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Article: Multidisciplinary management of cardiovascular disease in women: Delphi consensus.

Gámez, José M / Pedreira Pérez, Milagros / Fernández Olmo, María Rosa / Fasero Laiz, María / Inaraja, Verónica / Pallarés Carratalá, Vicente

Frontiers in cardiovascular medicine

2024 Volume 11, Page(s) 1315503

Abstract: Background: Current clinical guidelines on cardiovascular disease (CVD) do not specifically address the female population. The aim of this consensus is to know the opinion of a group of experts on the management of CVD in women.: Methods: Through a ... ...

Abstract	Background: Current clinical guidelines on cardiovascular disease (CVD) do not specifically address the female population. The aim of this consensus is to know the opinion of a group of experts on the management of CVD in women. Methods: Through a Delphi consensus, 31 experts in cardiology, 9 in gynecology and obstetrics, and 14 primary care physicians, showed their degree of agreement on 44 items on CVD in women divided into the following groups: (1) risk factors and prevention strategies; (2) diagnosis and clinical manifestations; and (3) treatment and follow-up. Results: After two rounds, consensus in agreement was reached on 27 items (61.4%). Most of the non-consensus items (31.8%) belonged to group 3. The lack of consensus in this group was mainly among gynecologists and primary care physicians. The panelists agreed on periodic blood pressure control during pregnancy and delivery to detect hypertensive disorders, especially in women with a history of preeclampsia and/or gestational hypertension, and diabetes mellitus control in those with gestational diabetes. Also, the panelists agreed that women receive statins at a lower intensity than men, although there was no consensus as to whether the efficacy of drug treatments differs between women and men. Conclusions: The high degree of consensus shows that the panelists are aware of the differences that exist between men and women in the management of CVD and the need to propose interventions to reduce this inequality. The low level of consensus reveals the lack of knowledge, and the need for information and training on this topic.
Language	English
Publishing date	2024-02-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2024.1315503
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Cardiovascular Risk in Patients with Dyslipidemia and Their Degree of Control as Perceived by Primary Care Physicians in a Survey-TERESA-Opinion Study.

Pallarés-Carratalá, Vicente / Barrios, Vivencio / Fierro-González, David / Polo-García, Jose / Cinza-Sanjurjo, Sergio

International journal of environmental research and public health

2023 Volume 20, Issue 3

Abstract: Objective: The aim of this study was to evaluate, through a survey, the opinion of primary care (PC) physicians on the magnitude of dyslipidemia and its degree of control in their clinical practice.: Materials and methods: An ecological study was ... ...

Abstract	Objective: The aim of this study was to evaluate, through a survey, the opinion of primary care (PC) physicians on the magnitude of dyslipidemia and its degree of control in their clinical practice. Materials and methods: An ecological study was carried out, in which the physicians were invited to participate by means of an online letter. Data were collected at a single timepoint and were based only on the experience, knowledge, and routine clinical practice of the participating physician. Results: A total of 300 physicians answered the questionnaire and estimated the prevalence of dyslipidemia between 2% and 80%. They estimated that 23.5% of their patients were high-risk, 18.2% were very high-risk, and 14.4% had recurrent events in the last 2 years. The PC physicians considered that 61.5% of their patients achieved the targets set. The participants fixed the presence of side-effects to statins at 14%. The statin that was considered safest with regard to side-effects was rosuvastatin (69%). Conclusions: PC physicians in Spain perceive that the CVR of their patients is high. This, together with the overestimation of the degree of control of LDL-C, could justify the inertia in the treatment of lipids. Moreover, they perceive that one-sixth of the patients treated with statins have side-effects.
MeSH term(s)	Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Physicians, Primary Care ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/drug therapy ; Risk Factors ; Dyslipidemias/drug therapy ; Surveys and Questionnaires ; Heart Disease Risk Factors
Chemical Substances	Hydroxymethylglutaryl-CoA Reductase Inhibitors
Language	English
Publishing date	2023-01-29
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20032388
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Approach to Patients with Obesity and Other Cardiovascular Risk Factors in Primary Care Using the Delphi Methodology.

