Clustering of unhealthy lifestyle behaviors is associated with a low adherence to recommended preventive practices among COPD patients in Spain.

AIMS: To analyze clustering of unhealthy lifestyle behavior and its relationship with non-adherence to recommended clinical preventive care services among Spanish COPD patients. METHODS: Cross-sectional study including 2,575 COPD subjects from the 2006 Spanish National Health Survey (NHS) and 2009 European Health Survey for Spain (EHISS). Subjects were asked about the following recommended preventive practices: uptake of blood pressure (BP) measurement, lipid profile, influenza vaccination and dental examination. Lifestyle behaviors included: smoking status, physical activity, alcohol consumption and obesity. Logistic regression models were built to assess the association between clustering of unhealthy lifestyle and the uptake of preventive activities. RESULTS: Blood pressure measurement in the previous 6 months and a blood lipid test in the last year had not been taken by 11.74% and 23.26% of the subjects, respectively, in 2006 NHS and by 11.16% and 16.33% of the subjects, respectively, in EHISS 2009. Then, 36.36% percent had not been vaccinated and 70.61% had not received dental examination in 2006 NHS and these percentages decreased to 27.33% and 66.22%, respectively, in 2009 EHISS. A higher number of unhealthy lifestyle behaviors increased the probability of not being vaccinated and not having a dental examination. Clustering of unhealthy lifestyle behaviors is linearly associated with a greater number of preventive measures unfulfilled. CONCLUSIONS: Compliance with healthy lifestyles and adherence to recommended clinical preventive services is under desirable levels among Spanish COPD patients. Patients with lifestyles considered as "worse" are those who also have lower uptake of recommended preventive activities.

Mental health among adults with asthma and chronic bronchitis. A population-based study in Spain.

OBJECTIVES: To analyze the conditions of psychological dysfunction and positive mental health in patients with asthma and chronic bronchitis (CB), as compared to healthy individuals, and to identify the factors associated with these mental health indicators. METHODS: Cross-sectional study based on data obtained from the European Health Interview Survey for Spain (EHISS, 2009). We identified individuals with asthma and CB using a specific questionnaire. In order to assess mental health, two indicators extracted from questionnaire SF-36 were used: psychological dysfunction and positive mental health status. RESULTS: Out of 19,598 subjects included in the study, 8.3% were classified as asthmatic and 7.4% as CB. Healthy individuals had significantly higher psychological dysfunction scores than those with asthma and CB. The same occurred with positive mental health. The variables independently associated with lower scores out of these variables were gender female, a greater number of chronic diseases and obesity. On the contrary, alcohol consumption and physical exercise were associated with a higher score in the aforementioned variables. CONCLUSIONS: Healthy individuals have significantly higher scores in psychological dysfunction and positive mental health than patients with asthma and CB. This suggests that their mental health is much better. The variables related with lower scores out of these variables, and therefore with worse mental health, are: being female, having a greater number of chronic diseases and obesity. On the contrary, alcohol consumption and the practicing of physical exercise are associated with a higher score in the aforementioned variables, thus indicating a greater degree of mental health.

[Comorbidities in COPD]. / Comorbilidades de la EPOC.

The comorbidities of chronic obstructive pulmonary disease (COPD) consist of all the alterations and disorders associated, for one reason or another, with this disease. These comorbidities may be causal (other diseases also caused by smoking, such as ischemic heart disease or lung cancer), a complication (pulmonary hypertension or heart failure), a concurrence (disorders related to advanced age such as hypertension, diabetes mellitus, depression or osteoarthritis) or an intercurrent process (an acute process, generally time-limited, such as a respiratory infection). Of all these comorbidities, those most frequently associated with COPD are hypertension, diabetes mellitus, infections, cancer and cardiovascular diseases. Comorbidities in COPD not only increase the social repercussions and annual cost of the disease but are also a prognostic factor for mortality in affected individuals. Indeed, in addition to respiratory failure, frequent causes of death in patients with COPD are ischemic heart disease and malignancies. The present article discusses the comorbidities of COPD with the greatest impact due to their frequency or influence on mortality. Although not precisely known, the common mechanism of all these comorbidities could be systemic inflammation and its mediators, which play an important role in the pathogenesis of COPD.