Hyperlipidemias: del Barrio JL

Medrano MJ, Pastor-Barriuso R, Boix R, del Barrio JL, Damián J, Alvarez R, Marín A, Anonymous00066. · Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, España. · Rev Esp Cardiol. · Pubmed #18082090 links to  free full text

Abstract: INTRODUCTION AND OBJECTIVES: The proportion of the ischemic heart disease (IHD) burden attributable to cardiovascular risk factors in Spain has traditionally been extrapolated from populations in other countries. The aim of this study was to estimate the IHD risk attributable to smoking, hypercholesterolemia, hypertension, diabetes and excess weight using data from studies carried out in the Spanish population. METHODS: Data on the prevalence of cardiovascular risk factors in the general population were obtained from a meta-analysis of 48 cross-sectional studies carried out in Spain, and data on corresponding prevalences among IHD patients were derived from the PRIAMHO II and PREVESE II multicenter hospital registries. Crude and adjusted relative risks of IHD were obtained from follow-up data collected over 5 years in a primary-care cohort of 6124 adults without cardiovascular disease. The crude and adjusted population attributable fractions for various risk factors were calculated for both sexes combined and for men and women separately. RESULTS: Among men, 42.5% (95% confidence interval [CI] 6.8%-59.6%) of the adjusted incidence of IHD was attributable to overweight, 33.9% (95% CI 22.6%-41.0%) to smoking, 19.4% (95% CI 8.2%-26.5%) to hypercholesterolemia, and 15.5% (95% CI 1.6%-24.6%) to hypertension. Among women, 36.5% (95% CI -8.0%-56.3%) of IHD cases were attributable to overweight, 24.8% (95% CI 12.0%-31.9%) to diabetes, and 20.1% (95% CI 6.1%-28.6%) to hypercholesterolemia. CONCLUSIONS: The cardiovascular risk factors found to contribute most to IHD in the Spanish population were excess weight in both sexes, followed by smoking in men.

del Barrio JL, Medrano MJ, Arce A, Bergareche A, Bermejo F, Díaz J, Gascón J, García FJ, Garré J, Gómez C, Lobo A, Martínez A, Otero A, Reñé R, Sánchez MI, Saz P, Vega S, Vilalta-Franch J, Zunzunegui MV, de Pedro J. · Instituto de Salud Carlos III, Centro Nacional de Epidemiología, Madrid, Spain. · Neurologia. · Pubmed #17364251 links to  free full text

Abstract: INTRODUCTION: The aim of this study was to re-analyze door-to-door studies on neurological diseases among the elderly, in which vascular risk factors (VRF) were studied, describing methodological characteristics and prevalence of VRF. METHODS: The surveys were identified in two phases. They were aimed at ascertaining prevalence of stroke, dementias or Parkinsonisms and, at the time of individual screening, had collected data on at least three of the following VRF: arterial hypertension (AHT), smoking habit, diabetes mellitus and hypercholesterolemia. A questionnaire was drawn up to collect the data reported in each study, and a database was constructed. VRF prevalences were quantified and analyzed using logistic regression. RESULTS: The total of the re-analyzed population was 12,510 persons aged 70 years and over, residents in seven geographic areas during the period 1994-2002. Information available on VRF was essentially self-reported. The prevalence of self-reported AHT was 25.7 % in men and 44.2 % in women, and that of measured AHT was 61 % and 71.9 %, respectively. Populations with arterial pressure obtained by direct measurement registered 138 higher risks (OR: 1.74; 95 % CI: 1.51-2.01, and OR: 1.48; 95% CI: 1.33-1.64). Reported prevalence of diabetes, hypercholesterolemia and smoking habit were 14.3 %, 23.3% and 8.5 %, respectively. CONCLUSIONS: There was a high prevalence of VRF among the Spanish elderly population. However, its relationship with dementia, Parkinsonisms and cerebrovascular disease could not be studied due to the poor quality of the VRF data. The differences between measured and self-reported arterial pressure suggest the existence of undetected AHT and wide scope for prevention.