El sedentarismo y la actividad física en relación a la salud cardiovascular en Aragón

Introducción y objetivo: Analizar el grado de seguimiento de las recomendaciones sobre actividad física difundidas por la Organización Mundial de la Salud en la población adulta trabajadora aragonesa, incluyendo a aquellas personas que presentan algún factor de riesgo cardiovascular (HTA, DM, dislipemia) y describir las características socio-demográficas, clínicas y de estilo de vida de las aquellas personas que cumplen con dichas recomendaciones. Métodos: Estudio transversal realizado sobre 2561 voluntarios, pertenecientes a la cohorte del Aragon Workers´ Health Study. Se obtuvieron datos acerca del cumplimiento de las recomendaciones de AF mediante la versión española validada del cuestionario de práctica de actividades utilizado en el Nurses’ Health Study y el Health Professionals’ Follow-up Study. Se consideró que cumplían las recomendaciones aquellos trabajadores que reportaron una práctica de 150 minutos semanales de AF aeróbica moderada o bien 75 minutos semanales de AF aeróbica vigorosa o bien una combinación de ambas, durante el tiempo de ocio, los desplazamientos o el trabajo. Se analizaron mediante cuestionarios características sociodemográficas y de estilo de vida, y se obtuvieron datos bioquímicos y antropométricos. Resultados: el 47% de los trabajadores cumplían las recomendaciones de AF. El cumplimiento era mayor en los trabajadores con estudios superiores, en los que desempeñaban un trabajo de tipo administrativo y en aquellos con un horario laboral a turno fijo. No se hallaron diferencias significativas en relación al sexo, a la estructura familiar o al estado civil. El cumplimiento de las recomendaciones se asociaba a menor IMC y circunferencia abdominal, menores niveles de TG y Apolipoproteína B100 y mayores de HDL y Apolipoproteína A1, valores más bajos de glucosa en ayunas, insulinemia, HbA1c, resistencia a la insulina y PCR. El número de personas con diagnóstico y/o tratamiento de HTA, DM, dislipemia y Síndrome metabólico era menor en el grupo de los cumplidores. Los trabajadores que siguen las recomendaciones presentaban un estilo de vida menos sedentario y una alimentación más saludable. El cumplimiento fue del 39,7% en hipertensos, 38,7% en dislipémicos y 32,7% en diabéticos. Conclusiones: menos de la mitad de los trabajadores adultos aragoneses cumple con las recomendaciones de AF, siendo menor este cumplimiento en aquellos con factores de riesgo CV. El cumplir con las recomendaciones se asocia con una mejor alimentación, un menor hábito tabáquico, menor comportamiento sedentario, mayor nivel de estudios, trabajo administrativo a turno fijo, mejor perfil lipídico y glucémico, menores parámetros inflamatorios, menor prevalencia de diagnóstico y tratamiento de HTA, DM, dislipemia y Síndrome Metabólico. ----------------------------------------------------------------------------------------- Introduction and objectives: To analyze the adherence of World Health Organization´s physical activity recommendations in the Aragon´s working adult population, including those with cardiovascular risk factors. Another objective is to describe the sociodemographic, clinic and lifestyle characteristics of those who meet the recommendations. Methods: Cross-sectional study carried out in a sample of 2561 volunteers belonging to the Aragon Workers´ Health Study. Adhesion data were obtained using the Nurses´ Health Study and the Health Professionals´ Follow-up Study Spanish version questionnaire. It was considered that the worker complied with the recommendation when practiced at least 150 minutes per week of aerobic physical activity of moderate intensity or 75 minutes per week of aerobic physical activity of vigorous intensity or a combination of both of at least 10 minutes, through activities in leisure time, transports and work. We also analyzed sociodemographic and lifestyle characteristics associated with the adherence using several questionnaires. To analyze clinical variables we obtained anthropometric and laboratory data. Results: Adherence was 47% of workers. It was higher in those with higher education, paperwork and fixed shift. No significant differences were found about gender, family members or civil status. Adherence was associated with lower BMI and waist circumference, lower triglycerides and Apolipoprotein B100, higher HDL and Apolipoprotein A1 levels, lower fasting blood glucose, HbA1c, insulin, HOMA-IR an C reactive protein. The prevalence of hypertension, dyslipidemia, diabetes and metabolic syndrome´ s diagnosis and treatment was lower in the group of those with comply with the recommendations. Adherence was associated with lower sedentary lifestyle and more healthy dietary. Among people with any cardiovascular risk factor, adherence was less prevalent: 39,7% in Hypertensives, 38,7% in people with dyslipidemia and 32,7% in Diabetics. Conclusions: Less than half of adults workers in Aragón comply with the physical activity recommendations, and the prevalence is lower in those with cardiovascular risk factors. Adherence is associated with a better dietary, less sedentary behavior and smoking habit, higher study level, office work and fixed shift. Those who meet the recommendations presents better lipid profile and glycaemia, lower inflammatory parameters and lower prevalence of hypertension, dyslipidemia, diabetes and metabolic syndrome diagnosis and treatment

