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Inicio Medicina Clínica (English Edition) Vascular age in a sample of general population of the sanitary area of Toledo (S...
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Vol. 157. Issue 11.
Pages 513-523 (December 2021)
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Vol. 157. Issue 11.
Pages 513-523 (December 2021)
Original article
Vascular age in a sample of general population of the sanitary area of Toledo (Spain). RICARTO study
Edad vascular de una muestra de población general del área sanitaria de Toledo (España). Estudio RICARTO
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Alejandro Villarín-Castroa, Gustavo C. Rodríguez-Rocab,
Corresponding author
grodriguezr@semergen.es

Corresponding author.
, Antonio Segura-Fragosoc, Francisco J. Alonso-Morenod, Giovani A. Rojas-Marteloe, Luis Rodríguez-Padialf, Julio A. Fernández-Condeg, María Carmen Lorenzo-Lozanoh, Antonio Menchén-Herrerosh, Juan Fernández-Martíni, on behalf of the RICARTO working group
a Unidad Docente Multiprofesional de Atención Familiar y Comunitaria de Toledo, Toledo, Spain
b Centro de Salud de La Puebla de Montalbán, La Puebla de Montalbán, Toledo, Spain
c Medicina Preventiva y Salud Pública, Asesor en Metodología de la Investigación de la Fundación de la Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Facultad de Ciencias de la Salud, Universidad de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
d Centro de Salud Sillería, Toledo, Spain
e North Western Doctors on Call (NoWDOC), Carrick-on-Shannon, Leitrim, Ireland
f Servicio de Cardiología, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
g Unidad Administrativa, Gerencia de Atención Primaria de Toledo, Toledo, Spain
h Servicio de Bioquímica Clínica, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
i Medicina Preventiva y Salud Pública, Servicio de Investigación e Innovación, Dirección General de Asistencia Sanitaria, Servicio de Salud de Castilla-La Mancha (SESCAM), Toledo, Spain
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Tables (4)
Table 1. Characteristics of the sample (n = 1,496).
Table 2. Differences in vascular age according to study variables.
Table 3. Comparison between chronological age and vascular age.
Table 4. Differences between the vascular age calculated with the Framingham equation and that of the SCORE project.
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Abstract
Objective

To know the vascular age (VA) of a sample of general population included in the RICARTO study.

Patients and method

Epidemiological study of the general population aged ≥ 18 from the Health Area of Toledo, based on the health card database. VA was calculated from the absolute cardiovascular risk (CVR) estimated with the Framingham and SCORE equations (type 2 diabetes increased CVR in SCORE 2-fold in men and 4-fold in women). Patients with cardiovascular or renal disease were excluded. An ANCOVA analysis was conducted to adjust and compare the mean of VA by age and sex.

Results

1,496 subjects (53.54% women) were analyzed. Mean (SD) age was 48.77 (14.89) years old and. Mean VA was 51.37 (19.13) with Framingham equation and 57.09 (17.63) years old with SCORE equation. VA was significantly higher in men, low education level, arterial hypertension, dyslipidemia, hypertriglyceridemia, diabetes mellitus, abdominal obesity, general obesity, smoking and in individuals with 5 CVR factors vs none (P < .001 in all). Higher differences (Cohen’s D > 0.5) were found in non-diabetic vs diabetic people (1.58 Framingham; 2.44 SCORE), normotensive vs hypertensive subjects (1.64 Framingham; 1.19 SCORE), and non-dyslipidemia vs presence of dyslipidemia (0.95 Framingham; 0.66 SCORE).

Conclusions

VA of our sample is two and a half years older than chronological one with Framingham equation and more than eight years with SCORE equation. Control of CVR factors is the key to get a VA closer to real and to obtain a better cardiovascular health in the population.

Keywords:
Vascular age
Disease prevention
Public health
Cardiovascular risk
Cardiovascular diseases
Primary health care
Resumen
Objetivos

Conocer la edad vascular (EV) de una muestra de población general del área sanitaria de Toledo incluida en el estudio RICARTO.

Pacientes y método

Estudio epidemiológico transversal realizado en población general ≥ 18 años, aleatorizada según tarjeta sanitaria. La EV se calculó a partir del riesgo cardiovascular (RCV) absoluto estimado con las escalas de Framingham y SCORE (la presencia de diabetes mellitus duplicó el RCV obtenido en varones y lo cuadruplicó en mujeres). Se excluyeron los sujetos con patología cardiovascular o renal. Se realizó ANCOVA para ajustar y comparar las medias de EV por edad y sexo.

Resultados

Se analizaron 1.496 individuos (53,54% mujeres), con una edad media (DE) de 48,77 (14,89) años. La EV media fue 51,37 (19,13) años con Framingham y 57,09 (17,63) años con SCORE, resultando significativamente mayor en varones, nivel de estudios bajo, hipertensión arterial, dislipidemia, hipertrigliceridemia, diabetes mellitus, obesidad abdominal, obesidad general, tabaquismo y en sujetos con 5 factores de RCV frente a ninguno (p < 0,001 en todos). Las mayores diferencias (D de Cohen > 0,5) se hallaron entre no diabéticos y diabéticos (1,58 Framingham; 2,44 SCORE), normotensos e hipertensos (1,64 Framingham; 1,19 SCORE) y no dislipidémicos y dislipidémicos (0,95 Framingham; 0,66 SCORE).

Conclusiones

En nuestra muestra la EV es 2,5 años superior a la cronológica con la ecuación de Framingham y más de 8 años con la del SCORE. El control de los factores de RCV es clave para lograr una EV más próxima a la real y lograr una mejor salud cardiovascular de la población.

Palabras clave:
Edad vascular
Prevención de enfermedades
Salud pública
Riesgo cardiovascular
Enfermedades cardiovasculares
Atención primaria de salud

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