title: Association Between Improvement in Cardiovascular Risk Profile and Changes in Sickness Absence: Results of the ICARIA Study.
abstract: OBJECTIVE
  The purpose of this study was to investigate whether changes in cardiovascular risk (CVR) are associated with the length and cost of sickness absence.
  
  
  METHODS
  A prospective cohort of 179 186 participants was evaluated. Each participant's CVR (SCORE) was assessed on 2 consecutive medical examinations, approximately 1 year apart (365 ± 90 days). Cardiovascular risk was categorized as < 4% or ≥ 4%, and participants were divided into 4 groups according to changes in their risk between the 2 assessments. After the second CVR estimate, a 1-year follow-up was carried out to assess sickness absence. Differences between the 4 groups in terms of the total count of sickness absence days during the follow-up period were tested using Poisson regression models.
  
  
  RESULTS
  After adjustment for covariates, participants who showed an improvement in CVR had a lower count of sickness absence days compared with both those who showed a worsening in risk and those who remained stable at ≥ 4% (RR, 0.91; 95%CI, 0.84-0.98). In comparison with participants whose CVR did not improve, more of the participants whose risk did improve had quit smoking (+17.2%; P < .001), and had controlled their blood pressure (+26.0%, P < .001), total cholesterol (+9.3%; P < .001), low-density lipoprotein cholesterol (+14.9%; P < .001), and triglyceride levels (+14.6%; P < .001).
  
  
  CONCLUSIONS
  Our results suggest that an improvement in CVR profile is accompanied by a decrease in sickness absence during a 1-year follow-up.
authors.affiliation: Departamento de Proyectos Sanitarios, Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Calvo-Bonacho
authors.affiliation: Departamento de Proyectos Sanitarios, Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain. Electronic address: carloscatalina@ibermutuamur.es.
authors.forename: Carlos
authors.initials: C
authors.lastname: Catalina-Romero
authors.affiliation: Departamento de Proyectos Sanitarios, Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain.
authors.forename: Martha
authors.initials: M
authors.lastname: Cabrera
authors.affiliation: Departamento de Proyectos Sanitarios, Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernández-Labandera
authors.affiliation: Departamento de Medina Interna, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Sánchez Chaparro
authors.affiliation: Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Brotons
authors.affiliation: Instituto de Investigación, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Luis Miguel
authors.initials: LM
authors.lastname: Ruilope
mesh_terms: D000041:Absenteeism; D000062:Accidents, Occupational / Q000191:economics / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology*; D008078:Cholesterol, LDL / Q000378:metabolism; D017281:Cost of Illness; D050171:Dyslipidemias / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000191:economics / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D018582:Sick Leave / Q000191:economics / Q000706:statistics & numerical data*; D013030:Spain / Q000453:epidemiology; D014280:Triglycerides / Q000378:metabolism
chemical_list: D000959:Antihypertensive Agents; D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents; D014280:Triglycerides
keywords: Accidente de trabajo; Baja por enfermedad; Cardiovascular disease; Cardiovascular risk; Enfermedad cardiovascular; Incapacidad temporal; Riesgo cardiovascular; Sick leave; Sickness absence; Work-related accidents