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The General Practitioner's role in diagnosing and monitoring the pacients with rheumatoid arthritis (RA) is not very well established in Romania. RA, a chronic inflammatory disease with a progressive evolution, systemic symptoms and severe disfunctions, decreases the quality of life, leading to early retiring and the descrease of life expectancy with 5 to 10 years. Establishing PRE-RA (Personalized Risk Estimator for Rheumatoid Arthritis) for first degree relatives of the RA affected patients, according to age, gender, family history and risk behavior, allows the prevention and the delay of the disese. Some preventing measures are the following: giving up smoking, mediteranean diet, weigh control, statines therapy in order to descrese the cardiovascular risk, oral hygiene. RA begins with a prolonged asymptomatic period, characterized by the presence of asymptomatic smallairway disease, certain infections and inflammatory disease (gut, periodontium, genitourinary tract) or dysbiosis. We can find increased circulating disease specific autoantibodies or increased levels of cytokines and chemokines. A good knowledge of the first symptoms is very important for the general practitioner (GP) and could also help the rheumatologist to start the treatment immediately after the occuring of the disease. The GP could have a very important role together with the rheumatologist and the hole team in surveying the disease evolution and also the associated comorbidities, complications and possible opposite reactions to the treatment. The GP is also involved in the pacients' and their families' counciling, and his presence in the multidiscipinary teams increases the adherence, compliance and persistence to the therapy. [ABSTRACT FROM AUTHOR]

Metabolic syndrome is also called insulin resistance syndrome or catecholamine excess syndrome and is a cluster of cardiometabolic factors that result in increased incidence of cardiovascular disease and diabetes type 2. Due to sedentary lifestyle and hypercaloric diet with an increased content of saturated fat and carbohydrates that characterizes modern life style of the population, especially in urban areas, the prevalence of metabolic syndrome is increasing, thus becoming a very topical issue for the medical world. During the years 2013-2014 we conducted an observational study on a sample of 111 hypertensive patients without major cardiovascular events such as myocardial infarction or stroke, aged between 48 and 83 years, who have determined the prevalence of modern cardiovascular risk factors such as hs CRP, serum uric acid, 24-hour proteinuria, serum fibrinogen and the ratio of apo B/apo A1, associated with the metabolic syndrome. The study was conducted separately by gender in the sense that we followed prevalence of these modern risk factors associated with metabolic syndrome in both genders, women and men. We also watched the influence of risk factors related to lifestyle on metabolic syndrome. Finally, we determined the correlation of these factors with the risk of death from cardiovascular disease to observe their influence on the prognosis of metabolic syndrome. [ABSTRACT FROM AUTHOR]

The total cardiovascular risk of hypertensive patients is due to the simultaneous action of risk factors, hypertension-mediated target organ damage or to the presence of established cardiovascular disease. The clustering of cardiovascular risk factors which act simultaneously in patients with hypertension will cause a higher risk than the sum of individual risks due to their multiplicative effect in developing of the atherosclerosis process. This effect is particularly relevant in young patients apparently healthy with a low absolute risk and at who the presence of cardiovascular risk factors in high levels can hide an elevated relative risk of cardiovascular disease which makes as the intensive measures of lifestyle changes to achieve the control of risk factors over time, decreasing the risk of cardiovascular disease. During the years 2017-2018, we performed a retrospective observational study on 280 hypertensive patients, from who 123 patients (43.9%) got established cardiovascular disease called case and the other group called control consists of 157 patients (56.1%) without cardiovascular disease. The study showed that the number of cases with occurred cardiovascular disease has constantly exceeded the number of expected cases after clustering of at least six cardiovascular risk factors upwards, proving that the cardiovascular risk factors do not act individually but synergistically, which what has a multiplicative effect on process of atherosclerosis. [ABSTRACT FROM AUTHOR]