María Eugenia Velasco-Contreras Grado
Objective: To know what is the degree of association between the presence of vascular complications in people with obesity, diabetes, hypertension and the different degree of consumption of tobacco or alcohol.
Methods: From March to December 2009 were 20,000 surveys to health workers and other occupational categories randomly selected in the 35 delegations of the IMSS, in each State. The study of variables included: affiliation, sex, age, job category, and registration of known diseases, smoking, nicotine addiction, and consumption of alcohol risk, addiction to alcohol, habits, physical exercise and eating habits. Analysis statistical, was held in the SPSS version 17 system, was obtained frequencies, point prevalence of the risk factors, smoking, prevalence of chronic diseases and Terminal vascular complications, chronic pulmonary damage, (COPD) liver cirrhosis and neoplasm’s (cancer unspecified organ. Analysis bivariate estimate of the relative risk of Association of risk factors and addictions with obesity, and with chronic diseases and complications terminals, by estimating the right odds to the prevalence, CI=confidence interval; Chi-square of Mantel-Haenszel (Xmh)
Results: The consumption of more than five cigarettes per day in women associated with obesity RMP 1.43 IC (1.03-1.98) Xmh 2.1 and abusive consumption of alcohol is associated with obesity in men with 1.81 RMP IC (1.57-2.10) Xmh 8.0
With respect to vascular complications in women who smoke at least one cigarette a day’s Association was found with cerebral vascular disease (EVC) 3.24 RMP IC (1.58-6.66) Xmh 3.38, with RMP cardiac infarct of 2.69 IC (1.66-4.38) Xmh 4.16; Women in large smokers for more than 5 cigarettes a day Association was found with EVC RMP 4.50 CI (1.37-14.8) Xmh 2.71; with infarct heart 3.07 IC (1.23-7.65) Xmh 2.53, diabetes, RMP 1.61 IC (1.05-2.46) Xmh 6.82 hypertension RMP 1.21 IC (1.00- 1.74) Xmh 3.05 and Dyslipidemia RMP 1.22 IC (1.00-2.04) Xmh 2.29
Men in heavy smokers Association was established as follows: EVC, RMP 2.69 IC (2.22-14.61) Xmh 4.08; Cardiac infarct, RMP 2.68 IC (1.51 - 4.76) Xmh 3.48; diabetes, RMP 1.63 IC (1.20-2.20) Xmh 7.13; Hypertension, RMP 1.30 CI (1.00 - 1.69) Xmh 4.31.
With regard to the abusive consumption of alcohol in women Association was found with EVC, RMP 2.40 IC (1.08 - 5.31) Xmh 2.22.
In men with alcohol addiction Association was found to EVC, RMP 7.15 IC (1.65 - 31.01) Xmh 3.07, cardiac infarction, RMP 3.21 IC (1.16-8.92) Xmh 2.36, diabetes, RMP 1.96 IC (1.11-3.46) Xmh 2.35; arterial hypertension, RMP 1.75 IC (1.07-2.87) Xmh 2.26
In women with alcohol addiction Association was found to RMP 25.82 IC (7.46-98.40) cardiac infarct Xmh 7.68, diabetes, RMP 4.69 IC (1.71-12.80) Xmh 3.31; arterial hypertension, RMP 2.99 IC (1.17-7.66) Xmh 2.40
In hypertensive patients with more than 5 cigarettes a day smoking Association was found with EVC, RMP 85.6 IC (40.1- 182.9) Xmh 12.6; Cardiac infarct, RMP 2.88 IC (2.50-3.33) Xmh 10.5. In hypertensive patients with alcohol addiction Association was found with EVC, RMP 45.9 IC (23.7-88.9) Xmh 9.13; Cardiac infarct, RMP 37.7 IC (22.5-62.1) Xmh 12.8. In large smoking diabetic patients Association was found with EVC, RMP 97.8 IC (36.4-262.5) Xmh 11.0, with RMP 50.8 IC (26.5-97.2) cardiac infarct Xmh 13.1. In diabetic patients with addiction alcohol Association was found with EVC, RMP 35.9 IC (15.1-85.4) Xmh 5.4, with cardiac infarct, RMP 26.9 IC (14.6-49.7) Xmh 8.1
Conclusions: The metabolic syndrome is identified clinically by obesity, associated with hypertension, diabetes mellitus and Dyslipidemia. This increases the risk of vascular complications even before having identified chronic diseases, diabetes and hypertension. In this study associated with vascular damage in women who smoke at least one cigarette in the day, both of EVC, and cardiac infarction. The increase of the Association is not much larger with more than 5 smoking a day, suggesting greater vascular lability in women who smoke without serious nicotine addiction. Analyze the Association of smoking of cigarettes more than 5 a day with other components of the metabolic syndrome is identified to increase the presence of diabetes 1.61 times higher in women and 1.63 in men, when compared with non-smokers, Increases 1.21-1.30 and women hypertension and 1.22 single dyslipidaemia in women. With respect to vascular complications, large men smoking their increase is one and a half times less than in women, but 2 and half times higher than in men non-smoking.
In hypertensive and diabetic heavy smokers compared patient’s non-smoking increases by 85 and 100 times the risk of EVC respectively: for myocardial infarction 3-50 times more respectively. This suggests a clear difference in the coronary vascular damage generated by diabetes to hypertension.
In men, the abusive consumption of alcohol was clearly associated to obesity. In women compared with abstemias women the EVC associated with 2 and a half times more.
Addiction to alcohol in men increased 7 times more the presence of EVC. In men and women cardiac infarct, 3 and 25 times more, diabetes mellitus 2 and 5 and arterial hypertension 2 and 3 respectively when compared with abstainers men and women.
In hypertensive and diabetic patients with alcohol addiction Association was found with EVC 46 and 36 times more risk, to cardiac infarct almost 40 and 27 times more risk when compared with hypertensive and diabetic abstainers.
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