Estimation of aterosclerotic cardiovascular risk in adult patients without a suspicion of having high pressure readings
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Abstract
Introduction: Cardiovascular diseases are the main cause of death in the world. The estimation of the Cardiovascular Risk (CVR) could both reduce the burden of the illness and improve the quality of life of the patients.
Objective: To estimate the CVR in adult patients without a suspicion of having high pressure readings in a Clinic of Family Medicine in Mexico City.
Methods: This is a descriptive and transversal study with a sample of 101 male and female patients in the range of 40 to 69 years old, who did not have a previous hypertension diagnosis but who, at the moment of this study, showed high tension readings. The American Heart Association 2017 criteria were used. The cardiovascular risk was assessed using the ASCVD-Risk Estimator Plus.
Results: Arterial hypertension readings were found in 55.4 % of the sample. 54.4 % of the sample met the criteria for low risk, 11.8 % for limit risk, 25.7 % for medium risk, and 7.9 % for high risk. The most prevalent factors associated with cardiovascular risk were type 2 diabetes mellitus, overweight, obesity, and hypertension.
Discussion: An important percentage of the sample showed cardiovascular risk to some degree, suggesting that perhaps using stricter parameters to define hypertension could prompt more timely interventions.
Conclusion: Considering both the high percentage of participants who demonstrated having a cardiovascular risk of concern and the high prevalence of risk factors such as Type 2 Diabetes Mellitus, hypertension, and overweight, timely monitoring interventions should be promoted in order to prevent the development of cardiovascular diseases.
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References
Gómez LA. Las enfermedades cardiovasculares: un problema de salud pública y un reto global. Biomédica. 2011; 31(4): 469-73. https://bit.ly/3kk7xdB
OMS. Enfermedades cardiovasculares. Ginebra: OMS; 2017. https://bit.ly/39g7vwN
Kunstmann S, Gainza F. Herramientas para la estimación del riesgo cardiovascular. Rev. méd. Clín. Las Condes. 2018; 29(1): 6-11. https://doi.org/10.1016/j.rmclc.2017.11.010
Andrade-Castellanos CA. Hipertensión arterial primaria: tratamiento farmacológico basado en la evidencia. Med Int Méx. 2015; 31: 191-5. https://bit.ly/39lazHU
Secretaría de Salud. Guía de Práctica Clínica. Diagnóstico y tratamiento de dislipidemias (hipercolesterolemia) en el adulto. México: CENETEC; Actualización 2016. https://bit.ly/3hQl1Md
Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA Guideline on the primary prevention of cardiovascular disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019; 140(11): 596-646. https://doi.org/10.1161/CIR.0000000000000678
American Heart Association. Know your risk factors for high blood pressure. Dallas: AHA; 2020. https://bit.ly/2Xv3D8z
Forouzanfar MH, Liu P, Roth GA, Ng M, Biryukov S, Marczak L, et al. Global burden of hypertension and systolic blood pressure of at least 110 to 115 mm Hg, 1990-2015. JAMA. 2017; 317(2): 165-82. https://doi.org/10.1001/jama.2016.19043
World Health Organization. The top 10 causes of death. Ginebra: WHO; 2020. https://bit.ly/2Xtsr0K
Instituto Nacional de Salud Pública. Encuesta Nacional de Salud y Nutrición 2018. Presentación de resultados. México: INEGI/INSP/SSA; 2020. https://bit.ly/3krAy7e
Valenzuela-Flores AA, Solórzano-Santos F, Valenzuela-Flores AG, Durán-Arenas LG, Ponce de León-Rosales SP, Oropeza-Martínez MP, et al. Key recommendations of the clinical guidelines of arterial hypertension in primary care. Rev Med Inst Mex Seguro Soc. 2016; 54(2): 249-60. https://bit.ly/3u3isLN
Himmelfarb CRD, Commodore-Mensah Y, Hill MN. Expanding the role of nurses to improve hypertension care and control globally. Ann Glob Health. 2016; 82(2): 243-53. https://doi.org/10.1016/j.aogh.2016.02.003
Spies LA, Bader SG, Opollo JG, Gray J. Nurse-led interventions for hypertension: A scoping review with implications for evidence-based practice. Worldviews Evid Based Nurs. 2018; 15(4): 247-56. https://doi.org/10.1111/wvn.12297
Spies LA, Nanyonga RC, Nakaggwa F. Nurse‐led interventions in the interim: Waiting on universal health coverage. Int Nurs Rev. 2019; 66(4): 549-52. https://doi.org/10.1111/inr.12558
Taler SJ. Initial treatment of hypertension. N Engl J Med. 2018; 378(7): 636-44. https://doi.org/10.1056/NEJMcp1613481
Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018; 71(6): 1269-324. https://doi.org/10.1161/HYP.0000000000000066
Bress AP, Colantonio LD, Cooper RS, Kramer H, Booth JN, Odden MC, et al. Potential cardiovascular disease events prevented with adoption of the 2017 American College of Cardiology/American Heart Association blood pressure guideline. Circulation. 2019; 139(1): 24-36. https://doi.org/10.1161/CIRCULATIONAHA.118.035640
Universidad Nacional Autónoma de México. Los médicos familiares, pilar de la salud. Gaceta Facultad de Medicina. 2018; 9(251): 1-16. https://bit.ly/39tq40t
León E, Tranche S, Montano J. Impacto económico de la medicina familiar en los sistemas de salud de Iberoamérica. Rev Bras Med Fam Comunidade. 2018; 13(Suppl 1): 43-53. https://doi.org/10.5712/rbmfc13(1)1852
Institute for Health Metrics and Evaluation. GBD Compare|Viz Hub. Seattle: University of Washington; 2020.
Gijón-Conde T, Gorostidi M, Camafort M, Abad-Cardiel M, Martín-Rioboo E, Morales-Olivas F, et al. Documento de la Sociedad Española de Hipertensión-Liga Española para la lucha contra la hipertensión arterial (SEH-LELHA) sobre las guías ACC/AHA 2017 de hipertensión arterial. Hipertens Riesgo Vasc. 2018; 35(3): 119-29. https://doi.org/10.1016/j.hipert.2018.04.001
Amercian College of Cardiology. ASCVD Risk Estimator Plus. Washington, D.C.: ACC; s/f. https://bit.ly/2XyIsCq
Wilson PWF, Kannel WB. Obesity, diabetes, and risk of cardiovascular disease in the elderly. Am J Geriatr Cardiol. 2002; 11(2): 119-24. https://doi.org/10.1111/j.1076-7460.2002.00998.x
Joseph JJ, Golden SH. Type 2 diabetes and cardiovascular disease: What next? Curr Opin Endocrinol Diabetes Obes. 2014; 21(2): 109-20. https://doi.org/10.1097/MED.0000000000000044
Merino J, Jablonski KA, Mercader JM, Kahn SE, Chen L, Harden M, et al. Interaction between type 2 diabetes prevention strategies and genetic determinants of coronary artery disease on cardiometabolic risk factors. Diabetes. 2020; 69(1): 112–20. https://doi.org/10.2337/db19-0097
Secretaría de Salud/Instituto Nacional de Salud Pública. Encuesta Nacional de Salud y Nutrición de Medio Camino 2016 (ENSANUT MC 2016). Informe final de resultados. México: SSA/INSP; 2016. https://bit.ly/3hW6XRo
Hinton TC, Adams ZH, Baker RP, Hope KA, Paton JFR, Hart EC, et al. Investigation and treatment of high blood pressure in young people: Too much medicine or appropriate risk reduction? Hypertension. 2020; 75(1): 16-22. https://doi.org/10.1161/HYPERTENSIONAHA.119.13820
Packer M. Heart Failure: The most important, preventable, and treatable cardiovascular complication of type 2 diabetes. Diabetes Care. 2018; 41(1): 11-3. https://doi.org/10.2337/dci17-0052
Adiukwu F, Ofori S, Ugbomah L. Vascular cognitive impairment, a cardiovascular complication. World J Psychiatry. 2016; 6(2): 199-207. https://doi.org/10.5498/wjp.v6.i2.199
Hisni D, Rukmaini R, Saryono S, Chinnawong T, Thaniwattananon P. Cardiovascular self-management support program for preventing cardiovascular complication behaviors and clinical outcomes in the elderly with poorly controlled type 2 diabetes mellitus in Indonesia: A pilot study. Jpn J Nurs Sci. 2019; 16(1): 25-36. https://doi.org/10.1111/jjns.12208
Wenger NK. Female‐friendly focus: 2019 ACC/AHA Guideline on the primary prevention of cardiovascular disease. Clin Cardiol. 2019; 42(8): 706-9. https://doi.org/10.1002/clc.23218
Wu P, Haththotuwa R, Kwok CS, Babu A, Kotronias RA, Rushton C, et al. Preeclampsia and future cardiovascular health: A systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2017; 10(2): 1-9. https://doi.org/10.1161/CIRCOUTCOMES.116.003497
Woodward M. Cardiovascular disease and the female disadvantage. Int. J. Environ. Res. Public Health. 2019; 16(7): 1165.
