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Riesgo de por vida y años vividos libres de enfermedad cardiovascular total
John T Wilkins1, Hongyan Ning, Jarett Berry
1Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. j-wilkins@fsm.northwestern.edu
JAMA
|November 3, 2012
Resumen
El riesgo de por vida de enfermedad cardiovascular (ECV) es alto para todos, incluso para aquellos con factores de riesgo óptimos. El mantenimiento de hábitos saludables aumenta significativamente los años vividos libres de ECV.
Área de la Ciencia:
- Epidemiología cardiovascular.
- Cardiología preventiva de la cardiología.
- Salud pública La salud pública.
Sus antecedentes:
- Las estimaciones de riesgo de por vida para la enfermedad cardiovascular total (ECV) son cruciales para proyectar la carga futura de la enfermedad y ayudar a la comunicación clínica.
- Estudios anteriores no han reportado estimaciones completas del riesgo a lo largo de la vida para el total de ECV.
Objetivo del estudio:
- Para calcular las estimaciones de riesgo de por vida para el total de ECV basado en perfiles de edad y factores de riesgo.
- Para estimar el número de años que las personas viven libres de ECV en diferentes estratos de factores de riesgo.
Principales métodos:
- Análisis de supervivencia combinada utilizando más de 900.000 años-persona de datos de cinco importantes estudios de cohorte en los Estados Unidos.
- El análisis incluyó a participantes libres de ECV al inicio, con datos sobre la presión arterial, el colesterol, la diabetes y el estado de tabaquismo.
- Se realizó un seguimiento de los eventos totales de ECV, incluidos los resultados fatales y no fatales.
Principales resultados:
- El riesgo general de enfermedad cardiovascular a la edad de 45 años fue del 60,3% para los hombres y del 55,6% para las mujeres.
- Las personas con factores de riesgo elevados o mayores enfrentaban riesgos de por vida superiores al 50% a los 95 años.
- Incluso aquellos con factores de riesgo óptimos a los 55 años tenían riesgos significativos de ECV durante toda la vida, pero vivieron hasta 14 años más libres de ECV en comparación con aquellos con múltiples factores de riesgo.
Conclusiones:
- El riesgo de por vida para el total de ECV es sustancial en todos los individuos, incluidos aquellos con factores de riesgo óptimos en la mediana edad.
- El mantenimiento de niveles óptimos de factores de riesgo cardiovascular en la mediana edad está fuertemente asociado con una duración de vida significativamente más larga libre de ECV.
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