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Journal Information
Vol. 148. Issue 3.
Pages 107-113 (February 2017)
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Vol. 148. Issue 3.
Pages 107-113 (February 2017)
Original article
DOI: 10.1016/j.medcle.2017.02.003
Evolution and degree of control of cardiovascular risk factors after 5 years of follow-up and their relationship with the incidence of peripheral arterial disease: ARTPER cohort
Evolución y grado de control de los factores de riesgo cardiovascular tras 5 años de seguimiento y su relación con la incidencia de arteriopatía periférica: cohorte poblacional ARTPER
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Rosa Forésa,b,c,d,
Corresponding author
ssiga@hotmail.es

Corresponding author.
, María Teresa Alzamoraa,b,d, Guillem Perab, Marta Valverdeb,c,e, Maria Anglab,c, José Miguel Baena-Díezd,f, Xavier Mundet-Tuduric,g
a Centro de Salud Riu Nord-Riu Sud, Institut Català de la Salut, Santa Coloma de Gramenet, Barcelona, Spain
b Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Barcelona, Spain
c Universitat Autònoma de Barcelona, Barcelona, Spain
d Institut d’Investigació Germans Trias i Pujol, Badalona, Barcelona, Spain
e Hospital Nostra Senyora de Meritxell, Escaldes-Engordany, Andorra
f Centro de Salud La Marina, Institut Català de la Salut, Barcelona, Spain
g Unitat de Suport a la Recerca Barcelona, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
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Table 1. Characteristics of the study sample at baseline and follow-up (n=2125).
Table 2. Cardiovascular risk factors associated with prevalent and incident peripheral arterial disease. Multivariate analysis.
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Abstract
Background and objective

Although cardiovascular risk factors (CVRF) are well known, their degree of control is not optimal. The aim of this study is to assess the evolution and control of CVRFs after 5 years of monitoring a population-based cohort and their association with the incidence of peripheral arterial disease (PAD).

Material and method

Prospective cohort study recruited between 2006 and 2008. Second phase between 2011 and 2012. An ankle–brachial index was determined for all participants in both phases. Demographic variables, CVRF and previous cardiovascular events, blood pressure, total cholesterol and its fractions (HDL, LDL), triglycerides, glucose and glycosylated haemoglobin levels in diabetic patients and the cardiovascular risk score according to the REGICOR table were recorded.

Results

A total of 2125 individuals were analyzed. We observed an increase in the prevalence of hypertension (HT) (15.4%), diabetes (DM) (8.2%) and hypercholesterolemia (20.4%), with no changes in obesity and smoking. The cardiovascular risk determined on the basis of the REGICOR table remained at around 5.5%. We observed an increased control of CVRF throughout the follow-up period, except in the case of DM and obesity. In the multivariate analysis, uncontrolled HT 2-folded the risk of onset of PAD (odds ratio [OR] 2.3; 95% confidence interval [95% CI] 1.3–4.1), whereas smoking 5-folded this risk (OR 5.0; 95% CI 2.5–10.2).

Conclusions

Smoking and uncontrolled HT increase the risk of onset of PAD in this population. Despite the increase in drug treatments, the control of CVRFs continues to be suboptimal.

Keywords:
Cardiovascular risk factors
Ankle–brachial index
Cohort studies
Peripheral arterial disease
Resumen
Fundamento y objetivo

Los factores de riesgo cardiovascular (FRCV) son bien conocidos, pero su grado de control no es óptimo. Este trabajo pretende valorar la evolución y el control de los FRCV clásicos tras 5 años de seguimiento de una cohorte poblacional y su relación con la incidencia de arteriopatía periférica (AP).

Material y método

Estudio de cohortes prospectivo. Selección de pacientes 2006-2008; segunda visita entre 2011-2012. En ambas fases se realizó un índice tobillo-brazo en condiciones estandarizadas. Se registraron variables demográficas, antecedentes y FRCV, presión arterial, perfil lipídico, glucosa y hemoglobina glucosilada en pacientes diabéticos y cálculo del riesgo cardiovascular mediante REGICOR.

Resultados

Fueron analizados 2.125 individuos. Se incrementó la prevalencia de hipertensión arterial (HTA) en un 15,4%, en un 8,2% la diabetes (DM) y en un 20,4% la hipercolesterolemia, manteniéndose estables la obesidad y el tabaquismo. REGICOR se mantuvo alrededor de 5,5%. Se incrementó el control de los FRCV durante el seguimiento, excepto para la DM y la obesidad. En el análisis multivariante la HTA no controlada presentó un riesgo de más del doble para AP incidente (odds ratio [OR] 2,3; intervalo de confianza al 95% [IC 95%] 1,3-4,1), y el tabaquismo, de 5 veces (OR 5,0; IC 95% 2,5-10,2).

Conclusiones

Tabaquismo y HTA mal controlados incrementan el riesgo para AP en esta población. A pesar del aumento del tratamiento farmacológico persiste un control subóptimo de los FRCV.

Palabras clave:
Factores de riesgo cardiovascular
Índice tobillo-brazo
Cohorte
Arteriopatía periférica

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