Morillas Blasco, Pedro / Gómez Moreno, Silvia / Febles Palenzuela, Tomás / Pallarés Carratalá, Vicente

Journal of clinical medicine

2022 Volume 11, Issue 14

Abstract: Background: Implementing preventive strategies for patients with obesity would improve the future burden of cardiovascular diseases. The objective was to present the opinions of experts on the approach to treating patients with obesity and other ... ...

Abstract	Background: Implementing preventive strategies for patients with obesity would improve the future burden of cardiovascular diseases. The objective was to present the opinions of experts on the approach to treating patients with obesity and other cardiovascular risk factors from a primary care perspective in Spain; Methods: Using the Delphi technique, a 42-question questionnaire was developed based on results from the scientific literature, and sent to 42 experts in primary care. Two rounds of participation were held; Results: There is a close relationship between obesity and cardiovascular risk factors among primary care physicians. It is necessary to use a checklist in primary care that includes metabolic parameters such as body mass index, waist circumference, and levels of C-reactive protein and ferritin. It is also useful to combine pharmacological treatment, such as liraglutide, with a change in lifestyle to achieve therapeutic goals in this population; Conclusions: There is a high level of awareness among experts in Spain regarding obesity and other cardiovascular risk factors, and the need to address this pathology comprehensively. The need to incorporate specific tools in primary care consultations that allow for better assessment and follow-up of these patients, such as cuffs adapted to arm size or imaging techniques to assess body fat, is evident. Teleconsultation is imposed as a helpful tool for follow-up. Experts recommend that patients with obesity and associated comorbidities modify their lifestyle, incorporate a Mediterranean diet, and administer liraglutide.
Language	English
Publishing date	2022-07-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11144130
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Article: Heart Failure Prevalence Rates and Its Association with Other Cardiovascular Diseases and Chronic Kidney Disease: SIMETAP-HF Study.

Ruiz-García, Antonio / Serrano-Cumplido, Adalberto / Escobar-Cervantes, Carlos / Arranz-Martínez, Ezequiel / Turégano-Yedro, Miguel / Pallarés-Carratalá, Vicente

Journal of clinical medicine

2023 Volume 12, Issue 15

Abstract: Introduction and objectives: Heart failure (HF) is a major health problem that causes high mortality and hospitalization rates. This study aims to determine the HF prevalence rates in populations aged both ≥18 years and ≥50 years and to assess its ... ...

Abstract	Introduction and objectives: Heart failure (HF) is a major health problem that causes high mortality and hospitalization rates. This study aims to determine the HF prevalence rates in populations aged both ≥18 years and ≥50 years and to assess its association with cardiovascular diseases and chronic kidney disease. Methods: A cross-sectional observational study was conducted in a primary care setting, with a population-based random sample of 6588 people aged 18.0-102.8 years. Crude and adjusted prevalence rates of HF were calculated. The associations of renal and cardiometabolic factors with HF were assessed in both populations using univariate, bivariate and multivariate analysis. Results: The HF crude prevalence rates were 2.8% (95%CI: 2.4-3.2) in adults (≥18 years), and 4.6% (95%CI: 4.0-5.3) in the population aged ≥ 50 years, without significant differences between males and females in both populations. The age- and sex-adjusted prevalence rates were 2.1% (male: 1.9%; female: 2.3%) in the overall adult population, and 4.5% (male: 4.2%; female: 4.8%) in the population aged ≥ 50 years, reaching 10.0% in the population aged ≥ 70 years. Atrial fibrillation, hypertension, low estimated glomerular filtration rate (eGFR), coronary heart disease (CHD), stroke, sedentary lifestyle, and diabetes were independently associated with HF in both populations. A total of 95.7% (95%CI: 92.7-98.6) of the population with HF had an elevated cardiovascular risk. Conclusions: This study reports that HF prevalence increases from 4.5% in the population over 50 years to 10% in the population over 70 years. The main clinical conditions that are HF-related are sedentary lifestyle, atrial fibrillation, hypertension, diabetes, low eGFR, stroke, and CHD.
Language	English
Publishing date	2023-07-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12154924
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Article ; Online: Vitamin D Supplementation and Its Impact on Mortality and Cardiovascular Outcomes: Systematic Review and Meta-Analysis of 80 Randomized Clinical Trials.

