title: Estimating Cardiovascular Risk in Spain by the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice.
abstract: OBJECTIVE
  There are no nationwide, population-based studies in Spain assessing overall cardiovascular risk. We aimed to describe cardiovascular risk and achievement of treatment goals following the 2012 European Guidelines on cardiovascular disease prevention strategy. We also investigated clinical characteristics (non-classical risk factors) associated with moderate risk.
  
  
  METHODS
  Participants (n=2310, 58% women) aged 40 to 65 years from a national population-based study (Di@bet.es Study) were identified. First, a priori high/very-high risk individuals were identified. Next, total cardiovascular risk (Systematic Coronary Risk Evaluation equation including high-density lipoprotein cholesterol) was used to assess risk of a priori non-high risk individuals. Variables independently associated with moderate versus low-risk were investigated by multiple logistic regression analysis.
  
  
  RESULTS
  Age-and-sex standardized (direct method) percentages of high/very-high, moderate, and low-risk were 22.8%, 43.5%, and 33.7%, respectively. Most men were at moderate (56.2%), while 55.4% of women were at low risk. Low-density lipoprotein cholesterol (< 70,<100, < 115 mg/dL) and blood pressure (<140/90 mmHg) goals for very-high, high and moderate risk were met in 15%, 26% and 46%, and 77%, 68% and 85% of the individuals, respectively. Body mass index, high triglycerides concentrations, diastolic blood pressure, and low Mediterranean diet adherence (in women) were independently associated with moderate (versus low) risk.
  
  
  CONCLUSIONS
  Cardiovascular risk in Spain is mainly moderate in men and low in women. Achievement of treatment goals in high-risk individuals should be improved. The prevalence of non-classical cardiovascular risk factors is elevated in subjects at moderate risk, an important aspect to consider in a population-based strategy to decrease cardiovascular disease in the most prevalent group.
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínic, IDIBAPS, Barcelona, Spain.
authors.forename: Antonio Jesús
authors.initials: AJ
authors.lastname: Amor
authors.affiliation: Unidad de Medicina Vascular y Metabolismo, Hospital Universitario Sant Joan de Reus, Universidad Rovira i Virgili, Reus, Tarragona, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Masana
authors.affiliation: Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Málaga, Spain.
authors.forename: Federico
authors.initials: F
authors.lastname: Soriguer
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Goday
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Universitario San Carlos , Madrid, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Calle-Pascual
authors.affiliation: Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Grupo de Investigación de Diabetes, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Gaztambide
authors.affiliation: Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Málaga, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Rojo-Martínez
authors.affiliation: Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Málaga, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Valdés
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínic, IDIBAPS, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Gomis
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínic, IDIBAPS, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain. Electronic address: eortega1@clinic.ub.es.
authors.forename: Emilio
authors.initials: E
authors.lastname: Ortega
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
keywords: Cardiovascular risk; European Guidelines on Cardiovascular Disease Prevention in Clinical Practice; Framingham-Registre Gironí del Cor; Guía europea de prevención de la enfermedad cardiovascular en la práctica clínica; Riesgo cardiovascular; Systematic Coronary Risk Evaluation