Marcelo Fernández

Association between cardiorespiratory fitness and cardiovascular risk factors in healthy individuals

BACKGROUND Cardio respiratory fitness (FIT) is associated with a better profile in most modifiable cardiovascular risk factors (RF). In Chile, sedentary lifestyle is highly prevalent, reaching almost 90%. AIM To determine the association between FIT and traditional and emergent RF in a primary prevention population. MATERIAL AND METHODS We prospectively studied 1973 subjects (36% women, mean age 56+/- 13 years) without history of cardiovascular disease and absence of ischemic changes on exercise testing. We assessed cardiovascular RF and determined body mass index (BMI), waist circumference, systolic and diastolic blood pressure, fasting blood lipids, glucose, C-reactive protein (CRP) and fibrinogen. FIT was measured by a Sci f-reported physical activity questionnaire and by a maximal treadmill exercise test, expressed in metabolic equivalents (METs). RESULTS Subjects in the highest FIT according to the treadmill test had significantly lower BMI, waist circumference, systolic and diastolic blood pressure, total cholesterol, triglycerides, glucose, CRP and fibrinogen, and higher HDL cholesterol (adjusted by age and gender). LDL cholesterol did not show significant changes. The same pattern of RF (including LDL cholesterol) and CRP was observed when using Sci f-reported physical activity as a FIT parameter There was a significant association between both methods to measure FIT (p <0.0001, Chi-square Mantel-Haenszel). CONCLUSIONS Our findings show that a better level off IT, assessed by exercise testing or through Sci f report is associated with improved levels of traditional and emergent RF.

Unidad de dolor torácico: primera experiencia en Chile

In large series, nearly 60% of admissions forsuspected acute coronary syndrome (ACS) had a non-coronary etiology of the pain. However,short term mortality of non recognized ACS patients, mistakenly discharged from the emergencyroom is at least twice greater than the expected if they would had been admitted. The concept ofa chest pain unit (CPU) is a methodological approach developed to address these issues.

Rehabilitación cardiovascular y ejercicio en prevención secundaria

Exercise and cardiac rehabilitation are indications with type I A evidence in most secondary cardiovascular prevention guidelines. Rehabilitation programs not only include exercise but also provide integral care and education about cardiovascular risk factors. However there is a paucity of such programs in Chile. Moreover there is a lack of awareness about the benefits of exercise and there is lack of knowledge about the details of exercise prescription in secondary prevention. Therefore, the divulgation of this knowledge is of utmost importance.

Body fat and its relationship with clustering of cardiovascular risk factors.

BACKGROUND Body mass index (BMI) and waist circumference (WC) are the most commonly measured anthropometric parameters given their association with cardiovascular risk factors (RFs). The relationship between percentage body fat (%BF) and cardiovascular risk has not been extensively studied. AIMS This study evaluated %BF and its relationship with cardiometabolic RFs in healthy subjects and compared these findings with the relationship between BMI/ WC and cardiovascular RFs. METHODS This was a cross-sectional study of 99 males and 83 females (mean age 38 ± 10 years) evaluated in a preventive cardiology program. All subjects completed a survey about RFs and lifestyle habits. Anthropometric parameters, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting lipid profile, and blood glucose were collected. Body fat was determined using four skinfold measurements. Fat mass index (FMI) was also calculated. RESULTS Percentage body fat was significantly and directly associated with total cholesterol (R(2)=0.11), triglycerides (R(2)=0.14), low-density lipoprotein cholesterol (R(2)=0.16), non-high-density lipoprotein cholesterol (R(2)=0.24), fasting blood glucose (R(2)=0.16), SBP (R(2)=0.22), and DBP (R(2)=0.13) (p<0.001 for all) and inversely related to high-density lipoprotein cholesterol (R(2)=0.32; p<0.001). When the models of %BF, FMI, WC, and BMI were compared, all of them were significantly related to the same cardiometabolic RFs and the clustering of them. CONCLUSION Percentage body fat and FMI were significantly associated with biochemical variables and to the clustering of RFs. However, these associations were similar but not better than WC and BMI.