Prevalência de hipertensão arterial sistêmica em estudantes de medicina de uma instituição privada / Prevalence of systemic arterial hypertension in medical students of a private institution

A Hipertensão Arterial Sistêmica (HAS) é uma das doenças mais prevalentes no mundo. O objetivo deste trabalho foi verificar a prevalência da HAS em estudantes do Curso de Medicina, assim como de fatores de risco que possam levar a médio e longo prazo ao aumento da prevalência de HAS nesta faixa etária. Tratou-se de um estudo transversal, cujos dados foram coletados de questionários preenchidos por 310 alunos do primeiro ao quarto ano de medicina. O valor adotado como sendo hipertensão arterial (autorreferida) foi igual ou superior a 140x90mmHg. Os resultados foram analisados e apresentados em porcentagem de frequência ou média (desvio padrão). A maioria dos estudantes foi do sexo feminino (72,6%), idade média de 22,04 (3,11) anos. A prevalência de HAS primária já diagnosticada foi de 2,6%. Dos alunos, 73,2% apresentaram história familiar positiva para HAS, 32,6% relataram ser sedentários, 36,8% disseram não possuir alimentação rica em fibras e frutas e 54,5% afirmaram não ter dieta pobre em sal. A média de IMC foi de 23,14 (4,05), sendo verificado sobrepeso (18%) e obesidade (4%). 6,1% disseram dormir menos de 5 horas por dia, 75,8% se consideraram ansiosos e 16,1% deprimidos, relatando uso de antidepressivos (10,32%) ou ansiolíticos e sedativos (3,55%). Por fim, 18% relataram já ter usado drogas ilícitas e 6,5% afirmaram ser fumantes. Concluiu-se que a prevalência da HAS em jovens foi baixa, mas os fatores de risco para a patologia estiveram presentes já nesta faixa etária, o que sugere a necessidade de medidas preventivas.

The Systemic Arterial Hypertension (SAH) is one of the most prevalent diseases in the world. The objective of this study was to verify the prevalence of hypertension in medical students, as well as risk factors that may lead to an increase in the prevalence of hypertension in this age group in the medium and long term. This was a cross-sectional study, whose data were collected from questionnaires filled by 310 students from the first to the fourth year of Medicine. The value adopted as hypertension (self-reported) was equal to or greater than 140x90mmHg. The results were analyzed and presented as percentage of frequency or mean (standard deviation). The majority of the students were female (72.6%), mean age of 22.04 (3.11) years. The prevalence of primary hypertension already diagnosed was 2.6%. Of the students, 73.2% had a positive family history of hypertension, 32.6% reported being sedentary, 36.8% said they did not have a high fiber and fruit diet and 54.5% said they did not have a low salt diet. The mean BMI was 23.14 (4.05), being overweight (18%) and obesity (4%). 6.1% reported sleeping less than 5 hours per day, 75.8% considered themselves anxious and 16.1% depressed, reporting use of antidepressants (10.32%) or anxiolytics and sedatives (3.55%). Finally, 18% reported having already used illicit drugs and 6.5% reported being smokers. It was concluded that the prevalence of SAH in young people was low, but the risk factors for the pathology are already present in this age group, which suggests the need for preventive measures

Effects of Coexistence Hypertension and Type II Diabetes on Heart Rate Variability and Cardiorespiratory Fitness / Efeitos da Coexistência de Diabetes Tipo 2 e Hipertensão sobre a Variabilidade da Frequência Cardíaca e Capacidade Cardiorrespiratória