La turnicidad laboral como factor de riesgo cardiovascular

Introducción: El trabajo a turnos parece asociarse a un peor perfil metabólico, sin embargo, la evidencia epidemiológica actual es limitada y los resultados muestras discrepancias. Objetivos: Analizar la prevalencia de los factores de riesgo cardiovascular según los turnos de trabajo realizados. Material y métodos: Estudio descriptivo transversal en el cual se han analizado una población activa de 2358 trabajadores hombres de una fábrica automovilística. Se recogen variables antropométricas, bioquímicas, clínicas y cuestionarios para averiguar el tipo de alimentación y actividad física realizada. Se realizan análisis univariantes, bivariantes y de regresión logística. Resultados: Encontramos diferencias estadísticamente significativas en cuanto a las variables edad, IMC, perímetro cintura, presión arterial sistólica, niveles de triglicéridos y glucosa, ingesta de hidratos de carbono, proteínas, grasas, energía total, consumo de café y té, horas sentados al día y horas de sueño. El riesgo de ser obeso es 2.6 veces mayor (IC 95%: 1,78 - 4,08) en el turno Mañana-Tarde-Noche, 2.2 (IC 95%: 1,39 - 3,48) en el turno de noche y 1.6 (IC 95%: 1,12 - 2,45) en el turno Mañana-Tarde en comparación con el central. Conclusión: Este estudio confirmó que los trabajadores de turno central tienen mejor perfil metabólico que los trabajadores de turno rotatorio y nocturno, además, la razón de prevalencias de obesidad en turnos rotatorios respecto al central es de 2.<br /

Phthalate exposure and the metabolic syndrome: A systematic review and meta-analysis

Phthalates are chemicals widely used in plastic-based consumer products, and human exposure is universal. They are classified as endocrine disruptors, and specific phthalate metabolites have been associated with an increased risk of cardiometabolic diseases. The aim of this study was to assess the association between phthalate exposure and the metabolic syndrome in the general population. A comprehensive literature search was performed in four databases (Web of Science, Medline, PubMed, and Scopus). We included all the observational studies that evaluate the association between phthalate metabolites and the metabolic syndrome available until January 31st, 2023. Pooled Odds Ratios (OR) and their 95% confidence intervals were calculated by using the inversevariance weighted method. Nine cross-sectional studies and 25,365 participants aged from 12 to 80 were included. Comparing extreme categories of phthalate exposure, the pooled ORs for the metabolic syndrome were: 1.08 (95% CI, 1.02–1.16, I 2 = 28%) for low molecular weight phthalates, and 1.11 (95% CI, 1.07–1.16, I 2 = 7%) for high molecular weight phthalates. For individual phthalate metabolites, the pooled ORs that achieved statistical significance were: 1.13 (95% CI, 1.00–1.27, I 2 = 24%) for MiBP; 1.89 (95% CI, 1.17–3.07, I 2 = 15%) for MMP in men; 1.12 (95% CI, 1.00–1.25, I 2 = 22%) for MCOP; 1.09 (95% CI, 0.99–1.20, I 2 = 0%) for MCPP; 1.16 (95% CI, 1.05–1.28, I 2 = 6%) for MBzP; and 1.16 (95% CI, 1.09–1.24, I 2 = 14%) for DEHP (including ΣDEHP and its metabolites). In conclusion, both low molecular weight and high molecular weight phthalates were associated with an 8 and 11% higher prevalence of the MetS, respectively. The exposure to six specific phthalate metabolites was associated with a higher prevalence of the MetSData collection was funded by the following grants: FIS PI17/1709, PI20/144 (State Secretary of R + D and FEDER/FSE), and the CIBERESP, Instituto de Salud Carlos III. Madrid, Spain. MM has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement [(No 801342 (Tecniospring INDUSTRY)] and the Government of Catalonia’s Agency for Business Competitiveness (ACCIO) ´ (TECSPR19-1-0022

Soluble and insoluble dietary fibre intake and risk factors for metabolic syndrome and cardiovascular disease in middle-aged adults: The AWHS cohort

