Cardiovascular Risk Prevention Research Articles

Lifestyles and alterations of finger-stick glucose and cholesterol and blood pressure among fifty-year-old Italian and foreign residents in the Alto Vicentino Health District (Veneto Region, Northern Italy)

to describe and compare cardiovascular risk prevalence in a large sample of Italian and foreign fifty-year-old residents in Veneto Region (Northern Italy) who do not have a co-pay fee exemption for cardiovascular diseases. Data collection comes from standardized and objective measurements carried out by health personnel of the Department of Prevention of the Local Health Agency 7 of Veneto Region. cross-sectional study. Italian and foreign fifty-years-old residents who do not have a co-pay fee exemption for cardiovascular diseases were extracted from the registry list, excluding people already affected by diabetes, hypertension, hypercholesterolemia or cardiovascular diseases, and received a written invitation to participate. adherents were studied through standardized questionnaires about their lifestyles (tobacco, alcohol, weight excess, central obesity, physical inactivity), anthropometric measurements (height, weight, body mass index, waist circumference), the direct measurement of blood pressure and a finger-stick for glucose and cholesterol. Educational level was also recorded in a large subgroup of adherents. Risk factor prevalence has been described and analyzed by geographical area of origin, separately for men and women and adjusted for educational level. among the invited people, 3,420 out of 5,088 accepted the invitation (67.2%); the adherence was lower among foreign women. Both foreign women and men showed lower prevalence of healthy lifestyles compared to Italian participants (women: 20.3% vs. 34.3%; men: 13.2 vs. 25.6%). These differences remained large and statistically significant after adjusting for educational level. The prevalence of hypertension and of hypercholesterolemia/hyperglycaemia (finger stick) was higher among foreign women than among Italian (39.1% vs. 28.4%); remarkably, the prevalence of hyperglycaemia was 8.7% vs.1.9%. the majority of foreign residents can be reached through a personal invitation to participate in a cardiovascular prevention intervention. Foreign participants show a higher prevalence of cardiovascular risk factors compared to Italian residents. It is advisable to implement a strategy involving both the health personnel of the Department of Prevention and the General practitioners aiming at improving individual and community healthy choices and at an early recognition of diabetes mellitus, hypertension, and hypercholesterolemia onset among foreign residents.

Cardiovascular risk prevention: One size does not fit all

Cardiovascular risk prevention: One size does not fit all

Utilization of Statins in Reducing Comorbidities of Diabetes Mellitus: A Systematic Review

Background: Medical care for the patients with diabetes, especially medication regimens, has become more complex over time, producing a barrier to achieving evidence-based goals of treatment. National and international clinical guidelines in the prevention of cardiovascular risk in diabetics advocate the utilization of statin therapy in appropriate patients. In this review, we will systematically review about utilization of Statins in reducing Comorbidities of Diabetes Mellitus. Methods: We searched the various electronic databases such as: PUBMED, BMJ, LANCET, WHO Website, Unicef Website and Google Scholar for studies related about utilization of Statins in reducing Comorbidities of Diabetes Mellitus. We also checked reference lists of reviews and retrieved articles for additional studies. By systemic searches, we reviewed each paper and retrieved potentially relevant references. Results: Many landmark studies across the world like the Heart Protection Study (HPS), the largest trial to date, confirmed the findings of earlier primary and secondary across a wide range of patients, including those with diabetes mellitus. In diabetic patients, statin therapy was associated with a significant 22% reduction in the risk of a first vascular event. The collaborative Atorvastatin diabetes study (CARDS) a study that involved over 2,800 men and women with type 2 diabetes (aged 40-75 years) and at least one other CHD risk factor, was stopped early when patients in the statin group showed significant reductions in myocardial infarction, stroke, angina and revascularization. Various Clinical trials such as MRC/BHF Heart Protections Study, Collaborative Atorvastatin Diabetes Study (CARDS) etc. showed evidence for the benefits of statins in diabetes. Conclusion: An overwhelming amount of data that confirm the morbidity and mortality benefit of statin therapy in diabetes mellitus have been reported, both in primary and secondary prevention settings. National and international clinical guidelines in the prevention of cardiovascular risk in diabetics advocate the utilization of statin therapy in appropriate patients. Key words: Diabetes Mellitus, Statins, Cardiovascular risk, Comorbidities.