Abstract Background: Type 2 diabetes Mellitus (T2DM) is associated with cardiac autonomic dysfunction, which is an independent predictor of mortality in chronic diseases. However, whether the coexistence of systemic arterial hypertension (HTN) with DMT2 alters cardiac autonomic modulation remains unknown. Objective: To evaluate the influence of HTN on cardiac autonomic modulation and cardiorespiratory fitness in subjects with DMT2. Methods: 60 patients of both genders were evaluated and allocated to two groups: DMT2 patients (n = 32; 51 ± 7.5 years old) and DMT2 + HTN patients (n = 28; 51 ± 6.9 years old). RR intervals were obtained during rest in supine position. Linear and nonlinear indices of heart rate variability (HRV) were computed using Kubios HRV software. Pulmonary gas exchange was measured breath-by-breath, using a portable telemetric system during maximal incremental exercise testing on a cycle ergometer. Statistical analysis included Shapiro-Wilk test followed by Student's t Test, Pearson correlation and linear regression. Results: We found that patients in the DMT2+HTN group showed lower values of mean RR intervals (801.1 vs 871.5 ms), Shannon entropy (3 vs 3.2) and fractal dimension SD 1 (9.5 vs 14.5), when contrasted with patients in the DMT2 group. Negative correlations were found between some HRV nonlinear indices and exercise capacity indices. Conclusion: HTN negatively affects the cardiac autonomic function in diabetic patients, who are already prone to develop autonomic dysfunction. Strategies are need to improve cardiac autonomic functionality in this population.

Resumo Fundamento: A diabetes mellitus tipo 2 (DM2) está associada com disfunção autonômica cardíaca, que é um preditor independente de mortalidade em doenças crônicas. No entanto, ainda não se sabe se a coexistência de hipertensão arterial sistêmica (HAS) e DM2 altera a modulação cardíaca autonômica. Objetivos: O objetivo deste estudo foi avaliar a influência de HAS sobre a modulação da função autonômica cardíaca e capacidade cardiopulmonar em indivíduos com DM2. Métodos: 60 pacientes de ambos os sexos foram avaliados e alocados em dois grupos; pacientes DM2 (n = 32; 51 ± 7,5 anos) e pacientes DM2 + HAS (n = 28; 51 ± 6,9 anos). Intervalos RR foram obtidos durante repouso e em posição supina. Índices lineares e não lineares da variabilidade da frequência cardíaca (VFC) foram registrados utilizando-se o programa Kubios HRV software. A troca gasosa pulmonar foi medida a cada inspiração, utilizando-se um sistema telemétrico portátil durante o teste incremental máximo de exercício em cicloergômetro. A análise estatística incluiu o teste Shapiro-Wilk seguido do teste t de Student, a correlação de Pearson e a regressão linear. Resultados: Encontramos que pacientes do grupo DM2+HAS apresentaram valores mais baixos de intervalos RR (801,1 vs 871,5 ms), entropia de Shannon (3,0 vs 3,2) e DP1 da dimensão fractal em comparação aos pacientes do grupo DM2. Foram encontradas correlações negativas entre alguns índices não lineares da VFC e índices da capacidade do exercício. Conclusão: A HAS afeta negativamente a função autonômica cardíaca em pacientes diabéticos, os quais já são propensos a desenvolverem disfunção autonômica. Estratégias são necessárias para melhorar a função autonômica cardíaca nessa população.

Factors affecting seasonal changes in blood pressure in North India: A population based four-seasons study

Objective There are no community based, longitudinal, intra individual epidemiological studies on effect of weather and season on blood pressure (BP). We evaluated the effect of season and temperature on prevalence and epidemiology of BP in tropical climate. Methods and results It was a longitudinal cross sectional survey of rural and urban subjects in their native surroundings. BP was measured in four different seasons in same subjects. A total of 978 subjects (452 rural and 521 urban) were included in the current analysis. Demographic characteristics such as age, gender, education, occupational based physical activity and body mass index (BMI) were recorded. Mean BP, both systolic and diastolic were significantly higher in winter season as compared to summer season. Mean difference between winter and summer was 9.01 (95% CI: 7.74–10.28, p < 0.001) in systolic BP and 5.61 (95% CI: 4.75–6.47, p < 0.001) in diastolic BP. This increase in BP was more marked in rural areas and elderly subjects. Prevalence of hypertension was significantly higher during winter (23.72%) than in summer (10.12%). Conclusion BP increases significantly during winter season as compared to summer season. Increase is more marked in rural areas and elderly subjects. Seasonal variation in BP should be taken into account while looking at prevalence of hypertension in epidemiological studies.

