Cardiovascular risk estimated after 13 years of follow-up in a low-incidence Mediterranean region with high-prevalence of cardiovascular risk factors

Huerta, José M.; Tormo, María-José; Gavrila, Diana; Navarro, Carmen
January 2010
BMC Public Health;2010, Vol. 10, p640
Academic Journal
Background: Murcia (south-east Spain) shows increased cardiovascular (CV) morbimortality as compared to other Spanish regions. Our objective was to assess the CV risk associated with major risk factors (RF) among adult population of Murcia. Methods: A cohort of 2314 subjects (18-70 years) with full biochemical and questionnaire data was followed-up for 13 years. Incident cases of ischemic heart disease and stroke were identified by record linkage, individual questionnaires and revision of medical records. Relative risks were obtained by multivariate Cox regression stratified by age and sex, and ischemic risk attributable to CVRF was calculated. Results: After more than 26276 person-years of follow-up, 57 incident ischemic events (77% men) and 37 stroke cases (62% men) were identified. Independent risk factors of ischemic heart disease (IHD) and all CV events combined, with RR ranging from 1.6 to 2.6, were total serum cholesterol ≥ 240 mg/dl (HR = 2.6, 95%CI:1.3-5.1), blood pressure levels ≥ 140/90 mmHg (HR = 2.6, 95%CI:1.4-4.8), ever tobacco smoking (HR = 2.2; 95%CI:1.1-4.5), and diabetes (HR = 2.0; 95%CI: 1.0-3.8). No increased CV risk was detected for known participants under treatment who showed cholesterol and blood pressure values below the clinical risk threshold. Smoking was significantly associated with stroke. For all events combined, the major risk factors were hypercholesterolemia, hypertension and ever use of tobacco. Despite its high prevalence, obesity was not associated to CV risk. Most of the IHD cases were attributable to smoking (44%), hypertension (38%) and hypercholesterolemia (26%). Conclusions: In the Region of Murcia, smoking accounted for the largest proportion of cardiovascular risk, whereas hypertension displaced hypercholesterolemia as the second leading cause of CV disease. Our study deepens in our understanding of the cardiovascular epidemiology in Spanish areas of Mediterranean Europe with relatively high cardiovascular morbimortality, that are poorly represented by the available risk equations.


Related Articles

  • High Blood Cholesterol in Elderly Men and the Excess Risk for Coronary Heart Disease. Rubin, Susan M.; Sidney, Stephen; Black, Dennis M.; Browner, Warren S.; Hulley, Stephen B.; Cummings, Steven R. // Annals of Internal Medicine;12/15/90, Vol. 113 Issue 12, p916 

    Determines whether high blood cholesterol is an important risk factor for mortality from coronary heart disease in elderly men. Relation between elevated levels of serum cholesterol and coronary heart disease in elderly men; Predictor of mortality from coronary heart disease; Effectiveness of...

  • CHD risk factors affect long-term mortality. Rubin, Aaron // Physician & Sportsmedicine;Apr2000, Vol. 28 Issue 4, p23 

    Discusses the abstract of the study entitled `Low Risk-Factor Profile and Long-Term Cardiovascular and Noncardiovascular Mortality and Life Expectancy,' by J. Stamler, R. Stamler, et al published in the 1999 issue of the `Journal of the American Medical Association.' INSET: Comment, by William...

  • Asia–Pacific Collaboration on Coronary Heart Disease Risk Factor Intervention: Study Design and Methods. Ritchie, Gemma; Ritchie, Gemma M. // Heart, Lung & Circulation;Feb2001, Vol. 10 Issue 1, p24 

    Background: Age-adjusted death rates for coronary heart disease (CHD) have been decreasing in populations of developed countries. At the same time, CHD in the Asia–Pacific region appears to be increasing in parallel with the ‘Westernisation’ of diet and lifestyle. More...

  • Matters of the heart.  // Dairy Industries International;Sep2001, Vol. 66 Issue 9, p12 

    Deals with studies made on the effect of milk intake on population health. Correlation between milk intake and coronary mortality rates; Milk contents that can increase and reduce coronary risk; Other factors that might have accentuated the association between milk consumption and coronary...

  • Increase in resting heart rate over 10-year period linked with increased risk of heart disease death.  // Biomedical Market Newsletter;12/21/2011, Vol. 21, p1 

    The article focuses on a study which suggests a link between an increase in resting heart rate (RHR) over a 10-year period and increased risk of ischemic heart disease (IHD) death. The study involved 30,000 apparently healthy men and women who had an increase in their resting heart rate. The...

  • Oscillatory functions affecting outcome of coronary heart disease: The hazard of too much or too... Wolf, Stewart // Integrative Physiological & Behavioral Science;Apr-Jun95, Vol. 30 Issue 2, p118 

    Identifies the physiological and behavioral indicators predictive of sudden arrhythmic death in patients who had experienced myocardial infarction in the past. Non-determinants of cardiac mortality; Degree of instability required in the proper physiological balance.

  • The Water Factor and Mortality from Ischemic Heart Disease: A Review and Possible Explanations for Inconsistent Findings with Additional Data from Manitoba. Abu-Zeid, Hassan A.H. // Archives of Environmental Health;Sep/Oct79, Vol. 34 Issue 5 

    Examines the relationship between water hardness and mortality from Ischemic heart disease (IHD). Known risk factors of IHD; Measures taken to prevent cardiovascular mortality; Methods used to measure water characteristics.

  • In-hospital death in acute coronary syndrome was related to admission glucose in men but not in women.  // Cardiovascular Diabetology;2012, Vol. 11 Issue 1, p47 

    The article presents information on a study conducted on how admission hyperglycaemia is associated with mortality in patients suffering from acute coronary syndrome (ACS). In the study, 959 ACS patients were grouped on the basis of glycaemia and gender; and a logistic regression analysis...

  • Is There a Glycemic Threshold for Mortality Risk? Balkau, Beverley; Bertrais, Sandrine; Ducimetiere, Pierre; Eschwege, Eveline // Diabetes Care;May99, Vol. 22 Issue 5, p696 

    Presents information on a study which determined whether there are thresholds for fasting and for 2-h glucose above which the risk of death from all causes and from coronary heart disease increases. Research design and methods; Results; Conclusions.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics