The association of urine metals and metal mixtures with cardiovascular incidence in an adult population from Spain: the Hortega Follow-Up Study.

BACKGROUND: The association of low-level exposure to metals and metal mixtures with cardiovascular incidence in the general population has rarely been studied. We flexibly evaluated the association of urinary metals and metal mixtures concentrations with cardiovascular diseases in a representative sample of a general population from Spain. METHODS: Urine antimony (Sb), barium (Ba), cadmium (Cd), chromium (Cr), cobalt (Co), copper (Cu), molybdenum (Mo), vanadium (V) and zinc (Zn) were measured in 1171 adults without clinical cardiovascular diseases, who participated in the Hortega Study. Cox proportional hazard models were used for evaluating the association between single metals and cardiovascular incidence. We used a Probit extension of Bayesian Kernel Machine Regression (BKMR-P) to handle metal mixtures in a survival setting. RESULTS: In single-metal models, the hazard ratios [confidence intervals (CIs)] of cardiovascular incidence, comparing the 80th to the 20th percentiles of metal distributions, were 1.35 (1.06, 1.72) for Cu, 1.43 (1.07, 1.90) for Zn, 1.51 (1.13, 2.03) for Sb, 1.46 (1.13, 1.88) for Cd, 1.64 (1.05, 2.58) for Cr and 1.31 (1.01, 1.71) for V. BKMR-P analysis was confirmatory of these findings, supporting that Cu, Zn, Sb, Cd, Cr and V are related to cardiovascular incidence in the presence of the other metals. Cd and Sb showed the highest posterior inclusion probabilities. CONCLUSIONS: Urine Cu, Zn, Sb, Cd, Cr and V were independently associated with increased cardiovascular risk at levels relevant for the general population of Spain. Urine metals in the mixture were also jointly associated with cardiovascular incidence, with Cd and Sb being the most important components of the mixture.

[Awareness, Treatment and Control of Hypertension in Population Aged 16 to 90 Years Old in the Valencia Region, Spain, 2010]. / Conocimiento, tratamiento y control de la hipertensión arterial por las personas de 16 a 90 años de edad participantes en la Encuesta de Nutrición de la Comunitat Valenciana de 2010.

OBJECTIVE: Hypertension is an important risk factor in terms of mortality attributable and the main modifiable cardiovascular risk factor. The aim of the study is to estimate the degree of awareness, treatment and control of hypertension in population of Valencia Region and identify predictors that explain the lack of proper control. METHODS: Cross-sectional population-based study in 413 men and 415 women between 16 and 90 years participants in Nutrition Survey of Valencia held in 2010. Automatic sphygmomanometer was used for taking blood pressure. Hypertension was defined according to the criteria of 2007 European Society of Hypertension and the European Society of Cardiology. Data on knowledge and treatment were obtained by survey. Predictors for awareness, treatment and control of hypertension were estimated by logistic regression models. RESULTS: The prevalence of hypertension estimated for the study population was 38.2% (95% CI: 34.9%-41.5%). 51.4% (95% CI: 45.9%-57.0%) of the hypertensive population, knew his condition. 88.8% of them (95% CI: 83.9%-93.6%) were receiving drug therapy and of these, 45.1% (95% CI: 36.9%-53.3%) maintained blood pressure controlled. CONCLUSIONS: Since the last survey in Valencia Region, the degree of awareness of hypertension has not improved although an increase in those treated with antihypertensive drugs is observed.

[Prevalence of Hypertension and Associated Factors in Population Aged 16 to 90 Years Old in Valencia Region, Spain]. / Prevalencia de hipertensión arterial y factores asociados en población de 16 a 90 años de edad en la Comunidad Valenciana.

OBJECTIVE: Hypertension is one of the main risk factor in terms of attributable mortality and the most common modifiable cardiovascular risk factor. The aim of the study was to estimate the prevalence of hypertension in population more than fifteen years of Valencia region and describe the strength of association between specific factors and the presence of hypertension. METHODS: Cross-sectional population-based study in 413 men and 415 women between 16 and 90 years participants in Nutrition Survey of Valencia held in 2010. Data were collected through household survey and blood pressure was measured using an automated sphygmomanometer. Hypertension was defined according to criteria established in 2007 by the European Society of Hypertension and the European Society of Cardiology. Strength of association between hypertension and associated factors was measured by binary logistic regression for demographic explanatory variables, family history, lifestyle, anthropometric variables and others. RESULTS: The prevalence of hypertension estimated for Valencia region was 38,2% [95% CI 34,9 to 41,5]; 40,7% in men [95% CI 35,0 to 45,5] and 35,7% in women [95% CI 31,1 to 40,3]. Remained as associated variables with hypertension: age [45-64 years OR 4.3, IC 95% 2.1-8.8; 65 or more years, OR 15.5, IC 95% 7.2-33.2], body mass index [overweight OR 2.1 95% CI 1.3 to 3.2; obesity OR 5.3, 95% CI 3.3 to 8.5] and diabetes [OR 2.4, 95% CI 1.2-4.8]. CONCLUSIONS: More than a third of the study population suffers from hypertension. Its risk increases with age. Overweight and diabetes mellitus double the likelihood of developing hypertension.