Hypertension in Older Adults in Jamaica: Prevalence, Treatment and Control / La Hipertensión en los Adultos Mayores en Jamaica: Prevalencia, Tratamiento y Control

ABSTRACT Objective: To examine the prevalence, treatment and control and associated risk factors for hypertension among older adults in Jamaica. Methods: Four parishes in Jamaica were surveyed using a cross-sectional study design involving 2943 participants. The survey used a cluster sampling methodology with probability-proportional-to-size. A sub sample of 373 persons was randomly selected for assessment with regard to hypertension prevalence, treatment and control. Results: The sample consisted of 373 older adults with the majority (56.6%) being female. The age of the participants ranged from 60 to 100 years, with the median age being 70 (interquartile range = 13) years. Reported prevalence of hypertension was 61.7% and significantly (p < 0.001) more females than males (71.4% vs 49.1%, respectively) reported having hypertension. There was no significant difference in being diagnosed with hypertension by age groups, area of residence, highest level of education and union status. Among older adults who reported having hypertension, the majority (90.0%) were being treated while one in ten (10%) reported not being treated. "Based on the Eighth Joint National Committee (JNC-8) definition of control, among older adults who reported having hypertension, only slightly more than a third (34.8%) were controlled; the majority (65.2%) were uncontrolled. Conclusion: The low level of hypertension control documented is of concern given the availability of medication subsidies and the priority attention being given to chronic disease. Further research is needed regarding facilitators and barriers to hypertension control to identify the best interventions to increase control levels.

RESUMEN Objetivo: Examinar la prevalencia, tratamiento y control, así como los factores de riesgo asociados con la hipertensión entre los adultos mayores en Jamaica. Métodos: Cuatro parroquias en Jamaica fueron encuestadas usando un diseño de estudio transversal que abarcó 2943 participantes. La encuesta utilizó una metodología de muestreo por conglomerados con probabilidad proporcional al tamaño. Una submuestra de 373 personas fue seleccionada aleatoriamente para su evaluación con respecto a la prevalencia, tratamiento y control de la hipertensión. Resultados: La muestra constó de 373 adultos mayores, de los cuales la mayor parte (56. 6%) eran mujeres. La edad de los participantes fluctúo de 60 a 100 años, siendo la edad mediana 70 años (rango intercuartil = 13). La prevalencia de hipertensión reportada fue 61.7%, y significativamente (p < 0.001) más hembras que varones (71.4% vs 49.1%, respectivamente) reportaron tener hipertensión. No hubo diferencia significativa alguna en ser diagnosticado con hipertensión por grupos de edad, área de residencia, nivel más alto de educación, y estado de la unión. Entre los adultos mayores que reportaron tener hipertensión, la mayoría (90.0%) estaban siendo tratados, mientras que uno de cada diez (el 10%) reportaron no tener tratamiento. Basándose en la definición de control ocho del Comité Nacional Conjunto (JNC, siglas en inglés) entre los adultos mayores que reportaron tener hipertensión, sólo poco más de un tercio (34.8%) eran controlados. La mayoría (65.2%) no eran controlados. Conclusión: El bajo nivel de control de la hipertensión documentado es asunto de preocupación, dada la disponibilidad de subsidios para medicamentos y la atención prioritaria que se da a las enfermedades crónicas. Se necesitan investigaciones adicionales sobre facilitadores y barreras al control de la hipertensión para identificar mejores intervenciones para aumentar los niveles de control.

