Prevalence rates of overweight and obesity and their associations with cardiometabolic and renal factors. SIMETAP-OB study

INTRODUCTION

Excess weight is a major health problem. Aims of this study were to determine the prevalence rates of overweight and obesity, and to compare their associations with cardiometabolic and renal risk factors between obese and non-obese populations, and between overweight and non-overweight populations.

METHODS

Cross-sectional observational study conducted in Primary Care. Population-based random sample: 6,588 study subjects between 18 and 102 years of age (response rate: 66%). Crude and sex- and age-adjusted prevalence rates of overweight and obesity were calculated, and their associations with cardiometabolic and renal variables were assessed by bivariate and multivariate analysis.

RESULTS

The age- and sex-adjusted prevalence rates of overweight and obesity were 36.0% (42.1% in men; 33.1% in women) and 25.0% (26.2% in men; 24.5% in women), respectively. These prevalences increased with age, and were higher in men than in women. Fifty-two percent (95%CI: 50.0-53.9) of the overweight population and 62.3% (95%CI: 60.1-64.5) of the obese population had a high or very high cardiovascular risk. Abdominal obesity, physical inactivity, prediabetes, hypertension, hypertriglyceridemia, and low HDL-C were independently associated with both entities. Furthermore, diabetes was independently associated with overweight and hypercholesterolemia with obesity.

CONCLUSIONS

The prevalence of overweight and obesity was 61.0% (68.4% in men and 59.0% in women). More than half of the overweight population and nearly two-thirds of the obese population had a high cardiovascular risk. Hyperglycemia, physical inactivity, hypertension, hypercholesterolemia, low HDL-C, and hypertriglyceridemia were independently associated with overweight and obesity.

Tasas de prevalencia de enfermedad renal crónica y su asociación con factores cardiometabólicos y enfermedades cardiovasculares. Estudio SIMETAP-ERC

INTRODUCTION

Chronic kidney disease (CKD) is a major health problem that contributes to the development of cardiovascular disorders such as heart failure and arteriosclerotic cardiovascular disease (ACVD). The aims of this study were to determine the prevalence of CKD and to assess its association with ACVD and cardiometabolic risk factors.

METHODS

Cross-sectional observational study conducted in primary care setting. Population-based random sample: 6,588 people between 18 and 102 years old (response rate: 66%). Crude and sex- and age-adjusted prevalence rates of CKD according to KDIGO were determined by assessing albuminuria and estimated glomerular filtration rate according to CKD-EPI, and their associations with cardiometabolic factors and ACVD were determined.

RESULTS

The crude prevalence of CKD was 11.48% (95%CI: 10.72-12.27%), without significant difference between men (11.64% [95%CI: 10.49-12.86%]) and women (11.35% [95%CI: 10.34-12.41%]). The age- and sex-adjusted prevalence rate of CKD was 9.16% (men: 8.61%; women: 9.69%). The prevalence of low estimated glomerular filtration rate (<60mL/min/1.73m²) and albuminuria (≥30mg/g) were 7.95% (95%CI: 7.30-8.61) and 5.98% (95%CI: 5.41-6.55), respectively. Hypertension, diabetes, prediabetes, increased waist-to-height ratio, heart failure, atrial fibrillation, and ACVD were independently associated with CKD (P<.001). Very high cardiovascular risk according to SCORE was found in 77.51% (95%CI: 74.54-80.49) of the population with CKD.

CONCLUSIONS

The adjusted prevalence of CKD was 9.2% (low estimated glomerular filtration rate: 8.0%; albuminuria: 6.0%). Most of the patients with CKD had very high cardiovascular risk. Hypertension, diabetes, prediabetes, increased waist-to-height ratio and ACVD were independently associated with CKD.

Prevalence of diabetes mellitus in Spanish primary care setting and its association with cardiovascular risk factors and cardiovascular diseases. SIMETAP-DM study

INTRODUCTION

The aims of this study were to determine the age- and sex-adjusted prevalence rates of DM, type-1 DM (T1DM), and type-2 DM (T2DM), and to compare the relationship with cardiovascular risk factors, cardiovascular diseases, chronic kidney disease, and metabolic diseases between populations with and without DM.