Effectiveness of Training Sessions in Changing the Level of Knowledge and Motivation of Family Doctors to the Implementation of Evidence-based Screening into Their Clinical Practice

The objective: evaluation of the effectiveness of training sessions in changing the level of knowledge and motivation of Family Doctors to the implementation of evidence-based screening into their clinical practiceMaterials and methods. Before the interactive training, immediately after, 3 and 12 months after the training the knowledge, as well as the assessment of the motivation to introduce knowledge into practical activities have been assessed. The total number of persons who took part in the testing was 334 persons, including 68,7% of the family doctors and 31,3% of nurses.Results. According to the test results, the average level of knowledge of family doctors at the beginning of the training was quite low and amounted to only 6,1±1,8 points out of 20 possible, immediately after the training the level of knowledge increased significantly and amounted to 14,9±2,3 points (p<0,001), and 3 months after the training, the average level of knowledge decreased to 10,21±3,21 points, but was higher than before the start of the training (p>0,005). The level of motivation of health workers at the beginning of the training was average; immediately after the training, the level of motivation rose to high: 19,95±2,38 and was significantly higher than at the beginning (p>0,005). 3 months after the training, the level of motivation of the training participants to implement changes in practice decreased slightly and amounted to 19,11±3,18 points (p<0,005), and 12 months after the training it was significantly lower than the previous data – 16,1±4,53 (p>0,005) and actually the starting starting level of motivation registered before the training.Conclusions. Interactive trainings have proven to be an effective way to increase the level of knowledge and motivation of health workers to implement evidence-based recommendations for the prevention and screening of cardiovascular risk in their clinical practice. Although the level of knowledge of health workers remained stable after 3 and 12 months after the training, the level of motivation 12 months after the training significantly decreased in the absence of a number of factors supporting the motivation of medical personnel to change.

Compliance With Dyslipidemia Guidelines in Daily Practice: How Effective Is Cardiovascular Risk Prevention?

PurposeCardiovascular disease (CVD) due to atherosclerosis is the leading cause of early mortality and morbidity. The current European guidelines on CVD prevention in clinical practice recommend the use of the Systematic Coronary Risk Estimation (SCORE) system. The current American Heart Association guidelines recommend the use of the new pooled cohort risk assessment equations to estimate the 10-year atherosclerotic CVD risk. The purpose of this article was to investigate the compliance of dyslipidemia guidelines in daily practice in patients with dyslipidemia or who have risk factors for CVD. MethodsThe study group consisted of 500 outpatients who had dyslipidemia or risk factors for CVD. The risk level was computed according to the European and American Heart Association guidelines. Therapeutic LDL-C targets were identified based on the calculated risk level. Therapeutic target levels were compared based on the dosage of statins used and achievement of the LDL-C goal in daily practice according to the risk levels. FindingsAccording to the European dyslipidemia guidelines, 231 patients were in the very-high/high-risk group, and 106 patients (45.9%) achieved the LDL-C target (<100 mg/dL); 210 patients were in the moderate-risk group, and 156 (74.3%) patients achieved the LDL-C target (<115 mg/dL); and 59 patients were in the low-risk group, and 55 (93.2%) patients achieved the LDL-C target (<155 mg/dL). Univariate and multivariate logistic regression analyses revealed that the LDL-C level and presence of coronary artery disease were significantly reverse associated with achievement of the LDL-C goal (both, P < 0.001). ImplicationsOur results showed that the majority of patients were in the very-high/high-risk group in daily practice. Although the European dyslipidemia guidelines are more likely to be used in daily practice, achievement of the guidelines-recommended treatment goals was low.

Variations in cardiovascular risk factors in people with and without migration background in Germany – Results from the STAAB cohort study

BackgroundAbout 20% of the German population have a migration background which might influence prevalence of preventable cardiovascular risk factors (CVRF). MethodsWe report data of the prospective Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) cohort study investigating a representative sample of inhabitants of the City of Würzburg, Germany, aged 30 to 79 years. Individuals without migration background were defined as follows: German as native language, no other native language, and/or born in Germany. All other participants were defined as individuals with migration background. ResultsOf 2473 subjects (51% female, mean age 54 ± 12 years), 291 (12%) reported a migration background: n = 107 (37%) from a country within the EU, n = 117 (40%) from Russia, and n = 67 (23%) from other countries. Prevalence of hypertension, atherosclerotic disease, and diabetes mellitus was similar in individuals with and without migration background. By contrast, prevalence of obesity and metabolic syndrome was significantly higher in individuals with migration background, with the least favourable profile apparent in individuals from Russia (individuals without vs. with migration background: obesity 19 vs. 24%, p < 0.05; odds ratio: EU: 1.6, Russia: 2.2*, other countries: 0.6; metabolic syndrome 18 vs. 21%, p < 0.05; odds ratio: EU: 1.2, Russia: 1.7*, other countries: 1.5; *p < 0.05). ConclusionIndividuals with migration background in Germany might exhibit a higher CVRF burden due to a higher prevalence of obesity and metabolic syndrome. Strategies for primary prevention of heart failure may benefit from deliberately considering the migration background.

