Cardiovascular risk estimated after 13 years of follow-up in a low-incidence Mediterranean region with high-prevalence of cardiovascular risk factors

Huerta, José María; Tormo, María-José; Gavrila, Diana; Navarro, Carmen

doi:10.1186/1471-2458-10-640

Cited by 13 publications

(14 citation statements)

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“…These results are in keeping with previous findings regarding the CVD risk in the Spanish population. 27 Also, we confirm that it is important to derive the CVD prediction model in the same population where the risk score will be later administered.…”

Section: Components Of the Risk Scoresupporting

confidence: 65%

The ERICE-score: the New Native Cardiovascular Score for the Low-risk and Aged Mediterranean Population of Spain

Gabriel

Brotons

Tormo

et al. 2015

Revista Española de Cardiología (English Edition)

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Introduction and objectivesIn Spain, data based on large population-based cohorts adequate to provide an accurate prediction of cardiovascular risk have been scarce. Thus, calibration of the EuroSCORE and Framingham scores has been proposed and done for our population. The aim was to develop a native risk prediction score to accurately estimate the individual cardiovascular risk in the Spanish population. Methods Seven Spanish population-based cohorts including middle-aged and elderly participants were assembled. There were 11 800 people (6387 women) representing 107 915 person-years of follow-up. A total of 1214 cardiovascular events were identified, of which 633 were fatal. Cox regression analyses were conducted to examine the contributions of the different variables to the 10-year total cardiovascular risk. Results Age was the strongest cardiovascular risk factor. High systolic blood pressure, diabetes mellitus and smoking were strong predictive factors. The contribution of serum total cholesterol was small. Antihypertensive treatment also had a significant impact on cardiovascular risk, greater in men than in women. The model showed a good discriminative power (C-statistic = 0.789 in men and C = 0.816 in women). Ten-year risk estimations are displayed graphically in risk charts separately for men and women. Conclusions The ERICE is a new native cardiovascular risk score for the Spanish population derived from the background and contemporaneous risk of several Spanish cohorts. The ERICE score offers the direct and reliable estimation of total cardiovascular risk, taking in consideration the effect of diabetes mellitus and cardiovascular risk factor management. The ERICE score is a practical and useful tool for clinicians to estimate the total individual cardiovascular risk in Spain. Resumen Introducción y objetivosEn España no existen unas cohortes poblacionales suficientemente grandes para hacer predicciones precisas del riesgo cardiovascular. Las ecuaciones de Framingham y EuroSCORE calibradas son las más utilizadas en España. El objetivo es desarrollar la primera ecuación de predicción autóctona para estimar con precisión el riesgo cardiovascular individual en España. Métodos Análisis conjunto de siete cohortes españolas de población de mediana edad y anciana. La población del estudio -11.800 personas (6.387 mujeres)-aportó un total de 107.915 personas-año de seguimiento y 1.214 eventos cardiovasculares (633 de ellos, mortales). Se efectuó un análisis de regresión de Cox para examinar la contribución de los diferentes factores al riesgo de cualquier evento cardiovascular (mortal y no mortal). Resultados La edad fue el principal factor de riesgo de eventos cardiovasculares. La presión arterial sistólica, la diabetes mellitus, el tabaquismo y el tratamiento antihipertensivo fueron factores predictivos fuertemente asociados con el riesgo cardiovascular. En cambio, la contribución del colesterol total sérico fue pequeña, especialmente en los mayores de 70 años. El modelo final de riesgo mostró un buen...

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Section: Components Of the Risk Scoresupporting

confidence: 65%

The ERICE-score: the New Native Cardiovascular Score for the Low-risk and Aged Mediterranean Population of Spain

Gabriel

Brotons

Tormo

et al. 2015

Revista Española de Cardiología (English Edition)

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“…The association of this condition with the risk of CV events [ 9 , 83 ] makes it all the more necessary to endorse the interventions aimed at managing the modifiable risk factors (diet and exercise), to prescribe a LLT accordingly to individual’s CV risk [ 7 ], and also to plan an adequate monitoring of the pharmacological therapies implemented to maximize their benefit. There are many examples of this relationship in our country: hypercholesterolemia doubled the risk of an ischemic disease [ 84 , 85 ], and would be the cause of 22% of all coronary events. The risk increased significantly among patients who did not have their lipid values controlled, while among those diagnosed with controlled hypercholesterolemia and, who are undergoing a lipid-lowering treatment, the increased risk of ischemic heart disease was not statistically significant [ 84 ].…”