Ruiz-García, Antonio / Pallarés-Carratalá, Vicente / Turégano-Yedro, Miguel / Torres, Ferran / Sapena, Víctor / Martin-Gorgojo, Alejandro / Martin-Moreno, Jose M

Nutrients

2023 Volume 15, Issue 8

Abstract: Background: The impact of vitamin D supplementation on cardiovascular outcomes and mortality risk reduction remains unclear due to conflicting study findings.: Methods: We conducted a systematic review and meta-analysis of randomized controlled ... ...

Abstract	Background: The impact of vitamin D supplementation on cardiovascular outcomes and mortality risk reduction remains unclear due to conflicting study findings. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), published between 1983 and 2022, that reported the effect of vitamin D supplementation in adults versus placebo or no treatment on all-cause mortality (ACM), cardiovascular mortality (CVM), non-cardiovascular mortality (non-CVM), and cardiovascular morbidities. Only studies with a follow-up period longer than one year were included. The primary outcomes were ACM and CVM. Secondary outcomes were non-CVM, myocardial infarction, stroke, heart failure, and major or extended adverse cardiovascular events. Subgroup analyses were performed according to low-, fair- and good-quality RCTs. Results: Eighty RCTs were assessed, including 82,210 participants receiving vitamin D supplementation and 80,921 receiving placebo or no treatment. The participants' mean (SD) age was 66.1 (11.2) years, and 68.6% were female. Vitamin D supplementation was associated with a lower risk of ACM (OR: 0.95 [95%CI 0.91-0.99] Conclusions: The emerging results of our meta-analysis present evidence that vitamin D supplementation appears to decrease the risk of ACM (especially convincing in the fair- and good-quality RCTs), while not showing a decrease in the specific cardiovascular morbidity and mortality risk. Thus, we conclude that further research is warranted in this area, with well-planned and executed studies as the basis for more robust recommendations.
MeSH term(s)	Adult ; Female ; Humans ; Aged ; Male ; Cause of Death ; Randomized Controlled Trials as Topic ; Myocardial Infarction/drug therapy ; Vitamin D/therapeutic use ; Dietary Supplements
Chemical Substances	Vitamin D (1406-16-2)
Language	English
Publishing date	2023-04-07
Publishing country	Switzerland
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu15081810
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Post-event follow-up costs in patients with atherosclerotic cardiovascular disease in Spain.

Martínez López, Icíar / Gómez Cerezo, Jorge Francisco / Gámez, José M / Egocheaga Cabello, Isabel / Castellanos, Mar / Campuzano Ruiz, Raquel / Barrios, Vivencio / Pallarés-Carratalá, Vicente / Rodríguez, José Manuel / Morant Talamante, Nuria / Parrondo, Javier / Mostaza, José María

Frontiers in cardiovascular medicine

2024 Volume 11, Page(s) 1324537

Abstract: Introduction: Atherosclerotic cardiovascular disease (ASCVD) is one of the main causes of morbidity and mortality in developed countries and entails high resources use and costs for health systems. The risk of suffering future cardiovascular (CV) events ...

