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Biomedical subjects

Jaume Marrugat

Publications and source records attributed to Jaume Marrugat.

At least 19 recordsLinked to original sources
PubMed2026

Aerobic Fitness and Health-Related Phenotypes: A Two-Stage Phenome-Wide Mendelian Randomization Study.

PURPOSE: We investigated potentially causal associations between genetically predicted aerobic fitness and multiple health phenotypes using a two-stage phenome-wide Mendelian randomization (MR) study. METHODS: Genetically determined aerobic fitness, as operationalized by Cai et al., served as the exposure instrument. We screened 712 health-related phenotypes as outcomes using publicly available European-ancestry genome-wide association studies (GWAS) summary statistics from OpenGWAS (Discovery GWAS n > 5000), prioritizing non-UK Biobank/non-FinnGen datasets for Discovery when available and selecting an independent GWAS for validation. Associations were estimated using the MR-Robust Adjusted Profile Score method, controlled for multiple testing (5% false discovery rate) and unaffected by violations of MR assumptions (directional concordance between discovery and validation; no evidence of horizontal pleiotropy across inverse-variance weighted, MR-Egger, weighted-median, and weighted-mode methods; negative control analysis on hair color). RESULTS: We identified 108 discovery associations, of which 34 remained valid and statistically significant after validation. Higher genetically determined aerobic fitness was associated with lower lacunar stroke risk, lower arterial stiffness, higher heart rate variability, lower diastolic blood pressure, more favorable anthropometric measures, lower use of antidiabetic drugs, lower asthma risk, lower C-reactive protein, higher bone mineral density, favorable liver function biomarkers, favorable platelet-related traits, multiple blood count-derived hematological cell indices and counts, as well as higher years of schooling. Adverse associations were confined to atrial fibrillation, valvular heart disease, and systolic blood pressure. CONCLUSIONS: Genetically determined aerobic fitness is linked to a broad pattern of favorable cardiometabolic, inflammatory, musculoskeletal, respiratory, hepatic, and hematological phenotypes, alongside a narrow set of potential cardiovascular hazards.

Humans↗
PubMed2007

Validity of an adaptation of the Framingham cardiovascular risk function: the VERIFICA Study.

BACKGROUND: To assess the reliability and accuracy of the Framingham coronary heart disease (CHD) risk function adapted by the Registre Gironí del Cor (REGICOR) investigators in Spain. METHODS: A 5-year follow-up study was completed in 5732 participants aged 35-74 years. The adaptation consisted of using in the function the average population risk factor prevalence and the cumulative incidence observed in Spain instead of those from Framingham in a Cox proportional hazards model. Reliability and accuracy in estimating the observed cumulative incidence were tested with the area under the curve comparison and goodness-of-fit test, respectively. RESULTS: The Kaplan-Meier CHD cumulative incidence during the follow-up was 4.0% in men and 1.7% in women. The original Framingham function and the REGICOR adapted estimates were 10.4% and 4.8%, and 3.6% and 2.0%, respectively. The REGICOR-adapted function's estimate did not differ from the observed cumulated incidence (goodness of fit in men, p = 0.078, in women, p = 0.256), whereas all the original Framingham function estimates differed significantly (p<0.001). Reliabilities of the original Framingham function and of the best Cox model fit with the study data were similar in men (area under the receiver operator characteristic curve 0.68 and 0.69, respectively, p = 0.273), whereas the best Cox model fitted better in women (0.73 and 0.81, respectively, p<0.001). CONCLUSION: The Framingham function adapted to local population characteristics accurately and reliably predicted the 5-year CHD risk for patients aged 35-74 years, in contrast with the original function, which consistently overestimated the actual risk.

Adult↗
PubMed2006

Effect of olive oils on biomarkers of oxidative DNA stress in Northern and Southern Europeans.

