Evolution of Cardiovascular Risk Factors in a Worker Cohort: A Cluster Analysis

The identification of the cardiovascular risk factor (CVRF) profile of individual patients is key to the prevention of cardiovascular disease (CVD), and the development of personalized preventive approaches. Using data from annual medical examinations in a cohort of workers, the aim of the study was...

Full description

Saved in:
Bibliographic Details
Published inInternational journal of environmental research and public health Vol. 18; no. 11; p. 5610
Main Authors Castel-Feced, Sara, Maldonado, Lina, Aguilar-Palacio, Isabel, Malo, Sara, Moreno-Franco, Belén, Mur-Vispe, Eusebio, Alcalá-Nalvaiz, José-Tomás, Rabanaque-Hernández, María José
Format Journal Article
LanguageEnglish
Published Basel MDPI AG 24.05.2021
MDPI
Subjects
Online AccessGet full text

Cover

Loading…
Abstract The identification of the cardiovascular risk factor (CVRF) profile of individual patients is key to the prevention of cardiovascular disease (CVD), and the development of personalized preventive approaches. Using data from annual medical examinations in a cohort of workers, the aim of the study was to characterize the evolution of CVRFs and the CVD risk score (SCORE) over three time points between 2009 and 2017. For descriptive analyses, mean, standard deviation, and quartile values were used for quantitative variables, and percentages for categorical ones. Cluster analysis was performed using the Kml3D package in R software. This algorithm, which creates distinct groups based on similarities in the evolution of variables of interest measured at different time points, divided the cohort into 2 clusters. Cluster 1 comprised younger workers with lower mean body mass index, waist circumference, blood glucose values, and SCORE, and higher mean HDL cholesterol values. Cluster 2 had the opposite characteristics. In conclusion, it was found that, over time, subjects in cluster 1 showed a higher improvement in CVRF control and a lower increase in their SCORE, compared with cluster 2. The identification of subjects included in these profiles could facilitate the development of better personalized medical approaches to CVD preventive measures.
AbstractList The identification of the cardiovascular risk factor (CVRF) profile of individual patients is key to the prevention of cardiovascular disease (CVD), and the development of personalized preventive approaches. Using data from annual medical examinations in a cohort of workers, the aim of the study was to characterize the evolution of CVRFs and the CVD risk score (SCORE) over three time points between 2009 and 2017. For descriptive analyses, mean, standard deviation, and quartile values were used for quantitative variables, and percentages for categorical ones. Cluster analysis was performed using the Kml3D package in R software. This algorithm, which creates distinct groups based on similarities in the evolution of variables of interest measured at different time points, divided the cohort into 2 clusters. Cluster 1 comprised younger workers with lower mean body mass index, waist circumference, blood glucose values, and SCORE, and higher mean HDL cholesterol values. Cluster 2 had the opposite characteristics. In conclusion, it was found that, over time, subjects in cluster 1 showed a higher improvement in CVRF control and a lower increase in their SCORE, compared with cluster 2. The identification of subjects included in these profiles could facilitate the development of better personalized medical approaches to CVD preventive measures.
