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2. COSMIC project: consensus on the objectives of the metabolic syndrome in clinic

Author

Pedro-Botet J, Ascaso JF, Barrios V, De la Sierra A, Escalada J, Millán J, Mostaza JM, Pérez-Martínez P, Pintó X, Salas-Salvadó J, and Valdivielso P

Subjects
cardiovascular prevention, diabetes prevention, insulin resistance, metabolic syndrome, obesity., Specialties of internal medicine, RC581-951
Abstract

Juan Pedro-Botet,1 Juan F Ascaso,2,3 Vivencio Barrios,4,5 Alejandro De la Sierra,6 Javier Escalada,7,8 Jesús Millán,9 Jose M Mostaza,10 Pablo Pérez-Martínez,8,11 Xavier Pintó,8,12 Jordi Salas-Salvadó,8,13 Pedro Valdivielso14 1Lipids and Vascular Risk Unit, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain; 2Endocrinology and Nutrition Service, Hospital Clínico, Universitat de Valencia, Valencia, Spain; 3INCLIVA Research Institute, Diabetes and Metabolic Diseases Ciber (Networked Biomedical Research Centres – CIBERDEM), Carlos III, Valencia, Spain; 4Cardiology Service, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain; 5Department of Medicine, Universidad Católica de Murcia (UCAM), Murcia, Spain; 6Internal Medicine Service, Hospital Mutua de Terrassa, Department of Medicine, Universidad de Barcelona, Spain; 7Department of Endocrinology and Nutrition, Clínica Universitaria de Navarra, IdiSNA; 8CIBEROBN “Physiopathology of Obesity and Nutrition”, Carlos III Health Institute, Spain; 9Lipid Unit, Department of Internal Medicine, Hospital Universitario General Gregorio Marañón, Universidad Complutense, Madrid, Spain; 10Lipid and Arteriosclerosis Unit, Internal Medicine Service, Hospital Carlos III, Madrid, Spain; 11Lipid and Arteriosclerosis Unit, Hospital Universitario Reina Sofía, IMIBIC/University of Cordoba, Cordoba, Spain; 12Lipids Unit, Department of Internal Medicine Hospital Universitario de Bellvitge, Universidad de Barcelona, Barcelona, Spain; 13Nutrition Unit, Hospital Universitari Sant Joan de Reus, Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili; 14Internal Medicine Service, Department of Medicine and Dermatology, Hospital Universitario Virgen de la Victoria, Málaga Biomedicine Institute (IBIMA), Universidad de Málaga, Málaga, Spain Abstract: Metabolic syndrome (MetS), a disorder with a high and growing prevalence, is a recognized risk factor for cardiovascular disease (CVD) and type 2 diabetes. It is a constellation of clinical and metabolic risk factors that include abdominal obesity, dyslipidemia, glucose intolerance, and hypertension. Unfortunately, MetS is typically underrecognized, and there is great heterogeneity in its management, which can hamper clinical decision-making and be a barrier to achieving the therapeutic goals of CVD and diabetes prevention. Although no single treatment for MetS as a whole currently exists, management should be targeted at treating the conditions contributing to it and possibly reversing the risk factors. All this justifies the need to develop recommendations that adapt existing knowledge to clinical practice in our healthcare system. In this regard, professionals from different scientific societies who are involved in the management of the different MetS components reviewed the available scientific evidence focused basically on therapeutic aspects of MetS and developed a consensus document to establish recommendations on therapeutic goals that facilitate their homogenization in clinical decision-making. Keywords: cardiovascular prevention, diabetes prevention, insulin resistance, hypertension, dyslipidemia, obesity

