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Título : Cardiovascular risk assessment in ecuadorian elderly population yield of four different models
Autor : Sisa, Iván (dir)
Roa Loor, Jorge Antonio
Palabras clave : Sistema Cardiovascular
Enfermedades
Geriatría
Agentes Cardiovasculares
Fecha de publicación : 2017
Editorial : Quito: USFQ, 2017
Citación : Tesis (Médico), Universidad San Francisco de Quito, Colegio de Ciencias de la Salud; Quito, Ecuador, 2017
Descripción : Objectives The present study aims to: i) calculate the cardiovascular disease (CVD) risk profile of an Ecuadorian hypertensive elderly sample using four different models: (1) the 2003 Systematic Coronary Risk Evaluation (SCORE) risk model, (2) the 2008 Framingham Risk Score (FRS, both using lipids profile and body mass index - BMI), (3) the 2013 AHA/ACC Pooled Cohort Equations model, and (4) the 2015 SCORE for Older Population - O.P., and; ii) assess the relationship between several independent variables: (1) dependence; (2) abuse; (3) creatinine; (4) estimated glomerular filtration rate (eGFR); (5) glucose; (6) HOMA-IR index; (7) albumin; (8) thyroid stimulating hormone (TSH); (9) high-sensitivity C-reactive protein (hsCRP); and (10) vitamin D (25OHD) serum levels and predicted CVD risk in the elderly according to each of the four tested models. Methods This cross-sectional study analyzed the Ecuadorian National Dataset of Health, Welfare and Aging in the Elderly (SABE-ECU) conducted in 2009. From 5235 subjects belonged to the original database, a sample of 951 participants was selected after excluded missing values. We estimated the predicted 10-year risk of CVD based on the four model equations previously mentioned. In addition, logistic regression models were used to find odds ratios (OR) and corresponding 95% confidence intervals (CI) between proposed novel cardiovascular risk factors and predicted CVD risk. Results In 2009, one-third of the Ecuadorian hypertensive elderly population is allocated in the “high CVD risk” category according to the four equations used. In the adjusted logistic regression model, low eGFR (<60 ml/min, OR 0.23, [0.06-0.92]), low albumin serum level (<3.5 g/dl, OR 8.09, [1.63-40.04]), high HOMA-IR index (≥3.2, OR 2.01, [1.22-3.30]), and high hsCRP serum level (≥1.1 mg/L, OR 2.00, [1.12-3.58]) showed association with CVD risk when using FRS and SCORE O.P. models. Conclusion We found that low eGFR, high HOMA-IR index, low albumin and high hsCRP serum levels are independently and significantly associated with CVD risk in the study individuals. These laboratory variables could be included as predictor markers for CVD risk in future elder-validated scores. More studies are needed to assess the complex interaction between aging, hypertension, nutritional
URI : http://repositorio.usfq.edu.ec/handle/23000/6471
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