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L Rodríguez Padial

Publications and source records attributed to L Rodríguez Padial.

At least 19 recordsLinked to original sources
PubMed2006

[Assessment of cardiovascular risk in population groups. Comparison of Score system and Framingham in hypertensive patients].

INTRODUCTION AND OBJECTIVES: Calculation of cardiovascular risk in populations allows for developing and assessing of intervention programs and adapting health resources. While the Framingham System has been used in the past, a group of European researchers have proposed a different method called the Score project. The purpose of this paper is to compare the value of both methods for assessing cardiovascular risk. METHODS: In 6,775 evaluable hypertensive patients distributed over the 17 Spanish autonomous communities (ACs), the 10-year risk of experiencing a coronary event (CR) was calculated using the Framingham equation, while risk of coronary death (RCD) and vascular death (RVD) was calculated using the Score project system, both at baseline and after one year of blood pressure control with amlodipine at the required dose. A comparison was made of the capacity to detect risk differences by both methods between populations with known different risks, and in the same population as a result of blood pressure control. RESULTS: Both the Score and the Framingham systems detected the significant decrease in both CR and RCD or RVD at one year of application of the CORONARIA study protocol. Risk decrease measured by any of the two methods was significant (p < 0.05) overall, by genders, and by ACs. However, the Score System, unlike the Framingham system, could not detect the reported differences in the mortality risk for coronary and vascular disease between the ACs of the North and the South-East parts of Spain.

Aged↗
PubMed2005

[Limited application of prevention measures in patients with diabetes mellitus type 2 and coronary artery disease in Spain. DIETRIC study].

INTRODUCTION AND OBJECTIVES: Diabetes is a disease with high prevalence that involves high mortality. The control of risk factors reduces the cardiovascular complications. The objective of this study is to define the control degree of cardiovascular risk factors in patients with diabetes and coronary artery disease. METHODS: In DIETRIC study 628 patients with diabetes type 2 and coronary artery disease have been included with the aim to study the antianginous effect of trimetazidine. Patients were studied basally with clinical history, physical exploration, laboratory testing, ECG and exercise test, with 6-month follow-up. In this article the profile of cardiovascular risk and the level of control of the risk factors in the basal study are analyzed. RESULTS: More than 80% of patients showed excess weight or obesity, 73% dyslipemia and 59% hypertension. More than 60% of patients showed 3 or more related risk factors. Only 15% had adequate control of blood pressure, and the control of diastolic pressure (55%) was most frequent than that of systolic (17%). Only 7.5% had adequate control of plasma lipids. Many patients did not take drugs to reduce mortality, as aspirin and statins. CONCLUSIONS: Most of these diabetic patients with coronary artery disease do not have adequate control of risk factors. A limited use of drugs that have proven to reduce cardiovascular mortality in these patients is observed.

Aged↗
PubMed2005

[A prospective study on trimetazidine effectiveness and tolerability in diabetic patients in association to the previous treatment of their coronary disease. DIETRIC study].

INTRODUCTION AND OBJECTIVES: Diabetics frequently suffer diffuse coronary disease with difficulties for coronary artery bypass graft, which means that they require multiple medical treatment. Trimetazidine is an anti-ischemic agent that improves the myocardial metabolism and that can be especially useful in the ischemic myocardium of diabetic patients. The objective of this study is to evaluate in diabetic patients the anti-ischemic effectiveness of trimetazidine associated with regular medical treatment. METHODS: In the DIETRIC study 580 patients with diabetes type 2 and coronary disease have been included for the assessment of antianginous effect of trimetazidine (20 mg/8 h). Basal clinical record, physical examination, laboratory evaluation, ECG and exercise test were carried out, with 6-month follow-up. In this article the clinical and exercise test response to the treatment is analyzed. RESULTS: A reduction of angina episodes was observed (2.8 vs 0,9; p < 0.001), in addition to a reduction of the number of weekly nitroglycerin tablets (2.5 vs 0,7; p < 0.001). In the exercise test carried out at 6-month follow-up an increase in its length was observed (441 vs 391 s; p < 0.001); also an increase of the time up to the decline of ST segment (214 vs 209 s; p = 0.02); at the same time a smaller decline of ST segment occurred (1.7 vs 1,2; p < 0.001). Tolerance was excellent. CONCLUSIONS: In this group of patients with diabetes mellitus type 2 and coronary artery disease, trimetazidine associated with regular medical treatment decreased the incidence of angina episodes and the ischemic response in the exercise test with an excellent tolerance.