Published
2018

3. Which thiazide to choose as add-on therapy for hypertension?

Author

Barrios V and Escobar C

Subjects
Internal medicine, RC31-1245
Abstract

Vivencio Barrios,1 Carlos Escobar2 1Department of Cardiology, Hospital Ramon y Cajal, 2Department of Cardiology, Hospital La Paz, Madrid, Spain Abstract: Combined therapy is required in the majority of patients with hypertension to achieve blood pressure (BP) targets. Although different antihypertensive drugs can be combined, not all combinations are equally effective and safe. In this context, the combination of a renin angiotensin system inhibitor with a diuretic, usually a thiazide, particularly hydrochlorothiazide (HCTZ) or thiazide-like diuretics, such as chlorthalidone or indapamide, is recommended. However, not all diuretics are equal. Although HCTZ, chlorthalidone, and indapamide as add-on therapy effectively reduce BP levels, the majority of studies have obtained greater BP reductions with chlorthalidone or indapamide than with HCTZ. Moreover, there are data showing benefits with chlorthalidone or indapamide beyond BP. Thus, chlorthalidone seems to have pleiotropic effects beyond BP reduction. Moreover, compared with placebo, chlorthalidone has small effects on fasting glucose and total cholesterol, and compared with HCTZ, chlorthalidone achieves significantly lower total cholesterol and low-density lipoprotein cholesterol levels. Similarly, indapamide has demonstrated no negative impact on glucose or lipid metabolism. More importantly, although head-to-head clinical trials comparing the effects of indapamide or chlorthalidone with HCTZ are not available, indirect comparisons and post hoc analyses suggest that the use of chlorthalidone or indapamide is associated with a reduction in cardiovascular events. Despite this, the most frequent diuretic used in clinical practice as add-on therapy for hypertension is HCTZ. The purpose of this review is to update the published data on the efficacy and safety of HCTZ, chlorthalidone, and indapamide as add-on therapy in patients with hypertension. Keywords: blood pressure control, hydrochlorothiazide, thiazide-like diuretics, chlorthalidone, indapamide, combined therapy

Published
2014

4. Emerging drug combinations to optimize renovascular protection and blood pressure goals

Author

Escobar C, Echarri R, and Barrios V

Subjects
Diseases of the genitourinary system. Urology, RC870-923
Abstract

Carlos Escobar1, Rocio Echarri2, Vivencio Barrios31Department of Cardiology, Hospital Infanta Sofía, Madrid, Spain; 2Department of Nephrology, Hospital Infanta Sofía, Madrid, Spain; 3Department of Cardiology, Hospital Ramón y Cajal, Madrid, SpainAbstract: Hypertension and renal disease are closely related. In fact, there is an inverse linear relationship between renal function and prevalence of hypertension. Hypertensive patients with renal dysfunction exhibit a poor clinical profile, which markedly increases their risk for cardiovascular outcomes. This review considers the available evidence on the best therapeutic approach for optimizing renovascular protection in the hypertensive population. To effectively reduce or at least slow the establishment and progression of renal disease in the hypertensive population it is critical to reach blood pressure targets. Many studies have shown that angiotensin-converting enzyme inhibitors and angiotensin receptor blockers prevent or at least delay the development of microalbuminuria in patients with hypertension and type 2 diabetes, reduce the incidence of overt diabetic nephropathy, and are also beneficial in patients with nondiabetic renal disease. Therefore, renin-angiotensin system (RAS) inhibition plays a key role in the prevention of renal outcomes. As the majority of patients with hypertension will need at least two antihypertensive agents to achieve blood pressure goals, the use of RAS inhibitors is a mandatory part of antihypertensive therapy. The question of which antihypertensive agent is the best choice for combining with RAS blockers should be considered. Many studies have shown that diuretics and calcium channel blockers are the best choice. However, more studies are needed to clarify the subgroups of patients who will benefit more from a combination with a diuretic or from a combination with a calcium channel blocker. To date, RAS inhibitors recommended in this context are angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Aliskiren, the first oral direct renin inhibitor available, has shown promising results.Keywords: antihypertensive drugs, renin-angiotensin system, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, combined therapy

