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Mexico City, Mexico

Fanghanel G.,Clinica Integral de Obesidad | Sanchez-Reyes L.,Clinica Integral de Obesidad | Felix-Garcia L.,PEMEX | Violante-Ortiz R.,Instituto Mexicano del Seguro Social | And 2 more authors.
Cirugia y Cirujanos | Year: 2011

Background: The World Health Organization reports that waist circumference (WC) independent of weight or body mass index (BMI) predicts cardiovascular risk. We undertook this study to determine the change of prevalence in comorbidities associated with obesity and cardiovascular risk after favorably modifying WC. Methods: We studied 153 nondiabetic patients with obesity (BMI ≥30 kg/m2) and WC in women ≥80 cm and in men ≥94 cm who entered a weight control program for 2 years. We evaluated the evolution of their anthropometric measurements and metabolic status. Ninety patients (58.8%) completed the study. With the prior acceptance of the patients, they received nutritional advice and psychological and physical activity support during their monthly visits. Also, anthropometric measurements and blood pressure were evaluated. At the beginning and after each 6 months, glucose, total cholesterol, HDL cholesterol and triglycerides were determined. At the beginning and at the end of study the Framingham risks were evaluated. Results: Of the 90 patients, 37 (group 1) decreased their WC: in women <80 cm and in men <94 cm. In 53 patients (group 2) there were no significant changes. Changes were shown in group 1 for blood pressure (from 36.6% to 21.6%), hyperglycemia >100 mg/dl decreased from 18.8% to 8.1%, triglycerides >150 mg/dl decreased from 28.8% to 18.9% and Framingham risk at 10 years decreased. Conclusions: There is a direct relationship between WC and cardiovascular risk. When WC decreases, cardiovascular risk is favorably modified. Measurement of WC is a good predictor of cardiovascular risk.

Alcocer L.A.,Hospital General de Mexico | Lozada O.,Hospital General de Mexico | Fanghanel G.,Clinica Integral de Obesidad | Sanchez-Reyes L.,Hospital General de Mexico | Campos-Franco E.,Hospital General de Mexico
Cirugia y Cirujanos | Year: 2011

Background: In the Mexican population we are unaware if the Framingham model is a better system than the SCORE system for stratifying cardiovascular risk. The present study was conducted to compare risk stratification with the Framingham tables using the same procedure but using the SCORE, with the aim of recommending the use of the most appropriate method. Methods: We analyzed a database of apparently healthy workers from the Mexico City General Hospital included in the study group "PRIT" (Prevalencia de Factores de Riesgo de Infarto del Miocardio en Trabajadores del Hospital General de México) and we calculated the risk in each simultaneously with the Framingham method and the SCORE method. Results: It was possible to perform risk calculation with both methods in 1990 subjects from a total of 5803 PRITHGM study participants. When using the SCORE method, we stratified 1853 patients into low risk, 133 into medium risk and 4 into high risk. The Framingham method qualified 1586 subjects as low risk, 268 as medium risk and 130 as high risk. Concordance between scales to classify both patients according to the same risk was 98% in those classified as low risk, 19.4% among those classified as intermediate risk and only 3% in those classified as high risk. Conclusions: According to our results, it seems more appropriate in our country to recommend the Framingham model for calculating cardiovascular risk due to the fact that the SCORE model underestimated risk.

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