OBJETIVO: La hipertensión es un importante factor de riesgo en términos de mortalidad atribuible y como factor de riesgo cardiovascular modificable. El objetivo del estudio fue estimar la prevalencia de hipertensión arterial en población mayor de quince años de la Comunitat Valenciana y describir su asociación con determinados factores etiológicos. METODOS: Estudio transversal de base poblacional en 413 hombres y 415 mujeres de 16 a 90 años de edad participantes en la Encuesta de Nutrición de la Comunitat Valenciana realizada en 2010. La información se obtuvo mediante encuesta a domicilio y medida de la presión arterial utilizando esfigmomanómetro automático. Para la definición de hipertensión arterial se siguió el criterio establecido en 2007 por la Sociedad Europea de Hipertensión Arterial y la Sociedad Europea de Cardiología. La asociación entre factores asociados e hipertensión medida mediante regresión logística binaria para variables explicativas sociodemográficas, antecedentes, estilos de vida, variables antropométricas y otras. RESULTADOS: La prevalencia de hipertensión estimada para la Comunidad Valenciana fue de 38,2% [IC95% 34,9-41,5]; 40,7% en hombres [IC95%35,0-45,5] y 35,7% en mujeres [IC95% 31,1-40,3]. La edad [45-64 años OR: 4,3, IC 95% 2,1-8,8; 65 o más años, OR 15,5, IC 95% 7,2-33,2)], la categoría ponderal [sobrepeso OR 2,1 IC95% 1,3-3,2; obesidad OR 5,3, IC95% 3,3-8,5] y padecer diabetes [OR 2,4, IC95% 1,2-4,8] se constituyeron como variables asociadas con hipertensión. CONCLUSIONES: Más de un tercio de la población estudiada padece hipertensión. La probabilidad de presentarla aumenta con la edad. El sobrepeso así como la diabetes mellitus duplican la probabilidad de padecerla.

Prevalencia de hipertensión arterial y de sus factores asociados en población de 16 a 90 añor de edad en la Comunitat Valenciana / Prevalence of hypertension and associated factors in population aged 16 to 90 years old in Valencia Region, Spain

Fundamento: La hipertensión es un importante factor de riesgo en términos de mortalidad atribuible y como factor de riesgo cardiovascular modificable. El objetivo del estudio fue estimar la prevalencia de hipertensión arterial en población mayor de quince años de la Comunitat Valenciana y describir su asociación con determinados factores etiológicos. Métodos: Estudio transversal de base poblacional en 413 hombres y 415 mujeres de 16 a 90 años de edad participantes en la Encuesta de Nutrición de la Comunitat Valenciana realizada en 2010. La información se obtuvo mediante encuesta a domicilio y medida de la presión arterial utilizando esfigmomanómetro automático. Para la definición de hipertensión arterial se siguió el criterio establecido en 2007 por la Sociedad Europea de Hipertensión Arterial y la Sociedad Europea de Cardiología. La asociación entre factores asociados e hipertensión medida mediante regresión logística binaria para variables explicativas sociodemográficas, antecedentes, estilos de vida, variables antropométricas y otras. Resultados: La prevalencia de hipertensión estimada para la Comunidad Valenciana fue de 38,2% [IC95% 34,9-41,5]; 40,7% en hombres [IC95%35,0-45,5] y 35,7% en mujeres [IC95% 31,1-40,3]. La edad [45-64 años OR 4,3, IC 95% 2,1-8,8; ≥65 años, OR 15,5, IC 95% 7,2-33,2)], la categoría ponderal [sobrepeso OR 2,1 IC95% 1,3-3,2; obesidad OR 5,3, IC95% 3,3-8,5] y padecer diabetes mellitus [OR 2,4, IC95% 1,2-4,8] se constituyeron como variables asociadas con hipertensión. Conclusiones: Más de un tercio de la población estudiada padece hipertensión. La probabilidad de presentarla aumenta con la edad. El sobrepeso así como la diabetes mellitus duplican la probabilidad de padecerla (AU)