Section: Discussionmentioning

confidence: 99%

“…There are many examples of this relationship in our country: hypercholesterolemia doubled the risk of an ischemic disease [ 84 , 85 ], and would be the cause of 22% of all coronary events. The risk increased significantly among patients who did not have their lipid values controlled, while among those diagnosed with controlled hypercholesterolemia and, who are undergoing a lipid-lowering treatment, the increased risk of ischemic heart disease was not statistically significant [ 84 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence, Treatment, and Control of Hypercholesterolemia in High Cardiovascular Risk Patients: Evidences from a Systematic Literature Review in Spain

et al. 2015

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IntroductionCardiovascular diseases (CVDs) represent a major Public Health burden. High serum cholesterol levels have been linked to major CV risk. The objectives of this study were to review the epidemiology of hypercholesterolemia in high risk CV patients from Spain, by assessing its prevalence, the proportion of diagnosed patients undergoing pharmacological treatment and the degree of attained lipid control.MethodsA systematic literature review was carried out using Medline and two Spanish databases. Manuscripts containing information on hypercholesterolemia in several high CV risk groups [diabetes mellitus (DM), Systematic COronary Risk Evaluation (SCORE) risk >5, or documented CVD], published between January 2010 and October 2014, were included.ResultsOf the 1947 published references initially retrieved, a full-text review was done on 264 manuscripts and 120 were finally included. Prevalence of hypercholesterolemia ranged from 50 to 84% in diabetics, 30–60% in patients with DM or elevated SCORE risk, 64–74% with coronary heart disease, 40–70% in stroke patients, and 60–80% in those with peripheral artery disease. Despite the finding that most of them were on pharmacological treatment, acceptable control of serum lipids was very variable, ranging from 15% to 65%. Among those with heterozygous familial hypercholesterolemia, 95–100% received treatment but less than 50% achieved their therapeutic goals.ConclusionsAn elevated prevalence of hypercholesterolemia can be found in targeted groups at high CV risk. Although most patients are receiving pharmacological treatment, rates of lipid control continue to be low, both in primary and secondary prevention.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-015-0252-y) contains supplementary material, which is available to authorized users.

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“…In DARIOS results, the baseline coronary risk was higher in men, although 10-year coronary disease risk was strongly associated with overweight, general and abdominal obesity in women as well. Previous studies in Spain report that obesity did not increase the incidence of cardiovascular events; however, further cohort studies with longer follow-up are needed [41,42]. In the Framingham Heart Study, for instance, obesity was associated with increased relative risk for development of cardiovascular disease in a population aged 35–75 and followed for 44 years [43].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of obesity and associated cardiovascular risk: the DARIOS study

Félix-Redondo¹,

Grau

Baena-Díez

et al. 2013

BMC Public Health

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BackgroundTo estimate the prevalence of overweight and obesity in the Spanish population as measured with body mass index (BMI), waist circumference (WC) and waist to height ratio (WHtR) and to determine the associated cardiovascular risk factors.MethodsPooled analysis with individual data from 11 studies conducted in the first decade of the 21st century. Participants aged 35–74 years were asked about the history of cardiovascular diseases, hypertension, diabetes and hypercholesterolemia. Height, weight, WC, blood pressure, glycaemia, total cholesterol, low-density and high-density lipoprotein cholesterol and coronary risk were measured. The prevalence of overweight (BMI 25–29.9 kg/m2), general obesity (BMI ≥30 kg/m2), suboptimal WC (≥ 80 cm and < 88 in women, ≥ 94 and < 102 in men), abdominal obesity (WC ≥88 cm ≥102 cm in women and men, respectively) and WHtR ≥0.5 was estimated, standardized for the European population.ResultsWe included 28,743 individuals. The prevalence of overweight and suboptimal WC was 51% and 30% in men and 36% and 22% in women, respectively; general obesity was 28% in both sexes and abdominal obesity 36% in men and 55% in women. The prevalence of WHtR ≥0.5 was 89% and 77% in men and women, respectively. All cardiovascular risk factors were significantly associated with abnormal increased values of BMI, WC and WHtR. Hypertension showed the strongest association with overweight [OR = 1.99 (95% confidence interval 1.81-2.21) and OR = 2.10 (1.91-2.31)]; suboptimal WC [OR = 1.78 (1.60-1.97) and OR = 1.45 (1.26-1.66)], with general obesity [OR = 4.50 (4.02-5.04), and OR = 5.20 (4.70-5.75)] and with WHtR ≥0.5 [OR = 2.94 (2.52-3.43), and OR = 3.02 (2.66-3.42)] in men and women respectively, besides abdominal obesity in men only [OR = 3.51 (3.18-3.88)]. Diabetes showed the strongest association with abdominal obesity in women [OR = 3,86 (3,09-4,89).ConclusionsThe prevalence of obesity in Spain was high. Overweight, suboptimal WC, general, abdominal obesity and WHtR ≥0.5 was significantly associated with diabetes, hypertension, hypercholesterolemia and coronary risk. The use of lower cut-off points for both BMI and particularly WC and could help to better identify the population at risk and therefore achieve more effective preventive measures.

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Cardiovascular risk estimated after 13 years of follow-up in a low-incidence Mediterranean region with high-prevalence of cardiovascular risk factors

Cited by 13 publications

References 30 publications

The ERICE-score: the New Native Cardiovascular Score for the Low-risk and Aged Mediterranean Population of Spain

The ERICE-score: the New Native Cardiovascular Score for the Low-risk and Aged Mediterranean Population of Spain

Prevalence, Treatment, and Control of Hypercholesterolemia in High Cardiovascular Risk Patients: Evidences from a Systematic Literature Review in Spain

Prevalence of obesity and associated cardiovascular risk: the DARIOS study

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