Adult↗
PubMed2004

[Coronary risk differences in hypertensive patients of different autonomous communities. CORONARY study].

OBJECTIVES: Various articles describe the existence of differences in cardiovascular morbidity and mortality between different Spanish Autonomous Communities (SACs). We have intended to know if there are coherent differences in hypertensive patients cardiovascular risk. MATERIAL AND METHODS: 1,720 family physicians distributed in the 17 SACs as the number of inhabitants of each one selected 5 consecutive patients maximum within a period of 2 months, with blood pressure > or = 140/90 mmHg and at least another coronary risk factor. In 6,775 of 7,469 patients (51% males), the risk of a coronary event (CE) in the next 10 years according to Framingham equation and the risk of fatal cardiovascular event (RCV) according to Score formula were calculated. RESULTS: CE calculated in the group of patients in primary prevention (and without diabetes) in northern SACs (Cantábrico) was 18.8%, and 20.5% in south-east SACs (Mediterranean) (p < 0.0001). In addition, CE in secondary prevention was 26.1% in northern SACs and 28.6% in south-east SACs (p < 0.0001). The differences remained upon considering diabetics in primary prevention. There were no significant differences, however, in the risk of cardiovascular death (Score) between both areas, being 8.9% in the north and 8.8% in the south-east. CONCLUSIONS: Our study demonstrates that coronary risk is increased in hypertensive populations of south east SACs with respect to SACs of the north and to national average, while the risk of suffering a fatal cardiovascular event is not different.

Aged↗
PubMed2000

[Spanish Society of Cardiology practice guidelines on arterial hypertension].

High blood pressure is a well-known cardiovascular risk factor that is responsible for an elevated morbidity and mortality. However, although efficacious drugs for treatment and numerous and updated scientific training programs are available, the reality is that only a low percentage of patients are followed up in accordance with the rates which are presently considered normal. The purpose of these guidelines is to provide medical guidance for the prevention, detection and evaluation of hypertension, and to provide the best diagnosis and treatment. The factors involved in cardiovascular complications in the hypertensive patient are multiple. That is why this report places more emphasis in the individual cardiovascular risk stratification as part of the treatment strategy. The information obtained in the most recent studies published confirms the interest in achieving the greatest decrease in rates of blood pressure. This treatment to lower levels is especially useful in the high-risk subgroup. It maintains the necessity of nonpharmacological measures or lifestyle modifications in all patients with high blood pressure who either need or do not need drug therapy. All pharmacological groups may be used, but it is appropriate to choose the specific antihypertensive agent adapted to the clinical and individual situation with the use of low doses of drugs to initiate therapy and the use of appropriate drug combinations.

Antihypertensive Agents↗
PubMed2000

[Clinical practice guidelines of the Spanish Society of Cardiology on echocardiography].

Doppler echocardiography has become the technique of choice for the diagnosis and follow-up of most heart diseases its main advantages are that it is non-invasive, easy to use, readily available, rapid and has a high cost-benefict ratio. Multiple studies have demonstrated the accuracy of the technique in the diagnosis and severity quantification of the severity of different diseases. Nevertheless, its main limitation lies in the fact that results are operator dependent, and therefore correct training of the echocardiographer is mandatory. In addition, adequate infrastructure and appropriate equipment are a required guarantee quality of the study. Finally, the technique should be used for the indications, in which beneficial information can be yielded. The aim of the present article was to define and update these considerations to enhance the usefulness of echocardiography in clinical practice.

Adolescent↗
PubMed1999

[An adrenaline-induced vasospasm as the form of presentation of variant angina].

