LÓPEZ JARAMILLO, JOSÉ PATRICIO

Preferred name

Main Affiliation

Facultad de Ciencias de la Salud Eugenio Espejo

CENIEC - Grupo de Investigación de Enfermedades Crónicas

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ORCID

0000-0002-9122-8742

Scopus Author ID

7004478068

Now showing 1 - 10 of 36

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Evaluación del perfil cardiometabólico en profesionales de salud de Latinoamérica
(Elsevier BV, 2021-07)
Ivetteh Gaibor-Santos
;
Jennifer Garay
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Daniela A. Esmeral-Ordoñez
;
Diana Rueda-García
;
Daniel D. Cohen
Scopus© Citations 2
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Core outcome sets for trials of interventions to prevent and to treat multimorbidity in adults in low and middle-income countries: the COSMOS study
(BMJ, 2024-08)
Aishwarya Lakshmi Vidyasagaran
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Rubab Ayesha
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Jan R Boehnke
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Jamie Kirkham
;
Louise Rose
Introduction The burden of multimorbidity is recognised increasingly in low- and middle-income countries (LMICs), creating a strong emphasis on the need for effective evidence-based interventions. Core outcome sets (COS) appropriate for the study of multimorbidity in LMICs do not presently exist. These are required to standardise reporting and contribute to a consistent and cohesive evidence-base to inform policy and practice. We describe the development of two COS for intervention trials aimed at preventing and treating multimorbidity in adults in LMICs. Methods To generate a comprehensive list of relevant prevention and treatment outcomes, we conducted a systematic review and qualitative interviews with people with multimorbidity and their caregivers living in LMICs. We then used a modified two-round Delphi process to identify outcomes most important to four stakeholder groups (people with multimorbidity/caregivers, multimorbidity researchers, healthcare professionals and policymakers) with representation from 33 countries. Consensus meetings were used to reach agreement on the two final COS. Registration: https://www.comet-initiative.org/Studies/Details/1580. Results The systematic review and qualitative interviews identified 24 outcomes for prevention and 49 for treatment of multimorbidity. An additional 12 prevention and 6 treatment outcomes were added from Delphi round 1. Delphi round 2 surveys were completed by 95 of 132 round 1 participants (72.0%) for prevention and 95 of 133 (71.4%) participants for treatment outcomes. Consensus meetings agreed four outcomes for the prevention COS: (1) adverse events, (2) development of new comorbidity, (3) health risk behaviour and (4) quality of life; and four for the treatment COS: (1) adherence to treatment, (2) adverse events, (3) out-of-pocket expenditure and (4) quality of life. Conclusion Following established guidelines, we developed two COS for trials of interventions for multimorbidity prevention and treatment, specific to adults in LMIC contexts. We recommend their inclusion in future trials to meaningfully advance the field of multimorbidity research in LMICs. PROSPERO registration number CRD42020197293.
Scopus© Citations 8
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Socioeconomic status and risk of cardiovascular disease in 20 low-income, middle-income, and high-income countries: the Prospective Urban Rural Epidemiologic (PURE) study
(Elsevier BV, 2019-06)
Annika Rosengren
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Andrew Smyth
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Sumathy Rangarajan
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Chinthanie Ramasundarahettige
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Shrikant I Bangdiwala
Scopus© Citations 518
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External validation and comparison of six cardiovascular risk prediction models in the Prospective Urban Rural Epidemiology (PURE)-Colombia study
(Oxford University Press (OUP), 2025-06-07)
Lopez-atalaya Jose P.
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Ángel A. Garcia-Peña
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Martinez-bello Daniel
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Gonzalez Ana M.
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Maritza Perez-Mayorga
AbstractTo externally validate the SCORE2, AHA/ACC pooled cohort equation (PCE), Framingham Risk Score (FRS), Non-Laboratory INTERHEART Risk Score (NL-IHRS), Globorisk-LAC, and WHO prediction models and compare their discrimination and calibration capacity. Methods and results Validation in individuals aged 40–69 years with at least 10 years of follow-up and without baseline use of statins or cardiovascular diseases from the Prospective Urban Rural Epidemiology (PURE)-Colombia prospective cohort study. For discrimination, the C-statistic, and receiver operating characteristic curves with the integrated area under the curve (AUCi) were used and compared. For calibration, the smoothed time-to-event method was used, choosing a recalibration factor based on the integrated calibration index (ICI). In the NL-IHRS, linear regressions were used. In 3802 participants (59.1% women), baseline risk ranged from 4.8% (SCORE2 women) to 55.7% (NL-IHRS). After a mean follow-up of 13.2 years, 234 events were reported (4.8 cases per 1000 person-years). The C-statistic ranged between 0.637 (0.601–0.672) in NL-IHRS and 0.767 (0.657–0.877) in AHA/ACC PCE. Discrimination was similar between AUCi. In women, higher over-prediction was observed in the Globorisk-LAC (61%) and WHO (59%). In men, higher over-prediction was observed in FRS (72%) and AHA/ACC PCE (71%). Overestimations were corrected after multiplying by a factor derived from the ICI. Conclusion Six prediction models had a similar discrimination capacity, supporting their use after multiplying by a correction factor. If blood tests are unavailable, NL-IHRS is a reasonable option. Our results suggest that these models could be used in other countries of Latin America after correcting the overestimations with a multiplying factor.