High consumption of olive oil in the Mediterranean diet has been suggested to protect DNA against oxidative damage and to reduce cancer incidence. We investigated the impact of the phenolic compounds in olive oil, and the oil proper, on DNA and RNA oxidation in North, Central, and South European populations. In a multicenter, double-blind, randomized, controlled crossover intervention trial, the effect of olive oil phenolic content on urinary oxidation products of guanine (8-oxo-guanine, 8-oxo-guanosine and 8-oxo-deoxyguanosine) was investigated. Twenty-five milliliters of three olive oils with low, medium, and high phenolic content were administered to healthy males (n=182) daily for 3 wk. At study baseline the urinary excretion of 8-oxo-guanosine (RNA oxidation) and 8-oxo-deoxyguanosine (DNA oxidation) was higher in the Northern regions of Europe compared with Central and Southern European regions (P=0.035). Urinary excretion of the 8 hydroxylated forms of guanine, guanosine, deoxyguanosine and their nonoxidized forms were not different when comparing olive oils with low, medium, and high phenolic content given for 2 wk. Testing the effect of oil from urinary 8-oxo-deoxyguanosine changes from baseline to post-treatment showed a reduction of DNA oxidation by 13% (P=0.008). These findings support the idea that ingestion of olive oil is beneficial and can reduce the rate of oxidation of DNA. This effect is not due to the phenolic content in the olive oil. The higher DNA and RNA oxidation in Northern European regions compared with that in Central and Southern regions supports the contention that olive oil consumption may explain some of the North-South differences in cancer incidences in Europe.

8-Hydroxy-2'-Deoxyguanosine↗
PubMed2006

Myocardial infarction and alcohol consumption: a population-based case-control study.

BACKGROUND AND AIM: Coronary heart disease (CHD) is the leading cause of death in industrialized societies. Identifying and characterizing modifiable variables associated with CHD is an important issue for health policy. The aim of the present study was to analyze the association of non-fatal myocardial infarction with total alcohol consumption and type of alcoholic beverage consumed. Preference of the subjects' consumption for beer, wine, or spirits was set at 80% or more of total alcoholic beverage consumption. METHODS AND RESULTS: A population-based case-control study (244 subjects and 1270 controls) was conducted. Male patients aged 25 to 74 years with first myocardial infarction (MI) were recruited in the same region as the healthy male controls, who were taken from a random sample representative of the Gerona population. Alcoholic beverage consumption during the preceding week was recorded. Multiple logistic regression analysis was performed to determine the association of alcohol consumption and non-fatal MI. Total alcohol consumption up to 30 g per day, adjusted for lifestyle and cardiovascular risk factors, was inversely associated (Odds ratio 0.14; 95% confidence interval 0.06-0.36) with the risk of non-fatal MI. Drinking up to 20 g of alcohol through wine, beer and spirits significantly decreased the adjusted risk of MI. Higher alcohol intake did not substantially reduce the risk. A preference for spirits was correlated with a significantly increased risk of non-fatal MI (P<0.05). CONCLUSION: Moderate alcohol consumption, independent of the type of alcoholic beverage, was associated with non-fatal MI risk reduction.

Adult↗
PubMed2006

The effect of polyphenols in olive oil on heart disease risk factors: a randomized trial.

