Examinando por Autor "Polentinos-Castro, Elena"

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Association between hypertension and selfperception of health status: Findings from a decade population-based survey in Spanish adults
(National Library of Science, 2025-05-07) Martín-Fernández , Jesús; Alonso-Safont, Tamara; Polentinos-Castro, Elena; Rodríguez-Martínez, Gemma; González-Anglada, Mª Isabel; Bilbao-González, Amaia; del-Cura-González, Mª Isabel
Objective This study, conducted in the community setting, aimed to assess and discuss how a diagnosis of arterial hypertension affects self-perceived health status, examining the association with potential explanatory factors and comparing its impact with that of other chronic conditions. Methods Cross-sectional observational study using the 2011–2012 and 2017 Spanish National Health Surveys and the 2020 European Health Interview Survey for Spain as data sources. Health perception was categorised as very good, good, fair, bad, or very bad. The independent variables recorded demographic, social, clinical, and lifestyle information. The associations between variables were evaluated via a generalisation of an ordered logit model. Results A total of 66,168 subjects were included (21,007 in 2011, 23,089 in 2017, and 22,072 in 2020), 21.6% of whom were diagnosed with hypertension, 51.3% were women, PLOS One | https://doi.org/10.1371/journal.pone.0322577 May 7, 2025 2 / 11 and the average age was 48.24 (18.89) years. Around one in five people in the general population reported a “very good” health status. The probability of reporting a “very good” health condition decreased with a diagnosis of hypertension (6.2%; CI 95%: 3.1–9.3%) and hypertensive medication (4.5%; CI 95%: 1.8–7.3%). Such associations were independent of age, gender, social group, other chronic conditions or limitations, or various lifestyle habits. In contrast, no association was found with reporting a “bad” or “very bad” health status. Conclusion Being diagnosed with hypertension and prescription of antihypertensive medication are associated with a lower probability of reporting a “very good” health status, irrespective of other comorbidities or complications related to the diagnosis.
Association of socioeconomic status with prognosis in hypertensive patients over age 65: a cohort study in the community setting
(BMJ Group, 2024-08) Martín-Fernández, Jesús; Alonso-Safont, Tamara; Gestri-Mora, Patricia Elena; Polentinos-Castro, Elena; Rodríguez-Martínez, Gemma; Bilbao, Amaia; del Cura-González, Mª Isabel
Objective: To examine whether socioeconomic status is associated with prognosis after the diagnosis of hypertension (HTN), in a population older than 65 years, in the community setting. Design: Retrospective cohort study. Setting: All the primary care centres of the Community of Madrid (n=392). Participants: All patients (>65 years) with a new diagnosis of HTN in 2007-08, without previous kidney or cardiovascular (K/CV) events (n=21 754).Patient records from primary care electronic health records and Spanish mortality database were analysed from January 2007 through December 2018. Sociodemographic data such as age, gender, Area Deprivation Index (MEDEA-Mortalidad en áreas pequeñas Españolas y Desigualdades Socioeconómicas y Ambientales-Index in quintiles), and characteristics, such as smoking, type 2 diabetes mellitus and hypercholesterolaemia, were collected at the time of enrolment. Primary and secondary outcome measures: The occurrence of K/CV events (including mortality from these causes) and total mortality were evaluated using Cox regression. Results: Patients had a mean age of 73.5 (SD 6.5) years, and 63.5% were women. The median follow-up was 128.7 months (IQR: 110.6-136.7 months). There were 10 648 first K/CV events, including 1508 deaths from these causes and 4273 deaths from other causes. Adjusted for age, gender, smoking, diabetes and hypercholesterolaemia, when comparing the third, fourth and last quintiles (less affluent) of the Deprivation Index with respect to the first quintile, the hazard of K/CV events increased by 14.8% (95% CI: 3.3 to 27.6%), 16.0% (95% CI: 6.4 to 26.4%) and 19.1% (95% CI: 8.9 to 30.2%), respectively. The MEDEA Index was not associated with differences in adjusted total mortality. Conclusion: Living in a low socioeconomic status area is associated with an increase in kidney or cardiovascular events in hypertensive patients diagnosed after age 65 years, which will result in a significant increase in disease burden even if not related to an increase in total mortality.
Impact of hypertension diagnosis on morbidity and mortality: a retrospective cohort study in primary care.
(Springer Nature, 2023-03) Martín Fernández, Jesús; Alonso-Safont, Tamara; Polentinos-Castro, Elena; Esteban-Vasallo, María Dolores; Ariza-Cardiel, Gloria; González-Anglada, Mª Isabel; Sánchez-Perruca, Luis; Rodríguez-Martínez, Gemma; Rotaeche-del-Campo, Rafael; Bilbao-González, Amaia
Background: Hypertension is responsible for a huge burden of disease. The aim of this study was to evaluate the impact of newly diagnosed hypertension on the occurrence of kidney or cardiovascular events (K/CVEs) and on mortality among community dwellers. Methods: Retrospective cohort study, conducted from January, 2007, to December, 2018. All patients (age > 18) newly diagnosed with hypertension and no previous K/CVEs in 2007 and 2008, in the primary care centers of Madrid (Spain) (n = 71,770), were enrolled. The control group (n = 72,946) included patients without hypertension, matched by center, sex and age. The occurrence of kidney or CV events, including mortality from these causes and total mortality were evaluated using Cox regression and multistate models. Data were collected from three sources: personal data from administrative records, clinical data from medical records, and mortality data from regional and national databases. Results: The median follow-up was 138.61 months (IQR: 124.68-143.97 months). There were 32,896 K/CVEs (including 3,669 deaths from these causes) and 12,999 deaths from other causes. Adjusted for sex, smoking, diabetes and socioeconomic status, K/CVEs HR was 4.36 (95% CI: 3.80-5.00) for diagnoses before 45 years of age, 2.45(95% CI: 2.28- 2.63) for diagnosis between 45 to 54 years, and HR decreased to 1.86 (95% CI: 1.64-210) for diagnoses over age 85. Total mortality risk was only higher for hypertension diagnosed before 55 years of age (HR: 2.47, 95% CI: 1.90-3.19 for ages 18 to 44; and HR: 1.14, 95% CI: 1.02-1.28 for ages 45 to 54). Conclusion: The diagnosis of hypertension in the community environment, in patients without evidence of previous kidney or CV disease, is associated with a large increase in the risk of K/CVEs, but especially in individuals diagnosed before the age of 55. This diagnosis is only associated with an increase in kidney or cardiovascular mortality or overall mortality when it occurs before age 55.