The identification of the cardiovascular risk factor (CVRF) profile of individual patients is key to the prevention of cardiovascular disease (CVD), and the development of personalized preventive approaches. Using data from annual medical examinations in a cohort of workers, the aim of the study was to characterize the evolution of CVRFs and the CVD risk score (SCORE) over three time points between 2009 and 2017. For descriptive analyses, mean, standard deviation, and quartile values were used for quantitative variables, and percentages for categorical ones. Cluster analysis was performed using the Kml3D package in R software. This algorithm, which creates distinct groups based on similarities in the evolution of variables of interest measured at different time points, divided the cohort into 2 clusters. Cluster 1 comprised younger workers with lower mean body mass index, waist circumference, blood glucose values, and SCORE, and higher mean HDL cholesterol values. Cluster 2 had the opposite characteristics. In conclusion, it was found that, over time, subjects in cluster 1 showed a higher improvement in CVRF control and a lower increase in their SCORE, compared with cluster 2. The identification of subjects included in these profiles could facilitate the development of better personalized medical approaches to CVD preventive measures.The identification of the cardiovascular risk factor (CVRF) profile of individual patients is key to the prevention of cardiovascular disease (CVD), and the development of personalized preventive approaches. Using data from annual medical examinations in a cohort of workers, the aim of the study was to characterize the evolution of CVRFs and the CVD risk score (SCORE) over three time points between 2009 and 2017. For descriptive analyses, mean, standard deviation, and quartile values were used for quantitative variables, and percentages for categorical ones. Cluster analysis was performed using the Kml3D package in R software. This algorithm, which creates distinct groups based on similarities in the evolution of variables of interest measured at different time points, divided the cohort into 2 clusters. Cluster 1 comprised younger workers with lower mean body mass index, waist circumference, blood glucose values, and SCORE, and higher mean HDL cholesterol values. Cluster 2 had the opposite characteristics. In conclusion, it was found that, over time, subjects in cluster 1 showed a higher improvement in CVRF control and a lower increase in their SCORE, compared with cluster 2. The identification of subjects included in these profiles could facilitate the development of better personalized medical approaches to CVD preventive measures.
Author Mur-Vispe, Eusebio
Castel-Feced, Sara
Aguilar-Palacio, Isabel
Alcalá-Nalvaiz, José-Tomás
Maldonado, Lina
Moreno-Franco, Belén
Rabanaque-Hernández, María José
Malo, Sara
AuthorAffiliation 1 Department of Preventive Medicine and Public Health, University of Zaragoza, 50009 Zaragoza, Spain; iaguilar@unizar.es (I.A.-P.); smalo@unizar.es (S.M.); mbmoreno@unizar.es (B.M.-F.); rabanake@unizar.es (M.J.R.-H.)
7 Institute of Mathematics and Applications (IUMA), 50009 Zaragoza, Spain
6 Department of Statistical Methods, University of Zaragoza, 50005 Zaragoza, Spain; jtalcala@unizar.es
3 GRISSA Research Group, 50009 Zaragoza, Spain
5 Prevention Department, Stellantis Spain, 50639 Figueruelas, Spain; eusebio.mur@stellantis.com
2 Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
4 Department of Economic Structure, Economic History and Public Economics, University of Zaragoza, 50005 Zaragoza, Spain; lmguaje@unizar.es
AuthorAffiliation_xml – name: 6 Department of Statistical Methods, University of Zaragoza, 50005 Zaragoza, Spain; jtalcala@unizar.es
– name: 1 Department of Preventive Medicine and Public Health, University of Zaragoza, 50009 Zaragoza, Spain; iaguilar@unizar.es (I.A.-P.); smalo@unizar.es (S.M.); mbmoreno@unizar.es (B.M.-F.); rabanake@unizar.es (M.J.R.-H.)
