Cohort profile: the Hortega Study for the evaluation of non-traditional risk factors of cardiometabolic and other chronic diseases in a general population from Spain.

PURPOSE: The Hortega Study is a prospective study, which investigates novel determinants of selected chronic conditions with an emphasis on cardiovascular health in a representative sample of a general population from Spain. PARTICIPANTS: In 1997, a mailed survey was sent to a random selection of public health system beneficiaries assigned to the University Hospital Rio Hortega's catchment area in Valladolid (Spain) (n=11 423, phase I), followed by a pilot examination in 1999-2000 of 495 phase I participants (phase II). In 2001-2003, the examination of 1502 individuals constituted the Hortega Study baseline examination visit (phase III, mean age 48.7 years, 49% men, 17% with obesity, 27% current smokers). Follow-up of phase III participants (also termed Hortega Follow-up Study) was obtained as of 30 November 2015 through review of health records (9.5% of participants without follow-up information). FINDINGS TO DATE: The Hortega Study integrates baseline information of traditional and non-traditional factors (metabolomic including lipidomic and oxidative stress metabolites, genetic variants and environmental factors, such as metals), with 14 years of follow-up for the assessment of mortality and incidence of chronic diseases. Preliminary analysis of time to event data shows that well-known cardiovascular risk factors are associated with cardiovascular incidence rates, which add robustness to our cohort. FUTURE PLANS: In 2020, we will review updated health and mortality records of this ongoing cohort for a 5-year follow-up extension. We will also re-examine elder survivors to evaluate specific aspects of ageing and conduct geolocation to study additional environmental exposures. Stored biological specimens are available for analysis of new biomarkers. The Hortega Study will, thus, enable the identification of novel factors based on time to event data, potentially contributing to the prevention and control of chronic diseases in ageing populations.

Síndrome cerebeloso inducido por metronidazol: un efecto adverso infrecuente / Cerebellar syndrome induced by metronidazole: a rare side effect

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Influence of sympathetic activity on blood pressure and vascular damage evaluated by means of urinary albumin excretion.

To analyze the influence of sympathetic activity on blood pressure (BP) and its effects on urinary albumin excretion (UAE), the authors carried out a cross-sectional study in their local health coverage area. The following variables were monitored in a representative sample of the general population made up of 495 individuals: anthropometric parameters; blood glucose, creatinine, and lipid levels; 24-hour urinary albumin, norepinephrine, and epinephrine excretion; and BP of patients with known hypertension and newly discovered BP > or =140/90 mm Hg, evaluated by ambulatory monitoring. In the multivariate analysis, only gender, systolic BP, and UAE were associated with norepinephrine levels; only gender, systolic BP, and body mass index were associated with epinephrine. After excluding those patients with chronic kidney disease, the multivariate analysis showed a strong association between UAE > or =30 mg/d and elevated norepinephrine and epinephrine levels. The authors concluded that in the subject population there is an association between elevated adrenergic activity and higher UAE, independent of factors such as age and BP.

Health-related quality of life of subjects with known and unknown hypertension: results from the population-based Hortega study.

OBJECTIVE: Analyze the impact of known and unknown hypertension on health-related quality of life (HRQOL). DESIGN AND SETTING: A descriptive cross-sectional study in the health coverage area of the Rio Hortega University Hospital, in north-western Spain, on a simple random sample of 33022 individuals. PARTICIPANTS: Following a multiphase sampling, a final sample of 466 people, representative of the general population, was analyzed. The blood pressure of patients with known hypertension and those with a blood pressure of >or= 140/90 mmHg was subjected to ambulatory monitoring in order to evaluate the degree of blood pressure control and to detect those patients with white-coat hypertension, respectively. RESULTS: After adjustment for sociodemographic variables, associated cardiovascular risk factors, hypertension complications and comorbidity, the patients with known hypertension presented lower scores on four SF-36 scales: physical function, general health, vitality and mental health. The group of subjects with hypertension, whether diagnosed or not, displayed a poorer HRQOL with respect to the non-hypertensive patients, solely in physical functioning and general health. Those patients with known hypertension reported more bodily pain than those subjects with unknown hypertension, while there were no differences between patients with unknown hypertension and the non-hypertensive ones. CONCLUSIONS: Patients with known hypertension presented a poorer HRQOL. This deterioration of the subjective state of health was not observed in patients who had not yet been diagnosed, which suggests it is due, above all, to the labeling effect and/or to the treatment more than to the hypertension per se.