BACKGROUND: Virgin olive oils are richer in phenolic content than refined olive oil. Small, randomized, crossover, controlled trials on the antioxidant effect of phenolic compounds from real-life daily doses of olive oil in humans have yielded conflicting results. Little information is available on the effect of the phenolic compounds of olive oil on plasma lipid levels. No international study with a large sample size has been done. OBJECTIVE: To evaluate whether the phenolic content of olive oil further benefits plasma lipid levels and lipid oxidative damage compared with monounsaturated acid content. DESIGN: Randomized, crossover, controlled trial. SETTING: 6 research centers from 5 European countries. PARTICIPANTS: 200 healthy male volunteers. MEASUREMENTS: Glucose levels, plasma lipid levels, oxidative damage to lipid levels, and endogenous and exogenous antioxidants at baseline and before and after each intervention. INTERVENTION: In a crossover study, participants were randomly assigned to 3 sequences of daily administration of 25 mL of 3 olive oils. Olive oils had low (2.7 mg/kg of olive oil), medium (164 mg/kg), or high (366 mg/kg) phenolic content but were otherwise similar. Intervention periods were 3 weeks preceded by 2-week washout periods. RESULTS: A linear increase in high-density lipoprotein (HDL) cholesterol levels was observed for low-, medium-, and high-polyphenol olive oil: mean change, 0.025 mmol/L (95% CI, 0.003 to 0.05 mmol/L), 0.032 mmol/L (CI, 0.005 to 0.05 mmol/L), and 0.045 mmol/L (CI, 0.02 to 0.06 mmol/L), respectively. Total cholesterol-HDL cholesterol ratio decreased linearly with the phenolic content of the olive oil. Triglyceride levels decreased by an average of 0.05 mmol/L for all olive oils. Oxidative stress markers decreased linearly with increasing phenolic content. Mean changes for oxidized low-density lipoprotein levels were 1.21 U/L (CI, -0.8 to 3.6 U/L), -1.48 U/L (-3.6 to 0.6 U/L), and -3.21 U/L (-5.1 to -0.8 U/L) for the low-, medium-, and high-polyphenol olive oil, respectively. LIMITATIONS: The olive oil may have interacted with other dietary components, participants' dietary intake was self-reported, and the intervention periods were short. CONCLUSIONS: Olive oil is more than a monounsaturated fat. Its phenolic content can also provide benefits for plasma lipid levels and oxidative damage. International Standard Randomised Controlled Trial number: ISRCTN09220811.

Adult↗
PubMed2006

The second Euro Heart Survey on acute coronary syndromes: Characteristics, treatment, and outcome of patients with ACS in Europe and the Mediterranean Basin in 2004.

AIMS: Our study aimed to examine the management of acute coronary syndromes (ACS) in Europe and the Mediterranean basin, and to compare adherence to guidelines with that reported in the first Euro Heart Survey on ACS (EHS-ACS-I), 4 years earlier. METHODS AND RESULTS: In a prospective survey conducted in 2004 (EHS-ACS-II), data describing the characteristics, treatment, and outcome of 6385 patients diagnosed with ACS in 190 medical centres in 32 countries were collected. ACS with ST-elevation was the initial diagnosis in 47% of patients, no ST-elevation in 48%, and undetermined electrocardiographic pattern in 5% of patients. Comparison of data collected in 2000 and 2004 showed similar baseline characteristics, but greater use of recommended medications and coronary interventions in EHS-ACS-II. Among patients with ST-elevation, the use of primary reperfusion increased slightly (from 56 to 64%), with a significant shift from fibrinolytic therapy to primary percutaneous coronary intervention (PPCI). The use of PPCI rose from 37 to 59% among those undergoing primary reperfusion therapy. Analysis of data in 34 centres that participated in both surveys showed even greater improvement with respect to the use of recommended medical therapy, interventions, and outcome. CONCLUSION: Data from EHS-ACS-II suggest an increase in adherence to guidelines for treatment of ACS in comparison with EHS-ACS-I.

Acute Disease↗
PubMed2006

Alcohol consumption is directly associated with circulating oxidized low-density lipoprotein.

Findings on the association of alcohol consumption and oxidation of low-density lipoprotein (LDL), which is thought to play a crucial role in the generation of atherosclerotic lesion, are inconsistent. The aim of the present study was to investigate the association of total alcohol consumption and type of alcoholic beverage with circulating plasma LDL oxidation. This cross-sectional study included data of circulating oxidized LDL (ox-LDL) from a subpopulation of 587 men and women enrolled in a population-based survey conducted in 2000 in Girona (Spain). Multivariate analysis was performed to describe the independent association of alcohol consumption and ox-LDL. Increasing alcohol consumption was associated with high in vivo ox-LDL levels in the present population. The consumption of 10 g of alcohol was associated with an increase of 2.40 U/L of ox-LDL (p = 0.002). Adjustment for dietary variables, leisure-time physical activity, educational level, smoking, LDL-cholesterol, high-density lipoprotein-cholesterol, glycemia, triglycerides, diabetes, body mass index, waist circumference, and systolic and diastolic blood pressures only slightly modified this association (p = 0.003). In this full adjusted model the consumption of 10 g of alcohol per day was associated with an increase of 2.11 U/L of ox-LDL. Consumption of wine (ml/day) was associated with increasing ox-LDL levels (p = 0.029), however, attenuated after controlling for alcohol. No significant relationship of ox-LDL with alcohol-independent consumption of wine, beer, and spirits was observed. Alcohol consumption was independently and directly associated with circulating ox-LDL in the present population.