– name: 4 Department of Economic Structure, Economic History and Public Economics, University of Zaragoza, 50005 Zaragoza, Spain; lmguaje@unizar.es
– name: 7 Institute of Mathematics and Applications (IUMA), 50009 Zaragoza, Spain
– name: 2 Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
– name: 3 GRISSA Research Group, 50009 Zaragoza, Spain
– name: 5 Prevention Department, Stellantis Spain, 50639 Figueruelas, Spain; eusebio.mur@stellantis.com
Author_xml – sequence: 1
  givenname: Sara
  orcidid: 0000-0002-5064-3763
  surname: Castel-Feced
  fullname: Castel-Feced, Sara
– sequence: 2
  givenname: Lina
  orcidid: 0000-0003-1647-3462
  surname: Maldonado
  fullname: Maldonado, Lina
– sequence: 3
  givenname: Isabel
  orcidid: 0000-0001-7293-701X
  surname: Aguilar-Palacio
  fullname: Aguilar-Palacio, Isabel
– sequence: 4
  givenname: Sara
  orcidid: 0000-0002-7194-8275
  surname: Malo
  fullname: Malo, Sara
– sequence: 5
  givenname: Belén
  orcidid: 0000-0003-0604-5042
  surname: Moreno-Franco
  fullname: Moreno-Franco, Belén
– sequence: 6
  givenname: Eusebio
  orcidid: 0000-0003-4060-1110
  surname: Mur-Vispe
  fullname: Mur-Vispe, Eusebio
– sequence: 7
  givenname: José-Tomás
  orcidid: 0000-0001-7549-8825
  surname: Alcalá-Nalvaiz
  fullname: Alcalá-Nalvaiz, José-Tomás
– sequence: 8
  givenname: María José
  orcidid: 0000-0002-6671-5661
  surname: Rabanaque-Hernández
  fullname: Rabanaque-Hernández, María José
BookMark eNp1kc1LAzEQxYMo1qpXzwEvXlonzcduPAhlsSoUBBE8hmw2a1PTTU12C_73bq2ICp5mmPm9xwxviPab0FiEzgiMKZVw6ZY2rhckJ4QLAnvoiAgBIyaA7P_oB2iY0hKA5kzIQzSgDDIGwI7Qw80m-K51ocGhxoWOlQsbnUzndcSPLr3imTZtiAm7Bmv8HOKrjbgIixDbKzzFhe9S20-mjfbvyaUTdFBrn-zpVz1GT7Obp-JuNH-4vS-m85GhkrcjwXg9IWWd0VKbCc8koZXkrKwqafLclhwqITIhKtDAQJs6Z5LamllpaWYkPUbXO9t1V65sZWzTRu3VOrqVju8qaKd-bxq3UC9ho3IiMwpbg4svgxjeOptatXLJWO91Y0OX1IRTwSQjE-jR8z_oMnSx__eTkhkjnIueGu8oE0NK0dbfxxBQ26jU76h6AfsjMK7V2yT6g53_T_YBd4aZ_Q
CitedBy_id crossref_primary_10_1186_s12872_024_03890_3
crossref_primary_10_1111_jch_70035
Cites_doi 10.1016/j.phrs.2016.09.040
10.1007/s00180-009-0178-4
10.1186/s41043-019-0201-5
10.1038/s41598-019-53546-y
10.1093/eurheartj/ehw334
10.1109/EMBC.2019.8856507
10.18637/jss.v065.i04
10.1093/ajh/hpx028
10.1001/jama.2013.285122
10.1161/CIRCULATIONAHA.115.020090
10.1186/1471-2261-12-45
10.1016/S0140-6736(19)32008-2
10.5334/gh.764
10.1016/j.jacc.2020.11.010
10.1038/jhh.2017.20
10.1016/S0195-668X(03)00114-3
10.1093/aje/kwq171
10.1007/s40292-016-0139-2
ContentType Journal Article
Copyright 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
2021 by the authors. 2021
Copyright_xml – notice: 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
– notice: 2021 by the authors. 2021
DBID AAYXX
CITATION
3V.
7X7
7XB
88E
8C1
8FI
8FJ
8FK
ABUWG
AFKRA
AZQEC
BENPR
CCPQU
DWQXO
FYUFA
GHDGH
K9.