Introduction: The Westernization of the Mediterranean lifestyle has led to a modification of certain dietary habits such as a decrease in the consumption of dietary fibre-rich foods. The impact of these changes on cardiovascular diseases (CVD) has been studied over the last few years and the effect of the different sources of fibre on cardiovascular risk parameters and coronary heart disease (CHD) continues to create controversy. Objective: To evaluate the association between the source of dietary fibre and the prevalence of metabolic syndrome (MetS) and other cardiovascular risk factors in a Spanish working population. Subjects and methods: The study was carried out in a sample of 1592 Spanish workers free of CVD (40-55 years old) within the Aragon Workers' Health Study (AWHS) cohort. Sociodemographic, anthropometric, clinical and biochemical data were collected. Fibre intake was assessed by means of a validated 136-items semiquantitative food-frequency questionnaire. MetS was defined by using the modified National Cholesterol Education Programme-Adult Treatment Panel III (NCEP-ATP III) definition. Results: After adjusting for possible confounding factors, we found an inverse association between insoluble fibre intake and systolic and diastolic blood pressure, total cholesterol, triglycerides, apolipoprotein B100 and ratio TG/HDL. Soluble fibre was inversely associated with triglycerides and apolipoprotein B100. Furthermore, prevalence of MetS was found to be lower (OR 0.62, 95% CI: 0.40-0.96) in those participants in the highest quartile of insoluble fibre intake. Conclusion: A higher intake of insoluble fibre could play an important role in the control and management of hypertension, lipid profile and MetS. Introducción: La occidentalización del estilo de vida mediterráneo ha dado lugar a una modificación de ciertos hábitos dietéticos, tales como una disminución en el consumo de alimentos ricos en fibra dietética. El impacto de estos cambios sobre las enfermedades cardiovasculares (ECV) se ha estudiado en los últimos años y el efecto de las diferentes fuentes de fibra en los parámetros de riesgo cardiovascular y en la enfermedad coronaria sigue creando controversia. Objetivo: Evaluar la asociación entre la fuente de fibra dietética y la prevalencia de síndrome metabólico (SM) y otros factores de riesgo cardiovascular en una población laboral española. Sujetos y métodos: El estudio se llevó a cabo en una muestra de 1592 trabajadores españoles libres de ECV (40-55 años) pertenecientes a la cohorte del Estudio de la Salud de los Trabajadores de Aragón (AWHS). Se recogieron datos sociodemográficos, antropométricos, clínicos y bioquímicos. La ingesta de fibra se evaluó por medio de un cuestionario semicuantitativo de frecuencia de consumo de alimentos de 136-items previamente validado. Para la definición de SM se siguieron los criterios del Programa Nacional de Educación del Colesterol en el marco del III Panel de Tratamiento de Adultos (NCEPATP III). Resultados: Se encontró una asociación inversa entre el consumo de fibra insoluble y la presión arterial sistólica y diastólica, colesterol total, triglicéridos, apolipoproteína B100 y la relación TG/HDL, tras ajustar por posibles factores de confusión. Así mismo, la fibra soluble se asoció inversamente con triglicéridos y apolipoproteína B100. Además, se encontró una menor prevalencia de SM (OR 0.62, IC del 95%: 0.40 a 0.96) en aquellos participantes en el cuartil más alto de consumo de fibra insoluble. Conclusión: Una mayor ingesta de fibra insoluble puede desempeñar un papel importante en el control y manejo de la hipertensión, el perfil lipídico y el SM

Risk factors control for primary prevention of cardiovascular disease in men: Evidence from the Aragon Workers Health Study (AWHS)

Benefits of cardiovascular disease (CVD) risk factors control are well known, but goals achievement remains low. The objective of this study is to evaluate the prevalence of CVD risk factors among men ina worker’s cohort with no previous CVD, to study control variations across time and the factors associated with poor control. To this end, we conducted a cohort reexamination (2010–2014) within the context of the Aragon Workers Health Study (AWHS). Data from working characteristics, analytical values and pharmacological prescription were included in the analysis. Prevalences of risk factor diagnosis and control were calculated, as well as factors associated with poor control. The prevalence of CVD risk factors was high. In 2014dyslipidaemia was the most prevalent (85.2%) followed by Hypertension (HT) (42.0%). People under treatment increased for the period analysed (p<0.001). The proportion of people treated varied from 72.2% in Diabetes Mellitus to 31.1% in dyslipidaemia in 2014. 46.2% of the workers with HT were controlled, decreasing to 21.9% in Diabetes and 11.0% in dyslipidaemia (2014). Working in a turn different to central shift was associated with poor control, especially for those working at night with HT (Odds Ratio in 2010: 3.6; Confidence Interval 95% 1.8–7.4) and dyslipidaemia (Odds Ratio 2010: 4.7; Confidence Interval 95% 1.3–16.4). We conclude that, although CVD control has increased significantly for the period studied, there are still many people that do not receive any treatment, and control goals are normally not achieved

