Así lo afirmaron expertos en el 43° Congreso Argentino de Cardiología

· Los elevados índices de tabaquismo y obesidad, el mal control de la hipertensión, la demora ante una emergencia, el colesterol elevado, el sedentarismo, el estrés y la diabetes son los factores que atentan contra la salud cardiovascular y que generaron que en 2015 murieran 197 personas por día por enfermedades del corazón[1].

· Durante esta importante reunión científica, los especialistas destacaron que aún queda mucho trabajo por hacer en materia del cuidado de la salud de este órgano y que deberíamos realizar cambios en el estilo de vida y conocer mejor cómo actuar ante urgencias.

En el marco del 43º Congreso Argentino de Cardiología, que se está celebrando en Buenos Aires, los especialistas coincidieron en que los argentinos no cuidamos lo suficiente nuestro corazón. Particularmente, afirmaron que los valores promedio de nuestra población, respecto de los principales factores de riesgo cardiovasculares, arrojan resultados preocupantes y que esto se debe en gran medida a una falta de toma de conciencia sobre la importancia de modificarlos para disminuir el riesgo y combatir la mortalidad por esta causa.

Prueba de lo contundente de estas afirmaciones es que 1 de cada 3 muertes de origen conocido en la Argentina se debe a alguna de las enfermedades cardiovasculares, que comprenden las patologías del corazón, cerebro, aterosclerosis y otras enfermedades del sistema circulatorio, representando la primera causa de defunción y el equivalente a un promedio de 197 fallecimientos diarios1.

“La hipertensión arterial, el colesterol elevado, altos niveles de sobrepeso y obesidad, tabaquismo, sedentarismo y el estrés son los principales factores de riesgo para desarrollar enfermedad cardiovascular. Si a eso le sumamos la demora en acudir a la atención médica ante una emergencia y la falta de adherencia a los tratamientos médicos, tenemos un combo explosivo que se refleja en los altos índices de mortalidad y de enfermedad cardiovascular”, manifestó el Dr. Miguel A. González, presidente de la Sociedad Argentina de cardiología (SAC) y presidente del Comité Organizador del 43° Congreso Argentino de Cardiología.

Solo por citar algunas estadísticas, entre los mayores de 18 años, 1 de cada 4 argentinos fuma (25,1%), casi 6 de cada 10 presentan sobrepeso u obesidad (57,9%), 3 de cada 10 son hipertensos (34,1%) y de ellos el 38,8% no lo sabe; tiene colesterol elevado el 29,8%, de los cuales apenas la mitad (53,2%) está bajo tratamiento; el 54,7% realiza un nivel bajo de actividad física y 1 de cada 10 tiene diabetes (9,8%), pero el 38,6% no se trata[2].

“Si presentar cualquiera de estos factores de riesgo por sí solo ya puede predisponer a padecer una enfermedad cardiovascular, la sumatoria de 2 ó más factores incrementa el riesgo de manera alarmante. Es muy frecuente encontrar que en un mismo paciente confluyen valores de presión y de colesterol elevados, un considerable sobrepeso y sedentarismo, solo por dar un ejemplo”, explicó el Dr. Ricardo Migliore, Vice Presidente de la SAC y Presidente del Comité Científico del 43º Congreso Argentino de Cardiología.

Además deben tenerse en cuenta parámetros que el individuo no puede modificar, como el hecho de ser varón (los hombres tienen más riesgo que las mujeres), la edad y la carga hereditaria.

Respecto de la atención del infarto, un trabajo evidenció que es muy alta la demora entre el inicio de los primeros síntomas, el arribo a un centro asistencial y la realización de un tratamiento de desobstrucción coronaria. Según resultados preliminares del estudio ARGEN IAM-ST, que involucró los reportes de 1670 personas con infarto que llegaron a la guardia de 247 centros de todo el país, casi 1 de cada 2 (45,6%) demoró más de 3 horas en promedio desde los primeros síntomas hasta arribar a una sala con capacidad para la realización de una angioplastia, de los cuales el 18,4% demoró entre 3 y 6 horas, el 14,3% entre 6 y 12, el 7,8% entre 12 y 24 y el 5,1% más de 24 hs[3].

