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Introduction and Objectives: The increasing incidence of abdominal aortic aneurysm (AAA), mainly due to the aging population, and its mortality of 85-90% in the event of rupture justify opting for early diagnosis and elective treatment to repair it. The main aim of this paper is to analyze the utility of transthoracic echocardiography (TTE) in the study of infrarenal aorta and AAA screening., Methods: The study included 512 patients (309 men and 203 women) consecutively assessed by TTE and, where possible, abdominal ultrasound for any reason in a cardiology department., Results: An AAA was detected in 25 patients (5.1%), the minimum age at diagnosis was 55 years, the ratio of men to women was 7.3:1 and the mean diameter of the aneurysms was 39.5 ± 12.2mm. Risk factors associated with AAA were to current and former smoking, age, and presence of femoral murmur. The TTE results were equivalent to those of abdominal ultrasound. All patients with AAA studied by coronary angiography showed significant coronary lesions., Conclusions: It is feasible and useful to complement conventional TTE with the study of the infrarenal aorta for AAA screening in patients visited at the department of cardiology. This study should be performed mainly in patients ≥55 years old or with risk factors to develop an AAA., (Copyright © 2010 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.)

Introduction and Objectives: Sprint Fidelis defibrillation leads are prone to early failure. Most of the reported series come from a single institution. This paper describes the clinical experience in nine Spanish hospitals., Methods: Clinical, implant, and follow-up data of all patients with a Sprint Fidelis lead were analyzed. All cases of lead failure were identified, medium-term lead survival was calculated, and possible predictors for lead failure were determined., Results: In total, 378 leads in 376 patients were studied. The mean age (male 85.7%) was 64.9 ± 13.6 years. The majority of patients (59.8%) had ischemic heart disease. Mean left ventricular ejection fraction was 33.4% ± 14.5%. Left subclavian vein puncture was used in 74.8%. During a mean follow-up of 30.9 ± 14 months, 16 lead failures have occurred, with a lead survival of 96.1% at 36 months after implantation. Eleven of 16 lead failures were caused by failure of pace/sense conductors, 3 by defects in the high-voltage conductor, and 2 by defects in both types of conductors. A less depressed left ventricular ejection fraction was associated with an increased probability of lead failure (42.4% ± 16% vs. 33% ± 14.3%; P =.011). Three hospitals presented a rate of lead failure higher than 10%; the rate was less than 5% in the remaining 6 hospitals., Conclusions: In this multicenter series of 378 leads, the 3-year estimated survival was higher than that reported in prior series. Clinical presentation of lead failures was similar to that reported previously. Left ventricular ejection fraction and hospital of implantation were variables associated to lead failure., (Copyright © 2010 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.)

Introduction and Objectives: The aim of this article was to report findings from the Spanish Pacemaker Registry on procedures carried out in 2007. The analysis includes details of patients' demographic characteristics, the type of procedure (i.e., implant or replacement), pacing mode, and the electrode and fixation systems used., Methods: The data collected comprised all the information recorded on European Pacemaker Patient Identification Cards, which were submitted voluntarily in either electronic or paper form., Results: The information received from 114 health-care centers included 11 360 cards, which covered 36.9% of all pacemakers thought to be implanted during 2007. Some 680.4 pacemakers were used per million inhabitants. Usage varied significantly between different Spanish autonomous regions, partly due to uneven ageing of the population. Some 25.3% of all procedures were to replace generators. The average age of patients undergoing a first implantation was 76.1 years, with a difference between the sexes: 75.4 years in men and 77.1 years in women. First implantations were carried out most often in patients in their 70s, who comprised 40% of the total, compared with other decades of life. There were more first implantations in men, who accounted for 57.9% of the total, due to a higher incidence of intraventricular conduction disturbance. In contrast, sick sinus syndrome was equally common in both sexes. Leaving aside patients with atrial tachyarrhythmia, it was observed that the VVI/R mode was used in 26.2% of those with sick sinus syndrome, 28% with atrioventricular block and 28.1% with intraventricular conduction disturbance. Age had a great influence on whether this pacing mode was selected. Almost all leads used were bipolar. The percentage using active fixation increased to 36.5%. The percentage of implants involving low-energy cardiac resynchronization therapy remained unchanged., Conclusions: The Spanish Pacemaker Registry received data on a highly representative sample of patients requiring cardiac pacing in 2007, which covered 11 360 device implantations or replacements. It was observed that the incidence of first implantations was influenced by sex, being greater in males, who underwent implantation at a younger age because conduction disturbances were more common. Age was one factor influencing the pacing mode selected for a range of electrocardiographic indications for pacing. Almost all leads implanted were bipolar. The percentage using active fixation continues to increase.

