Recomendaciones preventivas cardiovasculares. Actualización PAPPS 2018

Cuixart, Carlos Brotons; Sánchez, José Juan Alemán; Banegas, José R.; Leon, Carlos F. Mendes de; Lobos-Bejarano, José María; Rioboó, Enrique Martín; Pérez, Jorge Navarro; Orozco‐Beltrán, Domingo; Álvarez, Fernando

doi:10.1016/s0212-6567(18)30360-3

Cited by 24 publications

(17 citation statements)

References 198 publications

(179 reference statements)

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“…It has demonstrated that being an active smoker, having a sedentary lifestyle, being an excessive alcohol drinker or being overweight or obesity is significantly associated with a greater likelihood of having an acute stroke in patients aged 75 years or below, while a personal history of HBP increase the risk of having an acute cerebrovascular event in patients more than 75 years. These results are in line with other international studies [6,8,11,13,17]. In Spain, the prevalence of the main stroke RFs is high: 50.3% of the subjects have high apolipoproteins levels, 47.4% HBP, 29.7% sedentary lifestyle, 28.2% abdominal obesity, 19% DM, and 18% was an active smoker [20].…”

Section: Discussionsupporting

confidence: 90%

“…In this study, stroke RFs are distributed similarly to other studies, with some differences, which may be due to the characteristics of the sample analyzed or cultural components [6,17,20]. The IBERICAN project, a longitudinal study focused on cardiovascular RFs in Spanish adults treated in primary health care, has shown that its prevalence is increasing in the last years due to its low control [20].…”

Section: Discussionmentioning

confidence: 61%

“…Other data on sex, HBP, DM, dyslipidemia, overweight/obesity, cardiovascular disease, active smoking, excessive alcohol consumption, and sedentary lifestyle were collected. For the analysis and evaluation of the stroke RFs, the criteria defined by the INTERSTROKE project [5,6] and the Program of Preventive Activities and Health Promotion of the Spanish Society of Family and Community Medicine (PAPPS-SEMFYC) [17,18] were used. Patients were considered to be hypertensive if they had systolic (SBP) or diastolic blood pressure (DBP) of more than 140 mmHg or 90 mmHg, respectively, and/or were taking antihypertensive drugs.…”

Section: Methodsmentioning

confidence: 99%

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Age-Related Risk Factors at the First Stroke Event

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González-Bernal

González‐Santos

et al. 2020

JCM

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(1) Background: Stroke is a multifactorial disease, which can affect individuals at any age. Risk factors (RFs) associated with the first stroke event have been well identified; however, the influence of these RFs on the patient´s age needs to be studied. (2) Objective: This study aimed to examine the effect of modifiable RFs on the age at which a stroke occurs. (3) Methods: A cross-sectional study was conducted on patients admitted consecutively with a first-ever acute stroke at the Burgos University Hospital (Spain). Data on sociodemographic and clinical parameters were collected (high blood pressure (HBP), smoking habit, diabetes mellitus (DM), dyslipemia, abdominal obesity, sedentary lifestyle, alcohol consumption, and cardiovascular diseases). The possible associations between RFs and age were studied using univariate and multivariate regression analyses and a decision tree. (4) Results: A total of 436 patients with a mean age of 75.39 years (standard deviation (SD) ± 12.67) were included. HBP and overweight/obesity were the most prevalent stroke RFs. Being an active smoker (OR 21.48; 95% confidence interval (CI) 8.80–52.41), having a sedentary lifestyle (OR 3.24; 95% CI 1.97–5.31), being an excessive alcohol drinker (OR 2.36; 95% CI 1.45–3.84), or being overweight or obese (OR 1.95; 95% CI 1.14–3.34) increased the risk of having an acute cerebrovascular event in individuals aged 75 years or below. However, a personal history of HBP (OR 0.40; 95% CI 0.24–0.67) was significantly associated with a greater likelihood of having an acute stroke in individuals aged more than 75 years. (5) Conclusions: This study showed that the modifiable RFs strongly influence the first stroke event in patients aged below 75 years, which will be useful in guiding different prevention strategies.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 61%

Section: Methodsmentioning

confidence: 99%

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Age-Related Risk Factors at the First Stroke Event

Soto-Cámara

González-Bernal

González‐Santos

et al. 2020

JCM

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“…Although the follow-up, screening and vaccination indicators of the EQA are based on scientifically proven actions with numerous benefits [18,19], these are neither urgent nor vital actions which must be carried out in the short term. It is therefore understandable that they be postponed for some time and is consistent with what has happened in other countries [20,21].…”

