Iván D. Sierra

Valoración del riesgo cardiovascular global y prevalencia de dislipemias según los criterios del NCEP-ATP III en una población adulta de Bogotá, Colombia

Antecedentes Las enfermedades cardiovasculares son la principal causa de muerte en Colombia y en el mundo. Sin embargo, no se dispone de suficiente documentacion sobre la prevalencia y la distribucion de los factores de riesgo cardiovascular en la poblacion colombiana. Ningun studio ha determinado la prevalencia de las dislipemias y el syndrome metabolico de acuerdo con los criterios del NCEP-ATP III en Colombia. Objetivo Valorar el riesgo cardiovascular global y determinar la prevalencia de las dislipemias y los factores de riesgo cardiovascular en una muestra de adultos no hospitalizados residentes en Bogota, Colombia. Metodos Se estudio a 364 individuos adultos. Mediante una encuesta supervisada se indagaron la edad, los antecedentes familiares de enfermedad cardiovascular y el habito de fumar. Se determinaron la talla, el peso, el perimetro de la cintura, el perimetro de la cadera y la presion arterial por metodos estandarizados. En muestras de sangre tomadas el mismo dia se determinaron la glucemia en ayuno y el perfil lipidico minimo. Se calculo el riesgo cardiovascular global a 10 anos mediante las tablas de Framingham, y se clasifico a cada paciente en una categoria de riesgo de acuerdo con los criterios de ILIB-Latinoamerica (riesgo latente, intermedio o alto). La prevalencia de sindrome metabolico tambien se calculo de acuerdo con los criterios de ILIB-Latinoamerica. Se considero que era dislipemico todo individuo que no se encontrara en las metas trazadas para su categoria de riesgo segun el NCEP-ATP III. Resultados Se encontro una alta prevalencia de sobrepeso (37,3%), obesidad (9,6%), obesidad central (39,2%) y sindrome metabolico (28%). La hipertension arterial y la obesidad se asociaron con modificaciones significativas en el perfil de lipidos, especialmente con incrementos en los trigliceridos y descensos en el colesterol ligado a lipoproteinas de alta densidad (cHDL). El tabaquismo en ambos sexos y la obesidad central entre las mujeres se asociaron con valores mas bajos de cHDL. El riesgo cardiovascular global promedio a 10 anos fue del 3,89% (un 7,25% en varones y un 1,97% en mujeres). La prevalencia general de dislipemias fue del 66,7% (un 52% en el grupo de riesgo latente, un 88,8% en el de riesgo intermedio y un 100% en el de riesgo alto). En el grupo de riesgo latente predomino el cHDL bajo aislado, y en el de riesgo alto, la dislipemia combinada.

Consenso latino-americano de hipertensão em pacientes com diabetes tipo 2 e síndrome metabólica

The present document has been prepared by a group of experts, members of cardiology, endocrinology, internal medicine, nephrology and diabetes societies of Latin American countries, to serve as a guide to physicians taking care of patients with diabetes, hypertension and comorbidities or complications of both conditions. Although the concept of metabolic syndrome is currently disputed, the higher prevalence in Latin America of that cluster of metabolic alterations has suggested that metabolic syndrome is a useful nosography entity in the context of Latin American medicine. Therefore, in the present document, particular attention is paid to this syndrome in order to alert physicians on a particular high-risk population, usually underestimated and undertreated. These recommendations result from presentations and debates by discussion panels during a 2-day conference held in Bucaramanga, in October 2012, and all the participants have approved the final conclusions. The authors acknowledge that the publication and diffusion of guidelines do not suffice to achieve the recommended changes in diagnostic or therapeutic strategies, and plan suitable interventions overcoming knowledge, attitude and behavioural barriers, preventing both physicians and patients from effectively adhering to guideline recommendations. Arq Bras Endocrinol Metab. 2014;58(3):205-25

Consenso latinoamericano de hipertensión en pacientes con diabetes tipo 2 y síndrome metabólico

The present document has been prepared by a group of experts, members of Cardiology, Endocrinology, Internal Medicine, Nephrology and Diabetes societies of Latin American countries, to serve as a guide to physicians taking care of patients with diabetes, hypertension and comorbidities or complications of both conditions. Although the concept of metabolic syndrome is currently disputed, the higher prevalence in Latin America of that cluster of metabolic alterations has suggested that metabolic syndrome is useful nosography entity in the context of Latin American medicine. Therefore, in the present document, particular attention is paid to this syndrome in order to alert physicians on a particular high- risk population, usually underestimated and undertreated. These recommendations results from presentation and debates by discussion panels during a 2-day conference held in Bucaramanga, in October 2012, and all the participants have approved the final conclusions. The authors acknowledge that the publication and diffusion of guidelines do not suffice to achieve the recommended changes in diagnostic or therapeutic strategies, and plan suitable interventions overcoming both physicians and patients from effectively adhering to guideline recommendations.