Introduction and Objectives: The aim of this study was to analyze the patterns of investigator and institutional collaboration in papers published in the Revista Española de Cardiología., Methods: Details of coauthorship and institutional collaboration involved in articles published in the Revista Española de Cardiología in the period 2000-2005 were recorded and a collaboration index was derived. Collaboration networks were identified using the TextToPajek and PAJEK software tools., Results: Of the 980 papers analyzed, 95.1% had been authored by two or more individuals and 51.43% involved institutional collaboration. The overall collaboration index was 6.23 (standard deviation [SD] 3.1). There was a significant statistical relationship (P< .02) between the collaboration index and the journal section in which the article was published: the Original Articles and Special Reports sections had the highest collaboration indices (mean 7.87 [2.88]; and mean 6.59 [5.02], respectively). The 44 authors who had the highest publication rates were identified. In addition, 25 coauthorship networks involving 112 investigators were observed., Conclusions: An analysis of collaboration networks led to the identification of a number of author networks in cardiovascular medicine in Spain, and highlighted the interrelationships between them in terms of both scientific research and scientific publications. The most significant aspect of institutional collaboration was the predominance of collaboration within institutions and within Spanish autonomous regions (i.e., 80.57% of collaborations). Possible topics for future study include an analysis of the scientific productivity of the networks identified and of changes in the pattern of collaboration over time.

This paper describes the general situation regarding heart transplantation in Spain and the results obtained using the technique, incorporating data for the year 2004. In 2004, 294 heart transplants were carried out, which brings the total number of procedures performed since 1984 to 4680. Clinically, the typical heart transplant recipient in Spain is male, aged around 50 years, has blood group A, has non-revascularizable coronary artery disease, and is in NYHA functional class IV/IV. The percentage of emergency heart transplantations was 35%, which is higher than in the previous year (29%), and higher than the mean for the preceding 5 years (22%). The early mortality rate was 10%, which is lower that the mean for the preceding 5 years (13%). After combining the results for 2004 with those of previous years, the probability of survival at 1, 5 and 10 years was 80%, 70% and 60%, respectively. When the survival rates for different time periods were analyzed, a significant improvement could be seen in the last 5 years, with recent survival rates being 85% and 72% at 1 and 5 years, respectively. The most frequent cause of death in the first month was acute graft failure; in the first year, infection and rejection; and, over the long term, tumors and a combination of graft vasculopathy and sudden death. A comparative analysis of survival rates showed that long-term results in Spain are slightly better than those published in the world literature. Moreover, survival has tended to improve gradually in recent years.

The aim of this paper is to present the bibliometric indicators for Revista Española de Cardiologíathat were obtained from the "Potential impact factor of Spanish medical journals in 2001" study financed by the Spanish Ministerio de Educacion, Cultura y Deporte. Citations to Revista Española de Cardiología, its national and international impact factor, and its immediacy index were calculated with methods similar to those used by the Institute for Scientific Information. National indicators were based only on citations from 87 Spanish journals considered source journals, whereas international indicators were calculated on the basis of citations from both national journals and foreign source journals in the Science Citation Index. Revista Española de Cardiologíaobtained a national impact factor of 0.719 and an international impact factor of 0.837, placing it at the head of the ranking of Spanish medical journals.

This paper outlines the general characteristics and results obtained with heart transplantation in Spain after including the data for the year 2003. In 2003, 290 heart transplants were performed. Since 1984, a total of 4386 procedures have been performed. The average clinical profile of patients receiving a heart transplant in Spain is that of a man about 50 years old, blood group A, with nonrevascularizable coronary artery disease and functional status IV/IV (NYHA). The percentage of emergency heart transplantations was 29%, which is higher than in the previous year (26%) and the mean for the preceding 5 years (20%). The early mortality rate was 13%, which is similar to the mean for the preceding 5 years (13%). After combining the 2003 results with those of the previous years, the probability of survival at 1, 5 and 10 years was 76%, 66% and 54%, respectively. When survival rates for separate periods were considered, a significant improvement was seen in the last 5 years, with survival rates at of 81% at 1 year and 74% at 5 years. The most frequent causes of death were acute graft failure in the first month, infection and rejection in the first year, and a combination of vascular disease of the graft with sudden death in the long term. Comparative analysis of survival rates shows that our long-term results are slightly better than those published in the literature, with a gradual tendency for survival rate to improve in recent years.

