Forés Rosa, Alzamora María Teresa, Pera Guillem, Valverde Marta, Angla Maria, Baena-Díez José Miguel, Mundet-Tuduri Xavier
Centro de Salud Riu Nord-Riu Sud, Institut Català de la Salut, Santa Coloma de Gramenet, Barcelona, España; Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España; Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, España.
Centro de Salud Riu Nord-Riu Sud, Institut Català de la Salut, Santa Coloma de Gramenet, Barcelona, España; Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Barcelona, España; Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, España.
Med Clin (Barc). 2017 Feb 9;148(3):107-113. doi: 10.1016/j.medcli.2016.09.043. Epub 2016 Nov 25.
Although cardiovascular risk factors (CVRF) are well known, their degree of control is not optimal. The aim of this study is to assess the evolution and control of CVRFs after 5 years of monitoring a population-based cohort and their association with the incidence of peripheral arterial disease (PAD).
Prospective cohort study recruited between 2006-2008. Second phase between 2011-2012. An ankle brachial index was determined for all participants in both phases. Demographic variables, CVRF and previous cardiovascular events, blood pressure, total cholesterol and its fractions (HDL, LDL), triglycerides, glucose and glycosylated hemoglobin levels in diabetic patients and the cardiovascular risk score according to the REGICOR table were recorded.
A total of 2,125 individuals were analyzed. We observed an increase in the prevalence of hypertension (HT) (15.4%), diabetes (DM) (8.2%) and hypercholesterolemia (20.4%), with no changes in obesity and smoking. The cardiovascular risk determined on the basis of the REGICOR table remained at around 5.5%. We observed an increased control of CVRF throughout the follow-up period, except in the case of DM and obesity. In the multivariate analysis, uncontrolled HT 2-folded the risk of onset of PAD (odds ratio [OR] 2.3; 95% confidence interval [95% CI] 1.3-4.1), whereas smoking 5-folded this risk (OR 5.0; 95% CI 2.5-10.2).
Smoking and uncontrolled HT increase the risk of onset of PAD in this population. Despite the increase in drug treatments, the control of CVRFs continues to be suboptimal.
尽管心血管危险因素（CVRF）广为人知，但其控制程度并不理想。本研究的目的是评估对一个基于人群的队列进行5年监测后CVRF的演变与控制情况，以及它们与外周动脉疾病（PAD）发病率的关联。
前瞻性队列研究于2006年至2008年招募对象。2011年至2012年为第二阶段。在两个阶段均对所有参与者测定踝臂指数。记录人口统计学变量、CVRF及既往心血管事件、血压、总胆固醇及其组分（高密度脂蛋白、低密度脂蛋白）、甘油三酯、糖尿病患者的血糖和糖化血红蛋白水平，以及根据REGICOR表计算的心血管风险评分。
共分析了2125名个体。我们观察到高血压（HT）患病率增加（15.4%）、糖尿病（DM）患病率增加（8.2%）和高胆固醇血症患病率增加（20.4%），肥胖和吸烟情况无变化。基于REGICOR表确定的心血管风险保持在5.5%左右。我们观察到在整个随访期间CVRF的控制有所改善，但糖尿病和肥胖情况除外。在多变量分析中，未控制的HT使PAD发病风险增加2倍（比值比[OR] 2.3；95%置信区间[95% CI] 1.3 - 4.1），而吸烟使该风险增加5倍（OR 5.0；95% CI 2.5 - 10.2）。
在该人群中，吸烟和未控制的HT增加了PAD发病风险。尽管药物治疗有所增加，但CVRF的控制仍不理想。
