Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2015;68:417-25 - Vol. 68 Num.05 DOI: 10.1016/j.rec.2014.05.023

Estimating Cardiovascular Risk in Spain by the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice

Antonio Jesús Amor a, Luis Masana b, Federico Soriguer c,d, Albert Goday e, Alfonso Calle-Pascual f, Sonia Gaztambide c,g, Gemma Rojo-Martínez c,d, Sergio Valdés c,d, Ramón Gomis a,c, Emilio Ortega a,c,

a Servicio de Endocrinología y Nutrición, Hospital Clínic, IDIBAPS, Barcelona, Spain
b Unidad de Medicina Vascular y Metabolismo, Hospital Universitario Sant Joan de Reus, Universidad Rovira i Virgili, Reus, Tarragona, Spain
c Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
d Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Málaga, Spain
e Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, Spain
f Servicio de Endocrinología y Nutrición, Hospital Universitario San Carlos , Madrid, Spain
g Grupo de Investigación de Diabetes, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain

Keywords

Cardiovascular risk. European Guidelines on Cardiovascular Disease Prevention in Clinical Practice. Systematic Coronary Risk Evaluation. Framingham-Registre Gironí del Cor.

Abstract

Introduction and objectives

There are no nationwide, population-based studies in Spain assessing overall cardiovascular risk. We aimed to describe cardiovascular risk and achievement of treatment goals following the 2012 European Guidelines on cardiovascular disease prevention strategy. We also investigated clinical characteristics (non-classical risk factors) associated with moderate risk.

Methods

Participants (n = 2310, 58% women) aged 40 to 65 years from a national population-based study (Di@bet.es Study) were identified. First, a priori high/very-high risk individuals were identified. Next, total cardiovascular risk (Systematic Coronary Risk Evaluation equation including high-density lipoprotein cholesterol) was used to assess risk of a priori non-high risk individuals. Variables independently associated with moderate versus low-risk were investigated by multiple logistic regression analysis.

Results

Age-and-sex standardized (direct method) percentages of high/very-high, moderate, and low-risk were 22.8%, 43.5%, and 33.7%, respectively. Most men were at moderate (56.2%), while 55.4% of women were at low risk. Low-density lipoprotein cholesterol (< 70, < 100, < 115 mg/dL) and blood pressure (<140/90 mmHg) goals for very-high, high and moderate risk were met in 15%, 26% and 46%, and 77%, 68% and 85% of the individuals, respectively. Body mass index, high triglycerides concentrations, diastolic blood pressure, and low Mediterranean diet adherence (in women) were independently associated with moderate (versus low) risk.

Conclusions

Cardiovascular risk in Spain is mainly moderate in men and low in women. Achievement of treatment goals in high-risk individuals should be improved. The prevalence of non-classical cardiovascular risk factors is elevated in subjects at moderate risk, an important aspect to consider in a population-based strategy to decrease cardiovascular disease in the most prevalent group.

1885-5857/© 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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