Introduction and Objectives: The aim of this study was to evaluate the production of research papers by Spanish authors on diagnostic imaging published in the official journals of two Spanish scientific societies (Revista Española de Cardiología and Radiología) between 1994 and 1998, and to compare publication rates with those of research papers published in foreign cardiological and radiological journals included in Journal Citation Reports., Material and Method: Specific search profiles were devised to retrieve items from the Indice Médico Español (IME) and MEDLINE databases. The impact factor for non-Spanish journals devoted to different specialties was normalized for the number of papers published., Results: 967 articles were analyzed (301 on cardiac imaging, 666 on radiology). In the former specialty, 50.5% of the items were published in Revista Española de Cardiología, and in the latter, 55.1% were published in Radiología (no statistically significant difference). Impact factor was 2.46 for cardiology and 0.98 for radiology. The percentage of papers published in journals ranked in the top quartile according to impact factor was 38.6% (cardiology) and 17.2% (radiology); the difference was significant at P< .0001., Discussion: Although a tendency for radiologists to publish increasingly in foreign radiological journals has been observed, Spanish cardiologists and radiologists publish more than 50% of their research papers on diagnostic imaging in the official journals of their national societies. The differences in the percentage of articles by Spanish authors published in international specialty journals ranked in the first quartile (twice as great for cardiology as for radiology) suggests that Spanish radiologists are joining the scientific international community at a slower rate than Spanish cardiologists.

Introduction and Objectives: . The large amount of information on rates of acute coronary syndrome accumulated in Spain over the last two decades is summarized in this paper, which also estimates the number of cases expected in 2002 and the trend for 1997 to 2005., Methods: Published information on the situation in the 90's was reviewed and summarized. We present the incidence of acute myocardial infarction (AMI), and an estimate of the absolute number of patients expected for various acute coronary syndromes in each autonomous community in Spain in 2002, along with the trend for 1997 to 2005., Results: Approximately 68,500 patients will suffer AMI in 2002 and 40,989 of them will be hospitalized, while the rest will die before admission. A further 24.9% of admitted patients will not survive 28 days. Slightly less than half will be younger than 75 years old, an age with a better prognosis (28-day mortality 38.8%). Approximately 33,500 patients with unstable angina will be admitted, and 4.5% of them will die within 3 months of admission. Assuming the incidence of AMI remains stable, the absolute number of cases will increase by 2.28% yearly (9,847 cases in total) and hospitalizations for acute coronary syndromes will increase by 1.41% (8,817 cases in total) between 1997 and 2005., Conclusion: Ischaemic heart disease generates increasing demand for health care in Spain. Case fatality is high among the approximately 68,500 AMI patients, given that scarcely two thirds will have been hospitalized in 2002.

Introduction and Aims: This paper aimed to study the usefulness of the Statistical Bulletin of Deaths (SBD) for identifying extrahospital deaths due to acute coronary ischaemia, and to determine the most efficient strategy in the selection of death causes that appear in the SBD, which are the most efficient for the identification., Methods: Those extrahospital deaths, which, among the causes of death, recorded a diagnostic code indicating that they might have been caused by coronary ischaemia, were included. To study the usefulness of the death certificate we calculated the sensitivity and the positive predictive value of cardiac ischaemia. To determine the most efficient strategy for selecting causes of death we compared two selection strategies: the first, using only the basic cause of death; and the second using all the causes appearing in the SBD., Results: Of the 395 SBD selected, 161 were classed as acute heart attacks. In those SBD in which cardiac ischaemic disease was given as the basic cause of death, we obtained a sensitivity of 82.6% (CI 95%: 75.9-88.1) and a positive predictive value of 72.7% (CI 95%: 65.6-79). The most efficient strategy in SBD selection proved to be the investigation of death certificates in which cardiac ischaemia appeared as one of all the causes of death, and death certificates in which the basic cause of death was coded as diabetes mellitus, essential arterial hypertension, hypertensive heart disease, cardiac dysrhythmia, and cardiac insufficiency., Conclusions: The information provided by death certificates for extrahospital deaths due to coronary ischaemia is reliable. A sensitive and efficient SBD selection strategy is proposed for the detection of cases.