Adult↗
PubMed2006

Circulating oxidized LDL is associated with increased waist circumference independent of body mass index in men and women.

BACKGROUND: Obesity is associated with oxidative stress, and the oxidation of LDL is thought to play a crucial role in the generation of atherosclerotic lesions. OBJECTIVE: The objective was to describe the association of waist circumference (WC) and body mass index (BMI; in kg/m2) with plasma circulating oxidized LDL (ox-LDL) and C-reactive protein (CRP). DESIGN: This cross-sectional study included data for circulating ox-LDL and CRP from a subpopulation of 586 men and women enrolled in a population-based survey conducted in 2000 in Girona, Spain. Multivariate analysis was performed to describe the independent association of WC and BMI with ox-LDL and CRP. RESULTS: Multivariate logistic regression analysis adjusted for lifestyle, educational level, and dietary confounders showed a direct association of WC (quartile distribution) and BMI categories with ox-LDL (P for linear trend = 0.002) and CRP (P for linear trend = 0.004). Subjects in the top quartile of WC and with a BMI > 29.9 were at high risk of elevated circulating concentrations of ox-LDL and CRP. Further adjustment for cardiovascular disease risk factors did not substantially modify these associations. The risk of high ox-LDL concentrations in overweight (BMI = 25.0-29.9) or obese (BMI > or = 30) subjects with a WC < 102 cm (men) or < 88 cm (women) was not significantly different from that in normal-weight subjects with these WCs. In contrast, overweight or obese subjects with higher WCs (WC > or = 102 cm for men and > or = 88 cm for women) were at significantly higher risk of increased ox-LDL. CONCLUSION: High WC was associated with high concentrations of ox-LDL independently of BMI in the study population.

Abdominal Fat↗
PubMed2006

Relationship of classical and non-classical risk factors with genetic variants relevant to coronary heart disease.

BACKGROUND: In addition to the well established cardiovascular risk factors, evidence suggests a possible role of genetic and non-classical risk factors in the development and progression of atherothrombosis. We aimed to determine the relationship of classical and non-classical cardiovascular risk factors with candidate gene polymorphisms potentially involved in cardiovascular risk in the general Mediterranean population. DESIGN: Cross-sectional study. METHODS: We have determined the prevalence of classical (lipid profile, blood pressure, glycaemia, diabetes, smoking, body mass index, menopause and family history of coronary heart disease) and non-classical cardiovascular risk factors (infectious processes, homocysteinaemia, oxidative status, C-reactive protein, lipoprotein (a) and fibrinogen) in a population-based study. We analysed the relationship of these risk factors with the following five gene polymorphisms potentially involved in cardiovascular risk: ATP-binding cassette transporter A1-R219K, Peroxisome proliferator-activated receptor (PPAR)-alpha-L162V, Lipoprotein lipase (LPL)-HindIII, Paraoxonase (PON)1-Q192R, and Tumour necrosis factor (TNF)-alpha-G-308A. RESULTS: We found PPAR-alpha-V and LPL-H alleles to be associated with decreased high-density lipoprotein-cholesterol (HDL-c) concentration and with increased total cholesterol : HDL-c and triglyceride : HDL-c ratios. Regarding the non-classical risk factors, C-reactive protein concentration was higher for the PPAR-alpha-V allele. A higher oxidative status was shown in homozygotes for LPL-H and TNF-alpha-G alleles, although the latter also had lower homocysteinaemia. CONCLUSIONS: Three of the genetic variants analysed, PPAR-alpha-L162V, LPL-HindIII, and TNF-alpha-G-308A, were associated with non-classical risk factors, specifically lipid profile, inflammation, and oxidative status.

ATP Binding Cassette Transporter 1↗
PubMed2006

[Effect of combined beta-blocker and angiotensin-converting enzyme inhibitor treatment on 1-year survival after acute myocardial infarction: findings of the PRIAMHO-II registry].

