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2025, Número 2

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Rev Nefrol Dial Traspl 2025; 45 (2)


Desarrollo histórico del concepto de factor de riesgo cardiovascular y renal

Cusumano AM, Victoria BME

Idioma: Español
Referencias bibliográficas: 43
Paginas: 118-126
Archivo PDF: 269.80 Kb.


RESUMEN

A inicios del siglo XX, las enfermedades infecciosas eran la principal causa de muerte, pero con los progresos en medicina y mayor acceso a la salud, la mortalidad por estas enfermedades disminuyó; para 1940 las principales causas de muerte ya eran las enfermedades cardiovasculares (ECV). En 1947 inició el estudio de Framingham, centrado en las principales causas de ECV (ateroscleróticas e hipertensión arterial (HTA)). En los años 50, las causas de enfermedad coronaria eran la HTA, el colesterol (col.) elevado, el tabaquismo y la diabetes (DBT). En 1961 se acuñó el concepto de "factor de riesgo" (FR), reconociendo que la combinación de factores aumentaba el riesgo. En 1998, el Score de Framingham fue una herramienta clave en la prevención, diagnóstico y tratamiento de la ECV.
En el año 2000, se reconoció la ECV como principal causa de muerte en pacientes con ERC, y que debían usarse estrategias similares para prevenir la ECV y la ERC ya que los FR eran comunes (DBT, HTA, col. HDL bajo). La albuminuria se identificó como marcador y predictor de progresión de ERC y ECV. Luego se reconocieron FR no tradicionales de ECV en la ERC: inflamación crónica, estrés oxidativo y alteraciones del metabolismo fosfocálcico. A posteriori, se asoció el bajo peso (BP) al nacer con mayor riesgo de enfermedades crónicas no transmisibles, incluidas la ECV y la DBT (hipótesis de Barker); estudios a nivel renal confirmaron reducción del número de nefrones en recién nacidos con BP.


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