Documento de recomendaciones de la SEA 2018. El estilo de vida en la prevención cardiovascular

Abstract

Lifestyle is a complex concept that includes aspects external to ourselves that can modulate and influence our health. The knowledge of the relationship between lifestyle and cardiovascular risk does not attain the level of evidence achieved with clinical trials with drugs, because clinical studies are scarce and mainly of observational nature, albeit based on large cohorts. Nutritional epidemiology has the added difficulty of being based mostly on subjective dietary recall methods to ascertain nutrient and food intake over time, with the additional problems of incomplete data collection, variable measurements of adherence due to seasonal and geographical differences in food composition, and the changing eating behavior that human beings have over time. The purpose of this document is to carry out an updated and hierarchical review of the relationship between lifestyle and cardiovascular disease based on current evidence, paying attention to three aspects that are of great pathogenic importance and are directly modifiable: physical activity, tobacco consumption, and diet. With this, we intend to update the knowledge on this relationship, construct evidence-based recommendations, and provide a simple tool for clinical practice especially directed to health professionals involved in the care of people at cardiovascular risk, defining simple and easy strategies for individuals who receive advice for the primary and secondary prevention of cardiovascular diseases.

Misperception of the Cardiovascular Risk in Patients with Rheumatoid Arthritis

“…The results from the present study indicate that patients with RA do not perceive the increased risk of CV disease associated with this condition. In keeping with our findings, it was suggested that patients with RA do not seem to be aware of this problem [ 14 ] and often have trouble perceiving their actual CV risk [ 15 , 16 ]. With respect to this, a recent systematic review [ 16 ] identified only six studies that assessed the degree of the perceived risk of CV disease development in patients with RA, comparing it with EULAR SCORE or with classic CV risk factors.…”

“…However, despite the well-known fact that physical activity or a Mediterranean diet reduce the morbidity and mortality of CV disease and the symptoms of RA [ 11 , 12 , 13 ], little is known about the adherence to CV prevention factors in patients with RA. In this regard, some data indicate that it is low in the general population [ 14 ].…”

Documento de consenso SEA/SEMERGEN 2019. Recomendaciones dietéticas en la prevención cardiovascular

“…En definitiva, el consumo moderado de carne (no superior a 4 raciones por semana) no parece perjudicial para el riesgo cardiovascular, si bien hay que elegir piezas magras, retirando la grasa visible antes de su cocinado (6). Las carnes son fuente importante de proteínas animales, y deben alternarse con el pescado consumiendo una de estas opciones al día.…”

“…Las recomendaciones dietéticas tienen que encaminarse a incrementar el consumo de cereales integrales frente al de refinados (preferible la ingesta de pan y cereales integrales sobre la de pan blanco y cereales refinados). El consumo recomendado de cereales integrales es de unas 4 raciones/día, incluyendo pan en todas las comidas del día, pasta 2-3 veces/semana y arroz 2-3 veces/semana (6).…”

“…Por eso para conseguir una buena calidad proteica en la dieta es necesario que este aminoácido sea aportado por otros alimentos. Una buena combinación son legumbres (garbanzos, lentejas o alubias) con arroz o patata, que sí aportan la metionina aun siendo carentes en otros aminoácidos, como la lisina, que son aportados por las primeras (6). Las legumbres constituyen una fuente importante de fibra soluble que, al igual que la presente en la avena y la cebada, interfiere en la solubilización de colesterol en el intestino, reduciendo de forma modesta la colesterolemia.…”