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The burden of cardiovascular morbidity in a European Mediterranean population with multimorbidity : a cross-sectional study
Violán i Fors, Concepció (Universitat Autònoma de Barcelona)
Bejarano Rivera, Néker (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Foguet Boreu, Quintí (Universitat Autònoma de Barcelona)
Roso Llorach, Albert (Universitat Autònoma de Barcelona)
Pons‐Vigués, Mariona (Universitat Autònoma de Barcelona)
Martín Mateo, Miguel (Universitat Autònoma de Barcelona)
Pujol Ribera, Enriqueta (Universitat Autònoma de Barcelona)
Institut Universitari d'Investigació en Atenció Primària Jordi Gol

Fecha: 2016
Resumen: Cardiovascular diseases are highly represented in multimorbidity patterns. Nevertheless, few studies have analysed the burden of these diseases in the population with multimorbidity. The objective of this study was to identify and describe the cardiovascular diseases among the patients with multimorbidity. We designed a cross-sectional study in patients ≥19 years old assigned to 251 primary health care centres in Catalonia, Spain. The main outcome was cardiovascular morbidity burden, defined as the presence of one or more of 24 chronic cardiovascular diseases in multimorbid patients (≥2 chronic conditions). Two groups were defined, with and without multimorbidity; the multimorbidity group was further divided into cardiovascular and non-cardiovascular subgroups. The secondary outcomes were: modifiable major cardiovascular risk factors (smoking, hypertension, hypercholesterolaemia, diabetes) and cardiovascular risk score (REGICOR, Registre Gironí del Cor). Other variables analysed were: sex, age (19–24, 25–44, 45–64, 65–79, and 80+ years), number of chronic diseases, urban setting, active toxic habits (smoking and alcohol), physical parameters and laboratory tests. A total of 1,749,710 individuals were included (mean age, 47. 4 years [SD: 17. 8]; 50. 7 % women), of which nearly half (46. 8 %) had multimorbidity (95 % CI: 46. 9–47. 1). In patients with multimorbidity,, the cardiovascular burden was 54. 1 % of morbidity (95 % CI: 54. 0–54. 2) and the four most prevalent cardiovascular diseases were uncomplicated hypertension (75. 3 %), varicose veins of leg (20. 6 %), "other" heart disease (10. 5 %) and atrial fibrillation/flutter (6. 7 %). In the cardiovascular morbidity subgroup, 38. 2 % had more than one cardiovascular disease. The most prevalent duet and triplet combinations were uncomplicated hypertension & lipid disorder (38. 8 %) and uncomplicated hypertension & lipid disorder & non-insulin dependent diabetes (11. 3 %), respectively. By age groups, the same duet was the most prevalent in patients aged 45–80 years and in men aged 25–44 years. In women aged 19–44, varicose veins of leg & anxiety disorder/anxiety was the most prevalent; in men aged 19–24, it was uncomplicated hypertension & obesity. Patients with multimorbidity showed a higher cardiovascular risk profile than the non-multimorbidity group. More than 50 % percent of patients with multimorbidity had cardiovascular diseases, the most frequent being hypertension. The presence of cardiovascular risk factors and the cardiovascular risk profile were higher in the multimorbidity group than the non-multimorbidity group. Hypertension, diabetes and dyslipidaemia constituted the most prevalent multimorbidity pattern.
Nota: Altres ajuts: European Regional Development Fund (IP12/00427)
Nota: Número d'acord de subvenció ISCIII/RD12-0005
Derechos: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. Creative Commons
Lengua: Anglès.
Documento: article ; recerca ; publishedVersion
Materia: Multimorbidity ; Cardiovascular morbidity ; Cardiovascular risk factors ; Comorbidity ; Electronic health records ; Primary health care
Publicado en: BMC Family Practice, Vol. 17 (November 2016) , art. 150, ISSN 1471-2296

PMID: 27809772
DOI: 10.1186/s12875-016-0546-4


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