The current condition of the workers' general health examination in South Korea: a retrospective study

BACKGROUND: Business owners in the Republic of Korea must take part in the workers' general health examination. However, there have been few formal analyses of the uptake of this examination by employees. In the present study, we examined the rates of participation in medical examinations according to age group, health insurance type, and enterprise size, and then compared these results with those of the national general health screening. Furthermore, we determined the distribution of patients with abnormal results for diabetes and hypertension, and outlined the significance and history of domestic health examinations. METHODS: We started by comparing participation rates extracted from the among health examination data of the National Health Insurance Service from 2006–2013 by sex, age, insurance type, and enterprise size of workplace health insurance beneficiaries (i.e., those whose insurance is provided by their workplace). In addition, we analyzed the prevalence rates of abnormal results for hypertension and diabetes, and explored the history and significance of health examinations in the Republic of Korea. RESULTS: The overall participation rate in the primary health examination in 2006 was 56%, and this increased to 72% in 2013. However, the rates of the secondary screening did not increase much. Among workplace policyholders (i.e., those whose insurance is provided by their workplace), the participation rates of workers in enterprises with less than 50 employees were lower than were those in enterprises with 50 or more employees. Notably, the rates and odds ratios of patients with abnormal results for diabetes and hypertension were relatively high, particularly among those working in smaller enterprises. CONCLUSIONS: Although the workers' general health examination has been replaced with the national general health screening, it remains necessary to ensure uniform health management services among all workers in the Republic of Korea. This can, in turn, promote occupational health and improve working conditions throughout the Republic of Korea.

Prevalência de hipertensão arterial e fatores de risco em remanescentes de quilombos, Mato Grosso, Brasil / Prevalence of arterial hypertension and risk factors in quilombos remnants in the State of Mato Grosso, Brazil

A hipertensão arterial, importante problema de saúde pública, apresenta elevada prevalência e gravidade em negros, sendo escassos os estudos brasileiros sob o tema. O objetivo do estudo foi analisar a prevalência de hipertensão e fatores associados em uma população rural de remanescentes de quilombos no estado de Mato Grosso, Brasil. Estudo observacional, de corte transversal, realizado em 2012, abrangendo todos os adultos ≥ 18 anos residentes no quilombos rural de Mata Cavalo, município de Nossa Senhora do Livramento. Foram obtidos dados demográficos, socioeconômicos, de hábitos de vida, medidas antropométricas e da pressão arterial. A hipertensão foi definida pelo critério ≥ 140/90 mmHg, ou uso de medicação anti-hipertensiva. A relação entre variáveis independentes e hipertensão foi avaliada pela razão de prevalência com respectivos intervalos de confiança de 95% e nível de significância de p ≤ 0,05. A análise de 81,5% da população de estudo, 49% do sexo feminino, média de idade de 51,8 (± 17,7) anos revelou baixos índices de renda e escolaridade. A prevalência de hipertensão arterial foi de 52,5%, com discreto e não significativo predomínio em mulheres. Observou-se associação significativa entre hipertensão e idade, sedentarismo no trabalho, presença de história familiar para hipertensão, circunferência da cintura aumentada e relação cintura-quadril em faixa de risco. Em face da elevada prevalência de hipertensão observada em comunidade quilombola de Mato Grosso, Brasil, associada a fatores de risco bem conhecidos, o presente estudo chama a atenção para a necessidade da execução de políticas de saúde pública mais abrangentes, com o objetivo de atingir segmentos sociais específicos.

The hypertension, an important public health problem, presents a high prevalence and severity in blacks, being scarce Brazilian studies on the subject. The objective of the study was to analyze the prevalence of hypertension and associated factors in a rural population of remnants of the quilombos in the State of Mato Grosso, Brazil. This is an observational study, cross-sectional, conducted in 2012, covering all adults ≥ 18 years residing in rural quilombo Mata Cavalo, municipality of Nossa Senhora do Livramento. Were obtained demographic and socioeconomic data, lifestyle habits, anthropometric measurements and blood pressure. Hypertension was defined by criterion ≥ 140/90 mmHg, or use of antihypertensive medication. The relationship between independent variables and hypertension was presented by prevalence ratio with their respective 95% confidence intervals and significance level of p ≤ 0.05. The analysis of 81.5% of the study population, 49% female, mean age of 51.8 (±17.7) years revealed low levels of income and education. Theprevalence of hypertension was 52.5%, with a slight but not significant predominance in women. There was a significant association between hypertension and age, sedentary at work, presence of family history of hypertension, waist circumference increased and waist-hip ratio in risk range. In view of the high prevalence of hypertension observed in the quilombola community of Mato Grosso, Brazil, associated with the well-known risk factors, the present study draws attention to the need for the implementation of more comprehensive public health policies, with the objective of achieving specific social segments.

