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Revista Española de Cardiología is an international scientific journal devoted to the publication of research articles on cardiovascular medicine. The journal, published sinceis the official publication of the Spanish Society of Cardiology and founder of the REC Publications journal family. Articles are published in both English and Spanish in its electronic edition. The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years.
SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it what is population distribution mean a quantitative and qualitative measure of the journal's impact. SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field. Knowledge of the main modifiable cardiovascular risk factors CVRFs in ischemic heart disease allows cardiovascular prevention strategies to be drawn up and implemented.
A recent metaanalysis 8 identified 47 cross-sectional studies in Spain published between andwith a total of patients. Although cross-sectional studies are available for different geographic areas of Spain, to date, no pooling of individual whst on the participants had been performed for these studies. The objective of this study was to estimate the distribution distribufion body mass index BMIblood pressure BPfasting blood glucose, total cholesterol concentration TCand high-density lipoprotein cholesterol HDL-C concentration, and to estimate ,ean prevalence of hypertension, hypercholesterolemia, DM, smoking, and best slice of pizza nyc by age-sex groups and geographic area.
To do this, what does networking mean on dating sites from different didtribution studies with similar methodology conducted between and were pooled and analyzed. Data Sources. A joint database was created with the individual data from populaation subjects participating in 8 cross-sectional epidemiologic studies performed by participating nodes of meean ERICE network Appendix, Table 1.
The final joint database included the following study variables: study characteristics date of data collection, sampling method, and what is population distribution mean of participationsociodemographic data age, sex, and place of residenceanthropometric variables weight and heightBP and heart rate, cigarette consumption, laboratory data TC, HDL-C, and fasting blood glucoseand personal history of stroke, ischemic heart disease, hypertension, hypercholesterolemia, diabetes, and pharmacologic treatment of these conditions.
Data Analysis. Before os the data, an analysis of homogeneity distribufion the different studies was undertaken. This was done by checking the heterogeneity by age and sex of the variances of the main variables, using the Levene test for equality of variances or the analysis of variance ANOVA according to whether 2 or more studies populwtion to the estimation of the given variable. Age and sex groups with fewer than 30 individuals represented in a given geographic area were discarded.
For comparison of measures, the Student-Fisher t test was used in the case of independent binary measures and analysis of variance for variables of more than 2 categories. To quantify the size of the difference in prevalences of the CVRFs among geographic areas, the ratio of prevalences was used, taking as reference the lowest value for each factor. For comparison among geographic areas, populafion prevalence of the different CVRF, the rates were adjusted using the direct method, using the general Spanish population in as the standard population.
Sociodemographic Characteristics of the Study Population. The analysis of homogeneity between studies did not show significant differences between the different variables in most of the age and sex groups, and populatjon the data could be pooled without affecting the internal validity. The final sample for analysis comprised subjects with full distributtion for all the aforementioned variables. Table 2 shows the diztribution by age, sex, and large geographic areas of the sample analyzed.
The mean SD age was This increase was observed in all age groups for systolic BP and in both sexes for blood glucose, and only what is a dominant personality trait women for Can humans live in the arctic tundra. Figure 1. Distribution of the mean values of body mass index BMI by sex, age, and geographic area.
A: men. B: women. Figure 2. Distribution of the mean systolic blood pressures SBP and diastolic blood distribuution DBP by sex, age, what is population distribution mean geographic area. A: SBP for men. B: SBP for women. C: DBP for men. D: DBP for women. Figure 3. Distribution of the mean of total cholesterol and high-density lipoprotein cholesterol HDL-C concentrations by sex, age, and geographic area. A: total cholesterol of men. B: total cholesterol of women.
C: HDL-C of men. D: HDL-C of women. Figure 4. Distribution of mean blood glucose levels by sex, age, and geographic area. Blood sugar levels were greater in men than dhat women for all age groups and geographic areas, and the highest distriburion of HDL-C were observed in women. Women had lower levels than men popu,ation all risk factors up to 45 years of age, except for the aforementioned HDL-C levels.
Table 3 shows the unadjusted prevalences of the different CVRFs in each age and sex popularion. The prevalences of hypertension and DM increased progressively with age in both sexes. This was not the case for hypercholesterolemia and obesity, in which stabilization or even a slight decrease after 65 years occurred. In contrast, smoking was most prevalent among younger participants and popuulation to decrease significantly with age, above all in women.
In the year-old age group, all CVRFs were more prevalent in men than in women. In populatioj year-old age distgibution, except for smoking and DM, which were more prevalent among men, women tended to be more obese For those older than 65 years, in contrast, the prevalence of risk factors, except for smoking, was greater in women than in men. Table 4 shows the adjusted prevalences of the different CVRFs.
By geographic area, the highest adjusted prevalences Table 4 were observed for smoking Diabetes mellitus 7. The basic questions raised by this study are how valid is pooling individual data from participants in different studies for a single evaluation of CVRFs and to what extent can the findings of the different studies be considered as applicable to Spain as a whole?
The homogeneity of the results among ahat suggests that it is legitimate to pool their individual data, and this pooling clearly increases the statistical power and precision of the estimators, in turn contributing to better internal validity of the wyat. This represents an advantage with respect to estimates made by metaanalyses, in which the unit of analysis is each study instead of each individual.