PO306 Prevalence of Cardiovascular Risk in Female Employees from Rio de Janeiro Public Service

PO306 Prevalence of Cardiovascular Risk in Female Employees from Rio de Janeiro Public Service

Statin use in cancer survivors versus the general population: cohort study using primary care data from the UK clinical practice research datalink

BackgroundCancer survivors may be at increased risk of cardiovascular diseases, but little is known about whether prescribing guidelines for the primary prevention of cardiovascular disease are adequately implemented in these patients. We compared levels of statin initiation and cessation among cancer survivors compared to the general population to determine differences in uptake of pharmaceutical cardiovascular risk prevention measures in these groups.MethodsThe study population included individuals aged ≥40 during 2005–13 within the UK Clinical Practice Research Datalink primary care database. Within this population we identified cancer survivors who were alive and under follow-up at least 1 year after diagnosis, and controls with no cancer history. Follow-up time prior to cancer diagnosis was included in the control cohort. Using logistic regression, we compared these groups with respect to uptake of statins within 1 month of a first high recorded cardiovascular risk score. Then, we used Cox modelling to compare persistence on statin therapy (time to statin cessation) between cancer survivors and controls from the main study population who had initiated on a statin.ResultsAmong 4202 cancer survivors and 113,035 controls with a record indicating a high cardiovascular risk score, 23.0% and 23.5% respectively initiated a statin within 1 month (adjusted odds ratio 0.98 [91.8–1.05], p = 0.626). Cancer survivors appeared more likely to discontinue statin treatment than controls (adjusted hazard ratio 1.07 [1.01–1.12], p = 0.02). This greater risk of discontinuing was only evident after the first year of therapy (p-interaction < 0.001).InterpretationAlthough cardiovascular risk is thought to be higher in cancer survivors compared to the general population, cancer survivors were no more likely to receive statins, and marginally more likely to cease long-term therapy, than general population controls. There may be an opportunity to mitigate the suspected higher cardiovascular risk in the growing population of cancer survivors by improving uptake of lipid-lowering treatment and persistence on therapy.

Chemistry and Health Effect of Tea Polyphenol (−)-Epigallocatechin 3-O-(3-O-Methyl)gallate

Catechins are major polyphenols in tea and have been related to the health promotion of tea. Recently, a unique O-methylated catechin, (-)-epigallocatechin 3- O-(3- O-methyl)gallate (EGCG3″Me) has been identified in limited green and oolong tea. EGCG3″Me-enriched tea has shown distinct physiological functions in animal models and humans compared to common tea, including antiallergy, antiobesity, the prevention of cardiovascular disease risks, etc. This perspective aims to present current knowledge of EGCG3″Me, including its natural occurrence, chemical synthesis, chemical structure, and bioavailability, as well as the molecular mechanisms underlying its biological activities.

Genotype effects of glucokinase regulator on lipid profiles and glycemic status are modified by circulating calcium levels: results from the Korean Genome and Epidemiology Study

Single nucleotide polymorphisms (SNPs) in the glucokinase regulator (GCKR) are associated with major cardiovascular risk factors (ie, lipid profile and glycemic status). Recently, GCKR was shown to be related to circulating calcium levels involved in lipid and glycemic controls. Therefore, we hypothesized that GCKR SNPs are associated with major cardiovascular risk factors in the Korean population, and the association is modified by circulating calcium levels. Epidemiological data and GCKR SNPs (rs780093T>C, rs780094 T>C, and rs1260326 T>C) were collected from a subset of Ansung-Ansan cohort in the Korean Genome and Epidemiology Study (n = 7815). Consistent with the results of previous studies, GCKR SNPs were significantly associated with decreased total cholesterol and triglyceride levels and increased glucose levels and insulin resistance. Minor C allele carriers, particularly CC homozygotes, had lower serum calcium levels than TT homozygotes for all 3 SNPs. Particularly, the effect of GCKR SNPs on total cholesterol, triglyceride, fasting glucose, and insulin resistance was apparent when serum calcium levels were in normal range (8.8-10.1 mg/dL). When serum calcium levels were high (≥10.2 mg/dL), CC homozygotes also had significantly lower triglyceride and higher fasting glucose than TT homozygotes. However, the associations were not observed when serum calcium levels were low (<8.8 mg/dL). In conclusion, GCKR SNPs are associated with lipid profiles and glycemic status in the Korean population, and the genetic effect is modified by basal circulating calcium levels, particularly in normal or high ranges. It provides important information for individualized prevention and management of cardiovascular risk associated with GCKR SNPs.

