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ISSN 1527-3172 (Electronic)

2008, Number 2

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MEDICC Review 2008; 10 (2)

Cardiovascular risk among older women in a Havana health area

Armas RNB, Hernández ÁYC, Dueñas HAF, de la Noval GR, Castillo GA

Language: English
References: 49
Page: 21-26
PDF size: 207.59 Kb.


ABSTRACT

Introduction Cardiovascular morbidity and mortality increase in women after menopause. Various scoring models assess qualitative risk of cardiovascular disease. The Framingham Heart Study global risk score is among the most widely used.
Objective Determine level of coronary heart disease risk among women aged ≥60 years in a Havana health catchment area (geographic area whose residents are served by the Mártires del Corynthia Polyclinic, in the Plaza de la Revolución municipality of Havana).
Methods A descriptive, cross-sectional study was conducted in 2006. Universe: all women (3,396) aged ≥60 years in the catchment area, attended at the primary care level by the Polyclinic and 42 neighborhood family doctor-and-nurse offices. Equal probability sample: 1,082 women meeting the inclusion criteria, chosen through single-stage cluster sampling considering a ‹10% error margin for estimates for this parameter, a 95% confidence interval (CI) and a design effect of 1.5. Absolute frequencies and percentages were calculated to summarize the qualitative data obtained. Results were presented as tables.
Results The most common cardiovascular risk factors found in this study were: physical inactivity, 74.9%; hypertension (HTN), 70.6%; abdominal obesity, 53%; reported family history of coronary heart disease (CHD), 41.8%; diabetes mellitus (DM), 21.8%; and cigarette smoking, 17.2%. Scoring according to number of risk factors present in each individual, 79.3% of these women fell into the high-or moderate-risk categories.
Conclusion The large number of women categorized as high- or moderate-risk for coronary heart disease in this population emphasizes the need for preventive actions aimed at reducing these figures.


REFERENCES

  1. Ministerio de Salud Pública (MINSAP), Dirección Nacional de Estadísticas. Anuario Estadístico de Salud 2005. La Habana: MINSAP;2006.

  2. World Health Organization (WHO). Prevention of cardiovascular disease. Guidelines for assessment and management of cardiovascular risk. Geneva: WHO;2007.

  3. Fox CS, Evans JC, Larson MG, Kannel WB, Levy D. Temporal trends in coronary heart disease mortality and sudden cardiac death from 1950 to 1999: The Framingham Heart Study. Circulation. 2004;110:522–527.

  4. Ministerio de Salud Pública (MINSAP), Dirección Nacional de Estadísticas. Temas Estadísticas de Salud. La Habana: MINSAP (CU); 2002.

  5. Stamler J. The Marked Decline in Coronary Heart Disease Mortality. Rates in the United States, 1968-1981. Summary of Findings and Possible Explanations. Cardiology. 1985;72:11-22.

  6. Ferguson JL, Beckett GJ, Stoddart M, Wacqer SW, Fox KA. Myocardial information redefined: The new ACC/ESC definition, based on cardiac troponin, increases the apparent incidence of information. Heart. 2002 Oct;88(4):343-347.

  7. Wilson P, D’Agostino R, Jevy D. Prediction of coronary heart disease using risk factors categories. Circulation. 1999;97:1837-47.

  8. Dawler TR. The Framingham Study: Risk factors and coronary disease. Cambridge: Harvard University Press; 2000.

  9. Anderson KM, Wilson PW, Kannel WB, Odell PM. An updated coronary risk profile. A statement for health professionals. Circulation. 2001;83:356- 62.

  10. Wood D. Prevention of coronary heart disease in clinical practice. Recommendation of the Second Joint Task Force of European and other Societies on coronary prevention. Eur Heart J. 2002;19:1434-46.

  11. Marrugat J, Solanas P, D’Agostino R. Estimación del riesgo coronario en España mediante la ecuación de Framingham calibrada. Rev Esp Cardiol. 2003;56(03):253-61.