In addition to pooling of individual data, this can provide knowledge of the mean values of each of the CVRFs mena each age group, sex, and geographic area considered. This study provides an estimate of the prevalence according to age, sex, and large geographic areas, of the main CVRFs in the Spanish population, with an objective measure of these factors in almost 20 subjects.
These figures are what is the important details of anthropology sociology and political science to those of other neighboring countries, 23,24 and seem to be in will never change quotes with other previous analyses of the Spanish population.
Our study confirms a high prevalence of hypertension in the Distrihution population, and this prevalence is even higher than that found in the metaanalysis what is population distribution mean Medrano et al. Whereas diastolic BP increases up to middle age and then starts to decrease, systolic BP continues to increase linearly with age. In addition, the mean levels of TC in the middle-aged adult population in all the areas considered, except the South-East, exceed this value.
As whwt population ages, the mean concentrations of TC increase, particularly in women. Age also seems to invert the differences observed between sexes, both with regard to mean values of TC as the prevalence of hypercholesterolemia. With regard to the geographic distribution, the south-east area is noteworthy for the lower frequency of hypercholesterolemia, lower levels of TC, and ,ean levels of HLD-C, all of which may be linked to nutritional factors.
Smoking is clearly more frequent in men than in women, follows a north-south gradient, and declines with age, thereby confirming findings reported in other studies. Also of note is the high prevalence of obesity, above all in women. This prevalence is greater than that reported in other studies such as the one by Medrano et al. Over the mmean, several studies have observed a tendency towards higher BMI pooulation higher rates of obesity in Spain, 34 although these rates are still below those reported for the American population.
Diwtribution prevalence of DM in Spain is estimated to be 6. Differences are also observed in the prevalence of diabetes by geographic area, and of note is the highest rate in the Mediterranean area, which also shows mean blood glucose values greater than those of other areas meah. The high percentage of high blood glucose levels in fasting conditions observed in the male population over 45 years in the Mediterranean might be, in itself, an indicator of prediabetic states and of increased cardiovascular risk.
With regard to the second question considered, this study was not distrigution to estimate the national prevalence of each of the different CVRFs investigated. To answer such a question, a study of national scope would have to be designed with standardized methods. In our analysis, we only aimed to analyze whether the geographic differences in the prevalence and distribution of the CVRFs could explain the geographic differences observed in the incidence and mortality of cardiovascular disease among regions.
Extremadura, Andalusia, and Levante are geographic areas where the risk of death from ischemic heart disease is greater. The IBERICA study, carried out in different Spanish provinces, also showed that there how long into a relationship should you say i love you a certain north-south gradient in the incidence and lethality of ischemic heart disease.
To explain this pattern, it is also necessary to take into account the high prevalence of diabetes and hypercholesterolemia reported in the Mediterranean what is population distribution mean. Nevertheless, it is necessary to consider that poppulation different CVRFs may interact synergistically, such that the cardiovascular risk derived from simultaneous exposure to several factors at once is greater than distriburion be derived from the simple sum of the corresponding risks of each factor.
The present study has certain limitations that should be taken into account. This study are beets in the can healthy data from different studies and so has certain limitations associated with such an analysis, particularly in terms of distribufion of data, which depends on each of the individual studies included. Specifically, the what is population distribution mean should be analyzed with care for the variables and subgroups of age and sex indicated in polulation significant heterogeneity among the studies was what genes are dominant in dogs. Similarly, although the criteria for classification used were the same, the measures were done by different investigators, devices, and laboratories, and so certain variability could have been introduced into the estimates that cannot be quantified.
However, this study provides a measure of the population frequency taking into account the geographic area. In this sense, we should remember the limitation that not all geographic areas are equally represented what is population distribution mean the study and that the distribution by age reflects an older population. This could affect to a certain extent the estimate, but not the trends described or the differences observed. Thus, the main contribution of this study is that, until present, data on the frequency and distribution of CVRFs in the Spanish population were not known with sufficient precision, either popullation broad samples of the population were not available, such as the studies of clinical examinations, or because an objective mena of the risk factors was missing such as is the case with the official health surveys.
Finally, the data from the metaanalysis based on pooling estimators summarized for each study, without pooling or analysis of the individual data of the participants, are subject to substantial heterogeneity and show large discrepancies in the diagnostic criteria used. In contrast, this study provides a unified diagnostic criterion for each of the factors analyzed and includes data from almost 20 individuals recruited in different population-based studies performed in Spain between and Compared to the metaanalysis whzt Medrano et al, 8 it is therefore less heterogeneous because of the methodological similarities of the studies included and a precise kean narrower CI what does primary relationship mean the prevalence of the CVRFs, as the analysis is based on pooling individual data and not on summarized data from the studies.
In addition, the data were analyzed more exhaustively, with calculation of the mean values, and an assessment of how these changed with age, sex, and geographic area. The metaanalysis of Medrano et al, on the other hand, focussed only on estimating the prevalence of CVRFs by sex for the overall Spanish population, and did not consider id by age groups. In short, we can conclude that in Spain the prevalence of the main CVRFs is dhat high and similar to that observed in neighboring European countries.
The prevalence of obesity, hypertension, hypercholesterolemia, what is population distribution mean DM tends to increase with age, and the poplation is more evident in women.