Clínica e Investigación en Arteriosclerosis (English Edition)最新文献

Introduction

Excess weight is a major health problem. Aims of this study were to determine the prevalence rates of overweight and obesity, and to compare their associations with cardiometabolic and renal risk factors between obese and non-obese populations, and between overweight and non-overweight populations.

Methods

Cross-sectional observational study conducted in Primary Care. Population-based random sample: 6588 study subjects between 18 and 102 years of age (response rate: 66%). Crude and sex- and age-adjusted prevalence rates of overweight and obesity were calculated, and their associations with cardiometabolic and renal variables were assessed by bivariate and multivariate analysis.

Results

The age- and sex-adjusted prevalence rates of overweight and obesity were 36.0% (42.1% in men; 33.1% in women) and 25.0% (26.2% in men; 24.5% in women), respectively. These prevalences increased with age, and were higher in men than in women. Fifty-two percent (95%CI: 50.0–53.9) of the overweight population and 62.3% (95%CI: 60.1–64.5) of the obese population had a high or very high cardiovascular risk. Abdominal obesity, physical inactivity, prediabetes, hypertension, hypertriglyceridemia, and low HDL-C were independently associated with both entities. Furthermore, diabetes was independently associated with overweight and hypercholesterolemia with obesity.

Conclusions

The prevalence of overweight and obesity was 61.0% (68.4% in men and 59.0% in women). More than half of the overweight population and nearly two-thirds of the obese population had a high cardiovascular risk. Hyperglycemia, physical inactivity, hypertension, hypercholesterolemia, low HDL-C, and hypertriglyceridemia were independently associated with overweight and obesity.

Smoking remains the leading cause of morbidity and mortality worldwide. Because of its clear influence on cardiovascular and respiratory diseases, it is an important factor in internal medicine consultations. Although the rate of smoking cessation has been increasing in recent years, there is a percentage of patients who continue to smoke because they are unable or unwilling to quit, despite having tried existing pharmacological and non-pharmacological therapies. For this group of patients there are strategies based on interventions aimed at reducing the negative effects of smoking without the need for complete cessation. In this review it is shown that due to the absence of combustion of organic matter in conventional cigarettes, snus, e-cigarettes and heated tobacco products generate significantly lower levels of toxic substances.

Introduction

Clinical studies show that patients at elevated cardiovascular risk are still far from reaching therapeutic targets, especially for LDL-C levels. It is not known whether these patients are managed differently in specialised units than in other settings.

Patients and methods

Sixty-one certified lipid units certified in the Dyslipidaemia Registry of the Spanish SVociety of Arteriosclerosis were selected for collection of the study data. We included 3958 subjects >18 years of age who met the criteria of hypercholesterolaemia (LDL cholesterol ≥160 mg/dl or non-HDL cholesterol ≥190 mg/dl) without familial hypercholesterolaemia. A total of 1665 subjects were studied with a mean follow-up of 4.2 years.

Results and conclusions

A total of 42 subjects had a cardiovascular event since they were included in the Registry, which is .6%. There were no differences in the treatment used at the start of follow-up between subjects with and without a prospective event. LDL-C improved during follow-up but 50% of the patients had not achieved the therapeutic targets at the final follow-up visit. Increased used of high- potency lipid-lowering therapy, including PCSK9 inhibitors, was observed in 16.7% of the subjects with recurrence.

Background and objectives

Vitamin D (vitD) participates in phospho-calcium metabolism and exerts multiple pleiotropic effects. There is tissue 1-α (OH)ase that converts 25-OH cholecalciferol (25 (OH) D) in calcitriol that exerts autocrine and paracrine effects. 25 (OH)D deficiency could limit these tissue effects of vitD. The administration of nutritional vitD and the activator of the vitD receptor, paricalcitol, may promote beneficial effects on vascular and renal function. The objective of this work was to study in subjects with chronic kidney disease (CKD) the effect that the administration of different forms of vitD has on arterial function and albuminuria, and the possible relationship between the modifications of these variables.

Patients and methods

We studied in 97 patients with CKD stages 3–4 the effect of the administration of cholecalciferol (group 2; n: 35) and paricalcitol (n: 31; group 3) on parameters derived from brachial blood pressure, aortic blood pressure and on aortic stiffness studied using carotid-femoral pulse velocity (Vp_c-f), and on albuminuria. A group of patients with stages 3–4 CKD who did not receive vitD therapy served as a control group (n: 31; group 1). All parameters were studied at baseline and after the follow-up period which was 7 ± 2 months.

Results

In the baseline phase, no differences were observed between the groups in brachial systolic blood pressure (bSBP), central systolic blood pressure (SBP), brachial pulse pressure (bPP), and central pulse pressure (pCP) or in aortic stiffness that was increased in all groups with a baseline Vp_c-f value of 10.5 (9.2–12.1) m/sec. The baseline albuminuria value in the grouped patients was 229 (43–876) mg/g (median (interquartile range)), with no differences between the groups.

Serum calcium and phosphorus increased significantly in those treated with cholecal-ciferol (native vitD) and paricalcitol (active vitD). Parathormone (PTH) values ​​decreased in those treated with paricalcitol. bPP and cPP decreased in all groups treated with native and active vitD. No significant changes in bPP and cPP were observed in the control group.

Vp_c-f did not change significantly in any of the groups, although the variation was quantitatively greater in group 3 (11.2 ± 2 vs. 10.7 ± 1.6 (p:0.06)). No differences were observed in the changes in Vp_c-f between the groups when adjusted to the baseline values ​​of estimated glomerular filtration rate (eGFR), albuminuria, PTH, vitD, brachial and central blood pressure parameters, and their changes with treatment.

Those who received treatment with native and active vitD pr