Daily Consumption of Chocolate Rich in Flavonoids Decreases Cellular Genotoxicity and Improves Biochemical Parameters of Lipid and Glucose Metabolism.

In recent years, the incidence of atherosclerotic cardiovascular disease, obesity, and diabetes has increased largely worldwide. In the present work, we evaluated the genoprotective effect of the consumption of flavonoids-rich chocolate on 84 young volunteers. Biochemical indicators related to the prevention and treatment of cardiovascular risk and metabolic syndrome were also determined. A randomized, placebo-controlled, double-blind study was performed in the Autonomous University of Baja California. The treatments comprised the daily consumption of either 2 g of dark chocolate containing 70% cocoa, or 2 g of milk chocolate, for 6 months. The total amount of phenolic compounds and flavonoids was determined in both types of chocolate. Anthropometrical and Biochemical parameters were recorded prior to and after the study. The evaluation of the genotoxicity in buccal epithelial cells was performed throughout the duration of the study. Flavonoids from cocoa in dark chocolate significantly prevented DNA damage, and improved the nucleus integrity of cells. This effect could be related to the antioxidant capacity of the dark chocolate that decreased cellular stress. Biochemical parameters (total cholesterol, triglycerides, and LDL-cholesterol level in blood) and anthropometrical parameters (waist circumference) were improved after six months of daily intake of 2 g of dark chocolate with a 70% of cocoa.

Exercising in Stressful Environmental Conditions with Hypertension Versus Normal Blood Pressure

ABSTRACTHypertension (high blood pressure [BP]) is the most common, costly, and preventable cardiovascular disease risk factor in the world. Regular aerobic exercise is universally recommended as a lifestyle therapeutic intervention for the prevention, treatment, and control of high blood pressure. However, the stressor response to exercise in extreme but commonly experienced stressful environments may be exacerbated in individuals with hypertension, a situation not fully described in the literature. Therefore, we performed a systematic search examining the potential adverse health effects of exercising in hot, humid, cold, or air-polluted environments among adults with hypertension. Studies included adults with hypertension compared to normal BP and that with at least one physiological marker in response to heat, humidity, cold, windchill, or air pollution. The present systematic review revealed few studies that explored differences between individuals with hypertension and normal BP while exercising in commonly experienced stressful environmental conditions. Our preliminary evidence suggests that adults with hypertension may be more vulnerable to adverse cardiovascular stressor responses while exercising in the heat. Future studies are required to better characterize these maladaptive responses to extreme heat or humidity to better identify potential counter-measures for this vulnerable population.

Integrating Individuals With Stroke Into Cardiac Rehabilitation Following Traditional Stroke Rehabilitation: Promoting a Continuum of Care

Following stroke, people are at high risk for repeat strokes and for complications related to coronary artery disease (CAD). Indeed, stroke and CAD share many of the same risk factors. Unfortunately, patients become sedentary after stroke, which leads to cardiorespiratory deconditioning as well as muscle atrophy and weakness that in turn leads to deterioration in metabolic, cardiorespiratory, and functional health. Access to intensive secondary prevention programs with structured exercise components that include both aerobic and resistance training can help to prevent and reverse these health hazards. Traditional stroke rehabilitation programs face many barriers to providing exercise programming early post-stroke, such as lack of available therapy time and short length of stay, lack of equipment for exercise and assessments, and concerns for patient safety related to cardiac status. Building a partnership between traditional stroke rehabilitation programs and cardiac rehabilitation by operationalizing an automatic referral process has the potential to affect secondary prevention of stroke and cardiovascular risk significantly. It could also mitigate the tremendous burden on patients and their family members. This is an easily identified group that can achieve significant gains over multiple domains of recovery with the targeted exercise and risk-factor modification components offered by comprehensive cardiac rehabilitation programs.

