Prevalence and risk factors of systemic atherosclerosis disease
DOI:
https://doi.org/10.51481/amc.v56i1.824Keywords:
Atheromatous vascular disease, risk factors, cerebrovascular disease, peripheral artery disease, coronary artery diseaseAbstract
Background: The purpose of this study is to determine the prevalence and risk factors of polyvascular disease in ambulatory patients older than 50 years, attending the outpatient clinic of the Neurology Department in a tertiary care center.
Methods: It is a transversal study which included a sample of all patients, 50 years and older, attending the outpatient clinic of the Neurology Department of the Calderon Guardia Hospital between February and March 2011. Demographic, clinical and biological backgrounds (including waist circumference) were collected. The ankle-brachial index (ABI) was used to determine peripheral artery disease.
Results: 124 patients were selected (57.7% men). The mean age of the group was 68.6 years (CI 95%:66.6-70.7). In the case of 66.9% of patients, they presented atheromatous disease in at least one vascular territory. Polyvascular disease was present in 32% of patients from the sample (2 or 3 territories were affected). The risk factors for atheromatosis in the study's population were hypertension in 71.7%, dyslipidemia in 62.3%, diabetes mellitus in 32.8%, smoking in 37%, and obesity in 17.5% of patients. The data collected for waist circumference showed an incidence for obesity in 27% of men and 69.6% of women. The multivariate logistic regression analysis identified significant differences in the prevalence of risk factors among subgroups in the sample. Risk factor control was inadequate in 41% of patients with hypertension and in 39% of patients with dyslipidemia. As to diabetics, 40% of them did not receive any treatment for their condition.
Conclusions: The risk factors for atherosclerosis found in the sample were hypertension, diabetes and dyslipidemia. Systemic atherosclerosis or polyvascular disease was present in 30% of patients. Also, an inadequate control and follow-up of this population was observed.
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References
Tendera I, Aboyans V, Bartelink M, Baumgartner I, Clement D, Collet J.P, et al. ESC Guidelines on the diagnosis and treatment of peripheral artery diseases. Eur Heart J 2011; 32: 2851-2906.
Steg G, Deepak L.B, Wilson P, D'Agostino R, Ohman M, Rother J, et al. One-Year Cardiovascular Event Rates in Outpatients With Atherothrombosis. JAMA 2007; 297:1197-1206.
Bhatt DL, Steg PG, Ohman EM, Hirsch A, Goto Shinya, Mahoney E., ScD et al. The Reduction of Atherothrombosis for Continued Health (REACH) Registry: an international, prospective, observational investigation in subjects at risk for atherothrombotic events-study design. Am Heart J 2006; 151:180 -189.
Bhatt Deepak L, Eagle K, Ohman E. M, Hirsch A, Goto S, Mahoney E et al. Comparative Determinants of 4-Year Cardiovascular Event Rates in Stable Outpatients at Risk of or With Atherothrombosis. JAMA 2010; 304:1350-1357.
Roger V, Go A, M. Lloyd-Jones D, Adams R et al. Robert J. Adams, Jarett D. American Heart Association Heart Disease and Stroke Statistics—2011.Circulation 2011,123:e18-e209.
Quirós G, Salazar J, Castillo J. Atención de los pacientes con enfermedad arterial periférica en los hospitales de la Caja Costarricense del Seguro Social. AMC 2011; 53:181-187.
Huelmos A, Jiménez J, Guijarro C, Belinchon JC, Puras E, Sánchez C, et al. Enfermedad arterial periférica desconocida en pacientes con síndrome coronario agudo: prevalencia y patrón diferencial de los factores de riesgo cardiovascular tradicional y emergente. Rev Esp Cardiol 2005; 58:1403-1410.
Goessens BM, Visseren FL, Algra A, Banga JD Van der Graaf Y. Screening for asymptomatic cardiovascular disease with noninvasive imaging in patients at high-risk and low-risk according to the European Guidelines on Cardiovascular Disease Prevention: the SMART study. J Vasc Surg 2006; 43:525-532.
D'Agostino R.B, Pencina M, Massaro J, Coady S. Cardiovascular Disease Risk Assessment: Insights from Framingham. Global Heart 2013; 8:11-23.