“Este relevamiento, realizado en forma conjunta por la Sociedad Argentina de Cardiología (SAC) y la Federación Argentina de Cardiología (FAC), formó parte de las presentaciones del 43° Congreso Argentino de Cardiología, ya que evidencia los tiempos excesivos no solo de los pacientes en requerir asistencia, sino del propio sistema en brindarla”, completó el Dr. Hector Deschle, Secretario SAC.

Los argentinos y el cuidado de nuestro corazón

· Tabaquismo – 1 de cada 4 fuma

La Encuesta Nacional de Factores de Riesgo publicada en 2015 arrojó que el 25,1% de la población mayor de 18 años fuma2. Si bien se trata del único factor que disminuyó con respecto a relevamientos anteriores (era del 29,7% en 2007 y 27,1% en 20092), aún es una cifra elevada, ya que contribuye de manera contundente en el desarrollo de un gran abanico de patologías, no únicamente las del corazón.

· Exceso de peso – casi 6 de cada 10 tienen sobrepeso u obesidad

El 23% de los casos de cardiopatía isquémica puede ser explicado por la obesidad, por lo que también conforma un elemento central a modificar para lograr un mejor estado de salud2. En esta línea, casi 6 de cada 10 (57,9%) argentinos mayores de 18 años tienen sobrepeso u obesidad, una tendencia que se encuentra en aumento2.

· Hipertensión – 1 de cada 3 adultos es hipertenso, pero casi 4 de cada 10 no lo saben

Según una investigación denominada RENATA-2, que se realizó en nuestro país por médicos de SAC y FAC, el 36,3% de los argentinos mayores de 18 años padece hipertensión[4]. Cifras similares a las que maneja el Ministerio de la Nación (34,1%), lo que valida los resultados del estudio2. A su vez, casi 4 de cada 10 personas (38,8%) que padecen hipertensión no lo sabe5.

· Demora en intervención ante casos de IAM – más de 4 horas

El estudio ARGEN IAM-ST relevó que 1 de cada 3 pacientes con infarto agudo de miocardio demoró más de 4 horas en promedio desde los primeros síntomas hasta arribar a una sala con capacidad para la realización de una angioplastia[5], mientras que lo recomendado es un tiempo inferior a las 2 horas. Esto ocurre por diversos factores, entre los que se incluyen a) que los pacientes minimizan los síntomas y posponen el llamado a la ambulancia, b) la demora del servicio de emergencias y c) la derivación inicial a centros que no cuentan con servicio de hemodinamia para para la realización de angioplastias.

· Colesterol – Casi la mitad de quienes lo tienen elevado no se trata

El 29,8% de los mayores de 18 años presenta colesterol elevado y, dentro de esa población, solamente el 53,2% registró estar bajo algún tratamiento, ya sea modificaciones en el estilo de vida o la toma de alguna medicación, lo cual representa una cifra muy baja para el control de este factor2.

· Sedentarismo – más de la mitad hace poca actividad física

El 54,7% de los argentinos realiza un nivel bajo de actividad física. La realización en forma regular de actividad física disminuye la morbimortalidad mediante la reducción de la incidencia de enfermedades cardiovasculares, accidente cerebrovascular, enfermedad coronaria, hipertensión, enfermedad vascular renal, enfermedades metabólicas y algunos cánceres como el de colon y mama; también disminuye el riesgo de padecer depresión y de sufrir caídas2.