M0S
M1P
PHGZM
PHGZT
PIMPY
PJZUB
PKEHL
PPXIY
PQEST
PQQKQ
PQUKI
PRINS
7X8
5PM
DOI 10.3390/ijerph18115610
DatabaseName CrossRef
ProQuest Central (Corporate)
Health & Medical Collection
ProQuest Central (purchase pre-March 2016)
Medical Database (Alumni Edition)
Public Health Database
Hospital Premium Collection
Hospital Premium Collection (Alumni Edition)
ProQuest Central (Alumni) (purchase pre-March 2016)
ProQuest Central (Alumni)
ProQuest Central UK/Ireland
ProQuest Central Essentials
ProQuest Central
ProQuest One Community College
ProQuest Central Korea
Health Research Premium Collection
Health Research Premium Collection (Alumni)
ProQuest Health & Medical Complete (Alumni)
Health & Medical Collection (Alumni Edition)
Medical Database
ProQuest Central Premium
ProQuest One Academic (New)
Publicly Available Content Database
ProQuest Health & Medical Research Collection
ProQuest One Academic Middle East (New)
ProQuest One Health & Nursing
ProQuest One Academic Eastern Edition (DO NOT USE)
ProQuest One Academic
ProQuest One Academic UKI Edition
ProQuest Central China
MEDLINE - Academic
PubMed Central (Full Participant titles)
DatabaseTitle CrossRef
Publicly Available Content Database
ProQuest One Academic Middle East (New)
ProQuest Central Essentials
ProQuest Health & Medical Complete (Alumni)
ProQuest Central (Alumni Edition)
ProQuest One Community College
ProQuest One Health & Nursing
ProQuest Central China
ProQuest Central
ProQuest Health & Medical Research Collection
Health Research Premium Collection
Health and Medicine Complete (Alumni Edition)
ProQuest Central Korea
Health & Medical Research Collection
ProQuest Central (New)
ProQuest Medical Library (Alumni)
ProQuest Public Health
ProQuest One Academic Eastern Edition
ProQuest Hospital Collection
Health Research Premium Collection (Alumni)
ProQuest Hospital Collection (Alumni)
ProQuest Health & Medical Complete
ProQuest Medical Library
ProQuest One Academic UKI Edition
ProQuest One Academic
ProQuest One Academic (New)
ProQuest Central (Alumni)
MEDLINE - Academic
DatabaseTitleList CrossRef
Publicly Available Content Database

MEDLINE - Academic
Database_xml – sequence: 1
  dbid: BENPR
  name: ProQuest Central
  url: https://www.proquest.com/central
  sourceTypes: Aggregation Database
DeliveryMethod fulltext_linktorsrc
Discipline Public Health
EISSN 1660-4601
ExternalDocumentID PMC8197309
10_3390_ijerph18115610
GeographicLocations Spain
GeographicLocations_xml – name: Spain
GroupedDBID ---
29J
2WC
53G
5GY
5VS
7X7
7XC
88E
8C1
8FE
8FG
8FH
8FI
8FJ
8R4
8R5
A8Z
AADQD
AAFWJ
AAHBH
AAYXX
ABGAM
ABUWG
ACGFO
ACGOD
ACIWK
ADBBV
AENEX
AFKRA
AFRAH
AFZYC
AHMBA
ALIPV
ALMA_UNASSIGNED_HOLDINGS
AOIJS
BAWUL
BCNDV
BENPR
BPHCQ
BVXVI
CCPQU
CITATION
CS3
DIK
DU5
E3Z
EBD
EBS
EJD
EMB
EMOBN
F5P
FYUFA
GX1
HH5
HMCUK
HYE
KQ8
L6V
M1P
M48
MODMG
O5R
O5S
OK1
OVT
P2P
PGMZT
PHGZM
PHGZT
PIMPY
PQQKQ
PROAC
PSQYO
Q2X
RNS
RPM
SV3
TR2
UKHRP
XSB
3V.
7XB
8FK
AZQEC
DWQXO
K9.
PJZUB
PKEHL
PPXIY
PQEST
PQUKI
PRINS
7X8
5PM
ID FETCH-LOGICAL-c395t-645f21bf73bac257913d954bdd9c88eb50d66766d0a040acf8493ef4e9e37c93
IEDL.DBID M48
ISSN 1660-4601
1661-7827
IngestDate Thu Aug 21 13:35:37 EDT 2025
Fri Jul 11 16:28:55 EDT 2025
Fri Jul 25 09:53:23 EDT 2025
Tue Jul 01 04:22:13 EDT 2025
Thu Apr 24 23:01:30 EDT 2025
IsDoiOpenAccess true
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Issue 11
Language English
License https://creativecommons.org/licenses/by/4.0
Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
LinkModel DirectLink
MergedId FETCHMERGED-LOGICAL-c395t-645f21bf73bac257913d954bdd9c88eb50d66766d0a040acf8493ef4e9e37c93
Notes ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
content type line 23
These authors contributed equally to this work and served as senior co-authors.
