Cardiovascular Risk Factor Progression in Young Males at 15-Year Follow-Up in the General Military Academy of Zaragoza (AGEMZA) Study

Introduction and objectivesThe AGEMZA cohort comprises military men whose risk factors were studied in 1985 when they were 20 years old. As these men reached the age of 35 years, we investigated the stability of or changes in anthropometric measures, lipid levels and arterial pressure, and looked for interrelationships between any changes.MethodsIn 2000, we collected new data (by cross-sectional study) on body mass index (BMI), cholesterol, cholesterol fractions, triglycerides and blood pressure, which could be compared with the original data. Persistence or tracking was evaluated using standardized regression coefficients and odds for persistence within the same quintile. Current data were modelled using multivariate regression models.ResultsIn the 250 subjects studied, significant changes were observed in the following variables: weight +12.1 kg, BMI +3.9 kg/m2, cholesterol +68.0 mg/dL, HDL cholesterol −5.2 mg/dL, LDL cholesterol +57.9 mg/dL, and triglycerides +76.3 mg/dL. The degree of persistence was high for all variables, except for diastolic blood pressure. Persistence was most pronounced for BMI, cholesterol, and LDL cholesterol. The changes observed indicate an increase in cardiovascular risk that adds to the effect of aging. The change in lipid profile was mainly influenced by the increase in BMI experienced, whereas blood pressure was mainly influenced by the final BMI attained. In addition, being a current smoker was associated with worse cholesterol fractions and triglyceride levels.ConclusionsCardiovascular risk factors increase during the third decade of the life. Early evaluation (after adolescence) enables the identification of individuals who will later be at an increased risk. Modifiable risk factors were identified, such as weight increase and smoking. Preventive measures should be designed for these groups.

Introducción y objetivosLa cohorte AGEMZA son varones militares cuyos factores de riesgo fueron estudia-dos en 1985 a la edad de 20 años. A la edad de 35 años se estudian la antropometría, los lípidos y la presión arterial y se investiga su estabilidad, sus cambios y la inter-dependencia en su evolución.MétodosEn 2000, se obtuvieron datos (encuesta transversal) que se compararon con los originales: índice de masa corporal (IMC), colesterol y sus fracciones, trigli-céridos y presiones arteriales. La persistencia o tracking se evalúa mediante el coeficiente de regresión estandari-zado y la permanencia en quintiles. Se crearon modelos de regresión multivariante para los datos actuales.ResultadosTras estudiar a 250 sujetos, se observa-ron modificaciones significativas de los siguientes factores: peso, +12,1 kg; IMC, +3,9 kg/m2, colesterol, +68,0 mg/dl; colesterol unido a lipoproteínas de alta densidad, −5,2 mg/dl; colesterol unido a lipoproteínas de baja densidad (cLDL), +57,9 mg/dl, y triglicéridos, +76,3 mg/dl. To-dos los factores presentaron una persistencia elevada, excepto la presión arterial diastólica. Es más pronunciada la persistencia de IMC, colesterol y cLDL. Estos cambios suponen un peor riesgo cardiovascular independiente-mente de la diferente edad. El perfil de lípidos se vio in-fluido por el incremento del IMC experimentado y los va-lores de presión arterial por el IMC alcanzado. Ser fumador activo también se asoció a peores valores de las fracciones de colesterol y triglicéridos.ConclusionesDurante la tercera década de la vida los factores de riesgo cardiovascular se incrementan. Es-tudios precoces (en la postadolescencia) permiten identi-ficar sujetos con mayor riesgo posterior. Se constató la influencia en el perfil final de circunstancias modificables (incremento ponderal, tabaquismo). Es razonable planifi-car medidas preventivas orientadas a estos colectivos.