0000000000090020
AUTHOR
Vivencio Barrios
COSMIC project: consensus on the objectives of the metabolic syndrome in clinic
Juan Pedro-Botet,1 Juan F Ascaso,2,3 Vivencio Barrios,4,5 Alejandro De la Sierra,6 Javier Escalada,7,8 Jesús Millán,9 Jose M Mostaza,10 Pablo Pérez-Martínez,8,11 Xavier Pintó,8,12 Jordi Salas-Salvadó,8,13 Pedro Valdivielso14 1Lipids and Vascular Risk Unit, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain; 2Endocrinology and Nutrition Service, Hospital Clínico, Universitat de Valencia, Valencia, Spain; 3INCLIVA Research Institute, Diabetes and Metabolic Diseases Ciber (Networked Biomedical Research Centres – CIBERDEM), Carlos III, Valencia, Spain; 4Cardiology Service, Hospit…
Efficacy of combination therapy with angiotensin-converting enzyme inhibitor and calcium channel blocker in hypertension.
There are few clinical trials that provide evidence to support the hypothesis that combined therapies offer a favorable risk-benefit ratio in the reduction of cardiovascular mortality and morbidity. Combined therapies containing an angiotensin-converting enzyme inhibitor (ACEI) with a calcium channel blocker (CCB) is one of the recommended combinations in the reappraisal of the European Society of Hypertension.The authors have performed a systematic review of the available clinical evidence on the use of combined therapies containing an ACEI with a CCB versus other combinations in the management of arterial hypertension (HT) and in the reduction of cardiovascular morbidity/mortality, accord…
Atrial fibrillation and chronic kidney disease: focus on rivaroxaban
Renal insufficiency increases the risk of stroke and bleeding in atrial fibrillation patients. Although vitamin K antagonists reduce the risk of stroke in patients with moderate renal dysfunction, this observation is less clear in patients with renal impairment. Moreover, the risk of bleeding with vitamin K antagonists increases as renal function worsens. Maintaining international normalized ratio values within therapeutic targets is more difficult in patients with renal dysfunction, and those agents may cause warfarin-related nephropathy and vascular calcification. Rivaroxaban is the only nonvitamin K oral anticoagulant with a dose specifically tested in patients with moderate renal insuff…
Consenso Delphi sobre el manejo de la dislipidemia en pacientes con alteración del metabolismo de la glucosa: estudio Diana
Objectives The aim of the present study was to develop a multidisciplinary consensus based on the Delphi system to establish clinical recommendations for the management of dyslipidaemia when hyperglycaemia is present, and the relevant factors that should be taken into consideration when prescribing and monitoring treatment with statins. Methods The questionnaire developed by the scientific committee included four blocks of questions about dyslipidaemia in patients with impaired glucose metabolism. The results of the first two blocks are presented here: a) management of dyslipidaemia; b) relevant factors that should be taken into consideration when prescribing and monitoring treatment with s…
Chronic kidney disease and dyslipidaemia
Chronic kidney disease (CKD) has to be considered as a high, or even very high risk cardiovascular risk condition, since it leads to an increase in cardiovascular mortality that continues to increase as the disease progresses. An early diagnosis of CKD is required, together with an adequate identification of the risk factors, in order to slow down its progression to more severe states, prevent complications, and to delay, whenever possible, the need for renal replacement therapy. Dyslipidaemia is a factor of the progression of CKD that increases the risk in developing atherosclerosis and its complications. Its proper control contributes to reducing the elevated cardiovascular morbidity and …
COSMIC project : consensus on the objectives of the metabolic syndrome in clinic
Juan Pedro-Botet,1 Juan F Ascaso,2,3 Vivencio Barrios,4,5 Alejandro De la Sierra,6 Javier Escalada,7,8 Jesús Millán,9 Jose M Mostaza,10 Pablo Pérez-Martínez,8,11 Xavier Pintó,8,12 Jordi Salas-Salvadó,8,13 Pedro Valdivielso14 1Lipids and Vascular Risk Unit, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain; 2Endocrinology and Nutrition Service, Hospital Clínico, Universitat de Valencia, Valencia, Spain; 3INCLIVA Research Institute, Diabetes and Metabolic Diseases Ciber (Networked Biomedical Research Centres – CIBERDEM), Carlos III, Valencia, Spain; 4Cardiology Service, Hospital Universitario Ramón y Caja…