ORCID 0000-0003-4060-1110
0000-0001-7293-701X
0000-0002-6671-5661
0000-0001-7549-8825
0000-0002-5064-3763
0000-0003-0604-5042
0000-0003-1647-3462
0000-0002-7194-8275
OpenAccessLink http://journals.scholarsportal.info/openUrl.xqy?doi=10.3390/ijerph18115610
PMID 34074004
PQID 2539741556
PQPubID 54923
ParticipantIDs pubmedcentral_primary_oai_pubmedcentral_nih_gov_8197309
proquest_miscellaneous_2536494120
proquest_journals_2539741556
crossref_primary_10_3390_ijerph18115610
crossref_citationtrail_10_3390_ijerph18115610
ProviderPackageCode CITATION
AAYXX
PublicationCentury 2000
PublicationDate 20210524
PublicationDateYYYYMMDD 2021-05-24
PublicationDate_xml – month: 5
  year: 2021
  text: 20210524
  day: 24
PublicationDecade 2020
PublicationPlace Basel
PublicationPlace_xml – name: Basel
PublicationTitle International journal of environmental research and public health
PublicationYear 2021
Publisher MDPI AG
MDPI
Publisher_xml – name: MDPI AG
– name: MDPI
References Pennant (ref_8) 2010; 172
Genolini (ref_15) 2010; 25
Casasnovas (ref_11) 2012; 12
ref_14
Smitson (ref_21) 2017; 30
ref_13
Townsend (ref_3) 2016; 37
ref_23
Shirasawa (ref_5) 2019; 38
Rospleszcz (ref_24) 2019; 9
ref_1
Lin (ref_18) 2020; 15
Mosquera (ref_7) 2019; 19
Allen (ref_20) 2014; 311
ref_16
Roth (ref_2) 2020; 76
Redon (ref_17) 2016; 23
Tielemans (ref_19) 2017; 31
Balakumar (ref_4) 2016; 113
ref_9
Genolini (ref_10) 2015; 65
Norby (ref_22) 2016; 134
Yusuf (ref_6) 2020; 395
Conroy (ref_12) 2003; 24
References_xml – volume: 113
  start-page: 600
  year: 2016
  ident: ref_4
  article-title: Prevalence and Prevention of Cardiovascular Disease and Diabetes Mellitus
  publication-title: Pharmacol. Res.
  doi: 10.1016/j.phrs.2016.09.040
– volume: 25
  start-page: 317
  year: 2010
  ident: ref_15
  article-title: KmL: K-Means for Longitudinal Data
  publication-title: Comput. Stat.
  doi: 10.1007/s00180-009-0178-4
– ident: ref_9
– volume: 38
  start-page: 1
  year: 2019
  ident: ref_5
  article-title: Associations between Normal Weight Central Obesity and Cardiovascular Disease Risk Factors in Japanese Middle-Aged Adults: A Cross-Sectional Study
  publication-title: J. Health Popul. Nutr.
  doi: 10.1186/s41043-019-0201-5
– volume: 9
  start-page: 1
  year: 2019
  ident: ref_24
  article-title: Association of Longitudinal Risk Profile Trajectory Clusters with Adipose Tissue Depots Measured by Magnetic Resonance Imaging
  publication-title: Sci. Rep.
  doi: 10.1038/s41598-019-53546-y
– volume: 19
  start-page: 1
  year: 2019
  ident: ref_7
  article-title: Do Cardiovascular Disease Prevention Programs in Northern Sweden Impact on Population Health? An Interrupted Time Series Analysis
  publication-title: BMC Public Health.
