-to-high-density lipoprotein cholesterol ratio for predicting the first coronary event in men.

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.

Guía Europea de Prevención Cardiovascular en la Práctica Clínica. Adaptación española del CEIPC 2008 / European Guidelines on Cardiovascular Disease Prevention in Clinical Practice. CEIPC 2008 Spanish Adaptation

Presentamos la adaptación española realizada por el Comité Español Interdisciplinario para la Prevención Cardiovascular (CEIPC) de la Guía Europea de Prevención de las Enfermedades Cardiovasculares 2008. Esta guía recomienda el modelo SCORE de riesgo bajo para valorar el riesgo cardiovascular. El objetivo es prevenir la mortalidad y la morbilidad debidas a las enfermedades cardiovasculares (ECV) mediante el tratamiento de sus factores de riesgo en la práctica clínica. La guía hace énfasis en la prevención primaria y en el papel del médico y el personal de enfermería de atención primaria en la promoción de un estilo de vida cardiosaludable, basado en el incremento de los grados de actividad física, la adopción de una alimentación saludable y, en los fumadores, el abandono del tabaco. La meta terapéutica para la presión arterial es en general<140/90mmHg; pero en pacientes con diabetes mellitus, enfermedad renal crónica o ECV el objetivo es 130/80mmHg. El colesterol debe mantenerse por debajo de 200mg/dl (colesterol unido a lipoproteínas de baja densidad [cLDL]<130mg/dl); en los pacientes con ECV o diabetes mellitus el objetivo es cLDL<100mg/dl (80mg/dl si factible en individuos de riesgo muy alto). En pacientes con diabetes mellitus tipo 2 y en pacientes con síndrome metabólico se debe reducir el peso y aumentar la actividad física y, en su caso, utilizar los fármacos indicados, para alcanzar los objetivos del índice de masa corporal y de perímetro de cintura. El objetivo en pacientes con diabetes mellitus tipo 2 debe ser alcanzar una hemoglobina glucosilada<7%. La amplia difusión de las guías y el desarrollo de los programas destinados a favorecer su implantación, en los que se identifiquen barreras y se busquen soluciones, son objetivos prioritarios del CEIPC, como uno de los medios fundamentales para trasladar las recomendaciones establecidas a la práctica clínica diaria(AU)

The present CEIPC Spanish adaptation of the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice 2008. This guide recommends the SCORE model for risk evaluation. The aim is to prevent premature mortality and morbidity due to CVD by means of dealing with its related risk factors in clinical practice. The guide focuses on primary prevention and emphasizes the role of the nurses and primary care doctors in promoting a healthy life style, based on increasing physical activity, changing dietary habits, and not smoking. The therapeutic goal is to achieve a Blood Pressure<140/90mmHg, but in patients with diabetes, chronic kidney disease, or definite CVD, the objective is<130/80mmHg. Serum cholesterol should be<200mg/dl and cLDL<130mg/dl, although in patients with CVD or diabetes, the objective is<100mg/dl (80mg/dl if feasible in very high-risk patients). Patients with type 2 diabetes and those with metabolic syndrome must lose weight and increase their physical activity, and drugs must be administered whenever applicable, with the objective guided by body mass index and waist circumference. In diabetic type 2 patients, the objective is glycated haemoglobin<7%. Allowing people to know the guides and developing implementation programs, identifying barriers and seeking solutions for them, are priorities for the CEIPC in order to put the recommendations into practice(AU)

[European Guidelines on Cardiovascular Disease Prevention in Clinical Practice. CEIPC 2008 Spanish Adaptation]. / Guía Europea de Prevención Cardiovascular en la Práctica Clínica. Adaptación española del CEIPC 2008.

The present CEIPC Spanish adaptation of the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice 2008. This guide recommends the SCORE model for risk evaluation. The aim is to prevent premature mortality and morbidity due to CVD by means of dealing with its related risk factors in clinical practice. The guide focuses on primary prevention and emphasizes the role of the nurses and primary care doctors in promoting a healthy life style, based on increasing physical activity, changing dietary habits, and not smoking. The therapeutic goal is to achieve a Blood Pressure<140/90mmHg, but in patients with diabetes, chronic kidney disease, or definite CVD, the objective is<130/80mmHg. Serum cholesterol should be<200mg/dl and cLDL<130mg/dl, although in patients with CVD or diabetes, the objective is<100mg/dl (80mg/dl if feasible in very high-risk patients). Patients with type 2 diabetes and those with metabolic syndrome must lose weight and increase their physical activity, and drugs must be administered whenever applicable, with the objective guided by body mass index and waist circumference. In diabetic type 2 patients, the objective is glycated haemoglobin<7%. Allowing people to know the guides and developing implementation programs, identifying barriers and seeking solutions for them, are priorities for the CEIPC in order to put the recommendations into practice.