Published
2012

12. Evaluation of prophylaxis in primary prevention with acetylsalicylic acid in people with diabetes: A scoping review

Author

Ruiz-García, A., Pallarés-Carratalá, V., Serrano-Cumplido, A., Escobar-Cervantes, C., Barquilla-García, A., Divisón-Garrote, J.A., Turégano-Yedro, M., Prieto-Díaz, M.A., Cinza-Sanjurjo, S., Alonso-Moreno, F.J., Beato-Fernández, P., García-Matarín, L., Rey-Aldana, D., Martín-Rioboó, E., Moyá-Amengual, A., Crespo-Sabarís, R., Piera-Carbonell, A., Romero-Vigara, J.C., Carrasco-Carrasco, E., Velilla-Zancada, S., Seoane-Vicente, M.C., Górriz-Teruel, J.L., Polo-García, J., and Barrios, V.

Published
2022
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14. Comprehensive management of risk factors in peripheral vascular disease. Expert consensus

Author

Aicart Bort, Mª Dolores, Almagro Múgica, Fátima, Arrarte Esteban, Vicente Ignacio, Ayala Vigueras, Isabel, Barquilla García, Alfonso, Bellido Castañeda, Virginia, Berenguel Senén, Alejandro, Blanco Echevarría, Agustín, Botana López, Manuel Antonio, Brea Hernando, Ángel, Brito Banfiel, Miguel, Calsina Juscafresa, Laura, Cánovas Molina, María Gloria, Carbayo Herencia, Julio Antonio, Carrasco Carrasco, Eduardo, Carro, Amelia, Casañas Martínez, Marta, Castilla-Guerra, Luis, Cepeda Rodrigo, José María, Cinza-Sanjurjo, Sergio, Clarà, Albert, Comas Samper, José Manuel, Cordero, Alberto, Cosin Sales, Juan, de Juan Bagudá, Javier, de la Fuente, Natalia, Delgado, Elías, Doiz Artázcoz, Esther, Durán Martínez, María, Escalada, Javier, Escobar Cervantes, Carlos, Escribano Pardo, Daniel, Estallo Laliena, Luis, Félix Redondo, Francisco Javier, Fernández Pardo, Jacinto, Rodriguez-Lacin, Jose María Fernández, Ferrer García, Juan Carlos, Frías Vargas, Manuel, Galarza Tapia, Andrés, García León, Andrés, García Lerín, Aurora, García-Martín, Lisardo, Gargallo Fernández, Manuel, Gil, Inés Gil, Girbés Borrás, Juan, Guerra Requena, Mercedes, Guijarro Herraiz, Carlos, Hernández Martínez, Antonio Miguel, Hevia, Sergio, Ibarretxe Gerediaga, Daiana, Iborra Ortega, Elena, Jansen Chaparro, Sergio, Jarauta Simón, Estíbaliz, Jericó Alba, Carlos, Jiménez Muñoz, Beatriz, Lahoz, Carlos, Leiva Hernando, Luis, León Mazorra, Magdalena, López Valverde, María Eugenia, Lorente Calvo, Rosario, Martín Cañuelo, Jorge Jesús, Martínez Hervas, Sergio, Martínez López, María Ángeles, Masmiquel, Luis, Matía Cubillo, Ángel Carlos, Medina Falcón, Agustín, Merino Lanza, Esther, Morales-Pérez, Francisco M., Morata Barrado, Pilar Caridad, Moreno-Pérez, Óscar, Morillas Bueno, Miren, Mosquera Lozano, Jose Daniel, Muñiz Grijalvo, Ovidio, Muñoz Rivas, Núria, Navas de Solís, María Soledad, Obaya Rebollar, Juan Carlos, Ortega, Emilio, Pallarés-Carratalá, Vicente, Párraga Martínez, Ignacio, Pascual Fuster, Vicente, Peinado Adiego, Carmen, Pereira López, Eva María, Pérez Lázaro, M. Antonia, Pérez Pérez, Antonio, Pinés Corrales, Pedro J., Polo García, Jose, Prieto Díaz, Miguel Ángel, Quindimil Vázquez, José Antonio, Rama Martínez, Teresa, Reyes García, Rebeca, Ripoll Vera, Tomás, Rodilla Sala, Enrique, Rodríguez Piñero, Manuel, de Buruaga, Víctor Rodríguez Sáenz, Ruiz García, Antonio, Ruiz Ortiz, Martín, Ruiz Palomar, José Manuel, Saltijeral Cerezo, Adriana, Álvarez, Julio Sánchez, Ortiga, Ruth Sánchez, Sánchez-Hernández, Rosa María, Santos Altozano, Carlos, Seoane Vicente, Maria, Suárez Tembra, Manuel, Tejera Pérez, Cristina, Toledo Frías, Pablo Antonio, Turégano Yedro, Miguel, Valdivielso, Pedro, Valls-Roca, Francisco, de Ceniga, Melina Vega, Velasco Valdazo, Elisa, Vidal-Pérez, Rafael, Zamora Cervantes, Alberto, Barrios, V., Beato, P., Brotons, C., Campuzano, R., Merino-Torres, J.F., Mostaza, J.M., Plana, N., Rubio, J.A., and Comellas, M.

