[Cardiovascular risk and cardiovascular events in the general population of the sanitary area of Toledo. RICARTO Study]. / Justificación, objetivos y diseño metodológico del estudio RICARTO (RIesgo CARdiovascular y eventos cardiovasculares en la población general del área sanitaria de TOledo).

INTRODUCTION: The main aim of this study is to ascertain the prevalence of cardiovascular risk factors (CVRF), target organ damage (TOD), cardiovascular disease (CVD), as well as life habits (physical exercise, alcohol consumption, and Mediterranean diet) in the population of a Health Area in Toledo, Spain, to assess cardiovascular risk (CVR). MATERIAL AND METHODS: Epidemiological and observational study that will analyse a sample from the general population aged 18 years or older, randomly selected from a database of health cards, and stratified by age and gender. Clinical history, physical examination, and complementary tests will be performed. Aliquots of whole blood and serum samples will be stored at a temperature of-85°C to evaluate future genetic studies. CVR will be estimated by using SCORE project scales calibrated for Spanish population and the Framingham Heart Study scale. When the estimated sample size has been achieved and after a minimum follow-up of 5 years, a final visit will performed in which CVRF, TOD, CVD, CVRF control, and fatal and non-fatal outcomes will be evaluated. DISCUSSION: The RICARTO study is aimed to assess the prevalence of the main CVRF, TOD and CVD in order to determine the CVR in the general population of a health area of Toledo. An analysis will be repeated on the final sample after at least 5 years of follow-up to ascertain the incidence of CV outcomes and the temporal trends of life style, as well as the prevalence of CVRF, TOD, and CVD.

[Characteristics and cardiovascular events in a general population included in the RICARTO (RIesgo CARdiovascular TOledo) study: Data from the first 1,500 individuals included in the study]. / Características de la población general incluida en el estudio RICARTO (RIesgo CARdiovascular y eventos cardiovasculares en la población general del área sanitaria de TOledo): resultados con los primeros 1.500 individuos incluidos en el estudio.

INTRODUCTION: The aim of this study was to assess cardiovascular risk (CVR) by investigating the prevalence of CVR factors (CVRF), target organ damage (TOD), and cardiovascular disease (CVD) in general population of the health area of Toledo, Spain. MATERIAL AND METHODS: Epidemiological and observational study that analysed a sample from the general population aged 18years or older, randomly selected from a database of health cards stratified by age and gender. Clinical history, physical examination, and complementary tests were performed. Total blood and serum samples were frozen at -85°C to evaluate genetic studies in the future. Standard statistical analysis was performed. CVR was assessed by the SCORE scale calibrated for the Spanish population, and the Framingham Heart Study scale. RESULTS: A total of 1,500 individuals (mean age 49.1±15.8years, 55.6% women) were included. Prevalences: dyslipidaemia 56.9% (95% confidence interval [95% CI]: 54.3-59.4), hypertension 33.0% (95%CI: 30.6-35.4), diabetes mellitus 8.6% (95%CI: 7.17-10.1), smoking 24.2% (95%CI; 122.0-26.4), obesity 25.3% (95%CI; 23.1-27.5), and sedentary life-style 39.4% (95%CI; 36.9-41.8). No CVRF was reported in 21.1% of cases, and 18.6% had 3-5 CVRF. TOD: electrocardiographic left ventricular hypertrophy, 4.3%, peripheral artery disease, 10.1% (Doppler ultrasound), and 15.3% (oscillometric device), microalbuminuria, 4.3%, sub-clinical renal disease, 3.2%, and nephropathy in 3.8% (CKD-EPI). At least one CVD was reported in 9.2% of cases. A low CVR (SCORE) was present in 44.6% of individuals. CONCLUSIONS: Dyslipidaemia was found in 60% of individuals, 40% had a sedentary life-style, 30% with hypertension, 20% smoked, 20% obesity, and almost 10% with diabetes. More than a half of individuals have a moderate-high-very high risk. The prevalence of TOD and CVD are significant.

Prevalencia de infección tuberculosa en las personas inmigrantes de Lorca (Murcia) / Prevalence of tuberculous infection in immigrants in Lorca (Murcia)

FUNDAMENTO. La tuberculosis (TB) es una de las enfermedades más importantes a escala mundial por el número de enfermos y muertos que causa. El objetivo del estudio fue determinar la prevalencia de infección tuberculosa en la población inmigrante del municipio de Lorca. MÉTODOS. Estudio observacional descriptivo transversal en población inmigrante, con emplazamiento en Atención Primaria. La captación y reclutamiento se realizó en las consultas de Medicina de Familia entre febrero de 2005 y diciembre de 2006. Se realizó intradermorreacción de Mantoux (IDRM), con 0,1 ml (2UT) de PPD RT-23, previa firma del consentimiento informado. Otras variables recogidas fueron: edad, sexo, país de origen, nivel de estudios, situación laboral, número de convivientes y superficie de la vivienda, vacunación y escara (BCG) y tiempo de residencia en Europa. RESULTADOS. Fueron incluidas 106 personas inmigrantes y completaron el estudio el 95,3% (101), con una edad media de 30,5 ± 10,9. El 54,5% eran mujeres y llevaban un promedio de 2,8 años en Europa. La IDRM fue positiva en 28 (27,7% [IC 95%: 18,3-37,5]). Las personas inmigrantes con Mantoux positivo tenían una edad media de 35,7 años (IC 95%: 28,4-39,2). La prevalencia resultó mayor en los hombres, con diferencias significativas en los mayores de 39 años que residían en Europa ≥ 3 años y de nacionalidad ecuatoriana (17,8%). CONCLUSIONES. La prevalencia de infección por TB encontrada en la población inmigrante del municipio de Lorca es alta, superior a la de la población española. Consideramos que está justificada la realización de un examen de salud en su primer contacto con el Sistema Sanitario para descartarla, siendo el nivel sanitario más adecuado la Atención Primaria (AU)

BACKGROUND. Tuberculosis (TB) is one of the most important worldwide diseases due to the number of patients and deaths it causes. This study has aimed to determine the prevalence of tuberculous infection in the immigrant population of the Lorca municipality. METHODS. This is an observational, described, cross-sectional study in the immigrant population at the Primary Health Care level. Patient capture and enrolment was made in the Family Medicine Out-patient Clinics between February 2005 and December 2006. The Mantoux intradermal reaction (MIDR) with 0.1 ml (2UT) of PPD RT-23 was performed after obtaining signed informed consent. Other variables collected were: age, gender, country of origin, study level, work situation, number of persons living in the housing and its surface, vaccinations and scarring (BCG), time of residence in Europe. RESULTS. A total of 106 immigrants were included with 95.3% (101) completed the study. They had a mean age of 30.5 ± 10.9 and 54.5% were women. They had been living for an average of 2.8 years in Europe. MIDR was positive in 28 [27.7% (95% CI; 18.3-37.5)]. The immigrants with positive Mantoux had a mean age of 35.7 years (95% CI 28.4-39.2). Prevalence was greater in the men, with significant differences in those over 39 years of age, in those who had resided in Europe ≥ 3 years, with Ecuadorian nationality (17.8%). CONCLUSIONS. Prevalence of TB infection found in the immigrant population of the Lorca municipality is high, greater than in the Spanish population. We consider that making an examination of their health in their first contact with the Health Care system to rule out TB is justified, the most adequate level for this being Primary Health Care (AU)