Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

metabolic syndrome

 

Características Clínicas de Pacientes Hipertensos hospitalizados con y sin Enfermedad Cerebrovascular de 60 a 90 años en Quito, Ecuador: Estudio de Casos y Controles. Clinical Characteristics of hospitalized Hypertensive Patients with and without Stroke aged 60 to 90 years in Quito, Ecuador: A Case-Control Study.

Background: Stroke is the world’s second leading cause of death from disease, and disability-adjusted life years. The investment in management of a hospitalized stroke patient generates a high healthcare cost. In Ecuador it is the third leading cause of death. Hypertension is one of the most important factors in the stroke development. Patients with high blood pressure and stroke have a higher risk of complications, mortality and poor prognosis.

Objective: The present study aimed to identify which variables differ between hypertensive patients with stroke versus hypertensive patients without stroke, hospitalized, during 2017- 2020.

Methods: In a population of 96 cases and 57 controls, a retrospective analytical cohort study between two groups of patients was conducted.

Results: The variable education (primary education) was the most affected among cases (χ²=13.298; p=0.039). Patients with atrial fibrillation were significantly higher in the case group (χ²=7.31 p=0.007). Other variables like: sex, age, provenance, years lived with hypertension, smoking, type 2 diabetes mellitus, heart failure, hypercholesterolemia and anticoagulant therapy, showed no significant difference between the two groups.

Conclusions: Patients with complete primary education and atrial fibrillation had significant presence in hypertensive patients with stroke.

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Salud Cardiovascular en Habitantes de Atahualpa: Características y Correlatos. Cardiovascular Health Status In Atahualpa Residents: Characteristics And Correlates

Stroke and cardiovascular diseases will be the next epidemics in Latin America due to changes in lifestyle and increased life expectancy. Knowledge of cardiovascular health (CVH) status of the population is mandatory to implement cost-effective strategies directed to reduce the burden of vascular diseases in the region. In the Atahualpa Project, we assessed the CVH status of participants using the metrics proposed by the American Heart Association. The basal study included 616 subjects free of stroke and ischemic heart disease aged ≥40 years. Of these, 2.1% had ideal, 28.1% had intermediate and 69.8% had poor CVH status. Poorest metrics were blood pressure, fasting glucose, and BMI. The odds for having a poor CVH status were increased in persons aged ≥ 60 years and in those with only primary school education. Then, we compared our results with the Hispanic population of the Northern Manhattan Stroke Study (NOMAS), and found that Atahualpa residents had significantly better metrics than those enrolled in the NOMAS, with the exception of fasting glucose levels. Likewise, the odds for having 5 to 7 ideal metrics were also better in Atahualpa residents, irrespective of age. We also conducted a case-control study to assess the CVH status of Atahualpa residents according to their living arrangements, and found that social isolation was associated with a worse CVH status in this population. A couple of studies showed correlation between some sleep related disorders and poor CVH status. We have also started an ongoing program called “known your numbers”, which, together with community talks, is directed to improve the CVH status and to reduce the burden of vascular diseases in the region.

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