Impacte de la depressió i/o l'ansietat en l'aparició d'esdeveniments cardiovasculars en una cohort afectada de síndrome metabòlica. Projecte strex: cinc anys de seguiment

Identifier:  TDX:2529

Handle: https://hdl.handle.net/20.500.11797/TDX2529

Authors:  Ortega Vila, Yolanda

Abstract:
Objectives: To determine the prevalence of Metabolic Syndrome(MetS) and its phenotypes. To determine the incidence of cardiovascular events(CVE) globally and according to anxiety/depression, socioeconomic index and MetS phenotypes. Assess the impact of stress (measured anxiety, depression, socioeconomic status) and MetS phenotypes, on the incidence of CVE and overall mortality(OM). Identify independent factors determining higher incidence of CVE/OM from all causes in people with MetS. Design: Cohort study Ambit: Primary Care. Subjects: People(35-75 years) fulfilling MetS criteria, without CVE at the start(2009). Condisering 16 MetS phenotypes[NCEP-ATPIII criteria:HBP(high blood pressure), CHO(cholesterol),TG(triglycerides),WC(waist-circumference),GLU(glucose abnormalities)]. Primary outcomes were the incidence of CVE and OM(5years). Interest variables were: age, gender, MetS phenotype, socioeconomic index. Results: 401,743people with MetS (17.2% of the Catalan population), 51.1% men, mean age60,1+9.9years. We registered 8.7%depression, 16.0%anxiety and 3.8% both. MetS dominant phenotypes: CHO+HBP+TG+GLU; CHO+HBP+GLU; HBP+CHO+TG and HBP+WC+GLU. The WC criterion is not closely associated to event risk. In men predominate: hypertension/lowHDL-cholesterol/ hypertriglyceridemia. In women, obesity/hypertriglyceridemia/impaired glucose. The MetS phenotypes with more CVE, collect three/four criteria. Greater number of criteria do not determine increased risk of CVE. Anxiety is more frequent in the MetS (21.1%) which includes obesity/low HDL-cholesterol/impaired glucose. Depression predominates in the MetS(10.9%) containing the criteria hypertension/obesity/hypertriglyceridemia. The events remain, overall, the distribution in mood disorders: more anxiety and depression, more events. 20.5% of the Catalan population with MetS groups in rural areas; and in the urban, predominantly(21.7%) in urban-2. More socioeconomically diverse urban areas have the highest rate of CVE. In rural and urban-5, there are more cases of ischemic heart disease. All variables are predictive regarding the CVE incidence in five years. The overall mortality rate is determined by age, male sex, smoking and highest pulse pressure. Discussion: People with MetS and mood disorders require greater attention/ intervention to minimize the risk of CVE