METHODS

SIMETAP-DM is a cross-sectional observational study conducted in a Primary Care setting with a random population-based sample of 10,579 adults. Response rate: 66%. The diagnoses of DM, T1DM and T2DM were based on clinical and biochemical criteria and/or the checking of these diagnoses in the medical records. The crude and age- and sex-adjusted (standardised for Spanish population) prevalence rates were calculated.

RESULTS

The crude prevalence rates of T1DM, T2DM, and DM were 0.87% (95% confidence interval [95% CI]: 0.67-1.13), 14.7% (95% CI: 13.9-15.6), and 15.6% (95% CI: 14.7-16.5), respectively. The age- and sex-adjusted prevalence rates of T1DM, T2DM, and DM were 1.0% (1.3% for men and 0.7% for women), 11.5% (13.6% for men and 9.7% for women), and 12.5% (14.9% for men and 10.5% for women), respectively. The prevalence of DM in the population≥70 years was double (30.3% [95% CI: 28.0-32.7]) that of the population between 40 and 69 years (15.3% [95% CI: 14.1-16.5]). Hypertension, peripheral arterial disease, increased waist-to-height ratio, albuminuria, coronary heart disease, atherogenic dyslipidaemia and hypercholesterolaemia were associated with DM.

CONCLUSIONS

In a Spanish primary care setting, the age-adjusted prevalences of T1DM, T2DM and DM in the adult population were 1.0, 11.5, and 12.5%, respectively. One-third (33%) of the population over 70 years had DM.

Prevalence of erectile dysfunction in Spanish primary care setting and its association with cardiovascular risk factors and cardiovascular diseases. SIMETAP-ED study

INTRODUCTION

Few studies conducted in primary care setting report about age-adjusted prevalence rates of erectile dysfunction (ED). Aims of SIMETAP-ED study were to determine crude and age-adjusted prevalence rates of ED diagnosis, to compare these rates with other similar studies, and to compare prevalence rates of cardiovascular risk factors (CVRF), cardiovascular diseases (CVD), metabolic diseases and chronic kidney disease (CKD) between populations with and without ED.

METHODS

Cross-sectional observational study conducted in primary care setting. Population-based random sample: 2934 adult men. Response rate: 66%. A clinical interview was conducted to diagnose ED using a question derived from ED definition. The medical records of patients were reviewed to identify their CVRF and diseases associated with ED. The age-adjustments were standardized to Spanish population.

RESULTS

The prevalence rates of metabolic diseases, CVD, CVRF, and CKD in population with ED were higher than population without ED, highlighting the CVD. The crude prevalence of ED was 17.2% (95% confidence interval: 15.8-18.6). The age-adjusted prevalence rates of ED were 0.71% in men under 40 years, 12.4% in men over 18 years, 10.8% in men aged 40-69 years, 18.9% in men over 40 years, and 48.6% in men over 70 years.

CONCLUSIONS

SIMETAP-ED study showed association of ED with metabolic diseases, CKD, CVRF, and highlighting CVD. The age-adjusted prevalence of ED was 12.4% in adult men, 19% in men over 40 years, and almost 50% in men over 70 years.

Population and methodology of the SIMETAP study: Prevalence of cardiovascular risk factors, cardiovascular diseases, and related metabolic diseases

The prevention of cardiovascular disease is based on the detection and control of cardiovascular risk factors (CVRF). In Spain there are important geographical differences both in the prevalence and in the level of control of the CVRF. In the last decade there has been an improvement in the control of hypertension and dyslipidaemia, but a worsening of cardio-metabolic risk factors related to obesity and diabetes. The SIMETAP study is a cross-sectional descriptive, observational study being conducted in 64 Primary Care Centres located at the Community of Madrid. The main objective is to determine the prevalence rates of CVRF, cardiovascular diseases, and metabolic diseases related to cardiovascular risk. A report is presented on the baseline characteristics of the population, the study methodology, and the definitions of the parameters and diseases under study. A total of 6,631 study subjects were selected using a population-based random sample. The anthropometric variables, lifestyles, blood pressure, biochemical parameters, and pharmacological treatments were determined. The highest crude prevalences were detected in smoking, physical inactivity, obesity, prediabetes, diabetes, hypertension, dyslipidaemias, and metabolic syndrome. A detailed analysis needs to be performed on the prevalence rates, stratified by age groups, and prevalence rates adjusted for age and sex to assess the true epidemiological dimension of these CVRF and diseases.