Introduction and objectives: Heart failure (HF) is a major health problem that causes high mortality and hospitalization rates. This study aims to determine the HF prevalence rates in populations aged both ≥18 years and ≥50 years and to assess its association with cardiovascular diseases and chronic kidney disease. Methods: A cross-sectional observational study was conducted in a primary care setting, with a population-based random sample of 6588 people aged 18.0–102.8 years. Crude and adjusted prevalence rates of HF were calculated. The associations of renal and cardiometabolic factors with HF were assessed in both populations using univariate, bivariate and multivariate analysis. Results: The HF crude prevalence rates were 2.8% (95%CI: 2.4–3.2) in adults (≥18 years), and 4.6% (95%CI: 4.0–5.3) in the population aged ≥ 50 years, without significant differences between males and females in both populations. The age- and sex-adjusted prevalence rates were 2.1% (male: 1.9%; female: 2.3%) in the overall adult population, and 4.5% (male: 4.2%; female: 4.8%) in the population aged ≥ 50 years, reaching 10.0% in the population aged ≥ 70 years. Atrial fibrillation, hypertension, low estimated glomerular filtration rate (eGFR), coronary heart disease (CHD), stroke, sedentary lifestyle, and diabetes were independently associated with HF in both populations. A total of 95.7% (95%CI: 92.7–98.6) of the population with HF had an elevated cardiovascular risk. Conclusions: This study reports that HF prevalence increases from 4.5% in the population over 50 years to 10% in the population over 70 years. The main clinical conditions that are HF-related are sedentary lifestyle, atrial fibrillation, hypertension, diabetes, low eGFR, stroke, and CHD.
IntroductionElevated pulse pressure (ePP) is an independent marker of cardiovascular risk (CVR) in people older than 60, and a functional marker of subclinical target organ damage (sTOD) which can predict cardiovascular events in patients with hypertension (HTN), regardless of sTOD.ObjectiveTo evaluate the prevalence of ePP in adult population seen in primary care and its association with other vascular risk factors, sTOD and with cardiovascular disease (CVD).Materials and methodsObservational multicentre study conducted in Spain (8,066 patients, 54.5% women) from the prospective cohort study IBERICAN recruited in Primary Care. Pulse pressure (PP) was defined as the difference between the systolic blood pressure (SBP) and the diastolic blood pressure (DBP) ≥60 mmHg. Adjusted (for age and sex) ePP prevalence were determined. Bivariate and multivariate analyses of the possible variables associated with ePP were carried out.ResultsThe mean of PP was 52.35 mmHg, and was significantly higher (p < 0.001) in patients with HTN (56.58 vs. 48.45 mmHg) The prevalence of ePP adjusted for age and sex was 23.54% (25.40% men vs. 21.75% women; p < 0.0001). The ePP prevalence rates increased linearly with age (R2 = 0.979) and were significantly more frequent in population aged ≥65 than in population aged <65 (45.47% vs. 20.98%; p < 0.001). HTN, left ventricular hypertrophy, low estimated glomerular filtration rate, alcohol consumption, abdominal obesity, and CVD were independently associated with ePP. 66.27% of patients with ePP had a high or very high CVR, as compared with 36.57% of patients without ePP (OR: 3.41 [95% CI 3.08–3.77]).ConclusionsThe ePP was present in a quarter of our sample, and it was increased with the age. Also, the ePP was more frequent in men, patients with HTN, other TOD (as left ventricular hypertrophy or low estimated glomerular filtration rate) and CVD; because of this, the ePP was associated a higher cardiovascular risk. In our opinion, the ePP is an importer risk marker and its early identification lets to improve better diagnostic and therapeutic management.
Los relatos de tesoros y naufragios han despertado siempre la curiosidad de los lectores. En esa línea de fascinación, este libro aborda la historia del navío mercante de registro Nuestra Señora del Buen Consejo y San Leopoldo, apodado Oriflame, una embarcación del siglo XVIII que navegó por el Mediterráneo, el Atlántico y el Pacífico entre 1744 y 1770. A partir de una rigurosa labor de documentación histórica, centrada especialmente en el Archivo General de Indias de Sevilla, el Archivo General de Simancas y el Archivo Histórico Provincial de Cádiz, su autor reconstruye la historia completa del navío, desde su fabricación hasta su hundimiento en extrañas circunstancias frente a las costas de Chile, con el fin de dar a conocer un extraordinario tesoro cultural sumergido. De esta historia central surgen pequeños relatos colaterales que nos permiten adentrarnos en las rutas comerciales de la Carrera de Indias, en la América colonial y la España de la Ilustración. Se trata, pues, de una obra que nos adentrará en el fascinante mundo de la arqueología subacuática y de la investigación histórica para descubrir un yacimiento arqueológico sin precedentes que esconde un tesoro por el que se ha desatado una encarnizada batalla judicial.
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