Regitz‐Zagrosek V. Sex and gender differences in health: Science & society series on sex and science. EMBO Rep. 2012; 13(7): 596-603. https://doi.org/10.1038/embor.2012.87
Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020; 16(4): 223-37. https://doi.org/10.1038/s41581-019-0244-2
Yano Y, Reis JP, Colangelo LA, Shimbo D, Viera AJ, Allen NB, et al. Association of blood pressure classification in young adults using the 2017 American College of Cardiology/American Heart Association blood pressure Guideline with cardiovascular events later in life. JAMA. 2018; 320(17): 1774‐82. https://doi.org/10.1001/jama.2018.13551
Noubiap JJ, Bigna JJ, Nansseu JR, Nyaga UF, Balti EV, Echouffo-Tcheugui JB, et al. Prevalence of dyslipidaemia among adults in Africa: A systematic review and meta-analysis. Lancet Global Health. 2018; 6(9): e998-e1007. https://doi.org/10.1016/S2214-109X(18)30275-4
Harris MA, Ferguson TS, Boyne MS, Figueroa JP. High prevalence of dyslipidemia among primary care patients with hypertension and diabetes in Jamaica. Arch Med Sci Atheroscler Dis. 2017; 2: 61-7. https://doi.org/10.5114/amsad.2017.70596
American Diabetes Association. 10. Cardiovascular disease and risk management: Standards of medical care in diabetes-2020. Diabetes Care. 2020; 43(Suppl. 1): S111–34. https://doi.org/10.2337/dc20-s010
Lloyd-Jones DM, Braun LT, Ndumele CE, Smith SC, Sperling LS, Virani SS, et al. Use of risk assessment tools to guide decision-making in the primary prevention of atherosclerotic cardiovascular disease. J Am Coll Cardiol. 2019; 73(24): 3153-67. https://doi.org/10.1016/j.jacc.2018.11.005
Sarre-Álvarez D, Cabrera-Jardines R, Rodríguez-Weber F, Díaz-Greene E. Enfermedad cardiovascular aterosclerótica. Revisión de las escalas de riesgo y edad cardiovascular. Med. inter Méx. 2018; 34(6): 910-23. https://bit.ly/3cZgRim
Ahuja R, Ayala C, Tong X, Wall HK, Fang J. Public awareness of health-related risks from uncontrolled hypertension. Prev Chronic Dis. 2018; 15: 1-9. https://doi.org/10.5888/pcd15.170362
Thomas C, Brennan A, Goka E, Squires HY, Brenner G, Bagguley D, et al. What are the cost-savings and health benefits of improving detection and management for six high cardiovascular risk conditions in England? An economic evaluation. BMJ Open. 2020; 10(9): 2-10. https://doi.org/10.1136/bmjopen-2020-03748
Basu S, Wagner RG, Sewpaul R, Reddy P, Davies J. Implications of scaling up cardiovascular disease treatment in South Africa: A microsimulation and cost-effectiveness analysis. Lancet Glob Health. 2019; 7(2): e270-80. https://doi.org/10.1016/S2214-109X(18)30450-9
Heintzman JD, Bailey SR, Muench J, Killerby M, Cowburn S, Marino M. Lack of lipid screening disparities in obese latino adults at health centers. Am J Prev Med. 2017; 52(6): 805-9. https://doi.org/10.1016/j.amepre.2016.12.020
Mattiuzzi C, Sanchis-Gomar F, Lippi G. Worldwide burden of LDL cholesterol: Implications in cardiovascular disease. Nutr Metab Cardiovasc Dis. 2020; 30(2): 241-4. https://doi.org/10.1016/j.numecd.2019.09.008
Escortell-Mayor E, Del Cura-González I, Ojeda-Ruiz E, Sanz-Cuesta T, Rodríguez-Salceda I, García-Soltero J, et al. A primary healthcare information intervention for communicating cardiovascular risk to patients with poorly controlled hypertension: The Education and Coronary Risk Evaluation (Educore) study-A pragmatic, cluster-randomized trial. PLoS ONE. 2020; 15(1): 1-17. https://doi.org/10.1371/journal.pone.0226398
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