Guía Europea de Prevención Cardiovascular en la Práctica Clínica. Adaptación española del CEIPC 2008 / European guidelines on cardiovascular disease prevention in clinical practice. CEIPC (Comité Español Interdisciplinario para la Prevención Cardiovascular) 2008 Spanish Adaptation

Presentamos la adaptación española realizada Cardiovasculares 2008. Esta guía recomienda el por el Comité Español Interdisciplinario para la modelo SCORE de riesgo bajo para valorar el Prevención Cardiovascular (CEIPC) de la Guía riesgo cardiovascular. El objetivo es prevenir la Europea de Prevención de las Enfermedades mortalidad y la morbilidad debidas a las enfermedades cardiovasculares (ECV) mediante el tratamiento de sus factores de riesgo en la práctica clínica. La guía hace énfasis en la prevención primaria y en el papel del médico y el personal de enfermería de atención primaria en la promoción de un estilo de vida cardiosaludable, basado en el incremento de los grados de actividad física, la adopción de una alimentación saludable y, en los fumadores, el abandono del tabaco. La meta terapéutica para la presión arterial es en general < 140/90 mmHg; pero en pacientes con diabetes mellitus, enfermedad renal crónica o ECV el objetivo es 130/80 mmHg. El colesterol debe mantenerse por debajo de 200 mg/dl (colesterol unido a lipoproteínas de baja densidad [cLDL] < 130 mg/dl); en los pacientes con ECV o diabetes mellitus el objetivo es cLDL < 100 mg/dl (80 mg/dl si factible en individuos de riesgo muy alto). En pacientes con diabetes mellitus tipo 2 y en pacientes con síndrome metabólico se debe reducir el peso y aumentar la actividad física y, en su caso, utilizar los fármacos indicados, para alcanzar los objetivos del índice de masa corporal y de perímetro de cintura. El objetivo en pacientes con diabetes mellitus tipo 2 debe ser alcanzar una hemoglobina glucosilada < 7%. La amplia difusión de las guías y el desarrollo de los programas destinados a favorecer su implantación, en los que se identifiquen barreras y se busquen soluciones, son objetivos prioritarios del CEIPC, como uno de los medios fundamentales para trasladar las recomendaciones establecidas a la práctica clínica diaria (AU)

The present CEIPC Spanish adaptation of the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice 2008. This guide recommends the SCORE model for risk evaluation. The aim is to prevent premature mortality and morbidity due to CVD by means of dealing with its related risk factors in clinical practice. The guide focuses on primary prevention and emphasizes the role of the nurses and primary care doctors in promoting a healthy life style, based on increasing physical activity, changing dietary habits, and not smoking. The therapeutic goal is to achieve a Blood Pressure < 140/90 mmHg, but in patients with diabetes, chronic kidney disease, or definite CVD, the objective is < 130/80 mmHg. Serum cholesterol should be < 200 mg/dl and cLDL < 130 mg/dl, although in patients with CVD or diabetes, the objective is < 100 mg/dl (80 mg/dl if feasible in very high-risk patients). Patients with type 2 diabetes and those with metabolic syndrome must lose weight and increase their physical activity, and drugs must be administered whenever applicable, with the objective guided by body mass index and waist circumference. In diabetic type 2 patients, the objective is glycated haemoglobin < 7%. Allowing people to know the guides and developing implementation programs, identifying barriers and seeking solutions for them, are priorities for the CEIPC in order to put the recommendations into practice (AU)

Gender differences in obesity related cardiovascular risk factors in Spain.

