Page 47 - MemoriaCIBER-2017ENG

Cardiovascular epidemiology and risk factors
Coordinator: Jaume Marrugat
In 2017 the Epidemiology and Cardiovascular Risk Factors programme set forth its objectives for research and creation of transversal structures for the coming years Furthermore, thanks to the earlier cooperation at the RIC, some major milestones have been attained in the di erent work areas:
Transfer Projects. A survey on population cohorts recruited all over the country was made Twenty cohorts have agreed to take part, including roughly 85,000 participants This proposal will enable constructing BigData to answer the crucial questions of cardiovascular epidemiology, which will go along with a clinical-epidemiological database and a repository of biological samples Indicators of trends have also been obtained in the evolution of the body mass index and blood pressure worldwide (Lancet 2017;390:227-42 Lancet 2017:389:37-55), reinforcing the need for controlling these risk factors for cardiovascular illness (J Clin Lipidol 2017;11:1013-22)
Contribution to improving clinical practice The ATHOS study has been completed, including roughly 8,500 patients with acute coronary syndrome (ACS) cared for at 31 hospitals This contribution enables us to evaluate variability in handling patients with ACS at Spanish hospitals and provides an evaluation of performance in handling myocardial infarction, thanks to the EURHOBOP European benchmarking system coordinated by researchers from the Programme Categorical information has also been published on the e ectiveness of percutaneous coronary intervention in the elderly and patients with comorbidities in the acute phase (Int J Cardiol 2017; 249: 83-89) with major implications for clinical practice due to the infra-utilisation of this procedure in this age group In primary prevention, an analysis has been made of the e ectiveness of treatment with statins according to the level of cardiovascular risk and it was possible to estimate the number of patients required to be treated in order to prevent a cardiovascular event on the di erent risk levels (Clin Pharmacol Ther 2017)
Progress in knowledge on the mechanisms of pathology and potential new treatment strategies. In 2017 new genetic variants connected with hypertension were identi ed, indicating new mechanisms and therapeutic targets (Nat Genet 2017; 49: 403-415; Hypertension 2017,) Lipase lipoprotein was valued as a therapeutic target for controlling triglycerides and reducing the risk of coronary disease (JAMA 2017;317:937-46), validating the inhibition of the cholesterol ester transfer protein (CETP) as a therapeutic target for reducing the risk of heart disease, although the mechanism of this protection e ect could be mediated by an increase in levels of HDL-cholesterol or a reduction in the levels of LDL-cholesterol (Circ Res 2017;121:81-8) DNA methylation markers associated with obesity were identi ed (Epigenetics 2017;12:909-16), with the functionality of particles of HDL-cholesterol (Arterioscler Thromb Vasc Biol 2017 Mar;37(3):567-569) and with the risk of presenting heart diseases (Atherosclerosis 2017;263:323- 33) It has also been proven that one of the potential mechanisms making the Mediterranean diet reduce the risk of cardiovascular illness is the improvement in the functionality of HDL cholesterol particles (Circulation 2017;135:633-43)