Search

Background and Objective: Obesity is a major and independent cardiovascular risk factor. The aim of this study was to know overweight and obesity distribution in a sample of Spanish high systemic pressure patients (CORONARIA study), the risk factors associated and the calculated cardiovascular risk (CR) that the overweight produces., Material and Method: 1,720 family physicians included 7,087 hypertensive patients with at least another CR factor associated. Patients were classified depending on their body mass index: its value was < 25 kg/m2 in 1,150 patients; > or = 25 and < 30 kg/m2 in 3,724 (overweight); and > or = 30 kg/m2 in 2,213 patients (obesity)., Results: 83.7% of patients showed overweight or obesity; and 36.1% of women included were obese. Overweight was significantly more prevalent in the hypertensive population of Andalucía, Murcia, Canarias and Extremadura, and less frequent than the Spanish mean in Catalonia and Asturias. Hypertensive and obese patients showed higher prevalence of diabetes than normal weight patients (34.3% vs 24%); higher levels of triglycerides; high values of systemic pressure; and lower levels of high density lipoproteins-cholesterol; all these facts raised the CR, calculated value between a 19.7% in the overweight cases and a 11.6% in the obese patients compared with normal weight patients. Heart failure was two times more prevalent in obese patients., Conclusions: Overweight in hypertensive patients raises the cardiovascular risk by 20%, and has a strong association with diabetes and heart failure.

Background and Objective: Diabetes mellitus is a prevalent disease with high cardiovascular mortality. Treatment of risk factors can reduce the associated cardiovascular risk. The CORONARIA study included 7253 patients with high risk systemic hypertension from different regions of Spain. The aim of this study was to analyze the cardiovascular risk (CR) of diabetic patients at baseline and after one-year follow-up., Patients and Method: A total of 2105 (29%) patients with type 2 diabetes and systemic hypertension are included in the CORONARIA study. The CR profile is evaluated at baseline and after treatment of systemic hypertension with amlodipine (5-10 mg), while other cardiovascular risk factors were also treated. Data were compared with non diabetics., Results: Patients with systemic hypertension in Spain show a very high prevalence of diabetes (29%); it is higher in women than men (p<0.05) and higher in secondary prevention than primary prevention (p<0.05). Prevalence diabetes was higher in Murcia, Andalucía, Extremadura and Comunidad Valenciana, and lower in Madrid and País Vasco than the Spanish mean. The CR in primary prevention was significantly higher in diabetics than in non-diabetics (female: 22.9% vs 12.3% in Framingham, and 10.1% vs 5.2% in REGICOR; male: 39.9% vs 27.8% in Framingham and 15.7% vs 10.3% in REGICOR). After one year treatment, cardiovascular risk decreased significantly in both groups of patients, but it did more in diabetics (Framingham: -11.6% vs -6.7%; REGICOR: -5.3% vs -2.8%)., Conclusions: Most patients with diabetes and systemic hypertension did not have an adequate control of CR factors and presented a high cardiovascular risk. Treatment reduced the CR significantly in a greater proportion of diabetic than non diabetic-patients.

Introduction and Objectives: Calculation of cardiovascular risk in populations allows for developing and assessing of intervention programs and adapting health resources. While the Framingham System has been used in the past, a group of European researchers have proposed a different method called the Score project. The purpose of this paper is to compare the value of both methods for assessing cardiovascular risk., Methods: In 6,775 evaluable hypertensive patients distributed over the 17 Spanish autonomous communities (ACs), the 10-year risk of experiencing a coronary event (CR) was calculated using the Framingham equation, while risk of coronary death (RCD) and vascular death (RVD) was calculated using the Score project system, both at baseline and after one year of blood pressure control with amlodipine at the required dose. A comparison was made of the capacity to detect risk differences by both methods between populations with known different risks, and in the same population as a result of blood pressure control., Results: Both the Score and the Framingham systems detected the significant decrease in both CR and RCD or RVD at one year of application of the CORONARIA study protocol. Risk decrease measured by any of the two methods was significant (p < 0.05) overall, by genders, and by ACs. However, the Score System, unlike the Framingham system, could not detect the reported differences in the mortality risk for coronary and vascular disease between the ACs of the North and the South-East parts of Spain.

Objective: Evaluation of the effect of amlodipine on the hospitalizations for cardiovascular events (CVE) and their associated costs in patients with ischemic cardiopathy., Methods: Data from the multicenter, randomized, double-blind, placebo-controlled PREVENT (Prospective Randomized Evaluation of the Vascular Effects of Norvasc Trial) clinical trial were utilized. A tree-type model of decision was used in order to analyze the incremental costs expected from the treatment with amlodipine with regard to placebo. Hospitalization costs were estimated with regard to the DRG weights of the American Medicare adapted for the costs of average stay available in our environment., Results: Amlodipine reduced significantly the incidence of CVE that required hospitalization in contrast to placebo; 0.60 +/- 1.16 versus 0.77 +/- 1.31 (average +/- SD), p < 0.05. The expected direct expenses due to hospitalizations were higher in the placebo group than in the amlodipine group (saving of 205.76 Euro/patient). Total cost for patient in the amlodipine group was 1,723.52 Euro while in the placebo group was 1,929.28 Euro. When the relation cost/price shifted in the sensitivity analysis from 1.20 to 0.66 (cost of every hospitalization ranged between + 20% and -34%), the saving fluctuated from 330.56 Euro to 0. Accordingly, the breakeven point of the cost/price relation it is 0.66, and above this the treatment with amlodipine still generates savings in regard to its cost., Conclusions: Amlodipine is cost-effective in the treatment of the patients with ischemic cardiopathy, being able to reduce the hospital costs related to ischemic episodes in this type of patients.