Abstract	Introduction: Atherosclerotic cardiovascular disease (ASCVD) is one of the main causes of morbidity and mortality in developed countries and entails high resources use and costs for health systems. The risk of suffering future cardiovascular (CV) events and the consequent resources use is higher in those patients who have already had a previous cardiovascular event. The objective of the study was to determine the average annual cost of patients with a new or recurrent atherosclerotic CV event during the 2 years after the event. Methodology: Retrospective observational study of electronic medical records of patients from the BIG-PAC® database (7 integrated health areas of 7 Autonomous Communities; Results: A total of 26,976 patients with an ASCVD episode were identified during the recruitment period; Out of them, 6,798 had a recurrent event during the follow-up period and 2,414 died. The average costs per patient were €11,171 during the first year and €9,944 during the second year. Discussion: Patients with ASCVD represent a significant economic burden for the health system and for society. Despite the perception that drug costs in the follow-up of chronic patients imply a high percentage of the costs, these accounted for only one tenth of the total amount. Implementing preventive programs and increasing the control of cardiovascular risk factors may have a significant social and health impact by helping to reduce mortality and costs for the Spanish National Health System. The costs derived from pharmacological treatments were obtained from the NHS pricing nomenclator database (https://www.sanidad.gob.es/profesionales/nomenclator.do).
Language	English
Publishing date	2024-02-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2024.1324537
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Predictive Models for Forecasting Public Health Scenarios: Practical Experiences Applied during the First Wave of the COVID-19 Pandemic.

Martin-Moreno, Jose M / Alegre-Martinez, Antoni / Martin-Gorgojo, Victor / Alfonso-Sanchez, Jose Luis / Torres, Ferran / Pallares-Carratala, Vicente

International journal of environmental research and public health

2022 Volume 19, Issue 9

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	COVID-19/epidemiology ; Forecasting ; Humans ; Pandemics ; Public Health ; SARS-CoV-2
Language	English
Publishing date	2022-05-03
Publishing country	Switzerland
Document type	Journal Article ; Systematic Review
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph19095546
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Elevated pulse pressure and cardiovascular risk associated in Spanish population attended in primary care: IBERICAN study.

Moyá-Amengual, Ana / Ruiz-García, Antonio / Pallarés-Carratalá, Vicente / Serrano-Cumplido, Adalberto / Prieto-Díaz, Miguel Ángel / Segura-Fragoso, Antonio / Cinza-Sanjurjo, Sergio

Frontiers in cardiovascular medicine

2023 Volume 10, Page(s) 1090458

Abstract: Introduction: Elevated pulse pressure (ePP) is an independent marker of cardiovascular risk (CVR) in people older than 60, and a functional marker of subclinical target organ damage (sTOD) which can predict cardiovascular events in patients with ... ...

Abstract	Introduction: Elevated pulse pressure (ePP) is an independent marker of cardiovascular risk (CVR) in people older than 60, and a functional marker of subclinical target organ damage (sTOD) which can predict cardiovascular events in patients with hypertension (HTN), regardless of sTOD. Objective: To evaluate the prevalence of ePP in adult population seen in primary care and its association with other vascular risk factors, sTOD and with cardiovascular disease (CVD). Materials and methods: Observational multicentre study conducted in Spain (8,066 patients, 54.5% women) from the prospective cohort study IBERICAN recruited in Primary Care. Pulse pressure (PP) was defined as the difference between the systolic blood pressure (SBP) and the diastolic blood pressure (DBP) ≥60 mmHg. Adjusted (for age and sex) ePP prevalence were determined. Bivariate and multivariate analyses of the possible variables associated with ePP were carried out. Results: The mean of PP was 52.35 mmHg, and was significantly higher ( Conclusions: The ePP was present in a quarter of our sample, and it was increased with the age. Also, the ePP was more frequent in men, patients with HTN, other TOD (as left ventricular hypertrophy or low estimated glomerular filtration rate) and CVD; because of this, the ePP was associated a higher cardiovascular risk. In our opinion, the ePP is an importer risk marker and its early identification lets to improve better diagnostic and therapeutic management.
Language	English
Publishing date	2023-05-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2023.1090458
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Article ; Online: Prevalence Rates of Arterial Hypertension According to the Threshold Criteria of 140/90 or 130/80 mmHg and Associated Cardiometabolic and Renal Factors: SIMETAP-HTN Study.

