Factores de riesgo y morbimortalidad coronaria en una cohorte laboral mediterránea seguida durante 28 años. Estudio de Manresa

Abadal, Lluís Tomás; Lorenzo, Cristina Varas; Pérez, Iñaki; Vintró, Ignacio Balaguer; Puig, Teresa

doi:10.1016/s0300-8932(01)76472-x

Cited by 47 publications

(7 citation statements)

References 21 publications

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“…Lower relative risks were also reported by Tomàs i Abadal et al . [14] in a male occupational cohort from north-east Spain. However, large differences regarding the design, samples studied and follow-up periods preclude direct comparisons with the present study.…”

Section: Discussionmentioning

confidence: 99%

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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

et al. 2010

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BackgroundMurcia (south-east Spain) shows increased cardiovascular (CV) morbimortality as compared to other Spanish regions. Our objective was to assess the CV risk associated with major risk factors (RF) among adult population of Murcia.MethodsA cohort of 2314 subjects (18-70 years) with full biochemical and questionnaire data was followed-up for 13 years. Incident cases of ischemic heart disease and stroke were identified by record linkage, individual questionnaires and revision of medical records. Relative risks were obtained by multivariate Cox regression stratified by age and sex, and ischemic risk attributable to CVRF was calculated.ResultsAfter more than 26276 person-years of follow-up, 57 incident ischemic events (77% men) and 37 stroke cases (62% men) were identified. Independent risk factors of ischemic heart disease (IHD) and all CV events combined, with RR ranging from 1.6 to 2.6, were total serum cholesterol ≥ 240 mg/dl (HR = 2.6, 95%CI:1.3-5.1), blood pressure levels ≥ 140/90 mmHg (HR = 2.6, 95%CI:1.4-4.8), ever tobacco smoking (HR = 2.2; 95%CI:1.1-4.5), and diabetes (HR = 2.0; 95%CI: 1.0-3.8). No increased CV risk was detected for known participants under treatment who showed cholesterol and blood pressure values below the clinical risk threshold. Smoking was significantly associated with stroke. For all events combined, the major risk factors were hypercholesterolemia, hypertension and ever use of tobacco. Despite its high prevalence, obesity was not associated to CV risk. Most of the IHD cases were attributable to smoking (44%), hypertension (38%) and hypercholesterolemia (26%).ConclusionsIn the Region of Murcia, smoking accounted for the largest proportion of cardiovascular risk, whereas hypertension displaced hypercholesterolemia as the second leading cause of CV disease. Our study deepens in our understanding of the cardiovascular epidemiology in Spanish areas of Mediterranean Europe with relatively high cardiovascular morbimortality, that are poorly represented by the available risk equations.

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Section: Discussionmentioning

confidence: 99%

“…The scarce prospective literature available in Spain [13,14] confirms an elevated IHD risk for hypercholesterolemia and tobacco smoking, whereas associations for hypertension, overweight or diabetes are less consistent.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2010

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“…El único estudio de cohorte con seguimiento de más de 20 años demostró, a pesar de tratarse de una población laboral exclusivamente masculina, que el número de acontecimientos coronarios observado era inferior al esperado según el grado de exposición a factores de riesgo al inicio del estudio en 1968 32 . La corrección obtenida en nuestro estudio concuerda con este hallazgo aunque, por la información publicada del estudio de Manresa, no es posible determinar la magnitud de la diferencia entre lo esperado por la prevalencia de factores de riesgo al inicio del seguimiento y lo observado 32 .…”

Section: Discussionunclassified

Estimación del riesgo coronario en España mediante la ecuación de Framingham calibrada

et al. 2003

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Introduction and objectives. The Framingham coronary heart disease (CHD) functions overestimate the risk of CHD in countries with a low incidence. Consequently, these functions should be calibrated for the purpose of primary prevention. Calibrated Framingham function charts of overall CHD risk for the Spanish population are presented. Patients and methods. The Framingham functions were calibrated by substituting the prevalence of CHD risk factors and incidence found in Framingham with the same values for Spain. The Framingham function that included high-density lipoprotein (HDL) cholesterol was used. The 10-year probability of developing a CHD event was estimated for several combinations of risk factors and HDL levels ranging from 35 to 59 mg/dl. Color-coded charts were prepared that show the exact probability of CHD corresponding to each combination of risk factors, shown in separate cells on the chart. Results. The event rate and prevalence of CHD risk factors differed considerably between Girona and Framingham. HDL < 35 mg/dL increased risk by approximately 50% and HDL > 60 mg/dL reduced it by 50%. The proportion of cells in which the 10-year probability of developing a CHD event was > 9% was 2.3 times higher and that of cells with a probability > 19% was 13 times lower in the chart calibrated for Spain than in the original Framingham charts. Conclusions. The calibrated Framingham function may help to more accurately estimate the overall risk of CHD in the Spanish population for primary prevention purposes. The calibrated function should be validated, and the development of functions for the Spanish population should be promoted.

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“…En tal sentido existen publicaciones que han puesto en evidencia un comportamiento poblacional diferente a la cohorte de Framingham (34). De hecho, en el sur de Europa (este orden incluye a España) las variables que tenían un mayor poder predictivo de mortalidad por ECV eran el tabaquismo, la presión arterial sistólica (PAS), la edad y el IMC (35,36). En cambio, el valor de colesterol total no se asociaba significativamente con el riesgo de presentar un evento cardiovascular.…”

Section: Discussionunclassified

Valoración del riesgo cardiovascular después de gastrectomía vertical: comparativa del IMC, la adiposidad, el índice de Framingham y el índice aterogénico como marcadores del éxito de la cirugía

et al. 2016

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Valoración del riesgo cardiovascular después de gastrectomía vertical: comparativa del IMC, la adiposidad, el índice de Framingham y el índice aterogénico como marcadores del éxito de la cirugía . At the same time, the Framingham was 3.7% and Atherogenic Index: 1.64. Analyzing these data, after 12 months from surgery, the mean of BMI is in range of overweight, the adiposity is classifi ed as obesity (> 25% in men and > 35% in women), the Framingham range describes a low cardiovascular risk (< 5%) and the Atherogenic Index is located in the normal range (< 3). Correlating these parameters we observed that BMI is correlated with adiposity at preoperative values (Pearson 0.486; p = 0.004), postoperative (Pearson 0.957; p < 0.001), and the difference between them (Pearson 0.606; p = 0.017). This is logical, because the BMI is included in the formula for calculating the adiposity (by CUNBAE formula.) In the postoperative values correlated the adiposity with Framingham value (Pearson 0.814, p = 0.036) and with the atherogenic risk (p = 0.049, 0.517 Pearson.) In preoperative values, these correlations are not objectifi ed. BMI was not correlated with adiposity. Conclusion: The adiposity correlates better with cardiovascular risk indices, such as the Framingham Index or the Atherogenic Index, but only in the postoperative values. These elements represent useful tools for assessing the decreased risk of cardiovascular disease after bariatric surgery.

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Factores de riesgo y morbimortalidad coronaria en una cohorte laboral mediterránea seguida durante 28 años. Estudio de Manresa

Cited by 47 publications

References 21 publications

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

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

Estimación del riesgo coronario en España mediante la ecuación de Framingham calibrada

Valoración del riesgo cardiovascular después de gastrectomía vertical: comparativa del IMC, la adiposidad, el índice de Framingham y el índice aterogénico como marcadores del éxito de la cirugía

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