L. Álvarez-Sala

Estudio PREVENCAT: control del riesgo cardiovascular en atención primaria

Fundamento y objetivo: Muchos estudios de factores de riesgo cardiovascular (FRCV) realizados en nuestro medio se centran en solo uno. El estudio PREVENCAT se diseno para estimar el control de los principales FRCV en poblacion asistida en atencion primaria que presenta hipertension arterial (HTA), diabetes mellitus tipo 2 (DM-2) y/o hipercolesterolemia (HC) y para conocer la prevalencia de sindrome metabolico en estos pacientes. Pacientes y metodo: Estudio multicentrico, transversal, en pacientes con HTA, DM-2 y/o HC, reclutados de forma consecutiva por medicos de atencion primaria en Espana. Se evaluaron la presion arterial, el colesterol, la glucemia basal, la obesidad, el tabaquismo y el ejercicio fisico, y se estimaron el grado de control de estos FRCV y la prevalencia del sindrome metabolico. Resultados: Se incluyo en el estudio a 2.649 pacientes (un 51,6% mujeres) con una media (desviacion estandar) de edad de 64 (11,3) anos de edad. El diagnostico mas frecuente fue la HTA (78,9%), seguido de HC (58,4%) y de DM-2 (37,4%). En toda la muestra, el porcentaje de pacientes que tenia bien controlada o basalmente normal la presion arterial, el colesterol y la glucemia basal fue del 40,0% (intervalo de confianza [IC] del 95%, 38,2-41,9), del 42,6% (IC del 95%, 40,5-44,7) y del 62,7% (IC del 95%, 60,8-64,5), respectivamente. El 15,6% de los casos (IC del 95%, 14,3-17,0) tenia un indice de masa corporal menor o igual a 25 kg/m2, el 87,5% no fumaba en la actualidad (IC del 95%, 86,2-88,8) y el 46,2% practicaba ejercicio fisico regular (IC del 95%, 44,3-48,1). El 40% de los pacientes presentaba 2 o menos FRCV bien controlados. La prevalencia del sindrome metabolico fue del 50,6% (IC del 95%, 48,7-52,5). Conclusiones: El control de los FRCV considerados en poblacion atendida en atencion primaria es insuficiente. Apenas uno de cada 2 pacientes con HTA, DM-2 o HC esta controlado. El control del sobrepeso y el sedentarismo es aun peor.BACKGROUND AND OBJECTIVE Most studies of cardiovascular risk factors (CVRF) conducted in our environment concentrate in a single CVRF. The PREVENCAT study was designed to estimate the control of CVRF in the population attended in primary care presenting arterial hypertension (HT), type 2 diabetes mellitus (DM2) and/or hypercholesterolemia (HC) as well as to assess the prevalence of Metabolic Syndrome in these patients. PATIENTS AND METHOD Multicenter, cross-sectional study, in patients with HT, DM2 and/or HC, consecutively recruited by primary care physicians in Spain. The blood pressure, cholesterol, basal glycaemia, obesity, smoking and physical activity were assessed. The degree of control of these CVRF and the prevalence of MS were estimated. RESULTS 2,649 patients were recruited, aged 64 (11.3) years, with a 51.6% of women. The most frequent diagnosis was HT (78.9%), followed by HC (58.4%) and DM2 (37.4%). In the whole sample, the percentages of patients who had a control or had initially normal values of blood pressure, cholesterol and basal glycemia were 40.0% (confidence interval [CI], 95% 38.2-41.9), 42.6% (95% CI, 40.5-44.7) and 62.7% (95% CI, 60.8-64.5), respectively. 15.6% of cases (95% CI, 14.3-17.0) had body mass index < or = 25 kg/m2; 87.5% were non-current smokers (95% CI, 86.2-88.8); and 46.2% practiced regular physical activity (95% CI, 44.3-48.1). 40% of patients had < or = 2 CVRF in good control. The prevalence of metabolic syndrome was 50.6% (95% CI, 48.7-52.5). CONCLUSIONS The control of the CVRF considered in primary care attended population is insufficient. Hardly one of each 2 patients with HT, DM2 and HC is under control. The overweight and sedentarism control is still poorer.

Guía Europea de Prevención Cardiovascular en la Práctica Clínica: adaptación Española del CEIPC 2008