Published
2022
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23. Glomerulonefritis focal y segmentaria post COVID-19 en una paciente lúpica

Author

Vizcarra Vizcarra, Cristhian, Chávez Barrios, V., Taco Flores, M., Chávez Velásquez, E., Sumire, Julia, Vizcarra Vizcarra, Cristhian, Chávez Barrios, V., Taco Flores, M., Chávez Velásquez, E., and Sumire, Julia

Abstract

We present the case of a 29-year-old woman, with a diagnosis of chronic kidney disease, systemic lupus erythematosus without lupus nephritis criteria, who developed SARS-COV-2 infection, and had acute kidney injury, requiring dialysis. Renal biopsy showed focal segmental glomerulosclerosis, perihilar variant, and evidence of advanced sclerosis. However, renal function recovered several months later, without immunosuppression, so the glomerular damage and acute kidney injury were considered to be secondary to the COVID-19 infection. Since focal and segmental glomerulosclerosis occurred in patients with COVID-19, but its association was infrequent in patients who also had systemic lupus erythematosus, this case is reported., Presentamos el caso de una mujer de 29 años con diagnóstico de enfermedad renal crónica, lupus eritematoso sistémico, sin criterios de nefritis lúpica, quien desarrolló infección por SARS–COV–2, y cursó con injuria renal aguda, requiriendo diálisis. La biopsia renal mostró glomeruloesclerosis focal y segmentaria, variante perihiliar y evidencia de esclerosis avanzada. Sin embargo, recuperó función renal varios meses después, sin inmunosupresión, por lo que se consideró que el daño glomerular y la injuria renal aguda fueron secundarios a la infección por COVID–19. Dado que la glomeruloesclerosis focal y segmentaria, se presentó en pacientes con COVID–19, pero fue infrecuente su asociación en pacientes que, además tuvieron lupus eritematoso sistémico, se reporta este caso.

Published
2024

42. EE498 Cost of Follow-Up After an Ischemic Cerebrovascular Event in Patients With Atherosclerotic Cardiovascular Disease in Spain: Results from the Reality Study

Author

Castellanos, M, primary, Games, JM, additional, Mostaza, JM, additional, Egocheaga, I, additional, Gomez Cerezo, J, additional, Campuzano, R, additional, Pallares, V, additional, Barrios, V, additional, Morant Talamante, N, additional, Sicras-Mainar, A, additional, Pérez Román, I, additional, Rodriguez Barrios, JM, additional, Parrondo García, FJ, additional, and Martinez, I, additional

Published
2022
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43. EE636 Cost of Follow-Up After a Peripheral Arterial Event in Patients With Atherosclerotic Cardiovascular Disease in Spain: Results From the Reality Study

