title: Impact of the sustained control of cardiovascular risk factors on first episode heart failure: The relevant role of primary care.
abstract: BACKGROUND
  The role of cardiovascular risk factor control in the development of heart failure (HF) has not yet been clearly established.
  
  
  OBJECTIVE
  To determine the effect of cardiovascular risk factor control on the occurrence of a first episode of hospital admission for HF.
  
  
  METHODS
  A case-control study using propensity score-matching was carried out to analyse the occurrence of first hospital admission for HF taking into account the degree of cardiovascular risk factor control over the previous 24 months. All patients admitted to the cardiology unit of the Hospital del Mar between 2008 and 2011 because of a first episode of HF were considered cases. Controls were selected from the population in the hospital catchment area who were using primary care services. Cardiovascular risk factor measurements in the primary healthcare electronic medical records prior to the first HF episode were analysed.
  
  
  RESULTS
  After the matching process, 645 participants were analysed (129 HF cases and 516 controls). Patients suffering a first HF episode had modest increments in body mass index and blood pressure levels during the previous two years. Adjusted odds ratio for experiencing a first HF hospital admission episode according to systolic blood pressure levels and body mass index was (OR: 1.031, 95% CI: 1.001-1.04), and (OR: 1.09, 95% CI: 1.03-1.15), respectively.
  
  
  CONCLUSIONS
  Increased levels of body mass index and systolic blood pressure during the previous 24 months may determine a higher risk of having a first HF hospital admission episode.
authors.affiliation: a Institut Català de la Salut , Barcelona , Spain.|b Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) , Barcelona , Spain.|c School of Medicine, Universitat Autònoma de Barcelona , Bellaterra , Spain.
authors.forename: Miguel-Angel
authors.initials: MA
authors.lastname: Muñoz
authors.affiliation: b Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) , Barcelona , Spain.|d School of Medicine and Health Sciences, Universitat Internacional de Catalunya , Sant Cugat del Valles , Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Real
authors.affiliation: a Institut Català de la Salut , Barcelona , Spain.|b Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) , Barcelona , Spain.
authors.forename: José-Luis
authors.initials: JL
authors.lastname: Del Val
authors.affiliation: a Institut Català de la Salut , Barcelona , Spain.|b Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) , Barcelona , Spain.
authors.forename: Ernest
authors.initials: E
authors.lastname: Vinyoles
authors.affiliation: a Institut Català de la Salut , Barcelona , Spain.|b Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) , Barcelona , Spain.|c School of Medicine, Universitat Autònoma de Barcelona , Bellaterra , Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Mundet
authors.affiliation: a Institut Català de la Salut , Barcelona , Spain.|b Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) , Barcelona , Spain.
authors.forename: Mar
authors.initials: M
authors.lastname: Domingo
authors.affiliation: e Heart Failure Programme, Department of Cardiology , Hospital del Mar , Barcelona , Spain.|f Heart Diseases Biomedical Research Group, Programme of Research in Inflammatory and Cardiovascular Disorders, IMIM (Hospital del Mar Medical Research Institute) , Barcelona , Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Enjuanes
authors.affiliation: a Institut Català de la Salut , Barcelona , Spain.|b Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) , Barcelona , Spain.|c School of Medicine, Universitat Autònoma de Barcelona , Bellaterra , Spain.
authors.forename: José-Maria
authors.initials: JM
authors.lastname: Verdú-Rotellar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology*; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011320:Primary Health Care; D057216:Propensity Score; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*
keywords: Heart failure; cardiovascular risk factors; hospital admission; primary care