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Epidemiology and Prevention of Cardiovascular
Diseases

Fernando Rodríguez Artalejo

Department of Preventive Medicine and Public Health
Universidad Autónoma de Madrid
Magnitude and distribution of CVD

Madrid, 13 April, 2023

Objetives Las 15 causas de defunción más importantes en España, 2019

• Magnitude and distribution of CVD

• Risk factors
•Types of risk factors
•How do we know that a certain variable is a risk
factor?
•Magnitude and distribution
•Determinants of the risk factors
•Effectiveness of interventions on risk factors
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•Strategies for CVD prevention and control to the Pro version.

•Types of strategies
• Challenges in CVD prevention and control
Mortality in Spain 2021
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European
cardiovascular disease
statistics 2017.
Ischemic heart disease.

INE

European
cardiovascular disease
statistics 2017. Stroke.

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Tendencias en el tiempo en el número absoluto de muertes y las tasas de
mortalidad por enfermedad cardiovascular por sexo en España Risk factors
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A risk factor is any attribute, characteristic or exposure of an
individual that increases the likelihood of developing a
disease or injury

Risk factors can be:

• Causal and non-causal (risk markers)
• Among those that are causal
• Necessary
• Non-necessary
• Modifiable or not

Actualización de Bueno H, Pérez-Gómez B. Circulation 2019;140:13–15.

Main CVD risk factors

(well-established)

Non-modifiable Modifiable
Major RF
• Age
• Male • Tobacco
• Genes • Low activity/Sedentary
CVD Risk factors behavior
• Personal history of CVD
• Diabetes mellitus • Body mass index
• Socioeconomic level
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• Psychosocial factors • Blood pressure
• Cholesterolerolemia

The list is long: alcohol, chronic inflammation, oxidative stress, prothrombotic factors, etc..
 How do we know that a certain variable is a risk
factor?
The case of cholesterolemia in CVD
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to the Pro version. 1. Pathology
– Atheromatosis (and subsequent thrombosis) underlies/is present in occluded vessels that lead
to CVD events

2. Studies with animal models

– Guinea pig fed a diet high in saturated fat and cholesterol develop hypercholesterolemia and
vascular fatty streaks; this phenomenon regress when diet is reverted to plant-based diet

3. Investigation on human diseases characterized by high

cholesterolemia
– Patients with genetic diseases with high cholesteromeia (e.g., familial homo o heterozigous)
have early atherosclerosis and CVD

4. Epidemiologic studies: population correlation

5. Epidemiologic studies: cohorts
6. Trials with cholesterol lowering treatments
– Progression/regression atheromatous plaque
– Reduction of CVD events
Colesterol y mortalidad coronaria: estudios de Ranking of CVD risk factors according to CVD
cohortes con datos individuales (análisis observacional del MRFIT) Deaths attributed to each of them, Spain, 2019

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Institute for Health Metrics and Evaluation. http://www.healthmetricsandevaluation.org/tools/data-visualizations

 3 challenges
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Clinic, Acute
mediating clinical Chronic and terminal
Preclinic diseases events clinical forms
Genes Diabetes AMI Heart failure
Family history Hypertension Stroke Disability
Environment Abnormal Peripheral
Lifestyle lipids artery
Strategies for CVD prevention disease

RIP

Public Health Clinical Technological

challenge challenge challenge

Prevention strategies
(high risk versus population)

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