– volume: 37
  start-page: 3232
  year: 2016
  ident: ref_3
  article-title: Cardiovascular Disease in Europe: Epidemiological Update 2016
  publication-title: Eur. Heart J.
  doi: 10.1093/eurheartj/ehw334
– ident: ref_23
  doi: 10.1109/EMBC.2019.8856507
– volume: 65
  start-page: 1
  year: 2015
  ident: ref_10
  article-title: Kml and Kml3d: R Packages to Cluster Longitudinal Data
  publication-title: J. Stat. Softw.
  doi: 10.18637/jss.v065.i04
– volume: 30
  start-page: 587
  year: 2017
  ident: ref_21
  article-title: Association of Blood Pressure Trajectory with Mortality, Incident Cardiovascular Disease, and Heart Failure in the Cardiovascular Health Study
  publication-title: Am. J. Hypertens.
  doi: 10.1093/ajh/hpx028
– volume: 311
  start-page: 490
  year: 2014
  ident: ref_20
  article-title: Blood Pressure Trajectories in Early Adulthood and Subclinical Atherosclerosis in Middle Age
  publication-title: JAMA J. Am. Med. Assoc.
  doi: 10.1001/jama.2013.285122
– volume: 134
  start-page: 599
  year: 2016
  ident: ref_22
  article-title: Trajectories of Cardiovascular Risk Factors and Incidence of Atrial Fibrillation over a 25-Year Follow-Up
  publication-title: Circulation
  doi: 10.1161/CIRCULATIONAHA.115.020090
– volume: 12
  start-page: 1
  year: 2012
  ident: ref_11
  article-title: Aragon Workers’ Health Study-Design and Cohort Description
  publication-title: BMC Cardiovasc. Disord.
  doi: 10.1186/1471-2261-12-45
– ident: ref_16
– volume: 395
  start-page: 795
  year: 2020
  ident: ref_6
  article-title: Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): A prospective cohort study
  publication-title: Lancet
  doi: 10.1016/S0140-6736(19)32008-2
– volume: 15
  start-page: 9
  year: 2020
  ident: ref_18
  article-title: Heterogeneity in Trajectories of Systolic Blood Pressure among Young Adults in Qingdao Port Cardiovascular Health Study
  publication-title: Glob. Heart.
  doi: 10.5334/gh.764
– volume: 76
  start-page: 2982
  year: 2020
  ident: ref_2
  article-title: Global burden of cardiovascular diseases and risk factors, 1990–2019: Update from the GBD 2019 study
  publication-title: JACC
  doi: 10.1016/j.jacc.2020.11.010
– volume: 31
  start-page: 515
  year: 2017
  ident: ref_19
  article-title: Blood Pressure Trajectories in Relation to Cardiovascular Mortality: The Rancho Bernardo Study
  publication-title: J. Hum. Hypertens.
  doi: 10.1038/jhh.2017.20
– ident: ref_13
– ident: ref_14
– ident: ref_1
– volume: 24
  start-page: 987
  year: 2003
  ident: ref_12
  article-title: Estimation of Ten-Year Risk of Fatal Cardiovascular Disease in Europe: The SCORE Project
  publication-title: Eur. Heart J.
  doi: 10.1016/S0195-668X(03)00114-3
– volume: 172
  start-page: 501
  year: 2010
  ident: ref_8
  article-title: Community Programs for the Prevention of Cardiovascular Disease: A Systematic Review
  publication-title: Am. J. Epidemiol.
  doi: 10.1093/aje/kwq171
– volume: 23
  start-page: 87
  year: 2016
  ident: ref_17
  article-title: Global Cardiovascular Risk Assessment: Strengths and Limitations
  publication-title: High Blood Press. Cardiovasc. Prev.
  doi: 10.1007/s40292-016-0139-2
SSID ssj0038469
Score 2.2857387
Snippet The identification of the cardiovascular risk factor (CVRF) profile of individual patients is key to the prevention of cardiovascular disease (CVD), and the...