INTRODUCTION AND OBJECTIVES: Clinical trials have shown that combining beta-blockers and angiotensin-converting enzyme (ACE) inhibitors has an additive effect in reducing mortality in patients with left ventricular dysfunction following acute myocardial infarction. Whether this additive effect also occurs in unselected post-myocardial infarction patients is unknown. METHODS: In total, 5397 patients who were discharged from hospital after suffering an acute myocardial infarction were followed for 1 year. The primary endpoint was all-cause mortality. The effects of the medications on 1-year survival were analyzed using a Cox regression model, which included propensity scores for beta-blocker and ACE inhibitor use to take account of any potential imbalance in drug prescription rates. RESULTS: At hospital discharge, 55.9% of patients were receiving beta-blockers and 45.1%, ACE inhibitors. The 1-year mortality rate was 5.5%. Overall, combination of the two medications significantly reduced the 1-year mortality rate (hazard ratio [HR]=0.51; 95% confidence interval [IC], 0.32-0.82); P<.005) to a greater extent than ACE inhibitors alone (HR=0.78; 95% CI, 0.54-1.12; P=.2) or beta-blockers alone (HR=0.67; 95% CI, 0.43-1.05; P=.08). The same trend was also observed in low-risk patients without acute heart failure who had an ejection fraction > or =40%. CONCLUSIONS: In unselected post-myocardial infarction patients, combined prescription of beta-blockers and ACE inhibitors had an additive effect on the 1-year survival rate.

Adrenergic beta-Antagonists↗
PubMed2006

[Reduction in acute myocardial infarction mortality over a five-year period].

INTRODUCTION AND OBJECTIVES: To assess recent changes in the management of patients with acute myocardial infarction (AMI) and their impact on mortality using data from the PRIAMHO I and II registries (1995 and 2000). PATIENTS AND METHOD: Of the 168 public hospitals in Spain, 24 and 58 contributed to the 1995 and 2000 PRIAMHO registries, respectively. RESULTS: Patients in the PRIAMHO II registry (n=6221) were significantly older, more often female, and proportionally more likely to have coronary risk factors or a previous myocardial infarction, or to have undergone revascularization than those in PRIAMHO I (n=5242). Reperfusion therapy was administered more often (46.9% vs 41.9%, P<.001) and earlier (48 min vs 60 min, P<.001). Antiplatelet drugs were given to 96.1% vs 89.1% of patients, beta-blockers to 51.1% vs 30.1%, and ACE inhibitors to 41.6% vs 24.9% (P<.001 for all comparisons). In addition, 28-day mortality was 11.3% and 14.2% (P<.001), respectively, and one-year mortality, 16.4% and 18.5% (P<.001), respectively. The adjusted hazard ratio for mortality at one year in PRIAMHO II compared with PRIAMHO I was 0.78 (95% CI, 0.70-0.86, P<.001; adjusted for age, sex, diabetes, smoking, dyslipemia, hypertension, previous MI and CABG, ST-elevation status and Killip class at admission, and hospital characteristics). CONCLUSIONS: Even though patients registered in 2000 formed a higher risk group than those registered in 1995, one-year mortality after AMI decreased by 22% over the five-year period. This improvement was due to more frequent and earlier reperfusion therapy and better use of antithrombotics, beta-blockers and ACE inhibitors.

Adrenergic beta-Antagonists↗
PubMed2006

[Epidemiology of cardiovascular disease in women].

Both mortality due to cerebrovascular disease in individuals aged under 85 years and mortality due to acute myocardial infarction (AMI) are lower in women than men. In contrast, the age-adjusted 28-day case fatality rate after a first AMI is 20% higher in women, particularly in countries where the incidence of AMI is low. In Spain, the case fatality rate is elevated in women hospitalized for a first AMI, but not in those with other forms of coronary heart disease. The pattern of mortality observed after symptom onset, which shows that death is delayed in women, suggests that the mechanism of death is different in the two sexes. The substantial variation that exists in the way results are adjusted and presented make it very difficult to compare the findings of different studies. Relative to men, women with AMI are 10 years older, reach hospital one hour later on average, more frequently have a comorbid condition (mainly diabetes and hypertension), progress to a more serious clinical state, and have a higher adjusted 28-day mortality risk. Moreover, the treatment given to women during the acute phase is less aggressive. A change in healthcare workers' attitudes is needed so that women with acute coronary syndromes can be identified earlier, thereby increasing the use of diagnostic and therapeutic procedures to a level that corresponds to the greater severity of AMI observed in women at presentation.