Scopus© Citations 19
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Activity limitations, use of assistive devices, and mortality and clinical events in 25 high-income, middle-income, and low-income countries: an analysis of the PURE study
(Elsevier BV, 2024-08)
Raed A Joundi
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Bo Hu
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Sumathy Rangarajan
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Darryl P Leong
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Shofiqul Islam
Background: The focus of most epidemiological studies has been mortality or clinical events, with less information on activity limitations related to basic daily functions and their consequences. Standardised data from multiple countries at different economic levels in different regions of the world on activity limitations and their associations with clinical outcomes are sparse. We aimed to quantify the prevalence of activity limitations and use of assistive devices and the association of limitations with adverse outcomes in 25 countries grouped by different economic levels. Methods: In this analysis, we obtained data from individuals in 25 high-income, middle-income, and low-income countries from the Prospective Urban Rural Epidemiological (PURE) study (175 660 participants). In the PURE study, individuals aged 35–70 years who intended to continue living in their current home for a further 4 years were invited to complete a questionnaire on activity limitations. Participant follow-up was planned once every 3 years either by telephone or in person. The activity limitation screen consisted of questions on self-reported difficulty with walking, grasping, bending, seeing close, seeing far, speaking, hearing, and use of assistive devices (gait, vision, and hearing aids). We estimated crude prevalence of self-reported activity limitations and use of assistive devices, and prevalence standardised by age and sex. We used logistic regression to additionally adjust prevalence for education and socioeconomic factors and to estimate the probability of activity limitations and assistive devices by age, sex, and country income. We used Cox frailty models to evaluate the association between each activity limitation with mortality and clinical events (cardiovascular disease, heart failure, pneumonia, falls, and cancer). The PURE study is registered with ClinicalTrials.gov, NCT03225586. Findings: Between Jan 12, 2001, and May 6, 2019, 175 584 individuals completed at least one question on the activity limitation questionnaire (mean age 50·6 years [SD 9·8]; 103 625 [59%] women). Of the individuals who completed all questions, mean follow-up was 10·7 years (SD 4·4). The most common self-reported activity limitations were difficulty with bending (23 921 [13·6%] of 175 515 participants), seeing close (22 532 [13·4%] of 167 801 participants), and walking (22 805 [13·0%] of 175 554 participants); prevalence of limitations was higher with older age and among women. The prevalence of all limitations standardised by age and sex, with the exception of hearing, was highest in low-income countries and middle-income countries, and this remained consistent after adjustment for socioeconomic factors. The use of gait, visual, and hearing aids was lowest in low-income countries and middle-income countries, particularly among women. The prevalence of seeing close limitation was four times higher (6257 [16·5%] of 37 926 participants vs 717 [4·0%] of 18 039 participants) and the prevalence of seeing far limitation was five times higher (4003 [10·6%] of 37 923 participants vs 391 [2·2%] of 18 038 participants) in low-income countries than in high-income countries, but the prevalence of glasses use in low-income countries was half that in high-income countries. Walking limitation was most strongly associated with mortality (adjusted hazard ratio 1·32 [95% CI 1·25–1·39]) and most consistently associated with other clinical events, with other notable associations observed between seeing far limitation and mortality, grasping limitation and cardiovascular disease, bending limitation and falls, and between speaking limitation and stroke. Interpretation: The global prevalence of activity limitations is substantially higher in women than men and in low-income countries and middle-income countries compared with high-income countries, coupled with a much lower use of gait, visual, and hearing aids. Strategies are needed to prevent and mitigate activity limitations globally, with particular emphasis on low-income countries and women. Funding: Funding sources are listed at the end of the Article.
Scopus© Citations 17
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¿Repercutirán las nuevas cifras de hipertensión en la definición y manejo de la preeclampsia?
(Sociedad Peruana de Obstetricia y Ginecologia, 2018-07-16)
LOPEZ JARAMILLO, JOSÉ PATRICIO
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Cristina López-López
