ABSTRACT
No disponible
Subject(s)
Humans , Anticoagulants/therapeutic use , Stroke/epidemiology , Atrial Fibrillation/drug therapy , Reference Drugs , Drugs, Investigational/therapeutic useABSTRACT
OBJECTIVE: Smoking is a major risk factor for multiple chronic diseases, such as cardiovascular diseases and cancer, and an established risk factor for premature death .The objective was to analyze the association between smoking and total coronary risk (incidence of lethal and non-lethal coronary events) in a cohort of 35-74 years old patients followed for 10 years. METHODS: Longitudinal, observational study of a retrospective cohort followed for ten years in primary care practices in Badajoz (Spain). 1011 patients (mean 55.7 year-old; 56.0% women) without evidence of cardiovascular disease was studied. Multivariate analysis was performed using a binary logistic regression model, introducing as the dependent variable the presence of total coronary events during the follow-up period. RESULTS: 29.1% of the patients were smokers. Smokers were younger (52.1 vs 57.2 years, p smaller than 0.001), with less prevalence of arterial hypertension (46.9% vs 61.5%, p smaller than 0.01), obesity (25.5% vs 31.8%, p=0,055) and lower HDL-cholesterol (45.7 vs 54.0 mg/dl, p smaller than 0.001). During the follow-up, they presented a higher mortality (11.2% vs 6.7%, p smaller than 0.05) and higher incidence of total coronary events (14.3% vs 9.2%, p smaller than 0.05). The final model of the logistic regression multivariate analysis revealed that only smoking and age are predictor variables of total coronary events, the greater odds ratio (OR) corresponding to smoking [OR: 2.33; 95% confidence interval (CI):1.31-4.16; p smaller than 0.01]. CONCLUSIONS: In patients aged 35-74 years followed during 10 years, smoking doubles the risk of total coronary events.
OBJETIVO: El tabaquismo es un importante factor de riesgo para múltiples enfermedades crónicas, tales como enfermedades cardiovasculares y cáncer, y también de muerte prematura. El objetivo fue valorar la relación entre tabaquismo y riesgo coronario total en una cohorte de pacientes de 35 a 74 años de edad. METODOS: Estudio observacional de una cohorte retrospectiva de 1.011 personas (edad media 55,7 años, 56,0% mujeres) sin antecedentes de enfermedades cardiovasculares, seguidas durante 10 años en un centro de salud de Badajoz (Extremadura, España). Se realizó un análisis multivariante mediante regresión logística binaria, incluyéndose como variable dependiente la incidencia de eventos coronarios durante el periodo de seguimiento. RESULTADOS: El 29,1% de la población era fumadora, con menor edad (52,1 vs 57,2 años, p menor que 0,001), menores cifras de colesterol-HDL (45,7 vs 54,0 mg/dl, p menor que 0,001), menor prevalencia de hipertensión arterial (46,9% vs 61,5%, p menor que 0,01) y obesidad (25,5% vs 31,8%, p=0,055) que los pacientes no fumadores. Sin embargo, durante el seguimiento presentaron mayores tasas de mortalidad (11,2% vs 6,7%, p menor que 0,05) e incidencia de eventos coronarios totales (14,3% vs 9,2%, p menor que 0,05). En el análisis multivariante solamente la edad y el tabaquismo se comportaron como variables predictoras de eventos coronarios totales, correspondiendo al tabaquismo las mayores odds ratio (OR: 2,33; IC95%:1,31-4,16; p menor que 0,01). CONCLUSIONES: En personas de 35 a 74 años seguidos durante 10 años el consumo de tabaco duplica el riesgo de eventos coronarios.
Subject(s)
Coronary Disease/etiology , Smoking/adverse effects , Adult , Aged , Coronary Disease/mortality , Female , Follow-Up Studies , Humans , Logistic Models , Male , Middle Aged , Odds Ratio , Prevalence , Retrospective Studies , Risk Factors , Smoking/epidemiology , Spain/epidemiologyABSTRACT
Fundamentos. El tabaquismo es un importante factor de riesgo para múltiples enfermedades crónicas, tales como enfermedades cardiovasculares y cáncer, y también de muerte prematura. El objetivo fue valorar la relación entre tabaquismo y riesgo coronario total en una cohorte de pacientes de 35 a 74 años de edad. Métodos. Estudio observacional de una cohorte retrospectiva de 1.011 pacientes (edad media 55,7 años, 56,0% mujeres) sin antecedentes de enfermedades cardiovasculares, seguidos durante 10 años en un centro de salud de Badajoz (Extremadura, España). Se realizó un análisis multivariante mediante regresión logística binaria, incluyéndose como variable dependiente la incidencia de eventos coronarios durante el periodo de seguimiento. Resultados. El 29,1% de la población era fumadora, con menor edad (52,1 vs 57,2 años, p<0,001), menores cifras de colesterol-HDL (45,7 vs 54,0 mg/dl, p<0,001), menor prevalencia de hipertensión arterial (46,9% vs 61,5%, p<0,01) y obesidad (25,5% vs 31,8%, p=0,055) que los pacientes no fumadores. Sin embargo, durante el seguimiento presentaron mayores tasas de mortalidad (11,2% vs 6,7%, p<0,05) e incidencia de eventos coronarios totales (14,3% vs 9,2%, p<0,05). En el análisis multivariante solamente la edad y el tabaquismo se comportaron como variables predictoras de eventos coronarios totales, correspondiendo al tabaquismo las mayores odds ratio (OR: 2,33; IC95%:1,31-4,16; p<0,01). Conclusiones. En personas de 35 a 74 años seguidos durante 10 años el consumo de tabaco duplica el riesgo de eventos coronarios (AU)