Author

Egocheaga, I, primary, Games, JM, additional, Barrios, V, additional, Martinez, I, additional, Mostaza, JM, additional, Gomez Cerezo, J, additional, Castellanos, M, additional, Campuzano, R, additional, Morant Talamante, N, additional, Rodriguez Barrios, JM, additional, Sicras-Mainar, A, additional, Pérez Román, I, additional, Parrondo García, FJ, additional, and Pallares, V, additional

Published
2022
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44. EE637 Cost of Follow-Up in Patients With Heterozygous Familial Hypercholesterolemia in Spain: Results From the Reality Study

Author

Mostaza, JM, primary, Martinez, I, additional, Games, JM, additional, Pallares, V, additional, Campuzano, R, additional, Egocheaga, I, additional, Castellanos, M, additional, Gomez Cerezo, J, additional, Morant Talamante, N, additional, Rodriguez Barrios, JM, additional, Sicras-Mainar, A, additional, Pérez Román, I, additional, Parrondo García, FJ, additional, and Barrios, V, additional

Published
2022
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45. EE84 Cost of Follow-Up After an Ischemic Heart Disease Event in Patients With Atherosclerotic Cardiovascular Disease in Spain: Results From the Reality Study

Author

Martinez, I, primary, Barrios, V, additional, Pallares, V, additional, Campuzano, R, additional, Castellanos, M, additional, Gomez Cerezo, J, additional, Egocheaga, I, additional, Games, JM, additional, Morant Talamante, N, additional, Rodriguez Barrios, JM, additional, Sicras-Mainar, A, additional, Pérez Román, I, additional, Parrondo García, FJ, additional, and Mostaza, JM, additional

Published
2022
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46. Preliminary results from REALITY: a nation-wide study of a database with 1.8 million real-life patients to study atherosclerotic cardiovascular disease and familial hypercholesterolemia in Spain

Author

Campuzano, R, primary, Barrios, V, additional, Mostaza, J M, additional, Egocheaga, I, additional, Perez Roman, I, additional, Martinez Lopez, A, additional, Sicras-Mainar, A, additional, Morant Talamante, N, additional, Parrondo, J, additional, Gomez Cerezo, J F, additional, Pallares, V, additional, Martinez Lopez, I, additional, Castellanos, M, additional, and Gamez, J M, additional

Published
2022
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47. The REALITY project: analysis of a national database with 1.8 million real-life patients to study atherosclerotic cardiovascular disease and familial hypercholesterolemia in Spain

Author

Barrios, V, primary, Campuzano, R, additional, Egocheaga, I, additional, Martinez Lopez, I, additional, Castellanos, M, additional, Perez Roman, I, additional, Martinez Lopez, A, additional, Sicras-Mainar, A, additional, Morant Talamante, N, additional, Parrondo, J, additional, Mostaza, J M, additional, Gomez Cerezo, J F, additional, Gamez, J M, additional, and Pallares, V, additional

Published
2022
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49. Association of the KDIGO Risk Classification with the Prevalence of Heart Failure in Patients with Type 2 Diabetes

Author

Gimeno-Orna, J.A., Rodríguez-Padial, L., Anguita-Sánchez, M., Barrios, V., Muñiz, J., Pérez Pérez, Antonio, Universitat Autònoma de Barcelona, [Gimeno-Orna,JA] Endocrinology and Nutrition Service, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain. [Rodríguez-Padial,L] Cardiology Service, Complejo Hospitalario de Toledo, Toledo, Spain. [Anguita-Sánchez,M] Cardiology Service, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica (IMIBIC), Universidad de Córdoba, Córdoba, Spain. [Barrios,V] Cardiology Service, Hospital Universitario Ramón y Cajal, Madrid, Spain. [Muñiz,J] Coruña University, Cardiovascular Research Group, Health Sciences Department and Biomedic Research Institute de A Coruña (INIBIC), CIBERCV, A Coruña, Spain. [Pérez,A] Endocrinology and Nutrition Service and Research Institute (IIB Sant Pau) of the Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Barcelona, Spain., and This research was funded by the Spanish Society of Diabetes (SED) and the Spanish Society of Cardiology (SEC).

