20. Type 2 diabetes,
the metabolic syndrome and
cardiovascular disease in Europe
• By 2025 the number of people with diabetes is expected to
rise by
• 20% in Europe
• 50% in North America
• 75% in the Western Pacific
• 85% in South and Central America.
• For developing countries, there will be a projected increase of
a 170% of cases;
• For developed countries, there will be a projected rise of 42%.
• Diabetes is the fourth main cause of death in most developed
countries.
Diabetes – a growing threat
29. HIPERTENSION ARTERIAL Y CARDIOPATIA
ISQUEMICA EN CENTROAMERICA
1. PERDIDA DE IDENTIDAD MESOAMERICANA
2.. ABORDAJE TIPO USA /EUROPA CUESTIONABLE
3. ESTRATEGIAS DE PREVENCION POBRES
30. HIPERTENSION ARTERIAL Y CARDIOPATIA
ISQUEMICA EN CENTROAMERICA
PERDIDA DE
IDENTIDAD
MESOAMERICANA
34. Que tienen en Común aparte de
Asociarse con Enfermedad Coronaria ?
• Sobrepeso
• Obesidad
• Síndrome metabólico
• Dislipidemia
• Diabetes Mellitus
• Hipertensión Arterial
• Hiperuricemia
• Hígado graso
• Cardiopatía Isquémica
35. ROL DEL AZUCAR SULFITADO EN LAS ENFERMEDADES
CARDIOVASCULARES
36. ROL DEL AZUCAR SULFITADO EN LAS ENFERMEDADES
CARDIOVASCULARES
30 DE MAYO 1498, SANTO DOMINGO
37. ROL DEL AZUCAR SULFITADO EN LAS ENFERMEDADES
CARDIOVASCULARES
38. ROL DEL AZUCAR SULFITADO EN LAS ENFERMEDADES
CARDIOVASCULARES
39. ROL DEL AZUCAR SULFITADO EN LAS ENFERMEDADES
CARDIOVASCULARES
40. ROL DEL AZUCAR SULFITADO EN LAS ENFERMEDADES
CARDIOVASCULARES
41. ROL DEL AZUCAR SULFITADO EN LAS ENFERMEDADES
CARDIOVASCULARES
51. ROL DEL AZUCAR SULFITADO EN LAS ENFERMEDADES
CARDIOVASCULARES
52.
53.
54.
55.
56.
57. Indios yanomanos,amazonas
Excrecion urinaria de sodio: 1-2 mcromol diario
Oliver WJ, Cohen EL. Neel JV. Blood pressure, sodium intake and sodium related hormones in the
Yanomano Indians, a "no-salt" culture. Circulation 1975; 52:146-15
58.
59.
60.
61.
62.
63.
64. REGLA NICARAGUENSE DE LA SAL Y EL
QUESO UNO POR UNO
X
1 ONZA 1 LIBRA
30 gramos de CLNa
14 gramos de Sodio
90. HIPERTENSION ARTERIAL Y CARDIOPATIA
ISQUEMICA EN CENTROAMERICA
ABORDAJE TIPO USA
/EUROPA
CUESTIONABLE
91.
92.
93. Of 136,905 patients hospitalized with CAD, 77% had normal LDL levels
below 130 mg/dl
Modified from Sachdeva et al. AHJ, Vol 157, 111-117 Jan 2009
Chapter 1: Preventive Cardiology; the SHAPE of the Future in Naghavi et al. Asymptomatic Atherosclerosis:
Pathophysiology, Detection and Treatment. Humana Press, 2009
94. Modified from Sachdeva et al. AHJ, Vol 157, 111-117 Jan 2009
Chapter 1: Preventive Cardiology; the SHAPE of the Future in Naghavi et al. Asymptomatic Atherosclerosis:
Pathophysiology, Detection and Treatment. Humana Press, 2009
Of 136,905 patients hospitalized with CAD, 45.4% had normal HDL levels
above 40 mg/dl
95. Of 136,905 patients hospitalized with CAD, 61.8% had normal triglyceride
levels below 150 mg/dl
Modified from Sachdeva et al. AHJ, Vol 157, 111-117 Jan 2009
Chapter 1: Preventive Cardiology; the SHAPE of the Future in Naghavi et al. Asymptomatic Atherosclerosis:
Pathophysiology, Detection and Treatment. Humana Press, 2009
99. No SOBREPESO
NO FUMADOR
MUY ACTIVO
Jim Fixx, 53 años
QUIEN TIENE MAYOR RIESGO CARDIOVASCULAR BASADO EN SU SCORE ?
100. En >50% de los casos, la
primer manifestación de
aterosclerosis
asitomatica es la muerte
súbita o el infarto del
miocardio.
101. CANCER DE COLON Y ATEROSCLEROSIS. LO QUE DEBEMOS APRENDER DE LOS ONCOLOGOS
102. MASCULNO DE 70 AÑOS, HIPERTRIGLICERIDEMIA, HIPERTENSION,
PRUEBAS DE ESFUERZO NEGATIVAS CADA AÑO POR CINCO AÑOS
103. Coronary Calcium Progression
Calcium Score: 56 Calcium Score: 90 Calcium Score: 128
Volume Score: 45 Volume Score: 78 Volume Score: 113
1993 1995 1997
Progression of Right coronary artery calcium score over 5 years
104.
105. Carotid Intima Media Thickness (CIMT)
• Direct in vivo measurement of thickness of carotid artery wall by
B-mode ultrasound
• Vessel wall thickness correlates with status of atherosclerosis and
CV events
• Atherosclerosis is a systemic disorder
– Atherosclerosis in the carotid artery is predictive of disease in other
vascular beds
de Groot E, et al. Circulation. (2004) 109[Suppl III]:III-33-III-38.
106. Evidence That CIMT Predicts
Clinical Disease
• Epidemiologic Data
– CHS (Cardiovascular Health Study)1
– ARIC (Atherosclerosis Risk in Communities
Study)2,3
– Rotterdam Study4
– CLAS (Cholesterol Lowering Atherosclerosis
Study) post-treatment long-term outcomes
follow-up5
• Clinical Trials with Lipid Modifying Drugs
1. O’Leary DH, Polak JF, Kronmal RA, et al. N Engl J Med. 1999;340:14-22.
2. Chambless LE, Heiss G, Folsom AR, et al. Am J Epidemiol. 1997;146:483-494.
3. Chambless LE, Heiss G, Clegg LX, et al. Am J Epidemiol. 2000;151:478-487.
4. Bots ML, Hoes AW, Koudstaal PJ, et al. Circulation. 1997;96:1432-1437.
5. Hodis HN, Mack WJ, LaBree L, et al. Ann Intern Med. 1998;128:262-269.