Background. Smoking is a major risk factor for multiple chronic diseases, such as cardiovascular diseases and cancer, and an established risk factor for premature death .The objective was to analyze the association between smoking and total coronary risk (incidence of lethal and non-lethal coronary events) in a cohort of 35-74 year-old patients followed for 10 years. Methods. Longitudinal, observational study of a retrospective cohort followed for ten years in primary care practices in Badajoz (Spain). 1011 patients (mean 55.7 year-old; 56.0% women) without evidence of cardiovascular disease was studied. Multivariate analysis was performed using a binary logistic regression model, introducing as the dependent variable the presence of total coronary events during the follow-up period. Results. 29.1% of the patients were smokers. Smokers were younger (52.1 vs 57.2 years, p<0.001), with less prevalence of arterial hypertension (46.9% vs 61.5%, p<0.01), obesity (25.5% vs 31.8%, p=0,055) and lower HDL-cholesterol (45.7 vs 54.0 mg/dl, p<0.001). During the follow-up, they presented a higher mortality (11.2% vs 6.7%, p<0.05) and higher incidence of total coronary events (14.3% vs 9.2%, p<0.05). The final model of the logistic regression multivariate analysis revealed that only smoking and age are predictor variables of total coronary events, the greater odds ratio (OR) corresponding to smoking [OR: 2.33; 95% confidence interval (CI):1.31-4.16; p<0.01]. Conclusions: In patients aged 35-74 years followed during 10 years, smoking doubles the risk of total coronary events (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Smoking/adverse effects , Smoking/prevention & control , Coronary Disease/prevention & control , Chronic Disease/epidemiology , Chronic Disease/prevention & control , Tobacco Use Cessation/methods , Tobacco Use Cessation/statistics & numerical data , Cohort Studies , Retrospective Studies , Multivariate Analysis , Logistic Models , Primary Health Care/methods , Primary Health Care/trends , Longitudinal Studies , Analysis of VarianceABSTRACT
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Subject(s)
Humans , Male , Female , Atrial Fibrillation/complications , Atrial Fibrillation/diagnosis , Atrial Fibrillation/therapy , Anticoagulants/administration & dosage , Anticoagulants/classification , Anticoagulants/therapeutic use , Atrial Fibrillation/prevention & control , Anticoagulants/pharmacology , Drug Prescriptions/statistics & numerical data , Dosage Forms/standardsSubject(s)
Anticoagulants/therapeutic use , Atrial Fibrillation/complications , Thrombophilia/drug therapy , Administration, Oral , Aged , Aged, 80 and over , Anticoagulants/adverse effects , Antithrombins/adverse effects , Antithrombins/therapeutic use , Dabigatran/adverse effects , Dabigatran/therapeutic use , Drug Utilization/statistics & numerical data , Factor Xa Inhibitors/adverse effects , Factor Xa Inhibitors/therapeutic use , Female , Hemorrhage/chemically induced , Humans , Male , Pyrazoles/adverse effects , Pyrazoles/therapeutic use , Pyridones/adverse effects , Pyridones/therapeutic use , Rivaroxaban/adverse effects , Rivaroxaban/therapeutic use , Stroke/etiology , Stroke/prevention & control , Thrombophilia/etiology , Urban Health Services/statistics & numerical dataABSTRACT
BACKGROUND: Overweight and obesity are positively correlated with increased risk of morbidity and mortality. AIM: To evaluate whether obesity may be considered an independent cardiovascular risk factor in patients of ages from 35 to 74 years followed-up for 10 years. DESIGN OF STUDY: Observational, longitudinal retrospective study. SETTING: Primary care practices in Badajoz (Spain). METHOD: A cohort of 899 patients (mean 55.7 years; 58.2% female) without evidence of cardiovascular disease was studied. RESULTS: A total of 33.5% of the population were obese (body mass index > or =30 kg/m2). Patients meeting the obesity criteria were more commonly female (36.6%) and were older, had higher mean values of blood pressure and triglycerides, higher percentages of diabetes, and higher coronary risk using either the original Framingham or the Framingham function calibrated for the Spanish population (Framingham-REGICOR). During the follow-up period, the rates of cardiovascular events and death in patients with obesity tended to be higher: 16.3% versus 11.7%, P = 0.056 and 4.7% versus 2.2%, P<0.05, respectively. In the final model of the logistic regression multivariate analysis, the significant predictors of cardiovascular events in patients with obesity were age, sex (male), diastolic blood pressure, diabetes, and smoking. The highest odds ratio corresponded to smoking (odds ratio 2.03; 95% confidence interval = 1.22 to 3.38). CONCLUSION: Obesity may not be considered an independent cardiovascular risk factor in patients aged from 35 to 74 years followed-up for 10 years.