Subjects
medicine.medical_specialty, Multivariate analysis, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Analysis of Variance::Multivariate Analysis [Medical Subject Headings], heart failure, Heart failure, Type 2 diabetes, Logistic regression, Riesgo, KDIGO risk category, Article, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Enfermedades renales, cardiovascular disease, Internal medicine, Phenomena and Processes::Circulatory and Respiratory Physiological Phenomena::Cardiovascular Physiological Phenomena::Hemodynamics::Blood Pressure [Medical Subject Headings], medicine, Diseases::Respiratory Tract Diseases::Respiration Disorders::Apnea::Sleep Apnea Syndromes::Sleep Apnea, Obstructive [Medical Subject Headings], Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Hemeproteins::Globins::Hemoglobins [Medical Subject Headings], In patient, Phenomena and Processes::Mathematical Concepts::Probability::Odds Ratio [Medical Subject Headings], Diseases::Male Urogenital Diseases::Urologic Diseases::Kidney Diseases::Renal Insufficiency::Renal Insufficiency, Chronic [Medical Subject Headings], business.industry, Insuficiencia cardíaca, Diseases::Endocrine System Diseases::Diabetes Mellitus::Diabetes Mellitus, Type 2 [Medical Subject Headings], Diseases::Cardiovascular Diseases::Heart Diseases::Heart Failure [Medical Subject Headings], General Medicine, Odds ratio, medicine.disease, Cardiovascular disease, Diabetes mellitus tipo 2, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Ultrasonography::Echocardiography [Medical Subject Headings], Information Science::Information Science::Data Collection::Vital Statistics::Morbidity::Prevalence [Medical Subject Headings], Medicine, Observational study, type 2 diabetes, Enfermedades cardiovasculares, Resultado del tratamiento, business, Kidney disease
Abstract

The objectives of this study were to determine the main characteristics associated with the presence of heart failure (HF) in patients with type 2 diabetes (T2DM), and specifically to assess the association of the risk classification proposed by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines with HF. The DIABET-IC study is a multicentre, observational, prospective and analytical study in T2DM patients recruited in Spanish hospitals. This work, which features a cross-sectional design, has been conducted with the data obtained at the inclusion visit. The main dependent variable analysed was the presence of HF. The predictive variables evaluated were the demography, clinic, laboratory testing (including natriuretic peptides) and echocardiography. Patients were classified according to the number of vascular territories with atherosclerotic involvement and the KDIGO risk category. Multivariate logistic regression models were performed to determine the risk posed by the various baseline variables to present HF at the time of study inclusion. The study included 1517 patients from 58 hospitals, with a mean age of 67.3 (standard deviation (SD): 10) years, out of which 33% were women. The mean DM duration was 14 (SD: 11) years. The prevalence of HF was 37%. In a multivariate analysis, the independent predictors of HF were increased age (odds ratio (OR) per 1 year = 1.02, p = 0.006), decreased systolic blood pressure (OR per 1 mmHg = 0.98, p &lt, 0.001), decreased haemoglobin (OR per 1 g/dL = 0.86, 0.001), the presence of obstructive sleep apnoea (OR = 1.61, p = 0.006), the absence of hepatic steatosis (OR = 0.59, p = 0.016), the severity of atherosclerotic involvement (OR 1 territory = 1.38 and OR &gt, 1 territory = 2.39, p = 0.02 and p &lt, 0.001 respectively) and the KDIGO risk classification (high-risk OR = 2.46 and very high-risk OR = 3.39, 0.001 for both). The KDIGO risk classification is useful to screen for the presence of HF in T2DM patients. Therefore, we believe that it is necessary to carry out a systematic screening for HF in the high- and very high-risk KDIGO categories.

Published
2021

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