Hipertrofia ventricular izquierda en la población hipertensa española. Estudio ERIC-HTA
Introduccion y objetivos El objetivo del presente estudio es evaluar la prevalencia de hipertrofia del ventriculo izquierdo (HVI) en el electrocardiograma y el perfil epidemiologico en pacientes hipertensos atendidos en atencion primaria. Pacientes y metodo Estudio transversal, multicentrico, realizado en 15.798 pacientes hipertensos ≥ 55 anos de centros de atencion primaria. Se midio la presion arterial y se recogieron los antecedentes cardiovasculares de la historia clinica de los pacientes. La HVI se evaluo segun los criterios de Cornell. Resultados Se evaluo a 15.798 pacientes (edad media, 68,0 anos; 55,3% mujeres; 30,4% diabeticos). El 20,3% presento HVI en el electrocardiograma. La pr…
Prevalencia de filtrado glomerular disminuido en la población española de edad avanzada. Estudio PREV-ICTUS
Fundamento y objetivo Estimar la prevalencia de filtrado glomerular (FG) disminuido ( Pacientes y metodo Se analizo el estudio PREV-ICTUS, realizado en una muestra de individuos de 60 anos o mas seleccionada aleatoriamente, estratificada por comunidades autonomas segun el censo y el habitat de atencion. Se recogieron datos demograficos, factores de riesgo y enfermedades cardiovasculares. Se calculo el FG utilizando la formula de MDRD (Modification of Diet in Renal Disease). Resultados En 6.799 individuos (edad media 71,9 anos; 53,6% mujeres; 72,9% con hipertension arterial [HTA]; 27,0% con diabetes mellitus [DM]; 24,3% con enfermedad cardiovascular), el 25,9% presento FG disminuido (interva…
Underlying heart diseases and acute COVID-19 outcomes
Background: The presence of any underlying heart condition could influence outcomes during the coronavirus disease 2019 (COVID-19). Methods: The registry HOPE-COVID-19 (Health Outcome Predictive Evaluation for COVID-19, NCT04334291) is an international ambispective study, enrolling COVID-19 patients discharged from hospital, dead or alive. Results: HOPE enrolled 2798 patients from 35 centers in 7 countries. Median age was 67 years (IQR: 53.0-78.0), and most were male (59.5%). A relevant heart disease was present in 682 (24%) cases. These were older, more frequently male, with higher overall burden of cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus, smoking habit, …
Left Ventricular Hypertrophy in the Spanish Hypertensive Population. The ERIC-HTA Study
Introduction and objectives. Left ventricular hypertrophy (LVH) is the earliest manifestation of cardiac damage in hypertension. Its appearance is associated with a poor cardiovascular prognosis. The objectives of this study were to determine the prevalence of electrocardiographic LVH and to assess the epidemiological characteristics of hypertensive patients receiving primary care. Patients and method. A cross-sectional multicenter study of hypertensive patients aged 55 years or more was carried out in a primary care setting. Blood pressure was measured using the standard method. Cardiovascular history was determined from medical records and LVH was assessed electrocardiographically using C…
Impact of smoking on COVID-19 outcomes: a HOPE Registry subanalysis
BackgroundSmoking has been associated with poorer outcomes in relation to COVID-19. Smokers have higher risk of mortality and have a more severe clinical course. There is paucity of data available on this issue, and a definitive link between smoking and COVID-19 prognosis has yet to be established.MethodsWe included 5224 patients with COVID-19 with an available smoking history in a multicentre international registry Health Outcome Predictive Evaluation for COVID-19 (NCT04334291). Patients were included following an in-hospital admission with a COVID-19 diagnosis. We analysed the outcomes of patients with a current or prior history of smoking compared with the non-smoking group. The primary …
Evaluación del riesgo de un primer ictus en la población hipertensa española en atención primaria. Estudio ERIC-HTA
Fundamento y objetivo El accidente cerebrovascular (ictus) es una de las principales causas de morbilidad y mortalidad en la poblacion hipertensa. El objetivo de este estudio es estimar el riesgo a 10 anos de experimentar un primer ictus en la poblacion hipertensa espanola aplicando la escala de Framingham. Pacientes y metodo Estudio transversal y multicentrico realizado en centros de atencion primaria de Espana que incluyo a pacientes hipertensos de 55 o mas anos (10 pacientes consecutivos por medico). Se midio la presion arterial (PA) conforme a las normas estandarizadas. Los riesgos se estimaron aplicando las tablas de Framingham para riesgo de ictus y para riesgo de enfermedad coronaria…
Metabolic syndrome, organ damage and cardiovascular disease in treated hypertensive patients. The ERIC‐HTA study
The aim of this study is to assess the relationship among metabolic syndrome (MS), target organ damage (TOD) and established cardiovascular disease (CVD) in non-diabetic hypertensive elderly patients. ERIC-HTA is cross-sectional, multicentre study carried out in primary care, on hypertensive patients aged 55 or older. MS was defined by the NCEP-ATP III criteria, using body mass index (28.8 kg/m(2)) instead of abdominal perimeter. In 8331 non-diabetic hypertensive patients (3663 men and 4668 women, mean age 67.7 years), the prevalence of MS was 32.6% (men: 29.0%; women: 36.8%). A linear association was observed between a greater number of components of MS and a greater prevalence of left ven…
Paediatric research in Spain: Challenges and priorities. INVEST-AEP Platform
La investigación clínica es la piedra angular para el desarrollo de la Medicina, y, en el ámbito de la Pediatría, supone un reto adicional debido a las peculiaridades que diferencian a los niños de los adultos. A pesar del enorme impacto de la salud infantil en el resto de la vida, nuestra sociedad aún no está suficientemente concienciada sobre la importancia de la investigación pediátrica, que, en general, se encuentra también muy alejada del día a día de quienes nos dedicamos a esta profesión. Desde la Asociación Española de Pediatría (AEP) se ha creado una plataforma específica de investigación —INVEST-AEP— para dar respuesta específica a los retos de la investigación en el seno de nuest…
Improved short-term outcomes of kidney transplants in controlled donation after the circulatory determination of death with the use of normothermic regional perfusion.
