• 作者：Jaime Ferná ; ndez de Bobadilla^a ; Veró ; nica Sanz de Burgoa^b ; ^{veronica.sanz.de.burgoa@pfizer.com} ; Patricio Garrido Morales^c ; Esteban Ló ; pez de Sá ; ^d ; en representació ; n de los investigadores del estudio RETRATOS^&loz ;
• 关键词：Riesgo cardiovascular ; Tabaquismo ; Atenció ; n primaria ; Tratamiento
• 刊名：Atenci贸n Primaria
• 出版年：2011
• 期刊代码：pca69_02126567
• 类别：med
• 出版时间：November 2011
• 卷：43
• 期：11
• 页码：595-603
• 文件大小：192 K

Aim

To evaluate the level of cardiovascular risk in smokers seenin Primary Care clinics.

Design

Epidemiologic, cross-sectional and multicentre study.

Setting

Primary Care.

Patients

Every investigator included 4 consecutive patients (3 smokers, 1 non-smoker) aged 35-50 years, who came to the clinic for any reason. A total of 2,184 patients were included; 2,124 (1,597 smokers; 527 non-smokers) were evaluated and 60 patients were excluded because they did not meet with selection criteria.

Measurements

The 10-year risk of suffering from a fatal cardiovascular disease (CVDR) was calculated according to the SCORE (Systematic Coronary Risk Evaluation) model. The 10-year lethal CVR according SCORE model, was classified as: very high (> 15%), high (10-14%), slightly high (5-9%), average (3-4%), low (2%), very low (1%) and negligible (< 1%). A logistical regression model was used to estimate the relationship between smoking and prior cardiovascular events.

Results

10-year fatal CVDR according to the SCORE model was significantly higher in smokers (40 卤 5.3) vs. non-smokers (1.9 卤 2.5) (P < .0001). Risk stratification: low (< 3%) [78.0%non-smokers vs. 60.7%smokers (P < .0001)]; intermediate (3-5%) [11.1%non-smokers vs. 12.6%smokers (P < .001)]; high (> 5%) [10.9%non-smokers vs. 26.7%smokers (P < .001)]. The logistical regression model showed that non-smokers vs. smokers had less probability of suffering myocardial infarction (OR 0.3; 95%confidence interval (95%CI): 0.1-0.8; P < .0001), peripheral vascular disease (OR 0.6; 95%CI: 0.4-1.0; P = .0180) and chronic obstructive lung disease (OR 0.18; 95%CI: 0.1-0.2; P = .0507).

Conclusions

Smoking is related to a high risk of fatal cardiovascular disease.

Active promotion in Primary Care clinics of measures aimed at reducing the prevalence of the smoking habit would lead to a lowering of cardiovascular morbidity and mortality.