Manejo integral de los factores de riesgo en enfermedad arterial periférica. Consenso de expertos
Resumen Antecedentes y objetivo Actualmente existe cierta divergencia entre las principales guias de practica clinica sobre el manejo de los factores de riesgo de la enfermedad arterial periferica (EAP). El objetivo de este proyecto es conocer el manejo de los factores de riesgo de la EAP en la practica clinica y alcanzar un consenso multidisciplinar sobre las estrategias que se tienen que seguir para optimizar su identificacion, tratamiento y seguimiento. Metodologia Consenso multidisciplinar mediante metodologia Delphi. Resultados En la consulta participaron 130 profesionales con amplia experiencia en EAP. Los resultados sugieren que para optimizar el control de los factores de riesgo, lo…
Effectiveness of an Interventional Program to Improve Blood Pressure Control in Hypertensive Patients at High Risk for Developing Heart Failure: HEROIC study.
J Clin Hypertens (Greenwich). The Efectividad de un Programa de Intervencion en el Control de la Presion Arterial de los Hipertensos en Riesgo de Desarrollar Insuficiencia Cardiaca (HEROIC) study was designed to assess whether an educational program for primary care physicians could improve blood pressure (BP) control in hypertensive patients at high risk for developing heart failure. The program contained a combination of educational training (live group sessions or online training) and information feedback. Two hundred twenty-six physicians completed the program and provided valid data in 2489 patients before and 2168 after 1 year. There was a small but significant reduction of −1.1 mm Hg…
Comprehensive management of risk factors in peripheral vascular disease. Expert consensus
There is currently a degree of divergence among the main clinical practice guidelines on the management of risk factors for peripheral arterial disease (PAD). This project aims to gain understanding of the management of PAD risk factors in clinical practice and to reach a multidisciplinary consensus on the strategies to be followed in order to optimize its identification, treatment, and follow-up.A multidisciplinary consensus following the Delphi methodology.Professionals (n = 130) with extensive experience in PAD participated in this consultation. The results suggest that in order to optimize the control of risk factors, efforts should be aimed at: (1) promoting the involvement and awarene…
Enfermedad renal crónica y dislipidemia
Resumen La enfermedad renal cronica (ERC) ha de ser considerada como una situacion de alto e incluso muy alto riesgo cardiovascular, ya que provoca un aumento de la mortalidad cardiovascular que va incrementandose a medida que progresa la enfermedad. Es preciso realizar un diagnostico precoz de la ERC junto con la adecuada identificacion de los factores de riesgo, al objeto de frenar su evolucion a estadios mas severos, evitar las complicaciones y retrasar, en lo posible, la necesidad de tratamiento sustitutivo renal. La dislipidemia es un factor de progresion de la ERC que aumenta el riesgo de desarrollo de aterosclerosis y sus complicaciones. Su adecuado control contribuye a reducir la el…
Consenso Delphi sobre el manejo de la dislipidemia en pacientes con alteración del metabolismo de la glucosa: estudio Diana. [Delphi consensus on management of dyslipidaemia in patients with impaired glucose metabolism: Diana study].
Objetivos: El objetivo de este estudio fue desarrollar un consenso multidisciplinar mediante el sistema Delphi para establecer recomendaciones clínicas en torno al manejo de la dislipidemia cuando hay una alteración del metabolismo de la glucosa, y la importancia de los factores que se valoran al prescribir y realizar el seguimiento del tratamiento con estatinas. Métodos: El cuestionario formulado por el comité científico incluyó 4 bloques de preguntas alrededor del paciente dislipidémico con alteración del metabolismo de la glucosa, de los que aquí presentaremos los resultados de los 2 primeros: a) manejo de la dislipidemia; y b) factores que se valoran al prescribir y realizar el seguimie…