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dc.contributor.authorMedrano, Maria Jose 
dc.contributor.authorAlcalde-Cabero, Enrique 
dc.contributor.authorOrtiz Burgos, Cristina 
dc.contributor.authorGalan, Iñaki 
dc.date.accessioned2019-02-28T14:09:45Z
dc.date.available2019-02-28T14:09:45Z
dc.date.issued2014-02-17
dc.identifier.citationBMJ Open. 2014; 4(2): e004257es_ES
dc.identifier.issn2044-6055es_ES
dc.identifier.urihttp://hdl.handle.net/20.500.12105/7258
dc.description.abstractOBJECTIVE: To assess the overall population impact of primary prevention strategies (promotion of healthy lifestyles, prevention of smoking and use of vascular risk drug therapy) of coronary disease in Spain. DESIGN: Ecological time series analysis, 1982-2009. SETTING: All public and private hospitals in Spain. PARTICIPANTS: General population. OUTCOME: Incident coronary disease hospitalisation as derived from official hospital discharge data. METHODS: Annual hospitalisation rates were modelled according to nationwide use of statins, antihypertensive, antidiabetic and antiplatelet drugs, and prevalences of smoking, obesity and overweight. Additive generalised models and mixed Poisson regression models were used for the purpose, taking year as the random-effect variable and adjusting for age, sex, prevalence of vascular risk factors and the number of hospital beds in intensive and coronary care units. RESULTS: Across 28 years and 671.5 million person-years of observation, there were 2 986 834 hospitalisations due to coronary disease; of these, 1 441 980 (48.28%) were classified as incident. Hospitalisation rates increased from 1982 to 1996, with an inflection point in 1997 and a subsequent 52% decrease until 2009. Prevalences of smoking, obesity, overweight and use of vascular risk drug therapy were significantly associated with hospitalisation rates (p<0.001): incidence rates ratios (95% CI) for the fourth versus the first quartile were 1.46 (1.42 to 1.50), 1.80 (1.78 to 1.83), 1.58 (1.55 to 1.60) and 0.57 (0.51 to 0.63), respectively. These variables accounted for 92% of interannual variability. CONCLUSIONS: After decades of continuous rises, hospitalisation due to incident ischaemic heart disease has been cut by half, an achievement associated with the decline in smoking and the increase in vascular risk drug therapy. These results indicate that these two primary prevention strategies have been effective at a population level, thanks to an appropriate balance between financial and health goals, something that should be left intact despite the current economic crisis. Future strategies ought to lay special stress on excessive body weight prevention.es_ES
dc.language.isoenges_ES
dc.publisherBMJ Publishing Group es_ES
dc.type.hasVersionVoRes_ES
dc.rights.urihttp://creativecommons.org/licenses/by-nc/3.0/*
dc.subjectEpidemiologyes_ES
dc.subjectPreventive Medicinees_ES
dc.subjectPublic Healthes_ES
dc.subject.meshAdult es_ES
dc.subject.meshAged es_ES
dc.subject.meshFemale es_ES
dc.subject.meshCoronary Disease es_ES
dc.subject.meshHospitalization es_ES
dc.subject.meshHumans es_ES
dc.subject.meshIncidence es_ES
dc.subject.meshMale es_ES
dc.subject.meshMiddle Aged es_ES
dc.subject.meshOutcome and Process Assessment (Health Care)es_ES
dc.subject.meshPrevalence es_ES
dc.subject.meshPrimary Prevention es_ES
dc.subject.meshRisk Factors es_ES
dc.subject.meshSpain es_ES
dc.titleEffect of cardiovascular prevention strategies on incident coronary disease hospitalisation rates in Spain; an ecological time series analysises_ES
dc.typejournal articlees_ES
dc.rights.licenseAtribución-NoComercial- 3.0 Internacional*
dc.identifier.pubmedID24534258es_ES
dc.format.volume4es_ES
dc.format.number2es_ES
dc.format.pagee004257es_ES
dc.identifier.doi10.1136/bmjopen-2013-004257es_ES
dc.description.peerreviewedes_ES
dc.relation.publisherversionhttp://dx.doi.org/10.1136/bmjopen-2013-004257es_ES
dc.identifier.journalBMJ openes_ES
dc.repisalud.centroISCIII::Centro Nacional de Epidemiologíaes_ES
dc.repisalud.institucionISCIIIes_ES
dc.rights.accessRightsopen accesses_ES


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Atribución-NoComercial- 3.0 Internacional
Este Item está sujeto a una licencia Creative Commons: Atribución-NoComercial- 3.0 Internacional