BACKGROUND: Obesity and overweight are increasing progressively leading to an increase in cardiovascular risk factors and cardiovascular events. METHODS: The MESYAS Registry (Metabolic Syndrome in Active Subjects) recruited active workers from their annual health examinations in Spain through 2003. Body mass index was used to diagnose overweight and obesity. Metabolic syndrome (MS) and risk factors were assessed according to the ATP-III definitions. RESULTS: 19,041 subjects were included (80% males), mean age 42.2 (10.7). The prevalence of overweight was 44.6% (44.0-45.2), obesity 17.3% (17.0-17.5) and MS 12.0% (11.8-12.2). Women had lower prevalence of all cardiovascular risk factors. Multivariate analysis showed independent associations between overweight (OR: 2.4; 95% CI 2.2-2.6) or obesity (OR: 5.3; 95% CI 4.7-5.9) and any other two MS criteria. Overweight and obesity were independently associated with all cardiovascular risk factors, except low high-density lipoproteins in women. Significantly higher association was found in women between obesity and diabetes (OR: 13.6; 95% CI 3.8-48.6), MS (OR: 10.6; 7.6-14.8), hypertriglyceridemia (OR: 8.6; 95% CI 5.6-13.1), and impaired fasting glucose (OR: 3.7; 95% CI 2.7-5.3). CONCLUSIONS: Overweight and obesity are strongly related to classical cardiovascular risk factors, atherogenic dyslipidaemia and MS. Obesity has higher association to insulin-resistance related risk factors in women.

Comparison of cardiovascular risk factors in young Spanish men between the 1980s and after the year 2000. Data from the AGEMZA study.

INTRODUCTION AND OBJECTIVES: To investigate the cardiovascular risk profile of a sample of young Spanish men taken in the 1980s, the initial AGEMZA study cohort, and to compare the findings with those in another sample with similar characteristics taken after 2000. METHODS: The two AGEMZA study cohorts comprised young men who were resident at the Zaragoza General Military Academy, where they were studying as aspiring cadets. A descriptive study of each cohort was carried out and the participants' anthropometric characteristics, sporting and dietary habits, exposure to toxins, and biochemical and lipid profiles were analyzed. Data on the prevalence of various risk factors were obtained for each cohort and the coronary disease risk was estimated using the Framingham equation. RESULTS: Comparison of data on 248 subjects from the current cohort with data on 260 from the initial cohort showed the following significant changes: weight (+6.03 kg), body mass index (BMI) (+1.57), cholesterol (+12.46 mg/dL), low-density lipoprotein cholesterol (+15.8 mg/dL), high-density lipoprotein cholesterol (-4.11 mg/dL), triglycerides (+3.64 mg/dL), apolipoprotein B (+24.8 mg/dL), estimated coronary disease risk in the next 10 years (+1/1000 individuals) and estimated coronary disease risk up to the age of 65 years (+23/1000 individuals). There were significant correlations between increases in weight and BMI and lipid profile alterations. CONCLUSIONS: The lipid profile and BMI were worse in the current sample. These findings make it essential that preventive measures for young people should be introduced and that an increased effort should be made to develop programs aimed at either stopping the progressive rise in obesity or even preventing it altogether.

Comparación de los factores de riesgo cardiovascular de jóvenes españoles de los años ochenta y tras el 2000. Datos del estudio AGEMZA / Comparison of cardiovascular risk factors in young spanish men between the 1980s and after the year 2000. Data from the AGEMZA study

Introducción y objetivos. Analizar el perfil de riesgo cardiovascular de una muestra de jóvenes varones españoles de los años ochenta, cohorte inicial del estudio AGEMZA, y compararla con otra muestra de similares características, tras el 2000. Métodos. Las dos muestras de AGEMZA están compuestas por varones jóvenes residentes en la Academia General Militar de Zaragoza, donde estudiaban en calidad de cadetes aspirantes. Realizamos un estudio descriptivo de cada cohorte, analizando datos antropométricos, hábitos deportivos, dietéticos y tóxicos y sus perfiles bioquímico y lipídico. Obtuvimos datos de la prevalencia de los diferentes factores de riesgo en cada una de ellas y estimamos el riesgo coronario para las dos cohortes mediante la ecuación de Framingham. Resultados. Comparamos datos de 260 sujetos de la muestra inicial y de 248 de la muestra actual, de lo que se obtuvo las siguientes variaciones significativas: peso (+6,03 kg), IMC (+1,57), colesterol total (+12,46 mg/dl), colesterol de las lipoproteínas de baja densidad (+15,8 mg/dl), colesterol de las lipoproteínas de alta densidad (-4,11 mg/dl), triglicéridos (+3,64 mg/dl) y apolipoproteína B (+24,8 mg/dl), el riesgo coronario estimado en los próximos 10 años (+1/1.000 sujetos) y el proyectado a los 65 años de edad (+23/1.000 sujetos). Los aumentos de peso y del IMC se correlacionan de forma significativa con los cambios encontrados en el perfil lipídico. Conclusiones. La muestra actual tiene peor perfil lipídico e IMC. Estos resultados nos obligan a tomar medidas preventivas en los jóvenes y extremar el desarrollo de campañas destinadas a frenar este aumento progresivo de la obesidad y para prevenir su aparición (AU)

Introduction and objectives. To investigate the cardiovascular risk profile of a sample of young Spanish men taken in the 1980s, the initial AGEMZA study cohort, and to compare the findings with those in another sample with similar characteristics taken after 2000. Methods. The two AGEMZA study cohorts comprised young men who were resident at the Zaragoza General Military Academy, where they were studying as aspiring cadets. A descriptive study of each cohort was carried out and the participants' anthropometric characteristics, sporting and dietary habits, exposure to toxins, and biochemical and lipid profiles were analyzed. Data on the prevalence of various risk factors were obtained for each cohort and the coronary disease risk was estimated using the Framingham equation. Results. Comparison of data on 248 subjects from the current cohort with data on 260 from the initial cohort showed the following significant changes: weight (+6.03 kg), body mass index (BMI) (+1.57), cholesterol (+12.46 mg/dL), low-density lipoprotein cholesterol (+15.8 mg/dL), high-density lipoprotein cholesterol (-4.11 mg/dL), triglycerides (+3.64 mg/dL), apolipoprotein B (+24.8 mg/dL), estimated coronary disease risk in the next 10 years (+1/1000 individuals) and estimated coronary disease risk up to the age of 65 years (+23/1000 individuals). There were significant correlations between increases in weight and BMI and lipid profile alterations. Conclusions. The lipid profile and BMI were worse in the current sample. These findings make it essential that preventive measures for young people should be introduced and that an increased effort should be made to develop programs aimed at either stopping the progressive rise in obesity or even preventing it altogether (AU)

Comparison of serum lipid values in subjects with and without the metabolic syndrome.

Insulin resistance is supposed to be the basis of metabolic syndrome (MS), although it is difficult to measure. The ratio of triglyceride (TG) to high-density lipoprotein (HDL) has been proposed as a surrogate marker of insulin resistance in overweight subjects. The aim of the present study was to assess the accuracy of the TG/HDL ratio for the diagnosis of MS. Data of 18,778 active workers (77.6% men) enrolled in 3 insurance companies in Spain were collected from their annual health examinations. Mean age was 42.2 +/- 10.7 years. MS was assessed according to modified Adult Treatment Panel III criteria. Prevalences of MS were 18.8% in men and 6.1% in women. Mean value of the TG/HDL ratio was 2.50 +/- 2.2 and increased in parallel to the number of MS components present. Subjects with MS had a ratio that was 2 times higher compared with those without (5.10 vs 2.03, p <0.001). Receiver operating characteristic curves were performed to assess the capability of the TG/HDL ratio to contribute to a diagnosis of MS and 80% sensitivity and 78% specificity were obtained for values >2.75 in men and >1.65 in women. In conclusion, the TG/HDL ratio is a feasible and accurate measurement for assessment of MS in healthy subjects. We propose cut-off values of 2.75 for men and 1.65 for women for a diagnosis of MS.

[European Guidelines on Cardiovascular Disease Prevention in Clinical Practice: CEIPC 2008 Spanish adaptation]. / Guía europea de prevención cardiovascular en la práctica clínica: Adaptación española del CEIPC 2008.

We present the Spanish adaptation from the CEIPC of the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice 2008. This guide recommends the SCORE model for risk evaluation. The aim is to prevent premature mortality and morbidity due to CVD by means of dealing with its related risk factors in clinical practice. The guide focuses on primary prevention and emphasizes the role of the nurses and primary care medical doctors in promoting a healthy life style, based on increasing physical activity, change dietary habits, and non smoking. The therapeutic goal is to achieve a Blood Pressure <140/90 mmHg, but among patients with diabetes, chronic kidney disease, or definite CVD, the objective is <130/80 mmHg. Serum cholesterol should be <200 mg/dl and cLDL <130 mg/dl, although among patients with CVD or diabetes, the objective is <100 mg/dl (80 mg/dl if feasible in very high-risk patients). Patients with type 2 diabetes and those with metabolic syndrome must lose weight and increase their physical activity, and drugs must be administered whenever applicable, with the objective guided by BMI -body mass index- and waist circumference. In diabetic type 2 patients, the objective is glycated haemoglobin <7%. Allowing people to know the guides and developing implementation programs, identifying barriers and seeking solutions for them, are priorities for the CEIPC in order to put the recommendations into practice.