Mapping analysis to predict EQ-5D-5 L utility values based on the Oxford Hip Score (OHS) and Oxford Knee Score (OKS) questionnaires in the Spanish population suffering from lower limb osteoarthritis
(Springer Nature, 2020-06-15) Martín Fernández, Jesús; Morey-Montalvo, Mariel; Tomás-García, Nuria; Martín-Ramos, Elena; Polentinos-Castro, Elena; Rodríguez-Martínez, Gemma; Arenaza, Juan Carlos; García Pérez, Lidia; Magdalena-Armas, Laura; Bilbao, Amaia
Background: The EQ-5D-5 L is a quality-of-life questionnaire based on individuals' preferences that is widely employed for cost-effectiveness analysis. Given the current demand for mapping algorithms to directly assign "utilities", this study aimed to generate different mapping models for predicting EQ-5D-5 L utility values based on scores of the Oxford Hip Score (OHS) and Oxford Knee Score (OKS) questionnaires provided by patients suffering from hip and knee osteoarthritis (OA), respectively, and to assess the predictive capability of these functions. Methods: This was a prospective, observational study. Following the criteria of the American Rheumatism Association, 361 patients with hip OA and 397 with knee OA from three regions in Spain were included. Health-related quality of life (HRQoL) was assessed through the EQ-5D-5 L general questionnaire and the OHS and OKS specifically for lower limb OA. Based on the scores on the OHS and OKS questionnaires, EQ-5D-5 L utilities were estimated using 4 models: ordinary least squares (OLS), Tobit, generalized linear model (GLM), and beta regression (Breg). The models were validated on the same patients after 6 months: the mean absolute error (MAE) and mean squared error (MSE) with their 95% confidence intervals (CI), mean values of standard errors (SE), intraclass correlation coefficients (ICC), and Bland-Altman plots were obtained. Results: The lowest MAEs were obtained using GLM and Breg models, with values of 0.1103 (0.0993-0.1214) and 0.1229 (0.1102-0.1335) for hip OA, and values of 0.1127 (0.1014-0.1239) and 0.1141 (0.1031-0.1251) for knee OA. MSE values were also lower using GLM and Breg. ICCs between predicted and observed values were around or over the 0.8 cut-off point. Bland-Altman plots showed an acceptable correlation, but precision was lower for subjects with worse HRQoL, which was also evident when comparing MAEs of the bottom and top halves of the utilities scale. Predictive equations for utilities based on OHS/OKS scores were proposed. Conclusions: The OHS and OKS scores allow for estimating EQ-5D-5 L utility indexes for patients with hip and knee OA, respectively, with adequate validity and precision. GLM and Breg produce the best predictions. The predictive power of proposed equations is more consistent for subjects in better health condition.
Risk aversion, trust in institutions and contingent valuation of healthcare services: trying to explain the WTA-WTP gap in the Dutch population
(Springer Nature, 2021-05) Martín Fernández, Jesús; López-Nicolás, Ángel; Oliva-Moreno, Juan; Medina-Palomino, Héctor; Polentinos-Castro, Elena; Ariza-Cardiel, Gloria
Background: The preferences of citizens are a basic element to incorporate into the decision-making process when planning health policies. Contingent valuation (CV) is a common method for calculating the value for citizens that new technologies, interventions, and the provision of services or policies have. However, choosing the correct CV tool may not be a neutral decision. This work aims to assess the substitution of a healthcare service by comparing valuation differences between the willingness to pay (WTP) for the maintenance of the service versus the willingness to accept compensation (WTA) for its substitution, both of which are related to subject characteristics, with a particular focus on trust in institutions and risk aversion. Methods: A CV study was designed to study Dutch population preferences when physician assistants replace anaesthesiologists. Differences between the distributions of WTA and WTP were compared through full decomposition methods, and conditional quantile regression was performed. Results: Nearly two-thirds of surveyed citizens expressed null values for WTA and WTP. The other third systematically reported a value of WTA higher than that of WTP, which increased further with lower income and the possible presence of a strategic bias. In contrast, being more than 65 years old, having trust in government, and preferring anaesthesiologists decreased the WTA-WTP difference. Risk aversion had no clear association with the WTA-WTP gap. Conclusions: Known differences between the perceived value of health services from the perspective of gains and losses could be related to people's characteristics. Trust in government but not aversion to risk was related to the WTA-WTP differences. Identifying a profile of citizens who are averse to losing health services should be considered when designing and implementing health services or interventions or making disinvestment decisions.