SourceID pubmedcentral
proquest
crossref
SourceType Open Access Repository
Aggregation Database
Enrichment Source
Index Database
StartPage 5610
SubjectTerms Alcohol use
Blood pressure
Body mass index
Cardiovascular disease
Cholesterol
Cluster analysis
Diabetes
Factories
Glucose
Hypertension
Longitudinal studies
Population
Prevention
Risk factors
Smoking
Variables
Workers
SummonAdditionalLinks – databaseName: Health & Medical Collection
  dbid: 7X7
  link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV1LSyQxEA4-LguyuLqLo65EEDwFu_PoTvayyOAgCyqIwtyaPHFW6VZnZn-_VdM9o31YzwkdupLK96VS-YqQk8Sd5cInpoENM2kzz7TiknGdCseBn5YWHzhfXReX9_LPWI27gNu0S6tc7omLjTo0HmPkZ1wBciL6Fb-fXxhWjcLb1a6ExjrZROkyTOkqx6sDlwBsRfqbAwYxQMKyFW0UcMw_m_yN8B8AbzkSiD4ovTPNfp7kB-AZbZOvHWOk5-0UfyNrsd4hW224jbaviHbJzcW_bg3RJtFhL8mU3k6mj3TUFtahk5paiiHy-EqHzQOw71_0nA6f5qiYQJcaJd_J3ejibnjJuloJzAujZqyQKvHcpVI468ENTS6CUdKFYLzW0aksYDZrETILbmt90tKImGQ0UZTeiB9ko27quEeoDcrooAtXuCjLGGyWBS9DUinXMXf5gLClrSrf6YhjOYunCs4TaNuqb9sBOV31f24VNP7b83Bp-qrzpGn1Pu8DcrxqBh_Aiw1bx2a-6FNII3MOnyh7U7YaEVW0-y315GGhpg2UCHY5s__54AfkC8dslkwxLg_Jxux1Hn8CHZm5o8WaewMqMuFn
  priority: 102
  providerName: ProQuest
Title Evolution of Cardiovascular Risk Factors in a Worker Cohort: A Cluster Analysis
URI https://www.proquest.com/docview/2539741556
https://www.proquest.com/docview/2536494120
https://pubmed.ncbi.nlm.nih.gov/PMC8197309
Volume 18
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3daxQxEA-2BSmI-Imn9Ygg-BTdfG0SQaQudxahVUoL97bkk54ee-31TvS_d3K7d3WhvviSlyS7y2Rmf79JJjMIvU7MWcZ9IhrYMBG28ERLJgjTqXQM-Kmy-YLz8Ul5dC6-TOTkJv6pE-D1ra5drid1vpi9_XX1-yMY_IfscYLL_m76PcI3AVTRTAZ20B6gkspGeiy2JwoccDZTYQp4RAAVVZvA8Zb5--guBy8n63Yfq24IaD988i88Gj9A9zsiiQ_blX-I7sTmEbrX7sLh9nLRY_R19LNTLTxPuOrFnuLT6fUPPG7r7eBpgy3OO-dxgav5BcjjPT7E1WyVEyngTeqSJ-hsPDqrjkhXQoF4buSSlEImRl1S3FkP1mkoD0YKF4LxWkcni5CDXMtQWLBm65MWhsckoolcecOfot1m3sRnCNsgjQ66dKWLQsVgiyJ4EZJMVEfq6ACRjaxq36UXz1UuZjW4GVnMdV_MA_RmO_6yTazxz5EHG9HXG_2omQQilclQOUCvtt1gGvm8wzZxvlqPKYURlMEjVG_Jtm_MybX7Pc30Yp1kG5gS_PzM8_-e-QLtsxz_UkjCxAHaXS5W8SUQmKUboh01UdDqiuZ2_HmI9j6NTr6dDtc6-weC-_ZS
linkProvider Scholars Portal
