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"titulo" => "Famine in the Spanish civil war and mortality from coronary heart disease: a perspective from Baker's hypothesis"
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"resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Analizar si el hambre durante la Guerra Civil española y la inmediata posguerra influyó sobre la mortalidad por cardiopatía isquémica de las personas que nacieron en este período, según lo planteado en la hipótesis de Barker acerca de la posible programación fetal de enfermedades de la edad adulta.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Con los datos de mortalidad por edad y sexo por cardiopatía isquémica en el período 1990-2002, se calcularon las tasas anuales de mortalidad específicas y las tasas ajustadas por edad, por el método directo. Mediante análisis de regression de Poisson se analizó el efecto de la edad, el período y la cohorte anual de nacimiento (1918-1957).</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Durante el período de estudio, la mortalidad por cardiopatía isquémica ha disminuido un promedio anual de –2,3% en ambos sexos y para todas las edades. En el descenso de mortalidad están presentes los efectos cohorte y período (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,001); se observa un incremento del riesgo para todas las edades y ambos sexos en las muertes correspondientes a personas nacidas durante los años reconocidos como de mayor escasez alimentaria de la Guerra Civil y la inmediata posguerra (1937, 1940, 1943 y 1945).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los resultados obtenidos al estudiar anualmente la mortalidad por cardiopatía isquémica son compatibles con la hipótesis de Barker sobre el efecto del estrés alimentario durante el embarazo en la génesis de diversas enfermedades en el adulto. La Guerra Civil española, además de costes humanos, económicos y políticos, puede haber tenido consecuencias negativas para la salud de los nacidos en esas cohortes.</p>"
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"resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To determine whether the famine experienced during the Spanish civil war and immediate postwar period influenced mortality from coronary heart disease (CHD) in persons born in this period, following the lines of Barker's hypothesis on fetal programming of chronic diseases in adult life.</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Using CHD mortality data by age and sex for 1990-2002, annual and age-adjusted rates were calculated by the direct method. Poisson regressions were used to estimate period, age and cohort effects by year of birth (1918-1957).</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">During the study period, CHD mortality fell by a yearly average of –2.3% in both sexes and in all ages yearly. This trend was influenced by both cohort and period effects (p< 0.001); an increased risk was observed for both sexes and in all ages in the deaths corresponding to persons born during the war and postwar years when the famine was most intense (1937,1940, 1943 and 1945).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The results obtained by studying yearly CHD mortality are compatible with those expected by Barker's hypothesis of the effect of nutritional stress during pregnancy. In addition to its human, economic and political costs, the Spanish civil war could also have had negative consequences for the health of persons born in this period.</p>"
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