A 41-year-old-man without previous ischemic heart disease, developed a severe anaphylactic reaction. After administration of epinephrine (0.5 mg) the patient complained of chest pain. The electrocardiogram showed an elevation of ST segment in inferior leads. Myocardial necrosis was ruled out. Coronary arteriography disclosed normal coronary arteries. Eight months later, the patient developed severe chest pain during physical activity. ST elevation was again seen in inferior leads. ECG changes disappeared, when sublingual nitroglycerin was administered. A diagnosis of vasospastic angina was made. Exercise test was negative, during treatment with calcium-blocking agents. The patient subsequently remain free of symptoms taking medication. The physiological mechanisms of vasospastic angina and precipitating factors are discussed.

Adult↗
PubMed1997

[Usefulness of the Doppler index delta P/delta t in the evaluation of left ventricular systolic dysfunction].

INTRODUCTION AND OBJECTIVES: It has been shown that the delta P/delta t index, derived from the continuous Doppler mitral regurgitation signal correlates strongly with dP/dt. This study evaluates the feasibility, reproducibility and correlation of the index with ejection fraction and other conventional echocardiographic parameters. MATERIAL AND METHODS: One hundred and ten patients with mitral regurgitation demonstrated by colour Doppler were studied. delta P/delta t were calculated by the ratio between the interval of pression between two points of the Doppler signal (-1 and -3 m/s; 32 mmHg, applying the modified Bernouilli equation) and the interval of time (s) which separates both. Ejection fraction was measured in 70 patients by non-echocardiographic methods (isotopic ventriculography, n = 52, and angiography, n = 18). RESULTS: The index was feasible in 91 cases, the variability of intra and interobserver was 5% and 7% respectively. The correlation between delta P/delta t and ejection fraction was significant although weak (r = 0.59; p < 0.001; n = 70). It was better in the group of dilated idiopathic myocardiopathy (r = 0.72; p < 0.001; n = 18) than in the group of myocardial infarction (r = 0.54; p < 0.01; n = 25). No significant correlation was founded in the cases with mitral rheumatic valvulopathy. Regarding to the echocardiographic parameters, the best correlation was obtained with end systolic diameter (r = -0.64; p < 0.001; n = 49). Finally, a value of delta P/delta t < 1,000 mmHg/s predicted the existence of left ventricular systolic dysfunction with high accuracy (84%), sensitivity (80%) and specificity (92%). CONCLUSIONS: High feasibility when mitral regurgitation exists, adequate reproducibility and heightened precision in diagnosing left ventricular systolic dysfunction, are characteristics which make delta P/delta t useful in the echocardiographic routine practice.

Aged↗
PubMed1991

[The comparative treatment with lovastatin and bezafibrate of primary hypercholesterolemia. A randomized and double-blind trial].

The efficacy and tolerability of lovostatin (L) and bezafibrate (B) were compared in a total of 39 patients, 24 males and 15 females, 59 +/- 9 years old. Showing a total serum cholesterol superior to 250 mg/dl and total serum triglycerides inferior to 350 mg/dl, after 1 month on a low cholesterol diet and another on placebo, were eligible for participation. After randomization 19 treated with L started with 20 or 40 mg at night according to baseline cholesterol under or above 300 respectively and 20 with B received 200 mg tid. If after 6 weeks of therapy cholesterol remained above 200, the doses of L or matching placebo in those with B was double while dose of B or matching placebo remained constant. Cholesterol, triglycerides, LDL-cholesterol and HDL-cholesterol were determined using an enzymatic analytical method. Apolipoproteins were obtained by radial immunodiffusion. Routine hematological analysis and blood chemistry safety tests were performed at baseline and every 6 weeks during active treatment. The average most important results, after 12 weeks of treatment, comparing L vs B were: 1) cholesterol was reduced 26 vs 10% (p less than 0.001); 2) LDL-cholesterol decreased 35 vs 15% (p less than 0.001); 3) HDL-cholesterol increased 5 vs 19% (p = NS); 4) triglycerides diminished 15 vs 18% (p = NS). Three patients in L and 1 in B showed adverse events and two of them, one each group, were drop-out. In summary: a) L was more effective lowering total cholesterol and LDL-cholesterol; b) B was more potent decreasing triglycerides and increasing HDL-cholesterol; c) both drugs showed good tolerability.

Apolipoproteins A↗