Most exercise testing is performed in adults with known or suspected ischemic heart disease. In the last few years cardiac imaging techniques have been applied in this field, improving the information obtained with the procedure. However, the exceptions to this rule are emerging rapidly not only in healthy people (asymptomatic individuals, athletes, handicapped people) but also in cardiac patients (advanced congestive heart failure, hypertension, rhythm disorders, congenital heart disease, etc.). All the-se issues justify the need for a multidisciplinary consensus document in Spain. This paper reviews and updates the methodological aspects of the stress test, including those related to oxygen consumption measurements. The main aim of this review was to determine the role of exercise testing in the evaluation of ischemic heart disease as well as the applications of imaging stress testing. The usefulness of this test in other non-ischemic cardiac disorders and in selected subsets of healthy people is also reviewed.

Background and Objectives: Geographical differences in hospitalizations and mortality for heart failure serve to estimate the potential for reducing the associated hospital and demographic burden on the population. Accordingly, the objective of this paper is to analyze the geographic variation in heart failure hospitalizations and mortality in Spain during the period of 1980-1993, and to examine their potential determinants., Methods: Data on the primary diagnosis of heart failure were taken from the National Hospital Morbidity Survey and National Vital Statistics. Information on determinants of heart failure were obtained from large-scale nationally representative surveys conducted by the National Statistics Office., Results: The period of 1980-1993 witnessed a decrease in geographical differences in heart failure hospitalizations and mortality. Theoretically, however, heart failure hospitalizations and mortality among persons aged > or = 45 years could still be further reduced by 60% and 30% respectively. In the period of 1989-1993 heart failure hospitalizations were correlated (p < 0.05) with ischaemic heart disease hospitalizations and the number of beds/1,000 inhabitants. Heart failure mortality showed a statistically significant correlation (p < 0.05) with ischaemic heart disease mortality, illiteracy and unemployed status., Conclusions: There is a great potential for a reduction in the hospital and demographic burden of heart failure in Spain. Control of ischaemic heart disease and a reduction in the geographical differences in socio-economic status would probably contribute to lessening the healthcare burden of heart failure in Spain.

Introduction and Objectives: The information concerning stroke mortality is limited in Spain, and the information on morbidity is even scarcer similarly to other countries. This is true also for the decrease of frequency observed in the last decades. The objective of this paper is to provide data in the incidence, mortality and cardiovascular risk factors associated to stroke in our surrounding through by the prolonged observation of a working population., Material and Methods: In the Manresa Study, which began in 1968, a cohort of 1,059 men, from 30 to 59 years old, was followed for 28 years. We recorded new cases of fatal and nonfatal stroke and the relationship between stroke incidence and risk factors of cardiovascular disease found in the initial examination., Results: Incidence rate for stroke was 183 x 100,000 per year, 64% of the cases were registered after they turned 60 years of age. Mortality rate due to stroke was 88 x 100,000 per year, 91.6% of fatal cases were over 60 years old. Factors associated to the stroke morbimortality incidence were age, high blood pressure and overweight. In a bivariate regression model, stroke mortality was found significantly associated to the presence of atrial fibrillation, diabetes, hypercholesterolemia and tobacco smoking., Conclusions: Stroke frequency rates in the Manresa cohort are ranged at a medium level compared to data from other general population studies. The role of atrial fibrillation in the stroke morbimortality has been confirmed. The associated factors, age, high blood pressure and overweight, are similar role to that which was found in other research studies. The priorities in the cerebrovascular disease prevention in our surroundings are discussed.

This paper is a comprehensive and critical review of the updated information available in Spain for the elderly population on the epidemiology of cardiovascular diseases. Clinical (coronary heart disease, heart failure, and cerebrovascular disease) and subclinical (left ventricular hypertrophy, carotid stenosis) cardiovascular diseases are reviewed. Prevalence and distribution of major classical cardiovascular risk factors such as hypertension, hyperlipidemia, diabetes mellitus and smoking and information on new risk factors such as microalbuminuria or abdominal obesity are also presented. The article is also focused on the high rates of morbidity, mortality and the burden of handicap in this age group in comparison with middle-aged people. Finally we call attention to the few and inconsistent population data available for some of the mentioned topics in our country, particularly the lack of specific figures of incidence and risk rates from cohort studies of elderly people in Spain.