Normothermic Regional Perfusion (NRP) allows the in situ perfusion of organs with oxygenated blood in donation after the circulatory determination of death (DCDD). We aimed at evaluating the impact of NRP on the short-term outcomes of kidney transplants in controlled DCDD (cDCDD). This is a multicenter, nationwide, retrospective study comparing cDCDD kidneys obtained with NRP versus the standard rapid recovery (RR) technique. During 2012-2018, 2,302 cDCDD adult kidney transplants were performed in Spain using NRP (n=865) or RR (n=1,437). The study groups differed in donor and recipient age, warm and cold ischemic time and use of ex situ machine perfusion. Transplants in the NRP group were m…
Clinical profile and predictors of in-hospital mortality among older patients hospitalised for COVID-19.
Abstract Background the coronavirus disease 2019 (COVID-19) is characterized by poor outcomes and mortality, particularly in older patients. Methods post hoc analysis of the international, multicentre, ‘real-world’ HOPE COVID-19 registry. All patients aged ≥65 years hospitalised for COVID-19 were selected. Epidemiological, clinical, analytical and outcome data were obtained. A comparative study between two age subgroups, 65–74 and ≥75 years, was performed. The primary endpoint was all cause in-hospital mortality. Results about, 1,520 patients aged ≥65 years (60.3% male, median age of 76 [IQR 71–83] years) were included. Comorbidities such as hypertension (69.2%), dyslipidaemia (48.6%), card…
Colesterol HDL y enfermedad cardiovascular en mujeres hipertensas de España. Estudio RIMHA
Introduccion y objetivos. Evaluar la prevalencia de concentracion baja de colesterol de las lipoproteinas de alta densidad (cHDL), los factores asociados y la relacion con la enfermedad cardiovascular (ECV), en 11.042 mujeres hipertensas de 55 o mas anos de edad. Metodos. Analisis del estudio transversal RIMHA. Se recogieron datos demograficos, bioquimicos, y clinicos. Se analizo la relacion entre cHDL bajo (< 46 mg/dl) y ECV, y entre concentracion de cHDL (quintiles) y ECV mediante modelos multivariables de regresion logistica. Resultados. La prevalencia de cHDL bajo fue del 24,3% (intervalo de confianza [IC] del 95%, 23,5-25,1), y fue mayor en mujeres diabeticas o con ECV. El cHDL bajo se…
Prevalencia de fibrilación auricular en la población española de 60 o más años de edad. Estudio PREV-ICTUS
Introduction and objectives. The aims of this study were to determine the prevalence of atrial fibrillation in individuals aged 60 years or more in Spain using a random sample of the population and to identify associated factors. Methods. An analysis of the PREV-ICTUS study, a randomized cross-sectional population-based study of individuals aged 60 years or more, was carried out. Data on demographic variables, cardiovascular risk factors, and cardiovascular disease were obtained from medical records. The diagnosis of atrial fibrillation was based on the patient’s medical history and an electrocardiogram performed during the study. Results. In the 7108 individuals studied (mean age, 71.9 [7.…
Gender Differences in the Presentation and Outcomes of Hospitalized Patients With COVID-19
Gender-related differences in COVID-19 clinical presentation, disease progression, and mortality have not been adequately explored. We analyzed the clinical profile, presentation, treatments, and outcomes of patients according to gender in the HOPE-COVID-19 International Registry. Among 2,798 enrolled patients, 1,111 were women (39.7%). Male patients had a higher prevalence of cardiovascular risk factors and more comorbidities at baseline. After propensity score matching, 876 men and 876 women were selected. Male patients more often reported fever, whereas female patients more often reported vomiting, diarrhea, and hyposmia/anosmia. Laboratory tests in men presented alterations consistent w…
Prognostic Impact of Hyponatremia and Hypernatremia in COVID-19 Pneumonia. A HOPE-COVID-19 (Health Outcome Predictive Evaluation for COVID-19) Registry Analysis
Dysnatremia is associated with increased mortality in patients with community-acquired pneumonia. SARS-COV2 (Severe-acute-respiratory syndrome caused by Coronavirus-type 2) pneumonia can be fatal. The aim of this study was to ascertain whether admittance dysnatremia is associated with mortality, sepsis, or intensive therapy (IT) in patients hospitalized with SARS-COV2 pneumonia. This is a retrospective study of the HOPE-COVID-19 registry, with data collected from January 1th through April 31th, 2020. We selected all hospitalized adult patients with RT-PCR-confirmed SARS-COV2 pneumonia and a registered admission serum sodium level (SNa). Patients were classified as hyponatremic (SNa &lt;…