Prevención en diabetes mellitus y riesgo cardiovascular: enfoque médico y nutricional

Introducción. La epidemia de diabetes mellitus tipo 2 (DM2) incrementa la enfermedad cardiovascular y la morbimortalidad; por tanto, es importante prevenir, tratar integralmente y valorar complicaciones y comorbilidades asociadas.Objetivo. Presentar una revisión sobre prevención de DM2 y riesgo cardiovascular con enfoque médico y nutricional.Materiales y métodos. Se hizo una revisión en las bases de datos Embase, PubMed, Bireme (LILACS, SciELO) y Cochrane Library con términos específicos. La búsqueda se hizo en inglés y español sobre publicaciones entre 2001 y 2016.Resultados. Se encontraron 811 publicaciones y, después de aplicar los criterios de inclusión y exclusión, se seleccionaron 71 documentos clasificados así: 24 artículos de investigación, 14 artículos de revisión, 18 guías clínicas, 8 consensos y 7 de otras categorías (informes, capítulos de libro, normatividad y un libro)Conclusión. La educación es una herramienta fundamental para prevenir y tratar factores de riesgo. Se debe incentivar el trabajo en equipo con el paciente y la familia para reducir el desarrollo de comorbilidades asociadas a DM2.

Vitamin D replacement ameliorates serum lipoprotein functions, adipokine profile and subclinical atherosclerosis in pre-menopausal women

Background and aimsLow vitamin D (vitD) has been linked to increased cardiovascular (CV) risk, but the effects of vitD supplementation are not clarified. We evaluated the impact of vitD normalization on HDL cholesterol efflux capacity (CEC), which inversely correlates with CV risk, the proatherogenic serum cholesterol loading capacity (CLC), adipokine profile and subclinical atherosclerosis. Methods and resultsHealthy premenopausal women with vitD deficiency (n = 31) underwent supplementation. Subclinical atherosclerosis was evaluated by flow-mediated dilation (FMD), pulse wave velocity (PWV) and augmentation index (AIx), measured with standard techniques. HDL CEC and serum CLC were measured by a radioisotopic and fluorimetric assay, respectively. Malondialdehyde (MDA) in HDL was quantified by the TBARS assay. Pre-β HDL was assessed by 2D-electrophoresis. Serum adipokines were measured by ELISA.VitD replacement restored normal levels of serum 25-hydroxyvitamin D (25OHD) and significantly improved FMD (+4%; p < 0.001), PWV (−4.1%: p < 0.001) and AIx (−16.1%; p < 0.001). Total CEC was significantly improved (+19.5%; p = 0.003), with a specific increase in the ABCA1-mediated CEC (+70.8%; p < 0.001). HDL-MDA slightly but significantly decreased (−9.6%; p = 0.027), while no difference was detected in pre-β HDL. No change was observed in aqueous diffusion nor in the ABCG1-mediated CEC. Serum CLC was significantly reduced (−13.3%; p = 0.026). Levels of adiponectin were increased (+50.6%; p < 0.0001) and resistin levels were decreased (−24.3%; p < 0.0001). After vitD replacement, an inverse relationship was found linking the ABCA1-mediated CEC with pre-β HDL (r2 = 0.346; p < 0.001) and resistin (r2 = 0.220; p = 0.009). ConclusionOur data support vitD supplementation for CV risk prevention.

Cardiovascular Risk in South America Compared to Other Countries

The goal is to discuss the prevalence of cardiovascular risk in South America compared to other countries. The results highlight the importance of evidence-based approaches to promote the reduction of the prevalence of cardiovascular risk factors in a global context. Indicating the need for policies that promote cardiac health in the global sphere. Future efforts to generate global of risk factors for cardiovascular disease should be implemented. As well as prevention and treatment measures aimed at decreasing cardiovascular outcomes.

Low-Density Lipoprotein Cholesterol Goal Attainment Rates by Initial Statin Monotherapy Among Patients With Dyslipidemia and High Cardiovascular Risk in Japan - A Retrospective Database Analysis.