Changes in health systems are determining new hospital organization forms. The patient focused hospital suppose a new radical design of hospital processes from the patient's viewpoint. This paper defines the re-engineering process of the Cardiology and Cardiovascular Surgery Services of the Hospital Clínic of Barcelona in order to develop and Institute. The change consists fundamentally in a reorganization of the direction organs, creating a staff commission and director. The chief nursing and chief management report to the director. Also, a patients admission and management unit, that manage the beds infrastructure of both services has been developed. The first year results show a reduction of the length of stay and an increase in the in-hospital and external activity.

Introduction and Objectives: In Spain ischemic heart disease mortality was increasing prior to 1975 and has decreased since 1975. This trend is common to both genders. The goal of this paper is to separate the genetic, environmental and competitive risk factors influencing this evolution., Methods: The Gompertz function was adjusted cross-sectionally to age-specific mortality due to ischemic heart disease for each year from 1951 to 1992. The Gompertzian longitudinal analysis was applied to the coefficients obtained to estimate the effect due to environmental and competitive factors., Results: Ischemic heart disease in Spain is a Gompertzian disease with an intersection point at 67 years for men and 40 years for women. Environmental factors were increasing before 1975 and have decreased since then. However, the competitive factors decreased in men since 1980 and in women since 1951 on., Conclusion: The evolution of risk factors (smoking, hypercholesterolemia and hypertension) is responsible for the major proportion of ischemic disease mortality changes. Treatment of instaured ischemic disease has a low influence.

Introduction and Objectives: Hypolipemic treatment is a matter of controversy. The objective of this paper is to analyze how Spanish cardiologist knows the lipid role in ischemic heart disease and their intention of treatment hypercholesterolemia in ischemic cardiomiopathy patients. We also evaluate the grade of control and treatment of hypercholesterolemia in patients with ischemic heart disease who belong to a primary care center., Material and Methods: Two inquests were done to 1,850 Spanish cardiologist using a question paper in 1993 and 1996. At the Primary Care Center of Fuencarral (Madrid) we made a transversal study from February till March 1996., Results: In 1993, 11% answered the questionnaire and 25% in 1996. Cardiologists who considered the ideal level of cholesterol lower than 200 mg/dl raised from 62% in 1993 to 86% in 1996 (p < 0.001). Cardiologists who considered that cholesterol linked to low density lipoproteins should be lower than 100 mg/dl raised from 0% in 1993 to 28% in 1996 (p < 0.001). Drug treatment was prescribed by 68% when total cholesterol levels were higher than 300 mg/dl in 1993 and 14% of cardiologists never prescribed drugs. In 1996, 71% prescribed drug treatment when total cholesterol was between 200 and 250 mg/dl (p < 0.001). Cardiologists who worked at hospitals began with drugs with a lower cholesterol levels than out-hospital cardiologists. Hypercholesterolemia was considered as the most important risk factor in secondary prevention. We review 94 patients with ischemic heart disease; 37 did not receive hypolipemic treatment, though they had more than 200 mg/dl of cholesterol. Just 12 of the 45 treated reached figures below 200 mg/dl. 32% of the patients where controlled by family doctor's., Conclusions: Results of the two surveys in 1993 and 1996 have produced a change in Spanish cardiologist attitude about indication of hypolipemic treatment for patients suffering from ischemic cardiomiopathy. Family doctor's and cardiologists must assume secondary prevention. Indeed, it is necessary to make them both become aware of the importance of a correct treatment of those patients.

Introduction and Objectives: The superiority of surgical treatment over other procedures in the left main coronary artery stenosis is well known, being today the therapy of choice. The purpose of this work is to analyze the clinical characteristics and the immediate results of surgery in our patients., Patients and Methods: In this paper we under-took a retrospective study of 147 consecutive patients, 129 men and 18 women with a 50% or more left main coronary artery stenosis without associated valvular disease, operated on at our institution during a period of 3.5 years, between January 1992 and May 1995. Thirty-one variables were analyzed under Chi-square, comparison of proportions and Student's t-tests. Then, it has been developed into a multivariant logistic regression of significant variables (p less than 0.05) of factors influencing mortality and rhythm disturbances which have been the most frequent postoperative complication., Results: The mean age was 65 years. Sixty-two per cent had unstable angina and 51.7% had previous myocardial infarction. An average of 3.1 grafts were performed. Total mortality was 6.8%. The complications were 17% arrhythmias, 8% low cardiac output and 6% perioperative myocardial infarction. In the multivariate analysis, mortality has been strongly related to the presence of perioperative myocardial infarction and also with moderate to severe cardiomegaly and a high left ventricular end-diastolic pressure. Arrhythmias were related to an advanced age., Conclusions: 1) In hospital mortality remains within acceptable limits and is influenced by the presence of perioperative myocardial infarction, cardiomegaly and a high left ventricular end-diastolic pressure, and 2) elderly patients have more damaged vessels, more diseased coronary segments, and more complications, especially rhythm disturbances.

