Lopez-Carmona D.,Hospital Regional Universitario Carlos Haya |
Bernal-Lopez M.R.,Biomedical Research Laboratory CiberObn |
Bernal-Lopez M.R.,Institute Salud Carlos III |
Mancera-Romero J.,Ciudad Jardin Health Center |
And 8 more authors.
European Journal of Preventive Cardiology | Year: 2012
Aims: To evaluate adherence to guideline-recommended drug therapies for primary and secondary cardiovascular prevention in a general Mediterranean population.Subjects and methods: A cross-sectional study was conducted in a random sample of 2270 individuals (18-80 years) assigned to a health centre in Malaga (Spain). The appropriate use was analysed of statins, antithrombotics, beta-blockers, and angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II type 1 receptor blockers (ARB), based on the criteria of the European Guidelines on Cardiovascular Prevention and the European Society of Hypertension-European Society of Cardiology. Results: The prescription rate of statins, antithrombotics, beta-blockers, and ACEI/ARB was 7.8%, 5.1%, 3.3%, and 11%, respectively. The prescription of these drugs was inappropriate in 36.2%, 22.4%, 64.5%, and 0%, respectively. Overtreatment was more frequent in subjects with greater comorbidity or ≥2 vascular risk factors (p < 0.001). The percentage of individuals with prescription criteria but who did not receive the treatment was 19.5%, 4.7%, 2%, and 9.3%, respectively, increasing significantly with age, Charlson index, and the presence of ≥2 risk factors (p < 0.001). Only 11% of patients in secondary prevention received combination therapy with statins, antithrombotics, and ACEI/ARB. Patients with ischaemic heart disease, as compared to non-coronary vascular patients, more frequently received statins (56.1% vs. 25.6%; p = 0.0001) and antithrombotic drugs (66.7% vs. 56.4%; p = 0.02). Conclusions: We detected a low adherence to existing pharmacological guidelines for the prevention of cardiovascular disease. A priority is to establish appropriate training and dissemination of cardiovascular prevention guidelines in the field of primary care. © 2011 The European Society of Cardiology.
Alcala A.,University of Malaga |
Jansen S.,Carlos Haya Hospital |
Tellez T.,University of Malaga |
Gomez-Huelgas R.,Carlos Haya Hospital |
And 3 more authors.
Atherosclerosis | Year: 2010
Objective: To determine whether lipid-lowering treatment with diet or statins would provide beneficial effects on visual field alterations associated with hypercholesterolemia. Methods: 180 subjects with hypercholesterolemia were randomly assigned to a low fat diet (diet group) or to a low fat diet plus 40. mg/day of pravastatin (pravastatin group). At the beginning of the study and 6 months after the assigned treatment, all subjects underwent a computerized perimetry test and a determination of plasma concentration of glucose, total cholesterol, LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C) and triglycerides. Results: At 6 months, both groups showed a significant decrease in total cholesterol, LDL-C and triglycerides compared to basal values, and a significant increase in the HDL-C. The pravastatin group had a significantly greater reduction in total cholesterol (-85 ± 21. mg/dl) and LDL-C (-86 ± 23. mg/dl) than the diet group (-28 ± 9 and -28 ± 10. mg/dl, respectively). All perimetry parameters improved in both groups after the intervention period, although the improvement was greater in the pravastatin group. Using a general linear model, a significant effect of treatment with pravastatin compared to diet was observed in the improvement of all the perimetry parameters, whereas the change in LDL-C concentrations only had a significant effect on the improvement of one of them. Conclusion: In subjects with hypercholesterolemia, the decrease of blood lipids improves visual field parameters. The major beneficial effect noted with pravastatin, compared to diet, suggests that this effect could be due to the lipid-lowering and pleiotropic actions. © 2009 Elsevier Ireland Ltd.
Garcia-Serrano S.,CIBER ISCIII |
Moreno-Santos I.,IMABIS Foundation |
Garrido-Sanchez L.,CIBER ISCIII |
Gutierrez-Repiso C.,IMABIS Foundation |
And 14 more authors.
Molecular Medicine | Year: 2011
Animal studies have revealed the association between stearoyl-CoA desaturase 1 (SCD1) and obesity and insulin resistance. However, only a few studies have been undertaken in humans. We studied SCD1 in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) from morbidly obese patients and their association with insulin resistance, sterol regulatory element binding protein-1 (SREBP-1) and ATPase p97, proteins involved in SCD1 synthesis and degradation. The insulin resistance was calculated in 40 morbidly obese patients and 11 overweight controls. Measurements were made of VAT and SAT SCD1, SREBP-1 and ATPase p97 mRNA expression and protein levels. VAT and SAT SCD1 mRNA expression levels in the morbidly obese patients were ignificantly lower than in the controls (P = 0.006), whereas SCD1 protein levels were significantly higher (P < 0.001). In the morbidly obese patients, the VAT SCD1 protein levels were decreased in patients with higher insulin resistance (P = 0.007). However, SAT SCD1 protein levels were increased in morbidly obese patients with higher insulin resistance (P < 0.05). Multiple linear regressions in the morbidly obese patients showed that the variable associated with the SCD1 protein levels in VAT was insulin resistance, and the variables associated with SCD1 protein levels in SAT were body mass index (BMI) and ATPase p97. In conclusion, these data suggest that the regulation of SCD1 is altered in individuals with morbid obesity and that the SCD1 protein has a different regulation in the two adipose tissues, as well as being closely linked to the degree of insulin resistance. © 2011 The Feinstein Institute for Medical Research.
Bravo M.J.,University of Malaga |
Colmenero J.D.,University of Malaga |
Queipo-Ortuno M.I.,IMABIS Foundation |
Queipo-Ortuno M.I.,University of Malaga |
And 4 more authors.
Human Immunology | Year: 2010
Molecules involved in antigen processing (LMP) and peptide transport (TAP) are coded by polymorphic genes. This polymorphism may influence the peptide antigen selection process and play a role in the pathogenesis of human brucellosis. We studied the polymorphism of the antigen processing and transport genes (LMP and TAP) in 61 patients with human brucellosis and 102 controls from southern Spain. We found no differences in the frequencies of the LMP and TAP genotypes between the patients and the controls. Study of the patients with and without focal or complicated forms showed a significant increase in the TAP2A/TAP2F genotype in those with focal forms compared with those without focal forms (16% vs 0%, p = 0.02), though this difference lost its significance after correction for the number of comparisons. This study suggests that larger studies will be needed to confirm or rule out the possible association of the TAP2A/TAP2F genotype or other possible associations with focal forms of brucellosis. © 2010 American Society for Histocompatibility and Immunogenetics.