· Estrés

Estudios internacionales como el denominado Interheart, realizado hace más de una década, señalan que la percepción permanente de estrés junto con los antecedentes de hipertensión se encuentran entre los factores asociados más fuertemente con el infarto, seguidos en frecuencia por la diabetes y la obesidad abdominal. Esta investigación internacional de la que participaron 52 países, 6 de ellos de Latinoamérica, entre los que se encontraban Brasil, Colombia, Chile, Guatemala, México y la Argentina, con más 15 mil pacientes y un número similar de individuos control, y que tuvo como objetivo saber cómo influían los factores de riesgo convencionales y los nuevos sobre la frecuencia de infarto agudo de miocardio, concluyó que personas con estrés permanente o que sufrieron varios períodos de estrés en sus vidas presentaron riesgo más alto de IAM[6],[7].

· Diabetes – 1 de cada 10 tiene diabetes

El 9,8% de la población argentina mayor a 18 años padece diabetes, una patología que puede afectar la calidad de vida y que se relaciona con un mayor riesgo de padecer una afección del corazón. De hecho, la mitad (50%) de quienes padecen diabetes muere a causa de una enfermedad cardiovascular. Casi 4 de cada 10 (38,6%) no recibía ningún tratamiento, lo que representa un dato negativo en el control de las enfermedades no trasmisibles2.

Si bien la diabetes tipo 1, que suele ocurrir desde la infancia, no se puede prevenir, sí se pueden tomar ciertos recaudos para evitar la aparición de la diabetes tipo 2, que es la más común. Estos consisten en cambios en el estilo de vida: dieta más saludable, bajar de peso, realizar actividad física, no fumar y controlar la glucemia, entre otras.

Acerca del 43° Congreso Argentino de Cardiología
Organizado por la Sociedad Argentina de Cardiología (SAC) en pleno marco de los festejos por su 80° aniversario, se realiza en Buenos Aires del 19 al 21 de octubre el 43º Congreso Argentino de Cardiología, la reunión científica más importante de habla hispana para la especialidad, y la cuarta en relevancia a nivel internacional. En paralelo, también en el Predio Ferial de La Rural, se desarrollará el 17° Congreso Argentino de Cardiología Pediátrica.

Participan del encuentro más de 10 mil asistentes de nuestro país y de la región, además de representantes de algunas de las sociedades científicas más prestigiosas del mundo, como la Sociedad Europea de Cardiología (ESC), la American College of Cardiology (ACC), el Capítulo de New York del ACC, la American Heart Association (AHA), la Sociedad Española de Cardiología (SEC), la World Heart Federation (WHF), la Sociedad Interamericana de Cardiología (SIAC), la Sociedad Sudamericana de Cardiología (SSC), y la Sociedad de Cardiología de Centroamérica y Caribe (SCSCC) , junto a todos los Presidentes de Sociedades Científicas de Latinoamérica.

Participan del encuentro médicos cardiólogos y de otras especialidades como clínicos y pediatras, enfermeros, técnicos, estudiantes y otros profesionales vinculados a la salud. A su vez, el encuentro cuenta con más de 50 disertantes extranjeros de países como Estados Unidos, Canadá, Francia, Dinamarca, Escocia, España, Brasil, Chile, Colombia, Perú, Cuba, México, Bolivia, Uruguay y Paraguay.

El comité organizador está integrado, entre otros, por los doctores Miguel A. González (Presidente de la Sociedad Argentina de Cardiología y del Comité Organizador), Ricardo A. Migliore (Vicepresidente 1º de la Sociedad Argentina de Cardiología y Presidente del Comité Científico), Marcelo Rodríguez (Vicepresidente 2º de la Sociedad Argentina de Cardiología y del Comité Organizador), Héctor A. Deschle (Secretario de la Sociedad Argentina de Cardiología y del Comité Organizador), Alberto Fernández (Coordinador General del Comité Científico), Eduardo Guevara (Secretario Científico del Comité Científico), y Guillermo Liniado (Secretario Técnico del Comité Científico).

José María Oribe

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