[Prevalence of dyslipidemia in outpatients of the Spanish health service: the HISPALIPID Study]. / Prevalencia de dislipemia en las consultas ambulatorias del Sistema Nacional de Salud: Estudio HISPALIPID.

BACKGROUND AND OBJECTIVE: We intended to estimate the prevalence of dyslipidemia among patients attending outpatient clinics of the Spanish health service. PATIENTS AND METHOD: HISPALIPID is a multicenter, cross-sectional study performed in 33,913 patients (55.7% women) with a mean age of 54.6 +/- 18.3 years attended in outpatient clinics across 15 of the 17 autonomous communities of Spain. 1,461 physicians (78.8% primary care physicians, and 21.2% specialists) participated in the study. Patients were considered having dyslipidemia if their doctor had established a previous diagnosis. RESULTS: A total of 8,256 patients (52.4% women, mean age 62.4 +/- 12.4 years) had been diagnosed with dyslipidemia, representing a global prevalence of 24.3% (CI95%: 23.8-24.8) (M: 26.2%; W:22.9%; P<0.001). The communities with the higher and lower prevalence were the Canary Islands (33.9%) and Cantabria (18.6%), respectively. About 87% dyslipemic patients presented an additional cardiovascular risk factor and 36.7% of dyslipemic patients had an associated cardiovascular disease. CONCLUSIONS: The prevalence of dyslipidemia is high in patients attending outpatient clinics of the Spanish health service (one out of four patients). In addition, these patients are at a high cardiovascular risk.

Prevalencia de dislipemia en las consultas ambulatorias del Sistema Nacional de Salud: Estudio HISPALIPID / Prevalence of dyslipidemia in outpatients of the Spanish health service: The HISPALIPID Study

Fundamento y objetivo: Conocer la prevalencia de la dislipemia entre los pacientes atendidos en las consultas ambulatorias del Sistema Nacional de Salud (SNS). Pacientes y método: HISPALIPID es un estudio transversal y multicéntrico realizado en una muestra de 33.913 pacientes (55,7% mujeres), con una edad media (DE) de 54,6 (18,3) años, de 15 de las 17 comunidades autónomas de España. Participaron 1.461 médicos (78,8% de atención primaria y 21,2% especialistas). Se consideró dislipémicos a los pacientes que ya tenían el diagnóstico previamente establecido por su médico y control óptimo a valores de la PA < 130/85 mmHg. Resultados: Estaban diagnosticados de dislipemia 8.256 pacientes (52,4% mujeres), con una edad media de 62,4 (12,4) años, y representaban una prevalencia global del 24,3% (intervalo de confianza del 95%, 23,8-24,8) (varones: 26,2%; mujeres: 22,9%; p < 0,001). Las comunidades con mayor y menor prevalencia ajustada por edad, sexo e índice de masa corporal fueron, respectivamente, Canarias (33,9%) y Cantabria (18,6%). El 86,8% de los pacientes tenía al menos otro factor de riesgo cardiovascular asociado. El 36,7% de los pacientes dislipémicos presentaba alguna enfermedad cardiovascular asociada. Conclusiones: La prevalencia de la dislipemia es alta entre los pacientes atendidos en las consultas ambulatorias del SNS, ya que uno de cada cuatro pacientes está diagnosticado de este factor de riesgo cardiovascular. Estos pacientes tienen un perfil de alto riesgo cardiovascular

Background and objective: We intended to estimate the prevalence of dyslipidemia among patients attending outpatient clinics of the Spanish health service. Patients and Method: HISPALIPID is a multicenter, cross-sectional study performed in 33,913 patients (55.7% women) with a mean age of 54.6 ± 18.3 years attended in outpatient clinics across 15 of the 17 autonomous communities of Spain. 1,461 physicians (78.8% primary care physicians, and 21.2% specialists) participated in the study. Patients were considered having dyslipidemia if their doctor had established a previous diagnosis. Results: A total of 8,256 patients (52.4% women, mean age 62.4 ± 12.4 years) had been diagnosed with dyslipidemia, representing a global prevalence of 24.3% (CI95%: 23.8-24.8) (M: 26.2%; W:22.9%; P<0.001). The communities with the higher and lower prevalence were the Canary Islands (33.9%) and Cantabria (18.6%), respectively. About 87% dyslipemic patients presented an additional cardiovascular risk factor and 36.7% of dyslipemic patients had an associated cardiovascular disease. Conclusions: The prevalence of dyslipidemia is high in patients attending outpatient clinics of the Spanish health service (one out of four patients). In addition, these patients are at a high cardiovascular risk