  12. National Cholesterol Education Program (NCEP). Adult Treatment Panel III. JAMA. 2001;285:2486- 97.

  13. Ministerio de Salud Pública (MINSAP), Dirección Nacional de Atención Ambulatoria. Programa de Atención Médica Integral a la Familia. La Habana: MINSAP;1987:3-4.

  14. Kannel WB. Cardiovascular Risk Factors in the Elderly: The Framingham Study. Brit Med J. 2000;8:565-75.

  15. Ministerio de Salud Pública (MINSAP). Comisión Técnico Asesora de Hipertensión Arterial. Programa para la Prevención, Detección, Diagnóstico y Tratamiento de la Hipertensión Arterial. La Habana: MINSAP (CU); 2004.

  16. Joint National Committee. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Arch Intern Med. 1997;157:2413-16.

  17. Valdés Pacheco E, Morrees Abella A, Alonso Díaz NL. Prevalencia y factores de riesgo de cardiopatía isquémica. Rev Cubana Med Gen Integr. 1998;14(6):590-94.

  18. Mosca L, Grundy SM, Judelson D, King K, Limacher M, Oparil S, et al. Guide to preventive cardiology in women. Circulation. 1999;99:2480-4.

  19. Mosca L, Appel LJ, Benjamin EJ, Berra K, Chandra- Strobos N, Fabunmi RP, et al. Evidencebased guidelines for cardiovascular disease prevention in women. Circulation. 2004;109:672-93.

  20. Mosca L, Ferris A, Fabunmi R, Robertson RM. Tracking women’s awareness of heart disease. An American Heart Association National Study. Circulation. 2004;109:573-9.

  21. Instituto Nacional de Higiene, Epidemiología y Microbiología (INHEM). II Encuesta Nacional de Factores de Riesgo de Enfermedades Crónicas no Transmisibles en Cuba. Informe de Trabajo. La Habana: INHEM (CU); 2002.

  22. MacMahon S, Peto R, Cutler J, et al. Blood pressure, stroke, and coronary heart disease. Prolonged differences in blood pressure: Prospective observational studies corrected for the regression dilution bias. Lancet. 1995;335:765- 70.

  23. Baena Díez JM, Del Val García JL, Tomás Peregrina J, Martínez Martínez JL, Martín Peñacoba R, González Tejón I, et al. Epidemiología de las enfermedades cardiovasculares y FR en atención primaria. Rev Esp Cardiol. 2005;58:367-73.

  24. Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903-13.

  25. Pineda Cuenca M, Custardoy Olavarrieta J, Andreu Ortiz MT, Ortiz Arroniz JM, Cano Montoso JG, Medina Ferrer E, et al. Estudio de prevalencia de factores de riesgo cardiovascular en un área de salud. Aten Primaria. 2002;30:207-13.

  26. Segura Fragoso A, Rius Mey G. Factores de riesgo cardiovascular en una población rural de Castilla-La Mancha. Rev Esp Cardiol. 1999;52:577-8.

  27. Franklin SS, Larson MG, Khan SA, Wong ND, Leip EP, Kannel WB, et al. Does the relation of blood pressure to coronary heart disease risk change with aging? The Framingham Heart Study. Circulation. 2001;103:1245-9.

  28. Puras A, Sanchos C, Artigao LM, Divison JA. Prevalence, awareness, treatment, and control of hypertension in a Spanish population. Eur J Epidemiol. 1998;14:31-6.

  29. Nigro D, Vergonttini JC, Kuschnir E, et al. Epidemiología de la hipertensión arterial en la ciudad de Córdoba, Argentina. Rev Fed Arg Cardiol. 1999;28: 69-75.

  30. Contin M, Burges G, Soris J, Batista. HTA: Incremento esperanza de vida. Hipótesis. Rev Cubana Med. 2001;40(2):103-8.

  31. Banegas R, Rodríguez-Artalejo F, Ruilope LM, Graciani A, Luque M, De la Cruz-Troca JJ, et al. Hypertension magnitude and management in the elderly population of Spain. J Hypertens. 2002;20:2157-64.