<jats:p>Las nuevas guías de la Asociación Americana del Corazón (AHA)/ Colegio Americano del Corazón (ACC) han generado una importante discusión sobre los criterios diagnósticos y el manejo de la hipertensión arterial (HTA), ya que proponen cambios radicales en la definición de la HTA, pasando su diagnóstico de cifras de presión arterial (PA) iguales o superiores a 140/90 mmHg a cifras iguales o superiores a 130/80 mmHg. Además, las nuevas guías proponen que las metas a alcanzarse para definir el control adecuado de la HTA también sean más bajas, con cifras de PA menores de 120/80 mmHg, con lo cual en términos globales se espera un incremento sustancial en el número de individuos considerados hipertensos que necesiten un aumento de medicamentos para el adecuado control. Todo lo cual ha llevado al cuestionamiento sobre la viabilidad de la aplicación clínica de estas nuevas guías, dado el enorme incremento financiero que significa el tratar con medicamentos a los nuevos millones de pacientes hipertensos. Además de estos inconvenientes prácticos, también se ha cuestionado la validez académica de las nuevas guías AHA/ACC, dado el hecho de que las recomendaciones emergen básicamente de los resultados obtenidos de un solo estudio, el cual tiene importantes diferencias metodológicas y sus resultados son inconsistentes con lo demostrado en otros estudios. Ello ha determinado que importantes sociedades científicas como la American Diabetes Association (ADA) y la Sociedad Latinoamericana de Hipertensión (LASH) no se adhieran a las recomendaciones de la AHA/ACC y mantengan las anteriores. En términos generales las recomendaciones de la LASH para el diagnóstico y manejo de la preeclampsia son similares a las de las nuevas guías de la AHA/ACC, con excepción de que, de acuerdo a estas últimas, se consideraría como hipertensa a una mujer que se embaraza cuando sus cifras de PA son superiores a 130/80 mmHg. Si bien al momento no se ha pronunciado ninguna de las asociaciones de ginecología y obstetricia, nosotros creemos con base en lo revisado en este artículo, y esta es la respuesta a la pregunta del título, que no existe algún motivo racional para cambiar los criterios actuales que definen el diagnóstico y el manejo de la preeclampsia y la HTA en una mujer embarazada, y que por lo tanto las nuevas definiciones de HTA de la guías AHA/ACC no tendrán repercusión en el manejo de la preeclampsia.</jats:p>
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Clinical Perspective on Antihypertensive Drug Treatment in Adults With Grade 1 Hypertension and Low-to-Moderate Cardiovascular Risk: An International Expert Consultation
(Elsevier BV, 2017-07)
Alberto Morales Salinas
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Antonio Coca
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Michael H. Olsen
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Ramiro A. Sanchez
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Weimar K. Sebba-Barroso
Scopus© Citations 21
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Self-Reported Prevalence of Chronic Non-Communicable Diseases in Relation to Socioeconomic and Educational Factors in Colombia: A Community-Based Study in 11 Departments
(Ubiquity Press, Ltd., 2020)
Paul A. Camacho
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Diego Gomez-Arbelaez
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Johanna Otero
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Silvia González-Gómez
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Dora I. Molina de Salazar
Scopus© Citations 24
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The association of basal insulin treatment versus standard care with outcomes in anti‐GAD positive and negative subjects: A post‐hoc analysis of the ORIGIN trial
(Wiley, 2018-10-03)
Kåre I. Birkeland
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Valdemar Grill
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Cecilie Wium
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Matthew J. McQueen
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LOPEZ JARAMILLO, JOSÉ PATRICIO
<jats:p>We compared cardiovascular and other outcomes in patients with dysglycaemia with or without anti‐glutamic acid dehydrogenase (GAD) antibodies participating in the Outcome Reduction with Initial Glargine Intervention (ORIGIN) trial. Of the 12 537 participants, 8162 had anti‐GAD measured at baseline and 267 were anti‐GAD positive. The effects of insulin glargine versus standard care and of n‐3 fatty acids supplements versus placebo were compared by testing the interaction of the treatment effects and anti‐GAD status. The effect of glargine on development of new diabetes was assessed in participants without previous diabetes at baseline. The overall incidence of outcomes did not differ between anti‐GAD positive and anti‐GAD negative subjects. The incidence of the composite of cardiovascular death, non‐fatal myocardial infarction, or non‐fatal stroke did not differ between anti‐GAD positive participants randomized to insulin glargine or to standard care, with a hazard ratio (HR) (95% confidence interval [CI]) of 0.80 (0.44‐1.44) or in anti‐GAD negative participants with a HR of 1.07 (0.96‐1.20) (P for interaction = 0.20).</jats:p>
Scopus© Citations 5
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La realidad del riesgo cardiovascular en Iberoamérica
(Elsevier BV, 2020-10)
LOPEZ JARAMILLO, JOSÉ PATRICIO
;
José López-López
;
Salim Yusuf
Scopus© Citations 6

LÓPEZ JARAMILLO, JOSÉ PATRICIO

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