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Asociación entre el nivel de riesgo de eventos cardiovasculares medido por la escala de Framingham y el efecto "no dipper" del monitoreo ambulatorio de presión arterial, en pacientes de la cohorte Chicamocha

dc.contributor.advisorVillar Centeno, Juan Carlosspa
dc.contributor.authorBlanco Barrera, Néstor Fabiánspa
dc.date.accessioned2020-06-26T19:59:56Z
dc.date.available2020-06-26T19:59:56Z
dc.date.issued2017
dc.identifier.urihttp://hdl.handle.net/20.500.12749/1745
dc.description.abstractObjetivo: Se evaluó la relación entre el puntaje en la escala de Framingham de riesgo cardiovascular (EFRCV) y la condición “no dipper” (ND) por monitoreo ambulatorio de presión arterial (MAPA) en participantes de la cohorte CHICAMOCHA. Métodos: Estudio de corte transversal. Participantes clasificados como de mayor probabilidad de hipertensión arterial (HTA, n=269) o controles (n=39) en la visita de seguimiento (mediana 12 años) tuvieron MAPA para su adecuada clasificación. Se registró el puntaje en la EFRCV como variable independiente, además de las variables sociodemográficas y medidas antropométricas. Se describió el nivel de EFRCV en la población por terciles y se evaluó la relación entre ND (nuestra variable dependiente) y posibles variables de confusión. Basado en estos hallazgos se construyó un modelo de regresión logística para establecer la relación independiente entre ND y EFRCV. Resultados: Se encontró patrón ND en 200 (65%) participantes. En el análisis bivariado se identificó un patrón incremental de frecuencia de ND por niveles de EFRCV (57%, en el grupo de menor riesgo; 63% en el grupo intermedio y 74% en el de mayor riesgo, p=0.039). En el modelo de regresión logística (que incluyó los niveles de presión arterial como covariable) se encontró que la edad (OR= 1.06, IC 95% 1.02 -1.09 por cada año) y la obesidad (OR= 1.82, IC 95% 1.12- 2.95), pero no la EFRCV fueron independientemente asociadas con la condición ND. Conclusión: La mayoría de participantes fue clasificada como ND. Aun cuando se encontró un claro gradiente entre EFRCV y la condición ND, esta asociación está explicada por su relación con los niveles de presión arterial, que es un componente de la escala. Este hallazgo sugiere que la relación bien establecida entre la condición ND y los eventos cardiovasculares sea explicada por vías diferentes a las incluidas en la EFRCV.spa
dc.description.tableofcontents1 DESCRIPCIÓN DEL PROYECTO .................................................................. 14 1.1 PLANTEAMIENTO Y JUSTIFICACIÓN DEL PROBLEMA ....................... 14 1.2 PREGUNTA A INVESTIGAR .................................................................... 16 2 MARCO TEÓRICO Y ESTADO DEL ARTE .................................................... 17 3 OBJETIVOS .................................................................................................... 22 3.1 OBJETIVO GENERAL .............................................................................. 22 3.2 OBJETIVOS ESPECÍFICOS ..................................................................... 22 4 METODOLOGÍA PROPUESTA ....................................................................... 23 4.1 DISEÑO .................................................................................................... 23 4.2 UNIVERSO ............................................................................................... 25 4.3 POBLACIÓN OBJETO .............................................................................. 25 4.4 MUESTRA ................................................................................................ 25 4.5 CRITERIOS DE INCLUSIÓN Y EXCLUSIÓN ........................................... 27 4.6 VARIABLES DE INVESTIGACIÓN ........................................................... 28 4.7 PROCEDIMIENTOS ................................................................................. 32 4.8 CONSIDERACIONES ÉTICAS ................................................................. 33 4.9 PLAN DE ANÁLISIS ESTADISTICO......................................................... 35 5 RESULTADOS ................................................................................................ 37 6 DISCUSIÓN .................................................................................................... 48 7 CONCLUSIONES ............................................................................................ 51 8 BIBLIOGRAFÍA ............................................................................................... 52spa
dc.format.mimetypeapplication/pdfspa
dc.language.isospaspa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.titleAsociación entre el nivel de riesgo de eventos cardiovasculares medido por la escala de Framingham y el efecto "no dipper" del monitoreo ambulatorio de presión arterial, en pacientes de la cohorte Chicamochaspa
dc.title.translatedAssociation between the risk level of cardiovascular events measured by the Framingham scale and the "no dipper" effect of ambulatory blood pressure monitoring, in patients from the Chicamocha cohorteng
dc.degree.nameEspecialista en Medicina Internaspa
dc.coverageFloridablanca (Santander, Colombia)spa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.rights.localAbierto (Texto Completo)spa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.programEspecialización en Medicina Internaspa
dc.description.degreelevelEspecializaciónspa
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.localTesisspa
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.subject.keywordsFramingham scaleeng
dc.subject.keywordsBlood pressureeng
dc.subject.keywordsCardiovascular diseaseseng
dc.subject.keywordsMedicineeng
dc.subject.keywordsInternal medicineeng
dc.subject.keywordsInvestigationseng
dc.subject.keywordsComplicationseng
dc.subject.keywordsPatientseng
dc.subject.keywordsPrevention and controleng
dc.subject.keywordsHigh blood pressureeng
dc.subject.keywordsCardiovascular riskeng
dc.subject.keywordsAmbulatory blood pressure monitoringeng
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga - UNABspa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.accessrightshttp://purl.org/coar/access_right/c_abf2spa
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dc.subject.lembEscala de Framinghamspa
dc.subject.lembPresión arterialspa
dc.subject.lembEnfermedades cardiovascularesspa
dc.subject.lembMedicinaspa
dc.subject.lembMedicina internaspa
dc.subject.lembInvestigacionesspa
dc.subject.lembComplicacionesspa
dc.subject.lembPacientesspa
dc.subject.lembPrevención y controlspa
dc.description.abstractenglishObjective: The relationship between the score on the Framingham cardiovascular risk scale (EFRCV) and the “no dipper” condition (ND) was evaluated by ambulatory blood pressure monitoring (ABPM) in participants of the CHICAMOCHA cohort. Methods: Cross-sectional study. Participants classified as having a higher probability of arterial hypertension (HBP, n = 269) or controls (n = 39) at the follow-up visit (median 12 years) had ABPM for proper classification. The score on the EFRCV was recorded as an independent variable, in addition to the sociodemographic variables and anthropometric measures. The level of EFRCV in the population was described by tertiles and the relationship between DN (our dependent variable) and possible confounding variables was evaluated. Based on these findings, a logistic regression model was constructed to establish the independent relationship between ND and EFRCV. Results: ND pattern was found in 200 (65%) participants. In the bivariate analysis, an incremental pattern of DN frequency by levels of EFRCV was identified (57%, in the lowest risk group; 63% in the intermediate group and 74% in the highest risk group, p = 0.039). In the logistic regression model (which included blood pressure levels as a covariate) it was found that age (OR = 1.06, 95% CI 1.02 -1.09 for each year) and obesity (OR = 1.82, 95% CI 1.12- 2.95), but not EFRCV were independently associated with the ND condition. Conclusion: The majority of participants were classified as ND. Even when a clear gradient was found between EFRCV and the ND condition, this association is explained by its relationship with blood pressure levels, which is a component of the scale. This finding suggests that the well-established relationship between ND condition and cardiovascular events are explained by ways other than those included in the EFRCV.eng
dc.subject.proposalHipertensión arterial
dc.subject.proposalRiesgo cardiovascular
dc.subject.proposalMonitoreo ambulatorio de presión arterial
dc.subject.proposalDipper
dc.type.redcolhttp://purl.org/redcol/resource_type/TM
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*
dc.contributor.researchgroupGrupo de Investigación en Cardiología Preventivaspa
dc.contributor.researchgroupGrupo de Investigaciones Clínicasspa
dc.coverage.campusUNAB Campus Bucaramangaspa
dc.description.learningmodalityModalidad Presencialspa


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