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Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2017;70:941-51 - Vol. 70 Num.11 DOI: 10.1016/j.rec.2017.02.017

Association Between Improvement in Cardiovascular Risk Profile and Changes in Sickness Absence: Results of the ICARIA Study

Eva Calvo-Bonacho a, Carlos Catalina-Romero a,, Martha Cabrera a, Carlos Fernández-Labandera a, Miguel Ángel Sánchez Chaparro b, Carlos Brotons c, Luis Miguel Ruilope d

a Departamento de Proyectos Sanitarios, Ibermutuamur (Mutua colaboradora con la Seguridad Social 274), Madrid, Spain
b Departamento de Medina Interna, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain
c Unidad de Investigación, Equip d’Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain
d Instituto de Investigación, Hospital Universitario 12 de Octubre, Madrid, Spain


Cardiovascular risk. Cardiovascular disease. Sick leave. Sickness absence. Work-related accidents.


Introduction and objectives

The purpose of this study was to investigate whether changes in cardiovascular risk (CVR) are associated with the length and cost of sickness absence.


A prospective cohort of 179 186 participants was evaluated. Each participant's CVR (SCORE) was assessed on 2 consecutive medical examinations, approximately 1 year apart (365 ± 90 days). Cardiovascular risk was categorized as < 4% or ≥ 4%, and participants were divided into 4 groups according to changes in their risk between the 2 assessments. After the second CVR estimate, a 1-year follow-up was carried out to assess sickness absence. Differences between the 4 groups in terms of the total count of sickness absence days during the follow-up period were tested using Poisson regression models.


After adjustment for covariates, participants who showed an improvement in CVR had a lower count of sickness absence days compared with both those who showed a worsening in risk and those who remained stable at ≥ 4% (RR, 0.91; 95%CI, 0.84-0.98). In comparison with participants whose CVR did not improve, more of the participants whose risk did improve had quit smoking (+17.2%; P < .001), and had controlled their blood pressure (+26.0%, P < .001), total cholesterol (+9.3%; P < .001), low-density lipoprotein cholesterol (+14.9%; P < .001), and triglyceride levels (+14.6%; P < .001).


Our results suggest that an improvement in CVR profile is accompanied by a decrease in sickness absence during a 1-year follow-up.


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1885-5857/© 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved