Association between metabolic syndrome or its components and asymptomatic cardiovascular disease in the RIVANA-study.

OBJECTIVE: To assess the association between the metabolic syndrome (MetSd) and asymptomatic cardiovascular disease and determine if the MetSd or its single risk factors perform better in discriminating prevalent asymptomatic cardiovascular disease. METHODS: A total of 880 community-dwelling subjects (423 with and 457 without MetSd according to ATPIII) underwent a physical examination, an echocardiography and an ultrasound examination of carotid arteries and blood and urine samples were collected. Associations between the subclinical organ damage markers and the MetSd were addressed with non-conditional logistic regression. AUCs of ROCs were used to compare the models' ability to discriminate asymptomatic cardiovascular disease. RESULTS: The MetSd was independently associated with carotid subclinical atherosclerosis, increased left ventricular mass index and cardiac dysfunction. The MetSd did not discriminate prevalent increased carotid intima-media thickness better than abdominal obesity and impaired fasting glucose [AUC=0.75 (95% CI: 0.71-0.78) and 0.75 (0.71-0.79), respectively; p=0.55]. The MetSd performed worse than abdominal obesity in discriminating increased left ventricular mass index among males younger than 65 years [AUC=0.66 (95% CI: 0.62-0.69) and 0.69 (0.66-0.73), respectively; p=0.02]. No differences between the ability of MetSd or its components in discriminating increased left ventricular mass index were observed among older men or women. The discrimination ability for microalbuminuria for the MetSd or impaired fasting glucose was not statistically different [AUC=0.67 (95% CI: 0.60-0.74) and 0.69 (0.62-0.76), respectively; p=0.18]. CONCLUSION: This study supports the association between the MetSd and asymptomatic cardiovascular disease. The construct of the MetSd might not be better than its single components in addressing cardiovascular risk.

[Clinical interventions on the major vascular risk factors (RIVANA study)]. / Intervención clínica sobre los principales factores de riesgo vascular (estudio RIVANA).

BACKGROUND: To describe the diagnostic frequency of classical vascular risk factors, dietary and therapeutic interventions and their control. METHODS: Within the project Vascular Risk in Navarre (RIVANA), a transversal study was made of a random sample of 4,354 people between the ages of 35 and 84; antecedents were gathered by interview and clinical and analytical exploration was carried out. The subjects were classified for each risk factor into: diagnosed by information--when health personnel had informed them that they presented a risk factor; by intervention--when they take medication for it; and by detection in asymptomatic people. The variables of intervention were identified by dichotomic trees expressed by relative frequencies. RESULTS: Forty-five point three percent of the subjects are hypertense: 27% previously diagnosed and 18.3% at the time of the exploration. Thirty-nine percent are hypercholesterolemic: 33.4% previously diagnosed and 5.6% at the time of the exploration. Twenty-one point two percent presented hyperglycemia: 9.7% previously diagnosed and 11.6% at the time of the exploration. Sixty-five point six percent were diagnosed as overweight or obese: 25.9% previously and 39.6% at the time of the exploration. They received dietary counselling and pharmacological treatment respectively: 79.8% and 70.3% of the hypertense; 75.4% and 35% of the hypercholesterolemic; 83.1% and 47.4% of those who presented hyperglycemia and 68.5% and 4% of those who showed overweight or obesity. CONCLUSIONS: The frequency of cardiovascular risk factors is high. There is a margin for significant improvement in the detection, intervention and control of the risk factors.

[Study of vascular risk in Navarre: objectives and design. Prevalence of metabolic syndrome and of vascular risk factors]. / Estudio de riesgo vascular en Navarra: objetivos y diseño. Prevalencia del síndrome metabólico y de los factores mayores de riesgo vascular.

BACKGROUND: To determine in a representative sample of the population the prevalence of risk factors and metabolic syndrome; their association with sub-clinical atherosclerotic lesions and their impact on cardiocerebrovascular disease 10 years after. MATERIAL AND METHODS: (Phase 1) Cross sectional survey of a random sample stratified by age and sex of the population of Navarre aged between 35 and 84. Antecedents, risk factors, physical and analytical exploration. (Phase II) Ten year follow-up cohort study, in 500 exposed to MS and 500 not exposed persons, aged between 45 and 74 years; with an 82.25% power to detect a risk ratio of 2; with analytical and image markers of sub-clinical atherosclerosis. (Phase III) Follow up of vascular events at ten years. RESULTS: The subjects recruited were 6,553; excluded or not found 871; the final sample was 5,682 (2,644 men and 3,038 women); 4,168 (73,4%) took part in the study. The prevalence of MS was 22.1% (95%CI 20.5 - 23.7) for men and 17,2% (95%CI 15.8 - 18.5) for women. The main cardiovascular RF were high compared to other geographical areas except for HDL cholesterol. The rate was 8.5% (95%CI 7.4 - 9.6) for men and 1.7% (95%CI 1.3 - 2.2) CONCLUSIONS: There are important differences in risk between sex, being worst for men. The high figures for HDL cholesterol and the low prevalence of MS might mean a lower risk of vascular events in Navarra.

Programa de enfermedades cardio-cerebrovasculares / Heart and cerebrovascular diseases programme

No disponible

[The perception by the population of the functions and components of the primary care team]. / Percepción por parte de la población de las funciones y componentes del equipo de atención primaria.

OBJECTIVE: To find out how the population in Health Area IV of Navarra (Tafalla) see the new components of the primary care team (PCT) and their health education functions. DESIGN: A crossover descriptive study. SITE. Health Area IV of Navarra (Tafalla). PARTICIPANTS: 816 people aged 18 or over and who lived in the area under study made up a sample stratified according to age, gender and where they lived. Interviewees were selected through the random routes method. MAIN MEASUREMENTS AND RESULTS: A personal interview with a questionnaire was carried out in the home of the participants during March and April, 1988. There was widespread ignorance of what the PCT meant; paradoxically, this ignorance was significantly higher (p = 0.014) in the base areas where EAP had been set up (80%) than in those areas where it had not (73%). In spite of this, in the Tafalla base area the components of the PCT had begun to be understood. Only 7% replied that they knew other functions, apart from health care, of the PCTs: here, it was in the areas where PCTs had been set up that there was significantly greater knowledge (p = 0.0004). CONCLUSIONS: A large percentage of the population is ignorant regarding new elements (staff and functions) introduced into the PCT.