Adult↗
PubMed2005

Protective effect of the KCNMB1 E65K genetic polymorphism against diastolic hypertension in aging women and its relevance to cardiovascular risk.

The E65K polymorphism in the beta1-subunit of the large-conductance, Ca2+-dependent K+ (BK) channel, a key element in the control of arterial tone, has recently been associated with low prevalence of diastolic hypertension. We now report the modulatory effect of sex and age on the association of the E65K polymorphism with low prevalence of diastolic hypertension and the protective role of E65K polymorphism against cardiovascular disease. We analyzed the genotype frequency of the E65K polymorphism in 3924 participants selected randomly in two cross-sectional studies. A five-year follow-up of the cohort was performed to determine whether cardiovascular events had occurred since inclusion. Estrogen modulation of wild-type and mutant ion channel activity was assessed after heterologous expression and electrophysiological studies. Multivariate regression analyses showed that increasing age upmodulates the protective effect of the K allele against moderate-to-severe diastolic hypertension in the overall group of participants (odds ratio [OR], 0.35; P=0.006). The results remained significant when analyses were restricted to women (OR, 0.18; P=0.02) but not men (OR, 0.46; P=0.09). This effect was independent of the reported acute modulation of BK channels by estrogen. A five-year follow-up study also demonstrated a reduced age- and sex-adjusted hazard ratio of 0.11, 95% CI, 0.01 to 0.79 of K-carriers for "combined cardiovascular disease" (myocardial infarction and stroke) compared with EE homozygotes. Our study provides the first genetic evidence for the different impact of the BK channel in the control of human blood pressure in men and women, with particular relevance in aging women, and highlights the E65K polymorphism as one of the strongest genetic factors associated thus far to protection against myocardial infarction and stroke.

Adult↗
PubMed2005

Analysis of inequalities in secondary prevention of coronary heart disease in a universal coverage health care system.

OBJECTIVE: The purpose of this study was to analyse whether differences exist in social class or education level in coronary heart disease (CHD) secondary prevention and in cardiovascular risk factor control in a universal coverage health care system. DESIGN: Cross-sectional multi-centre study. PARTICIPANTS AND SETTING: 1022 CHD patients recruited from residents in the catchment areas covered by 23 primary health care facilities in Catalonia, Spain. MAIN OUTCOME MEASURES: Demographic data, cardiovascular co-morbidity, smoking, blood pressure, fasting blood glucose, triglycerides, total cholesterol, HDL and LDL cholesterol, body mass index (BMI), drug therapy used for secondary prevention, educational level, and social class based on occupation. RESULTS: Patients at the lowest educational level were more frequently women, older, and diabetic. Patients in the middle educational level were more frequently smokers than those in the highest or the lowest level (24.7, 8.7, and 12.0%, respectively; P = 0.008) and had better systolic blood pressure levels (125 mmHg (15), 135 mmHg (16), and 134 mmHg (17), respectively; P = 0.001). All educational levels and social classes had similar adjusted rates of risk factor control. Therapeutic management was also similar among all educational levels and social classes, after adjusting for confounders. CONCLUSIONS: CHD patients in the lower SES received similar treatment for secondary prevention and achieved similar control of risk factors. No social inequalities were found in secondary prevention in CHD patients using the National Health System in Spain.

Adult↗
PubMed2005

Sport practice and the risk of lone atrial fibrillation: a case-control study.

