Global cardiovascular risk on an elderly population in a rural area in Garabito, Puntarenas, Costa Rica
DOI:
https://doi.org/10.51481/amc.v57i3.888Keywords:
Cardiovascular risk factor, Framingham, elderlyAbstract
Purpose: To determine the global cardiovascular risk of an elderly population attending the Josefina Ugalde Day-care Center for the Elderly in Quebrada Ganado, Puntarenas, Costa Rica.
Methods: A prospective and analytical study of an elderly population that attends the day-care center. Between August 2012 and February 2014 demographic, clinical, biological and complementary studies were collected. The Framingham scale was used to determine cardiovascular risk.
Results: A total of 61 persons were studied (67% female), the mean age of this population was 75.7 years; there was no statistical difference regarding gender (p=0.199). Cardiovascular risk factor prevalence was as follows: hypertension 68%, altered abdominal circumference 59%, elevated LDL cholesterol 48%, low HDL cholesterol 39%, diabetes mellitus 37%, smoking 32% and prior cardiovascular events 18%. Patient follow-up at 12 and 18 months revealed a relevant reduction (p<0.001) in elevated LDL (32%) and abdominal circumference (40%). All other parameters remained unaltered. After 18 months, global cardiovascular risk was 14%, distributed as follows: 21.4% had low risk; 47.6% had moderate risk and 31% had high risk.
Conclusion: The classic risk factors for atherosclerotic disease are frequent and treated in a suboptimal manner in the population studied. This is associated with a high global cardiovascular risk.
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References
Instituto Nacional de Estadística y Censos (INEC). Indicadores demográficos: Boletín anual. Año 2015. Marzo 2014. http://www.inec.go.cr/A/ MT/Poblaci%C3%B3n%20 y%20Demograf%C3%ADa/ Indicadores%20 Demogr%C3%A1ficos/Publicaciones/C0/01-2013/Bolet%C3%ADn%20 de%20Indicadores%20Demogr%C3%A1ficos.pdf
2014 Framingham Heart Study. (based on D'Agostino, Vasan, Pencina, Wolf, Cobain, Massaro, Kannel. ‘A General Cardiovascular Risk Profile for Use in Primary Care: The Framingham Heart Study'). http://www. framinghamheartstudy.org/risk-functions/cardiovascular-disease/10-year-risk. php
Stone N, Robinson J, Lichtenstein A, Bairey Merz C. N. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. JACC 2014;63:2890-2932.
Laforest L, Ambegaonkar BM, Souchet T, Sazonov V, Van Ganse E. Mixed dyslipidemias in primary care patients in France. Vas Health Risk Manag 2012;8:247-54.
Mancia G, Fagard R, Narkiewicz K, Redon. Guía de práctica clínica de la ESH/ ESC 2013 para el manejo de la hipertensión arterial. Rev Esp Cardiol 2013; 66:880.1-64.
Preis SR, Pencina MJ, Mann Dm, D' Agostino RB Sr, Savage PJ, Fox CS. Eatly - adulthood Cardiovascular Disease Risk Factor Profiles Among Individuals With and Without Diabetes in The Framingham Heart Study. Diabetes Care 2013; 36:1590-6.
Nishimura R, Otto C, Bonow R, Carabello B l. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Practice Guidelines Report of the American College of Cardiology/American Heart Association Task Force. Circulation 2014;129:2440-2492.
Perk J, De Backer G, Gohlke H, Graham I. Guía europea sobre prevención de la enfermedad cardiovascular en la práctica clínica. Rev Esp Cardiol 2012; 65:937.e1-e66.
Reiner Z, Catapano A, De Backer G, Graham I. Guía de la ESC/EAS sobre el manejo de las dislipemias. Rev Esp Cardiol. 2011; 64:1168.1-60.
Masson W, Siniawski D, Krauss J, Cagide A. Aplicabilidad clínica de la función de Framingham a 30 años. Utilidad en la estratificación del riesgo cardiovascular y en el diagnóstico de placa aterosclerótica carotidea. Rev Esp Cardiol 2011; 64:305-11.
Machado Alba J, Machado Duque M. Prevalencia de factores de riesgo cardiovascular en pacientes con dislipidemia afiliados al sistema de salud en Colombia. Re Peru Med Exp Salud Publica 2013:30:205-11.
Gotto AM, Moon JE. Management of cardiovascular risk: the importance of meeting lipid targets. Am J Cardiol.2012;111:3 A-14 A.
Toth PP, Potter D, Ming EE. Prevalence of lipid abnormalities in the United States: the National Health and Nutrition Examination Survey 2003-2006. J Clin Lipidol 2012;35:604-10.
Gu SJ, Liu MM, Guo ZR, Wu M. Gene-gene interactions among PPAR polyporphiss for hypertriglyceridemia in Chinese Han Population. Gene .2013;515:272-6
Wu JY, Duan XY, Li L, Dai F. Dyslipidemia in Shangai, China. Prev Med.2010;51:412-5.
Feher M, Greener M, Munro N. Persistent hypertriglyceridemia in statin - treated patients with type 2 diabetes mellitus. Diabetes Metab Syndr Obes. 2013 ;6:11-5.
Bhatt Deepak L, Eagle K, Ohman E. M, Hirsch A. Comparative determinants of 4-Year cardiovascular event rates in outpatients with atherothrombosis. JAMA 2010; 304:1350-1357.
Quirós G, Salazar J, Castillo J. Atención de los pacientes con enfermedad arterial periférica en los hospitales de la Caja Costarricense de Seguro Social. AMC 2011;53:181-187.
Steg G, Deepak L.B, Wilson P, D' Agostino R. One-year cardiovascular event rates in outpatients with atherothrombosis. JAMA 2007; 297:1197-1206.
Roger V, Go A, M. Lloyd-Jones D, Adams R. American heart association heart disease and stroke statistics — 2011. Circulation 2011, 123:18-209.
Ferket BS, Spronk S, Hunink MG. Systematic review of guidelines on peripheral artery disease screening. Am J Med. 2012;125:198-208.
Roman M, Kizer J, Best L. Vascular Biomarkers in the Prediction of Clinical Cardiovascular Disease: The Strong Heart Study. Hypertension 2012;59: 29-35.
L. Bertoia, Pai J, Lee J. Oxidation-Specific Biomarkers and Risk of Peripheral Artery Disease. J Am Coll Cardiol 2013;61:2169-2179.
Tendera I, Aboyans V, Bartelink M, Baumgartner I, Clement D. ESC Guidelines on the diagnosis and treatment of peripheral artery diseases. Eur Heart J 2011; 32: 2851-2906.
Roger V, Go A, M. Lloyd-Jones D, Adams R. American Heart Association Heart Disease and Stroke Statistics - 2011.Circulation 2011, 123:18-209.
Quirós G, Salazar J, Castillo J. Prevalencia y factores de riesgo de ateroesclerosis en pacientes ambulatorios de un Servicio de Neurología. AMC 2014.53 :181187.
American Heart Association Guide for Improving Cardiovascular Health at the Community Level, 2013 update: a scientific statement for public health practitioners, healthcare providers, and health policy makers. Circulation 2013; 127: 1730-1753.
Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American Heart Association. Circulation 2012; 126: 1514-1563.
Ideal cardiovascular health predicts lower risks of myocardial infarction, stroke, and vascular death across whites, blacks, and hispanics: the northern Manhattan study. Circulation 2012; 125: 2975-2984.
Gómez L, Beltrán LR y García Puig J. Azúcar y enfermedades cardiovasculares.
Nutr Hosp 2013;28:88-94.
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