espanolPresentamos la adaptacion espanola del Comite Espanol lnterdisciplinario para la Prevencion Cardiovascular (CEIPC) 2008 de la Guia Europea de Prevencion Cardiovascular (IV Cuarto Grupo de Trabajo Conjunto de la ESC y otras sociedades). Esta guia se centra en la prevencion de la enfermedad cardiovascular en su conjunto, incluyendo las distintas manifestaciones clinicas (coronaria, cerebrovascular, periferica y otras) y mantiene la recomendacion del modelo SCORE de bajo riesgo en la poblacion espanola para la valoracion del riesgo cardiovascular global, con un punto de corte en el 5% para definir alto riesgo. El objetivo es prevenir la mortalidad y morbilidad debidas a las ECV, mediante la prevencion y el manejo adecuado de sus factores de riesgo en la practica clinica. Se enfatiza la prevencion primaria basada en la modificacion de los habitos y estilos de vida, buscando o manteniendo el perfil de las personas sanas. Se requiere una intervencion profesional adecuada y duradera, generalmente multidisciplinar, para que la poblacion y los pacientes en riesgo incrementen su actividad fisica, sigan una alimentacion saludable y abandonen el tabaco si son fumadores. Respecto a las guias previas, se subraya el papel del medico y enfermeria de Atencion Primaria, por su proximidad y accesibilidad en los cuidados e intervenciones preventivas y en la promocion de un estilo de vida cardiosaludable. La decision de iniciar el tratamiento para reducir la presion arterial dependera de sus valores, del riesgo cardiovascular y de la existencia o no de lesiones de organos diana o ECV asociada. La meta terapeutica es, en general, PA EnglishWe are pleased to present the Spanish adaptation from the Spanish Committee for Cardiovascular Disease Prevention (CEIPC) of the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice (IV Joint Task Force of the European Society of Cardiology and Other Societies). This guide is focused on the prevention of cardiovascular disease (CVD) as a whole, including coronary, cerebrovascular, periphery and others, recommending the SCORE model for risk assessment with a 5% threshold for the definition of high-risk. We empathize the need of primary prevention based on lifestyle changes included stop smoking, suitable nutrition and diary physical exercise, with the focus on the health people. The objective is to prevent premature mortality and morbidity due to CVD by means of dealing with its related risk factors in clinical practice. A maintained and multidisciplinary professional intervention is required in order to obtain an increase of physical activity, healthy alimentation and smoking cessation in smokers, to the general population and individuals at risk. The decision to start blood pressure treatment will depend upon the BP values, cardiovascular risk and possible damage to target organs or definite CVD. The treatment goal is to achieve BPThe present CEIPC Spanish adaptation of the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice 2008. This guide recommends the SCORE model for risk evaluation. The aim is to prevent premature mortality and morbidity due to CVD by means of dealing with its related risk factors in clinical practice. The guide focuses on primary prevention and emphasizes the role of the nurses and primary care doctors in promoting a healthy life style, based on increasing physical activity, changing dietary habits, and not smoking. The therapeutic goal is to achieve a Blood Pressure < 140/90 mmHg, but in patients with diabetes, chronic kidney disease, or definite CVD, the objective is < 130/80 mmHg. Serum cholesterol should be < 200 mg/dl and cLDL < 130 mg/dl, although in patients with CVD or diabetes, the objective is < 100 mg/dl (80 mg/dl if feasible in very high-risk patients). Patients with type 2 diabetes and those with metabolic syndrome must lose weight and increase their physical activity, and drugs must be administered whenever applicable, with the objective guided by body mass index and waist circumference. In diabetic type 2 patients, the objective is glycated haemoglobin < 7%. Allowing people to know the guides and developing implementation programs, identifying barriers and seeking solutions for them, are priorities for the CEIPC in order to put the recommendations into practice.

Adaptación española de la Guía Europea de Prevención Cardivascular

We are pleased to present the European Guidelines on Cardiovascular Disease Prevention, translated and adapted by the Interdisciplinary Spanish Committee for Cardiovascular Disease Prevention. This guide is focused on the prevention of cardiovascular disease as a whole, recommending the SCORE model for risk assessment and placing priority on the care of patients and high-risk individuals. The objective is to prevent premature death due to CVD by means of dealing with its related risk factors in clinical practice. Hence, a maintained professional intervention is required in order to obtain an increase of physical activity and of healthy diets in patients high-risk individuals, and smoking cessation in smokers. The decision to start blood pressure treatment will depend upon the BP values, cardiovascular risk and possible damage to target organs. The treatment goal is to achieve BP <140/90 mmHg, but among patients with diabetes, chronic kidney disease, a past history of ictus, coronary heart disease or heart failure, lower levels must be pursued. Serum cholesterol must be below 200 mg/dl and LDL cholesterol below 130 mg/dl, although among patients with CVD or diabetes, levels respectively below 175 mg/dl and 100 mg/dl must be pursued. Advice of a professional dietitian is always required in order to keep blood sugar levels controlled. Proper insulin therapy is required in Type I diabetes. Patients with Type II diabetes and those with metabolic syndrome must lose weight and increase their physical activity, drugs being administered wherever applicable. Lastly, an appendix is included providing diet recommendations adapted to our environment and criteria related to referral or seeing a specialist for hypertensive or dyslipemic patients.

Site of Mitochondrial Reactive Oxygen Species Production in Skeletal Muscle of Chronic Obstructive Pulmonary Disease and Its Relationship with Exercise Oxidative Stress

Exercise triggers skeletal muscle oxidative stress in patients with chronic obstructive pulmonary disease (COPD). The objective of this research was to study the specific sites of reactive oxygen species (ROS) production in mitochondria isolated from skeletal muscle of patients with COPD and its relationship with local oxidative stress induced by exercise. Vastus lateralis biopsies were obtained in 16 patients with COPD (66 ± 10 yr; FEV(1), 54 ± 12% ref) and in 14 control subjects with normal lung function who required surgery because of lung cancer (65 ± 7 yr; FEV(1), 91 ± 14% ref) at rest and after exercise. In these biopsies we isolated mitochondria and mitochondrial membrane fragments and determined in vitro mitochondrial oxygen consumption (Mit

Características clínicas de los pacientes con hipertrigliceridemia remitidos a las Unidades de Lípidos: registro de hipertrigliceridemias de la Sociedad Española de Arteriosclerosis

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Protective Effects of Cilastatin against Vancomycin-Induced Nephrotoxicity

o(2)) and ROS production before and after inhibition of complex I (rotenone), complex II (stigmatellin), and complex III (antimycin-A). We related the in vitro ROS production during state 3 respiration), which mostly corresponds to the mitochondria respiratory state during exercise, with skeletal muscle oxidative stress after exercise, as measured by thiobarbituric acid reactive substances.State 3 Mit

The effects of adiponectin and leptin on human endothelial cell proliferation: a live-cell study.

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