[Coronary disease risk attributable to cardiovascular risk factors in the Spanish population].
OBJECTIVE
The proportion of the ischemic heart disease (IHD) burden attributable to cardiovascular risk factors in Spain has traditionally been extrapolated from populations in other countries. The aim of this study was to estimate the IHD risk attributable to smoking, hypercholesterolemia, hypertension, diabetes and excess weight using data from studies carried out in the Spanish population.


METHODS
Data on the prevalence of cardiovascular risk factors in the general population were obtained from a meta-analysis of 48 cross-sectional studies carried out in Spain, and data on corresponding prevalences among IHD patients were derived from the PRIAMHO II and PREVESE II multicenter hospital registries. Crude and adjusted relative risks of IHD were obtained from follow-up data collected over 5 years in a primary-care cohort of 6124 adults without cardiovascular disease. The crude and adjusted population attributable fractions for various risk factors were calculated for both sexes combined and for men and women separately.


RESULTS
Among men, 42.5% (95% confidence interval [CI] 6.8%-59.6%) of the adjusted incidence of IHD was attributable to overweight, 33.9% (95% CI 22.6%-41.0%) to smoking, 19.4% (95% CI 8.2%-26.5%) to hypercholesterolemia, and 15.5% (95% CI 1.6%-24.6%) to hypertension. Among women, 36.5% (95% CI -8.0%-56.3%) of IHD cases were attributable to overweight, 24.8% (95% CI 12.0%-31.9%) to diabetes, and 20.1% (95% CI 6.1%-28.6%) to hypercholesterolemia.


CONCLUSIONS
The cardiovascular risk factors found to contribute most to IHD in the Spanish population were excess weight in both sexes, followed by smoking in men.
Medrano
María J
MJ
Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, España. pmedrano@isciii.es
Pastor-Barriuso
Roberto
R
Boix
Raquel
R
del Barrio
José L
JL
Damián
Javier
J
Alvarez
Rosa
R
Marín
Alejandro
A
D000328:Adult; D016001:Confidence Intervals; D003327:Coronary Disease / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D006973:Hypertension / Q000150:complications; D008297:Male; D017202:Myocardial Ischemia / Q000209:etiology; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D013030:Spain