Criqui MH, Vargas V, Denenberg JO, Ho E, Allison M, Langer RD, Gamst A, Bundens WP, Fronek A. Ethnicity and peripheral arterial disease: the San Diego Population Study. Circulation 2005; 112: 2703-2707.
Diehm C, Schuster A, Allenberg JR, Darius H,Haberl R, Lange S, et al. High prevalence of peripheral arterial disease and comorbidity in 6880 primary care patients: cross-sectional study. Atherosclerosis 2004; 172:95-105.
Herder M, Johnsen SH, Arntzen KA, Mathiesen EB. Risk factors for progression of carotid intima-media thickness and total plaque area: a 13-year follow-up study: the Tromsø Study. Stroke 2012 Jul; 43:1818-23.
Rundek T, Blanton S, Bartels S. Traditional Risk Factors Are Not Major Contributors to the Variance in Carotid Intima-Media Thickness. STROKEAHA.111.000745v1.
Aquino E, Barreto S, Bensenor et al. Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): Objectives and Design. Am J Epidemiol 2012; 175:315-324.
Meijer WT, Hoes AW, Rutgers D, Bots ML, Hofman A, Grobbee DE. Peripheral arterial disease in the elderly: the Rotterdam Study. Arterioscler Thromb Vasc Biol 1998; 18:185-192.
Kuo F, Gardener H, Dong C. Traditional Cardiovascular Risk Factors Explain the Minority of the Variability in Carotid Plaque. Stroke 2012; 43:1755-1760.
AACE Lipid and Atherosclerosis Guidelines, Endocr Pract. 2012; 18 (Suppl 1)
Aboyans V, Criqui MH. The epidemiology of peripheral arterial disease in Robert Dieter (ed): Peripheral arterial disease.New York: McGraw Hill 2009: pp1-25.
Reiner Z, Catapano A, De Backer G, Graham I, Taskinen MR, Wiklund O, Agewall S, Alegria E, Chapman MJ, Durrington P, Erdine S, Halcox J, Hobbs R, Kjekshus J, Perrone Filardi P, Riccardi G, Storey RF, Wood D. ESC/EAS Guidelines for the managemeint of dyslipidaemias. Eur Heart J 2011; 32:1769-1818.
L. Bertoia, Pai J, Lee J. Oxidation-Specific Biomarkers and Risk of Peripheral Artery Disease. J Am Coll Cardiol 2013; 61:21692179.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of The National Cholesterol Education Program (NCEP).
Hayashi C, Ogawa O, Kubo S, Mitsuhashi N, Onuma T, Kawamori R. Ankle brachial pressure index and carotid intimamedia thickness as atherosclerosis markers in Japanese diabetics. Diabetes Res Clin Pract 2004; 66:269-275.
Lanktree MB, Hegele RA, Schork NJ, Spence JD. Extremes of unexplained variation as a phenotype: an efficient approach for genome-wide association studies of cardiovascular disease. Circ Cardiovasc Genet. 2010; 3:215-221.
Spence JD, Eliasziw M, DiCicco M, Hackam DG, Galil R, Lohmann T. Carotid plaque area: a tool for targeting and evaluating vascular preventive therapy. Stroke. 2002;33:2916 -2922.
Johnsen SH, Mathiesen EB, Joakimsen O, Stensland E, Wilsgaard T, Lochen ML, et al. Carotid atherosclerosis is a stronger predictor of myocardial infarction in women than in men: a 6-year follow-up study of 6226 persons: the Tromso study. Stroke. 2007;38:2873- 2880.
World Health Organization. 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Non- Communicable Diseases. Geneva, Switerland: World Health Organization; 2009.
Diehm C, Schuster A, Allenberg JR, Darius H, Haberl R, Lange S, et al. High prevalence of peripheral arterial disease and comorbidity in 6880 primary care patients: cross-sectional study. Atherosclerosis 2004; 172:95-105.
Mostaza JM, Vicente I, Cairols M, Castillo J, González-Juanatey JR, Pomar JL, et al. Índice tobillo-brazo y riesgo cardiovascular. Med Clin (Barc) 2003;121:68-73.
Ferket BS, Spronk S, Hunink MG. Systematic review of guidelines on peripheral artery disease screening. Am J Med. 2012;125:198208.
Roman M, Kizer J, Best L. Vascular Biomarkers in the Prediction of Clinical Cardiovascular Disease:The Strong Heart Study. Hypertension 2012;59:29-35.
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