Factores asociados al cumplimiento de las recomendaciones sobre actividad física en población trabajadora de entre 40 y 55 años de edad

Fundamentos: La inactividad física continúa siendo un problema de salud pública a nivel mundial. El objetivo del presente estudio fue determinar la adherencia a las recomendaciones de actividad física (AF) establecidas por la Organización Mundial de la Salud (OMS) de una muestra de trabajadores españoles, así como analizar su asociación con diferentes factores de riesgo cardiovascular (FRCV), indicadores sociodemográficos y de estilo de vida. Métodos: Estudio tranversal con 2.651 participantes en la cohorte del Aragon Workers' Health Study (AWHS) (2.428 varones y 133 mujeres), con edades comprendidas entre los 40-55 años. Se dividió a la población en dos grupos en función de si habían cumplido o no durante el último año las recomendaciones sobre AF establecidas por la OMS, teniendo en cuenta las actividades relacionadas con la ocupación, ocio y recreación y desplazamientos. Se registraron variables sociodemográficas, antropométricas, clínicas, farmacológicas y de estilo de vida entre los años 2011-2014. Se calcularon la mediana y el intervalo intercuartílico para variables cuantitativas y la distribución de frecuencias para las categóricas. Se estimó un modelo de regresión logística binaria crudo y ajustado para analizar la probabilidad de cumplir las recomendaciones de AF en función del número de FRCV (hipertensión, dislipemia, diabetes, obesidad y tabaquismo). Resultados: El 47,0% de participantes cumplían las recomendaciones. El cumplimiento fue del 39,7% en hipertensos, del 38,7% en dislipémicos y 32,7% en diabéticos. El 51,3% reportó no realizar AF o realizar una AF ligera, el 20,2% moderada y el 28,5% vigorosa o muy vigorosa. Los resultados mostraron cómo a medida que aumentaba el número de FRCV disminuía la probabilidad de adherirse a las recomendaciones: 1 FRCV (OR: 0,62; 95%CI: 0,49-0,78), 2 FRCV (OR: 0,49; 95%CI: 0,38-0,62), 3 FRCV (OR: 0,34; 95%CI: 0,25-0,46), 4 FRCV (OR: 0,19; 95%CI: 0,11-0,32). Conclusiones: El incumplimiento de las recomendaciones de AF en nuestra población es frecuente sobre todo en personas con mayor riesgo cardiovascular

Work shift, lifestyle factors, and subclinical atherosclerosis in spanish male workers: A mediation analysis

(1) Background: Working night shifts has been associated with altered circadian rhythms, lifestyle habits, and cardiometabolic risks. No information on the potential association of working shift and the presence of atherosclerosis is available. The aim of this study was to quantify the association between different work shifts and the presence of subclinical atherosclerosis objectively measured by imaging. (2) Methods: Analyses were conducted on the baseline data of the Aragon Workers Health Study (AWHS) cohort, including information on 2459 middle-aged men. Categories of shift work included central day shift, rotating morning-evening or morning-evening-night shift, and night shift. The presence of atherosclerotic plaques was assessed by 2D ultrasound in the carotid and femoral vascular territories. Multivariable logistic models and mediation analysis were conducted to characterize and quantify the association between study variables. (3) Results: Participants working night or rotating shifts presented an overall worse cardiometabolic risk profile, as well as more detrimental lifestyle habits. Workers in the most intense (morning-evening-night) rotating shift presented higher odds of subclinical atherosclerosis (odds ratio: 1.6; 95% confidence interval: 1.12 to 2.27) compared to workers in the central shift, independently of the presence of lifestyle and metabolic risk factors. A considerable (21%) proportion of this association was found to be mediated by smoking, indicating that altered sleep-wake cycles have a direct relationship with the early presence of atherosclerotic lesions. (4) Conclusions: Work shifts should be factored in during workers health examinations, and when developing effective workplace wellness programs

New Male Users of Lipid-Lowering Drugs for Primary Prevention of Cardiovascular Disease: The Impact of Treatment Persistence on Morbimortality. A Longitudinal Study