Section: Follow-up Control Screening and Vaccination Indicatorsmentioning

confidence: 99%

Primary care in the time of COVID-19: monitoring the effect of the pandemic and the lockdown measures on 34 quality of care indicators calculated for 288 primary care practices covering about 6 million people in Catalonia

et al. 2020

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Background To analyse the impact of the COVID-19 epidemic and the lockdown measures on the follow-up and control of chronic diseases in primary care. Methods Retrospective study in 288 primary care practices (PCP) of the Catalan Institute of Health. We analysed the results of 34 indicators of the Healthcare quality standard (EQA), comprising different types: treatment (4), follow-up (5), control (10), screening (7), vaccinations (4) and quaternary prevention (4). For each PCP, we calculated each indicator’s percentage of change in February, March and April 2020 respective to the results of the previous month; and used the T-Student test for paired data to compare them with the percentage of change in the same month of the previous year. We defined indicators with a negative effect those with a greater negative change or a lesser positive change in 2020 in comparison to 2019; and indicators with a positive effect those with a greater positive change or a lesser negative change. Results We observed a negative effect on 85% of the EQA indicators in March and 68% in April. 90% of the control indicators had a negative effect, highlighting the control of LDL cholesterol with a reduction of − 2.69% (95%CI − 3.17% to − 2.23%) in March and − 3.41% (95%CI − 3.82% to − 3.01%) in April; and the control of blood pressure with a reduction of − 2.13% (95%CI − 2.34% to − 1.9%) and − 2.59% (95%CI − 2.8% to − 2.37%). The indicators with the greatest negative effect were those of screening, such as the indicator of diabetic foot screening with a negative effect of − 2.86% (95%CI − 3.33% to − 2.39%) and − 4.13% (95%CI − 4.55% to − 3.71%) in March and April, respectively. Only one vaccination indicator, adult Measles-Mumps-Rubella vaccine, had a negative effect in both months. Finally, among the indicators of quaternary prevention, we observed negative effects in March and April although in that case a lower inadequacy that means better clinical outcome. Conclusions The COVID-19 epidemic and the lockdown measures have significantly reduced the results of the follow-up, control, screening and vaccination indicators for patients in primary care. On the other hand, the indicators for quaternary prevention have been strengthened and their results have improved.

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“…Socio-demographic information such as age, sex, civil status (married/living with a partner, single/widower), maximum educational level (no studies/primary, secondary/higher education), employment status (employed, unemployed), average yearly income (<EUR 20,000, ≥EUR 20.000), living situation (living in a household accompanied by at least two residents, living alone), and the area of residence (urban, rural), as well as clinical data (past medical history and stroke signs and symptoms) were collected. For the evaluation of the stroke RFs were used the criteria defined by the INTERSTROKE project [37,38] and the Program of Preventive Activities and Health Promotion of the Spanish Society of Family and Community Medicine (PAPPS-SEMFYC) [39,40]. Operative details and outcomes have been reported previously [28,29].…”

Section: Main Outcomesmentioning

confidence: 99%

Knowledge on Signs and Risk Factors in Stroke Patients

Soto-Cámara

González-Bernal

González‐Santos

et al. 2020

JCM

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Background: There is a pressing need to contribute evidence to the improvement in the early identification of signs and symptoms associated with strokes, and address the treatment-seeking delays. The objective of this study is to describe the knowledge regarding the warning signs and risk factors (RFs) among stroke patients, as well as of their attitudes toward a suspected event, and the analysis of its possible relationship with the socio-demographic and clinical characteristics of these patients. Method: A cross-sectional study was designed, in which all stroke patients admitted consecutively to the Burgos University Hospital (Spain) were included. The principal outcomes were the patient’s ability to identify two RFs and two warning signs and the patient’s hypothetical response to a possible stroke event. The possible factors associated with the knowledge of warning signs, RFs, and the correct response to a new event were studied using univariate and multivariate regression analysis. Results: A total of 529 patients were included. Having a higher education level or a history of prior stroke were associated with a greater degree of knowledge of warning signs (odds ratio (OR) 3.19, 95% confidence interval (CI) 1.70–5.74, p = 0.003; OR 3.54, 95%CI 2.09–5.99, p ≤ 0.001, respectively), RFs (OR 3.15, 95%CI 1.75–5.67, p = 0.008; OR 4.08, 95%CI 2.41–6.91, p = 0.002, respectively), and the correct response to a possible stroke (OR 1.82, 95%CI 1.16–2.86; p = 0.030; OR 2.11, 95%CI 1.29–3.46, p = 0.022, respectively). Conclusion: Knowledge of warning signs or stroke RFs is low in the hospitalized patients. A previous stroke or secondary/higher education levels are the predictor factors that increase the probability of knowledge of warning signs, RFs, or reaction to possible event.

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Recomendaciones preventivas cardiovasculares. Actualización PAPPS 2018

Cited by 24 publications

References 198 publications

Age-Related Risk Factors at the First Stroke Event

Age-Related Risk Factors at the First Stroke Event

Primary care in the time of COVID-19: monitoring the effect of the pandemic and the lockdown measures on 34 quality of care indicators calculated for 288 primary care practices covering about 6 million people in Catalonia

Knowledge on Signs and Risk Factors in Stroke Patients

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