Pallarés-Carratalá, Vicente / Ruiz-García, Antonio / Serrano-Cumplido, Adalberto / Arranz-Martínez, Ezequiel / Divisón-Garrote, Juan Antonio / Moyá-Amengual, Ana / Escobar-Cervantes, Carlos / Barrios, Vivencio

Medicina (Kaunas, Lithuania)

2023 Volume 59, Issue 10

Abstract: Background and ... ...

Abstract	Background and objectives
MeSH term(s)	Adult ; Humans ; Male ; Female ; Cardiovascular Diseases/epidemiology ; Prevalence ; Cross-Sectional Studies ; Hypertension/complications ; Blood Pressure/physiology ; Diabetes Mellitus/epidemiology ; Risk Factors ; Coronary Disease ; Renal Insufficiency, Chronic/complications ; Obesity/complications ; Heart Failure/complications ; Atherosclerosis/complications
Language	English
Publishing date	2023-10-17
Publishing country	Switzerland
Document type	Observational Study ; Journal Article
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina59101846
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Lights and shadows of the 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice.

Martín-Rioboó, Enrique / Brotons-Cuixart, Carlos / Ruiz García, Antonio / Villafañe Sanz, Fátima / Frías Vargas, Manuel / Moyá Amengual, Ana / Divisón Garrote, Juan Antonio / Seoane Vicente, María Cruz / Banegas, José R / Pallarés Carratalá, Vicente

Revista espanola de salud publica

2023 Volume 97

Abstract: General practitioners see in their consultation a a significant number of patients at high vascular risk (VR). The European Guidelines for Cardiovascular Disease Prevention (2021) recommend a new risk classification and intervention strategies on on ... ...

Title translation	Luces y sombras de la Guía Europea esc-2021 de Prevención de la Enfermedad Cardiovascular en la Práctica Clínica.
Abstract	General practitioners see in their consultation a a significant number of patients at high vascular risk (VR). The European Guidelines for Cardiovascular Disease Prevention (2021) recommend a new risk classification and intervention strategies on on vascular risk factors (RF), with the aim of providing a shared decision-making recommendations between professionals and patients. In this document we present a critical analysis of these guidelines, offering possible solutions that can be implemented in Primary Care. It should be noted that there are positive aspects (lights) such as that the SCORE2 (from forty to sixty-nine years) and SCORE2-OP models (from seventy to eighty-nine years) are based on more current cohorts and measure cardiovascular risk in a more accurately manner. In addition, it is proposed to differentiate different risk thresholds according to age-groups. For sake of practicality, cardiovascular risk can be estimated using different websites with the new computer models. However, among the negative aspects (shadows), it seems to be add complexity implementing nine subgroups of subjects according to their age or level of risk, with a defined thresholds that could cause a substantial increase in the potential number of subjects susceptible to treatment without a clear evidence that supports it. In addition, two-step RF interventions could delay achievement of therapeutic goals, especially in very high-risk patients, diabetics, or patients with cardiovascular disease. Given these limitations, in this document we propose practical recommendations in order to simplify and facilitate the implementation of the guideline in primary care.
MeSH term(s)	Humans ; Cardiovascular Diseases/prevention & control ; Spain ; Risk Factors ; Referral and Consultation ; Retrospective Studies
Language	Spanish
Publishing date	2023-08-16
Publishing country	Spain
Document type	English Abstract ; Journal Article
ZDB-ID	1288657-9
ISSN	2173-9110 ; 0034-8899 ; 1135-5727
ISSN (online)	2173-9110
ISSN	0034-8899 ; 1135-5727
Database	MEDical Literature Analysis and Retrieval System OnLINE

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