Introduction and Objectives: Personal contact has been lost in medical training due to the increase in numbers of medical students but not of teachers. This fact has impaired training in medical specialties. This is the reason that the Hospital for Cardiology has developed a program of tutelary training. In this paper we present our initial evaluation of this program., Methods: The inclusive criteria for tutors and students have been defined as have the procedures to develop the program. After three months, 20 residents involved in the tutelary training program were randomly analyzed. Academic activities, clinical practice, research activities and extra-academic activities were evaluated., Results: Currently there are 14 tutors. 50% of residents have developed research projects, 60% has increased academic activities, 50% has improved clinical practice and 65% has defined their postgraduate research projects., Conclusions: It was concluded that tutelary training in Cardiology and Cardiothoracic Surgery is a useful alternative to improve quality of graduates in these specialties.

The endomyocardial biopsy is the best diagnostic procedure of the rejection in the cardiac transplant. In this paper we analize the more frequent findings observed in the biopsies and in the dead patient's hearts after a transplant. Due to the fact that the rejection' lesions have a focal distribution the biopsy has to contain at least four fragments. The diagnostic criteria for rejection was stablished since 1990. There are other lesions that can suppose a problem being the most frequent the ischemia, the infectious miocarditis and the Quilty effect. The post mortem studies permit the diagnostic of vascular lesions that are not identified in the routine biopsies.

This paper is the written version of the conference that under the same title was presented in the XXX Congreso Nacional de la Sociedad Española de Cardiología. In the paper, the topic of arterial hypertension (AHT) in Spain is approached from different perspectives, as well as to what extend cardiologists influence or are influenced by it. First, there is a brief overview concerning the diagnostic and therapeutic status of AHT in the population, and its evolution in the last years. The paper continues analyzing the research on AHT sponsored by the Fondo de Investigación Sanitaria in recent years, and emphasizes the little participation of cardiologists as principal investigators in this area. Next, publications in Spanish and international scientific journals are assessed. To end the paper, a proposal of the possible role of the cardiologist on diagnosis, treatment, continued education and research on hypertension is presented.

Introduction and Objectives: Anatomical correction of transposition of great arteries and double outlet right ventricle with subpulmonary ventricular septal defect is a surgical approach that has not been generally adopted in our clinical environment. Our aim with this paper is reporting on our initial experience with this technique., Methods: The clinical data and additional investigations are reviewed from 15 infants with transposition of the great arteries and 2 with double outlet right ventricle who underwent anatomical repair, with a postoperative follow-up of one year., Results: The survival rate has been 76% (13 out of 17 cases). The 13 survivors are in good hemodynamic condition, with no treatment whatsoever. Thirteen patients are in sinus rhythm with normal repolarization patterns and 5 patients show a right bundle branch block. Neither aortic nor pulmonary gradients have been detected on Doppler examination, and slight valvular insufficiencies are found at aortic level in 4 patients, pulmonary in 2 and mitral in one., Conclusion: Anatomical correction is the method of choice for transposition of the great arteries and double outlet right ventricle with pulmonary-related ventricular septal defect.

This paper briefly presents the situation of high blood pressure in Spain, both its prevalence in different parts of the country and its relevance as a cardiovascular risk factor and its relationship with demographic characteristics and other not removable risk factors. The association high blood pressure/hypercholesterolemia is discussed in greater detail, offering a multifactorial and quantitative approach of risk factors in the prevention of cardiovascular diseases.

In this paper, correlations between ischaemic heart disease and several cancers associated with cigarette smoking are examined. Also, tobacco consumption data are correlated against ischaemic heart disease mortality incidence rates. Furthermore, correlations between ischaemic heart disease incidences and per capita consumption of fattening foods (meat, milk and eggs) are analyzed. In this work, results referring to Spain, and at an ecologic level, confirm conclusions of observational and experimental studies carried out in other countries, which points out a strong association between ischaemic heart disease, cigarette consumption and fattening diet.