  32. Nerín I. El tabaquismo en la mujer: una atracción fatal. Arch Bronconeumol. 2005;41:360–2.

  33. Jane M, Saltó E, Pardell H, Tresserras R, Guayta R, Taberner JL, et al. Prevalencia del tabaquismo en Cataluña, 1982-1998: una perspectiva de género. Med Clin (Barc). 2002;118:81-5.

  34. Hennekens CH. Increasing burden of cardiovascular disease: current knowledge and future directions for research on risk factors. Circulation. 1998;97:1095-102.

  35. Serrano M, Madoz E, Ezpeleta I, San Julián B, Amézqueta C, Pérez-Marco JA, et al. Abandono del tabaco y riesgo de nuevo infarto en pacientes coronarios: estudio de casos y controles anidados. Rev Esp Cardiol. 2003;56:445-51.

  36. Sánchez-Recalde A, Kaski JC. Diabetes mellitus, inflamación y aterosclerosis coronaria: perspectiva actual y futura. Rev Esp Cardiol. 2001;54:751-63.

  37. Nathan D, Meigs J, Singer D. The Epidemiology of Cardiovascular Disease in Type 2 Diabetes Mellitus: How Sweet It Is or Is It? Lancet. 1997;350 (Suppl):1-32.

  38. Smith SC Jr, Clark LT, Cooper RS, Daniels SR, Kumanyika SK, Ofili E, et al. American Heart Association; Obesity, Metabolic Syndrome, and Hypertension Writing Group. Discovering the Full Spectrum of Cardiovascular Disease. Minority Health Summit 2003. Report of the Obesity, Metabolic Syndrome, and Hypertension Writing Group. Circulation. 2005;111:134-9.

  39. Lakka HM, Lakka TA, Tuomilehto J, Salonen JT. Abdominal obesity is associated with increased risk of acute coronary events in men. Eur Heart J. 2002;23:706-13.

  40. Kanaya AM, Vittinghoff E, Shlipak MG, Resnick H.E, Visser M, Barrett-Connor DE. Association of total and central obesity with mortality in postmenopausal women with coronary heart disease. Am J Epidemiol. 2003;158:1161-70.

  41. Larson B, Svardsudd K, Wilhelmsen L, Bjorntorp P. Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death. BMJ 1984;288:1401-04.

  42. Alexander NB, Galecki AT, Grenier ML. Task specific resistance training to improve the ability of activities of daily living-impaired older adults to rise from a bed and from a chair. J Am Geriatr Soc. 2002;49:1418-27.

  43. Dubach P. Exercise training in chronic heart failure: why, when and how. Swiss Med Wkly 2001;131(35-36):510-4.

  44. Bijnen FC, Caspersen DJ, Mosterd WL. Physical Inactivity as a Risk Factor for Coronary Heart Disease: A WHO and International Society and Federation of Cardiology Position Statement. Bull World Health Org. 1994;72:1-4.

  45. Manson JE, Hu FB, Rich-Edwards JW, Colditz GA, Stampfer MJ, Willett WC, et al. A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women. N Engl J Med. 1999;341:650-8.

  46. Macera CA, Hootman, JM, Sniezek, JE. Major public health benefits of physical activity. Arthritis Rheum. 2003;49(1):122-128.

  47. Nigro MB, Herrera HL, García G, Raviolo L, Ledesma RE. Evaluación de factores de riesgo cardiovascular en mujeres de la tercera edad. Rev Fed Arg Cardiol. 2005;34: 358-365.

  48. Grundy S, Bazarre T, Cleeman J, D’Agostino R, Hill M, Houston-Miller N, et al. Prevention Conference V: Beyond secondary prevention: identifying the patient for primary intervention: medical office assessment. Writing Group. Circulation. 2000;101:E3-E11.

  49. Alvarez Cosmea A. Las tablas de riesgo cardiovascular. Una revisión crítica. Medifam. 2001;11(3).




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