The objective of this study was to analyse persistence to lipid-lowering drug use for primary prevention of cardiovascular disease (CVD) in a new users cohort, to explore all-cause and cardiovascular related morbidity, comorbidity and mortality in this group and, finally, to study the relationship between persistence and morbimortality. We selected subjects who started lipid-lowering treatment for primary prevention of CVD between 1 January 2010 and 31 December 2017 (N = 1424), and classified them as treatment-persistent or -nonpersistent. Bivariate analyses were performed to compare sociodemographic and clinical variables, morbimortality and time to event between groups. The association between morbidities was explored using comorbidity network analysis. The effect of persistence was analysed using logistic regression and Cox survival analyses. Only 38.7% of users were persistent with treatment. Persistent and nonpersistent users had similar sociodemographic and clinical profiles, although differed in age, smoking status, and glycemia. Comorbidity networks revealed that the number of co-occurring diagnoses was higher in nonpersistent than persistent users. Adjusted analyses indicated a protective effect of treatment persistence, especially against major adverse cardiovascular events (MACE), but this effect was not statistically significant. Observational studies are crucial to characterize real-world effectiveness

Influence of cardiovascular condition on retinal and retinal nerve fiber layer measurements

Objective To assess changes in the retinal nerve fiber layer (RNFL) and macula in subjects with cardiovascular risk factors or subclinical ischemia. Design Prospective and observational study. Methods A total of 152 healthy men underwent cardiovascular examination, including quantification of subclinical atheroma plaques by artery ultrasound scans, blood analysis, and a complete ophthalmic evaluation, including spectral-domain optical coherence tomography. The variables registered in cardiovascular examination were quantification of classic major risk factors, subclinical atheroma plaques by artery ultrasound scans, and analytical records. The ophthalmic evaluation registered RNFL and macular thickness. Results Mean subject age was 51.27±3.71 years. The 40 subjects without classic cardiovascular risk factors did not show differences in RNFL and macular thicknesses compared with the 112 subjects with at least one risk factor (except in sector 9 that showed higher thicknesses in subjects with 1 risk factor). Comparison between the group of subjects with and without atheroma plaques revealed no differences in RNFL and macular thicknesses. The sub-analysis of subjects with subclinical atheroma plaques in the common carotid artery revealed a significant reduction in central macular thickness in the left eye compared with the right eye (p = 0.016), RNFL in the superior quadrant (p = 0.007), and the 11 o’clock sector (p = 0.020). Comparison between smokers and nonsmokers revealed that smokers had significant thinning of the central macular thickness (p = 0.034), the nasal RNFL quadrant (p = 0.006), and the 3 and 5 o’clock sectors (p = 0.016 and 0.009). Conclusions Classic cardiovascular risk factors do not cause RNFL or macular thickness reduction, but tobacco smoking habit reduces nasal RNFL thickness. Subclinical atherosclerosis in the common carotid artery associates a reduction in central macular and nasal RNFL quadrant thicknesses in the left eye compared with the right eye

Sleep duration and subclinical atherosclerosis: The Aragon Workers' Health Study

Background and aims: Few studies have evaluated the association of sleep duration with subclinical atherosclerosis, and with heterogeneous findings. We evaluated the association of sleep duration with the presence of coronary, carotid, and femoral subclinical atherosclerosis in healthy middle-age men with low prevalence of clinical comorbidities. Methods: We performed a cross-sectional analysis of 1968 men, 40–60 years of age, participating in the Aragon Workers' Health Study (AWHS). Duration of sleep during a typical work week was assessed by questionnaire. Coronary artery calcium scores (CACS) was assessed by computed tomography and the presence of carotid plaque and femoral plaque by ultrasound. Results: In fully adjusted models, the odds ratios (95% CI) for CACS >0 comparing sleep durations of =5, 6, and =8 h with 7 h were 1.34 (0.98–1.85), 1.35 (1.08–1.69) and 1.21 (0.90–1.62), respectively (p = 0.04). A similar U-shaped association was observed for CACS =100 and for CACS. The corresponding odds ratios for the presence of at least one carotid plaque were =5, 6, and =8 h with 7 h were 1.23 (0.88–1.72), 1.09 (0.86–1.38), and 0.86 (0.63–1.17), respectively (p = 0.31), and for the presence of at least one femoral plaque were 1.25 (0.87–1.80), 1.19 (0.93–1.51) and 1.17 (0.86–1.61), respectively (p = 0.39). Conclusions: Middle-aged men reporting 7 h of sleep duration had the lowest prevalence of subclinical coronary atherosclerosis as assessed by CACs. Our results support that men with very short or very long sleep durations are at increased risk of atherosclerosis