linkToHtml http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwtV1baxQxFA6lfVCQUm-4tdUIik-hM7nMTASRsnbZ2osgK-zbkCtdLTO1u6v4o_yPPWdnZus86FufJ0zg5Eu-L8nJdwh5Hbk1XLjIClDDTJrEsUJxyXgRM8tBn-YGHzifnWfjr_LTVE03yJ_uLQymVXZr4mqh9rXDM_IDroA5kf2yD1c_GFaNwtvVroRGA4uT8PsXbNnm748_wvi-4Xx0NBmOWVtVgDmh1YJlUkWe2pgLaxwAVqfCayWt99oVRbAq8Zj3mfnEAMCNi4XUIkQZdBC5Q-8lWPG3gHcTnFD5dL2_E0DlqLZToDwGxJs3HpFC6ORg9i1A2IBNU9QrfQ68Fbb9tMy_eG60Q7ZbgUoPG0Q9JBuhekQeNKd7tHm09Jh8PvrZQpbWkQ57Oa30y2z-nY6aOj50VlFD8UQ-XNNhfQFi_x09pMPLJRo00M4S5QmZ3EUQn5LNqq7CM0KNV7rwRWYzG2QevEkS76SPKqZFSG06IKyLVela23KsnnFZwvYFY1v2Yzsgb9ftrxrDjn-23OtCX7YTd17ewmxAXq0_w5TDexRThXq5apNJLVMOv8h7Q7buEU27-1-q2cXKvBsUGCyqevf_nb8k98aTs9Py9Pj85Dm5zzGRJlGMyz2yubhehn1QQgv7YoU_Sso7xvsNJXsd5Q
linkToPdf http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwtV1daxQxFA2lgggifuJq1QiKT2Fn8jGTCCJl26W1WkUq7NuQT7paZmp3V_Gn-e-8d2dm6zzoW58nTODmJOckuTmXkBeJO8uFT0yDGmbSZp5pxSXjOhWOgz4tLT5w_nBcHHyR72ZqtkV-929hMK2yXxPXC3VoPJ6Rj7kC5kT2K8apS4v4tDd9e_6dYQUpvGnty2m0EDmKv37C9m3x5nAPxvol59P9k8kB6yoMMC-MWrJCqsRzl0rhrAfwmlwEo6QLwXito1NZwBzQImQWwG590tKImGQ0UZQefZhg9b9WCpXjFCtnm72eAFpH5Z0D_TEg4bL1ixTCZOP51wghBGbNUbsM-fBS5A5TNP_ivOltcqsTq3S3RdcdshXru-Rme9JH2wdM98jH_R8dfGmT6GSQ30o_zxff6LSt6UPnNbUUT-fjBZ00pyD8X9NdOjlboVkD7e1R7pOTqwjiA7JdN3V8SKgNyuigC1e4KMsYbJYFL0NSKdcxd_mIsD5Wle8szLGSxlkFWxmMbTWM7Yi82rQ_b807_tlypw991U3iRXUJuRF5vvkM0w_vVGwdm9W6TSGNzDn8ohwM2aZHNPAefqnnp2sjb1BjsMCaR__v_Bm5Dkiv3h8eHz0mNzjm1GSKcblDtpcXq_gERNHSPV3Dj5LqiuH-Bx2tIhs
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Evolution+of+Cardiovascular+Risk+Factors+in+a+Worker+Cohort%3A+A+Cluster+Analysis&rft.jtitle=International+journal+of+environmental+research+and+public+health&rft.au=Castel-Feced%2C+Sara&rft.au=Maldonado%2C+Lina&rft.au=Aguilar-Palacio%2C+Isabel&rft.au=Malo%2C+Sara&rft.date=2021-05-24&rft.pub=MDPI&rft.issn=1661-7827&rft.eissn=1660-4601&rft.volume=18&rft.issue=11&rft_id=info:doi/10.3390%2Fijerph18115610&rft_id=info%3Apmid%2F34074004&rft.externalDocID=PMC8197309
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1660-4601&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1660-4601&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1660-4601&client=summon