Lipid profile, cardiovascular disease and mortality in a Mediterranean high-risk population: The ESCARVAL-RISK study
Por:
Orozco D, Gil V, Redon J, Martin-Moreno JM, Pallares-Carratala V, Navarro-Perez J, Valls-Roca F, Sanchis-Domenech C, Fernandez-Gimenez A, Perez-Navarro A, Bertomeu-Martinez V, Bertomeu-Gonzalez V, Cordero A, Pascual de la Torre M, Trillo JL, Carratala-Munuera C, Pita-Fernandez S, Uso R, Durazo-Arvizu R, Cooper R, Sanz G, Castellano JM, Ascaso JF, Carmena R and Tellez-Plaza M
Publicada:
18 oct 2017
Resumen:
Introduction
The potential impact of targeting different components of an adverse lipid profile in populations with multiple cardiovascular risk factors is not completely clear. This study aims to assess the association between different components of the standard lipid profile with allcause mortality and hospitalization due to cardiovascular events in a high-risk population.
Methods
This prospective registry included high risk adults over 30 years old free of cardiovascular disease (2008-2012). Diagnosis of hypertension, dyslipidemia or diabetes mellitus was inclusion criterion. Lipid biomarkers were evaluated. Primary endpoints were all-cause mortality and hospital admission due to coronary heart disease or stroke. We estimated adjusted rate ratios (aRR), absolute risk differences and population attributable risk associated with adverse lipid profiles.
Results
51,462 subjects were included with a mean age of 62.6 years (47.6% men). During an average follow-up of 3.2 years, 919 deaths, 1666 hospitalizations for coronary heart disease and 1510 hospitalizations for stroke were recorded. The parameters that showed an increased rate for total mortality, coronary heart disease and stroke hospitalization were, respectively, low HDL-Cholesterol: aRR 1.25, 1.29 and 1.23; high Total/HDL-Cholesterol: aRR 1.22, 1.38 and 1.25; and high Triglycerides/HDL-Cholesterol: aRR 1.21, 1.30, 1.09. The parameters that showed highest population attributable risk (%) were, respectively, low HDL-Cholesterol: 7.70, 11.42, 8.40; high Total/HDL-Cholesterol: 6.55, 12.47, 8.73; and high Triglycerides/HDL-Cholesterol: 8.94, 15.09, 6.92.
Conclusions
In a population with cardiovascular risk factors, HDL-cholesterol, Total/HDL-cholesterol and triglycerides/HDL-cholesterol ratios were associated with a higher population attributable risk for cardiovascular disease compared to other common biomarkers.
Filiaciones:
Orozco D:
Catedra de Medicina de Familia, Miguel Hernandez University, San Juan de Alicante, Spain
Gil V:
Catedra de Medicina de Familia, Miguel Hernandez University, San Juan de Alicante, Spain
Redon J:
CIBERObn, ISCIII, Madrid, Spain
Martin-Moreno JM:
Department of Preventive Medicine and Public Health, University of Valencia Medical School. Valencia, Spain
Pallares-Carratala V:
Health Surveillance Department, Mutual Society of Castellon. Department of Medicine. Jaume I University. Castellon, Spain
Navarro-Perez J:
Department of Medicine, University of Valencia, Valencia, Spain
:
Health Centre of Beniganim, Generalitat Valenciana, Beniganim, Valencia, Spain
:
Health Centre of Algemesi, Generalitat Valenciana, Algemesi, Valencia, Spain
Fernandez-Gimenez A:
Escarval Project, Valencia, Spain
Perez-Navarro A:
Escarval Project, Valencia, Spain
:
Department of Clinical Medicine, Miguel Hernandez University, San Juan de Alicante, Spain
:
Department of Clinical Medicine, Miguel Hernandez University, San Juan de Alicante, Spain
:
Department of Clinical Medicine, Miguel Hernandez University, San Juan de Alicante, Spain
:
Biomedical Informatics. Electronic Health Record Office. Conselleria de Sanitat. Valencia, Spain
:
Department of Pharmacy, Hospital Clinico de Valencia, Valencia, Spain
:
Catedra de Medicina de Familia, Miguel Hernandez University, San Juan de Alicante, Spain
Pita-Fernandez S:
Clinical Epidemiology and Biostatistics Unit, Complexo Hospitalario Universitario A Coruna (CHUAC), SERGAS, Universidad de A Coruna, A Coruna, Spain
:
Pharmacy Management. Conselleria de Sanitat. Valencia, Spain
Durazo-Arvizu R:
Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, United States of America
Cooper R:
Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, United States of America
Sanz G:
National Cardiovascular Research Center. Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
Castellano JM:
HM Hospitales, Hospital Universitario HM Monteprincipe, Madrid, Spain
Ascaso JF:
INCLIVA Research Institute. Ciber de Diabetes y Enfermedades Metabolicas (CIBERDEM), Carlos III. Valencia, Spain
Carmena R:
INCLIVA Research Institute. Ciber de Diabetes y Enfermedades Metabolicas (CIBERDEM), Carlos III. Valencia, Spain
Tellez-Plaza M:
Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, United States of America
Green Submitted, Green Published, gold
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