BACKGROUND: Lone atrial fibrillation (LAF) is characterized by the presence of atrial fibrillation in the absence of structural heart disease or other identifiable cause of arrhythmia. In a recent study, we reported sport practice to be more frequent in LAF patients than in the general population. The aim of the study was to determine the association between sport practice and the prevalence of LAF in men. METHODS: An age-matched case-control study was designed. Cases were identified from consecutive patients who attended an outpatient clinic; 51 men with LAF were included, 20 of them with vagal characteristics. Controls were selected from the general population (n=109). A questionnaire to assess former and current sport practice and the number of lifetime hours of sport practice was administered. Conditional logistic regression was used for statistical analysis. RESULTS: The proportion of patients with LAF who reported current sport practice (31%) was higher than that observed in controls (14%). In the logistic regression, current practice of sport was associated with a higher prevalence of LAF (OR=3.13; 95% CI: 1.39-7.05). The practice of more than 1500 lifetime hours of sport appears to be the threshold for the observed association. Current practice of sport with a lifetime practice greater than 1500 h was associated with LAF (OR=2.87; 95% CI: 1.20-6.91). CONCLUSION: In men, the combination of current and prolonged lifetime sport practice is associated with higher risk of LAF.

Adult↗
PubMed2005

Cardiovascular risk profile and type of alcohol beverage consumption: a population-based study.

AIMS: To determine the association between several cardiovascular risk factors with total alcohol and types of alcoholic beverage consumption. METHODS: The subjects were Spanish men (n = 2,383) and women (n = 2,535) aged 25-74 years who were examined in 1994-1995 and 1999-2000, in two population-based cross-sectional surveys in the north-east of Spain (Gerona). Information of total amount and type of alcohol consumption, educational level, smoking, leisure-time physical, antihypertensive and hyperlipidemic drug treatment was obtained through structured questionnaires. The cardiovascular risk factors total cholesterol, HDL cholesterol, triglycerides, fasting glucose, fibrinogen, lipoprotein (a), heart rate and systolic and diastolic blood pressures were determined. RESULTS: Men consumed significantly more alcohol than women (19.5 vs. 4.5 g/day, respectively) and the prevalence of elevated alcohol consumption (>2 glasses of wine/day) also was higher in men (35.3%) than women (3.5%). Total alcohol intake was significantly related with HDL cholesterol and fibrinogen improvements in both genders. In contrast, total cholesterol, triglycerides, heart rate, and systolic and diastolic blood pressures were directly and significantly (p < 0.05) associated with total alcohol consumption in men but not in women. Wine drinking, particularly in women, was associated with a healthy cardiovascular risk profile. Most of the observed significant associations between type of alcohol beverage and CHD risk factors disappeared after controlling for total alcohol consumption and other confounders. CONCLUSIONS: Alcohol consumption was favorably related to the cardiovascular risk profile in women but not in men. The relationship of alcohol beverages seems to be mediated by the total alcohol content rather than by the type of beverage itself.

Alcohol Drinking↗
PubMed2005

Association of time elapsed since the last coronary event with health services utilization.

BACKGROUND: Patients with chronic illness use health services more often but little is known about the use that coronary heart disease patients make of primary care. OBJECTIVE: To determine whether the time elapsed and the perceived quality of life following a major acute coronary event are associated with utilization rate of primary care services. DESIGN: Cross-sectional, multicentre study. SETTING: Twenty-three primary care health centres in Catalonia (Spain). PARTICIPANTS: Patients aged 30-80 years who had suffered a major coronary event in the previous 6 years. MAIN OUTCOME MEASURES: The number of consultations with the general practitioner during the year before the beginning of the study was noted and patients who consulted nine or more times were considered frequent attenders. The time elapsed since the last major coronary event was categorized using the median (2 years) as a cut-off value. The SF-12 quality of life questionnaire was administered. RESULTS: A total of 1022 patients with coronary heart disease were included. The median number of consultations with a general practitioner within the previous year was 5 (range 0 - 36). Patients with a shorter time elapsed since the last coronary event were seen more often by their general practitioner. The probability of being frequent attender was 24% Iower among patients with less recent coronary events (adjusted odds ratio: 0.76, 95% confidence interval: 0.69 - 0.85, p < 0.001). Quality of life scores were similar in frequent and non-frequent attenders. No relationship between comorbidity and frequent attendance was found. CONCLUSIONS: The shorter time elapsed since the last coronary event was an important factor related with frequent attendance in coronary heart disease patients regardless of cardiovascular comorbidity, and perceived quality of life.

Aged↗