Background: Hypertension is the main risk factor in terms of attributable mortality and the most common modifiable cardiovascular risk factor. The aim of the study was to estimate the prevalence of hypertension in population more than fifteen years of Valencia region and describe the strength of association between specific factors and the presence of hypertension. Methods: Cross-sectional population-based study in 413 men and 415 women between 16 and 90 years participants in Nutrition Survey of Valencia held in 2010. Data were collected through household survey and blood pressure was measured using an automated sphygmomanometer. Hypertension was defined according to criteria established in 2007 by the European Society of Hypertension and the European Society of Cardiology. Strength of association between hypertension and associated factors was measured by binary logistic regression for demographic explanatory variables, family history, lifestyle, anthropometric variables and others. Results: The prevalence of hypertension estimated for Valencia region was 38,2% [95% CI 34,9 to 41,5]; 40,7% in men [95% CI 35,0 to 45,5] and 35,7% in women [95% CI 31,1 to 40,3]. Remained as associated variables with hypertension: age [45-64 years OR 4,3, IC 95% 2,1-8,8; ≥65 years, OR 15,5, IC 95% 7,2-33,2], body mass index [overweight OR 2,1 95% CI 1,3 to 3,2; obesity OR 5,3, 95% CI 3,3 to 8,5] and diabetes [OR 2,4, 95% CI 1,2-4,8]. Conclusions: More than a third of the study population suffers from hypertension. Its risk increases with age. Overweight and diabetes mellitus double the likelihood of developing hypertension (AU)

Conocimiento, tratamiento y control de la hipertensión arterial en la población de 16 a 90 años en la Comunitat Valenciana, 2010 / Awareness, treatment and control of hypertension in population aged 16 to 90 years old in the Valencia Region, Spain, 2010

Fundamento: La hipertensión arterial es un importante factor de riesgo en términos de mortalidad atribuible y el principal factor de riesgo cardiovascular modificable. El objetivo del estudio fue estimar el grado de conocimiento y control de la hipertensión e identificar los factores que influyen en la falta de control adecuado. Métodos: Estudio transversal de base poblacional en 413 hombres y 415 mujeres entre 16 y 90 años participantes en la Encuesta de Nutrición de la Comunitat Valenciana realizada en 2010. Para la toma de la presión arterial se utilizó esfigmomanómetro automático. La hipertensión fue definida según el criterio de 2007 de la Sociedad Europea de Hipertensión Arterial y la Sociedad Europea de Cardiología. Los datos sobre conocimiento y tratamiento fueron obtenidos de la encuesta. Los factores predictores del conocimiento, tratamiento y control de hipertensión se estimaron mediante modelos de regresión logística. Resultados: La prevalencia de hipertensión estimada para la población estudiada fue del 38,2% (IC 95% 34,9%-41,5%). El 51,4% (IC 95% 45,9%-57,0%) de la población hipertensa conocía su condición. De estos el 88,8% (IC 95% 83,9%-93,6%) recibía tratamiento farmacológico y de ellos el 45,1% (IC95% 36,9%-53,3%) mantenía la presión arterial controlada. Conclusiones: Desde la última encuesta realizada en la Comunitat Valenciana, el grado de conocimiento del hipertenso no es mejor si bien se observa un incremento de las personas tratadas (AU)

Background: Hypertension is an important risk factor in terms of mortality attributable and the main modifiable cardiovascular risk factor. The aim of the study is to estimate degree of awareness, treatment and control of hypertension in population of Valencia Region and identify predictors that explain the lack of proper control. Methods: Cross-sectional population-based study in 413 men and 415 women between 16 and 90 years participants in Nutrition Survey of Valencia held in 2010. Automatic sphygmomanometer was used for taking blood pressure. Hypertension was defined according to the criteria of 2007 European Society of Hypertension and the European Society of Cardiology. Data on knowledge and treatment were obtained by survey. Predictors for awareness, treatment and control of hypertension were estimated by logistic regression models. Results: The prevalence of hypertension estimated for the study population was 38.2% (95% CI 34.9%-41.5%). 51.4% (95% CI 45.9%-57.0%) of the hypertensive population, knew his condition. 88.8% of them (95% CI 83.9%-93.6%) were receiving drug therapy and of these, 45.1% (95% CI 36.9%-53.3%) maintained blood pressure controlled. Conclusions: Since the last survey in Valencia Region, the degree of awareness of hypertension has not improved although an increase in those treated with antihypertensive drugs is observed (AU)