To understand the recent management status in Japan, we determined the low-density lipoprotein cholesterol (LDL-C) goal attainment (GA) rate of patients initiating statin monotherapy for dyslipidemia.Methods and Results:Dyslipidemic patients undergoing either primary prevention with high cardiovascular risk or secondary prevention (defined by 2012 Japan Atherosclerosis Society Guidelines) were retrospectively analyzed from a hospital-based claims database. In both groups, the LDL-C levels and GA rates of patients treated with intensive or standard statin monotherapy for ≥4 weeks (January 2012-August 2016) were evaluated. Among 1,501,013 dyslipidemic patients, 11,695 and 9,642 were included in the primary and secondary prevention groups, respectively. A total of 94% of patients underwent statin monotherapy as the initial lipid-lowering therapy, of which most (≥80%) took intensive statins. The proportions of patients in the primary prevention group who achieved an LDL-C goal <120 mg/dL by intensive and standard statins were 81.1% and 61.2%, respectively, and the proportions of those who achieved a goal <100 mg/dL in the secondary prevention group were 73.3% and 48.1%, respectively. The GA rates were similar regardless of disease complications. Most patients (>70%) in both groups achieved LDL-C management goals using intensive statin monotherapy. Further treatment approaches are required for high-risk patients not achieving LDL-C goals by initial statin monotherapy. Continuous efforts are crucial for adherence and persistence of lipid-lowering therapies.

Polyphenols Effect on Circulating Lipids and Lipoproteins: From Biochemistry to Clinical Evidence.

Polyphenols are a family of natural antioxidants that in recent years have been studied and tested for their potential benefits towards cardiovascular diseases. The aim of this review is to focus the attention on the presumed lipid-lowering and atheroprotective effects of polyphenols, administered either as individual molecules (nutritional supplements) and as functional foods, on the basis of the evidence coming from randomized controlled trials (RCTs) and their meta-analyses. A search strategy was conducted to identify studies in PubMed (January 1980 to September 2016); in particular, we have included human clinical trials, reviews and meta-analyses when they offered suitable insights and elucidations regarding the action of polyphenols on lipid profile and cardiovascular disease risk. Literature data on polyphenols suggest that they potentially could exert an effect on lipid profile, especially by reducing the oxidation of LDL-C. Polyphenols from cocoa, grape, green tea, berries and soy are the ones that have shown more clinically relevant effect. However, quantitative data on cholesterol reduction are still unclear and often conflicting. Polyphenols, if taken in adequate dosages, can exert in some cases a positive effect on the prevention of cardiovascular risk and lipid oxidation, despite an unclear effect on lipid levels.

Rheumatoid arthritis; a systemic disease with an under-estimated cardiovascular risk

ObjectiveTo determine the cardiovascular risk and the prevalence of cardiovascular risk (CVR) factors in patients with rheumatoid arthritis. Material and methodsObservational, descriptive and cross-sectional study performed in the General Hospital of Ciudad Real from June 2013 to May 2014. A complete laboratory analysis was performed, a clinical profile was prepared, the Systematic COronary Risk Evaluation (SCOREm) was calculated, and the CVR was stratified. Finally, the presence of sub-clinical atherosclerosis was determined by performing a carotid ultrasound. Results119 patients accepted to participate in the study. There was a prevalence of 73.1% of traditional risk factors; 6.72% having had a cardiovascular event at the time of the study, and 22.68% had an underdiagnosis of diabetes mellitus and/or nephropathy. The final distribution of the CVR was: Low risk 46 (38.7%), intermediate risk 33 (27.7%), high risk 2 (1.7%), very high risk 38 (31.9%). ConclusionsThere is a high prevalence of CVR factors and an elevated risk of underdiagnosis in the rheumatoid arthritis population. Therefore, although rheumatoid arthritis manifests itself more in the joints, it should be considered a systemic disease associated with a higher incidence of cardiovascular events.

Artritis reumatoide, una enfermedad sistémica con un riesgo cardiovascular subestimado

ObjectiveTo determine the cardiovascular risk and the prevalence of cardiovascular risk (CVR) factors in patients with rheumatoid arthritis. Material and methodsObservational, descriptive and cross-sectional study performed in the General Hospital of Ciudad Real from June 2013 to May 2014. A complete laboratory analysis was performed, a clinical profile was prepared, the Systematic COronary Risk Evaluation (SCOREm) was calculated, and the CVR was stratified. Finally, the presence of sub-clinical atherosclerosis was determined by performing a carotid ultrasound. Results119 patients accepted to participate in the study. There was a prevalence of 73.1% of traditional risk factors; 6.72% having had a cardiovascular event at the time of the study, and 22.68% had an underdiagnosis of diabetes mellitus and/or nephropathy. The final distribution of the CVR was: Low risk 46 (38.7%), intermediate risk 33 (27.7%), high risk 2 (1.7%), very high risk 38 (31.9%). ConclusionsThere is a high prevalence of CVR factors and an elevated risk of underdiagnosis in the rheumatoid arthritis population. Therefore, although rheumatoid arthritis manifests itself more in the joints, it should be considered a systemic disease associated with a higher incidence of cardiovascular events.