Survey on the prevalence of hypertention and risk factors among the people above 30 year-old of Bayankhongor province / Монголын Анагаах Ухаан

BackroundThe goal of the survey was to determine the prevalence of hypertension and common modifiable risk factors which is constantly increases and in highly lead of blood circulating system diseases among the people of Baynkhongor province in recent years, and also to find a reasonable ways to improve preventive actions for long life expectancy of the province residents.GoalThe goal of the survey was to determine the prevalence of hypertension and common modifiable risk factors among the people above 30 years old of Bayankhongor province.Objectives:1. To determine the prevalence of hypertension among the people above 30 years old of Bayankhongor province2. To determine the risk factors for hypertensionMaterials and Method:The cross-sectional survey used WHO STEPS survey methodology adapted to the countrys specifics. A total of 373 randomly selected above 30 year-old residents involved to the survey that all represented by ages, gender etc.Results:The survey result showed that about 41.3% of the target population who involved in the survey has the prevalence of hypertension and with no difference in all regions too. Men had significantly higher prevalence of hypertension compared to women as well (p=0.029), andit would occurs and happens more with the aging. Total of 34.6% of the target population who have the prevalence of hypertension (p=0.0001) have diagnosed and whereas men at risk about 66%. The survey result showed that the consumption of the pernicious habits of the population is high, and average daily serving of fruits and vegetables were (1.64 unit) once 3 more times less than the WHO recommendation. Daily salt intake was 9.8 grams per person (2 more times higher than the WHO recommendation) and nearly one in two persons were at increased risk for physical inactivity.Conclusions:The survey result showed that about 41.3% of the target population who involved in the survey has the prevalence of hypertension. In conclusion, the summary of combined hypertension risk factors demonstrates that 2 in 3 (65.9%) adults have 1-2 risk factors and 1 in 3 (30%) adults have three or more common modifiable risk factors. Twice as many young men (aged 30-49 years) than women have high 3 more risk factors.

Prevalence rate of dyslipidemia,hyperglycemia,hypertension and metabolic syndrome in a large occupational population in Beijing / 中华检验医学杂志

Objective To investigate the prevalence of dyslipidemia,hyperglycemia,hypertension and metabolic syndrome(MS)and compare the prevalence rate of dysilipidemia obtained in this study with the previous study during 1984--1986.Methods A total of 16 344 adults in Beijing who attended for the medical examinations were recruited in the study.Subjects were asked to complete questionnaires regarding personal health,lifestyle and family health history.The physical examination emphasized measurement of height,weight and blood pressure.Blood samples were collected after an overnight fast and subjected to serum glucose,TC,HDL-C,LDL-C and TG measurements.MS was diagnosed according to Diabetes Society of Chinese Medical Association(CDS)criteria.Results Dyslipidemia occurred in 36.9%(6 034)of subjects.948 hyperglycaemia cases were found.The prevalence rate of high blood glucose was 5.8%. Hypertension occurred in 17.1% of subjects.Obesity/Overweight occurred in 5 252 subjects with the prevalence rate of 32.1%.On the basis of the diagnostic criteria for MS in China.MS occurred in 12.2% of subjects(14.2% for males and 10.0% for females).In both genders,the rate increased along with the increment of age.65.5% participants had at least one of the metabolic disorders.The prevalence of hypercholesterolemia,hypertriglyceridemia,and abnormally low HDL-C were higher than previous analysis during 1984-1986 in all age groups.Conclusions The prevalence of MS in this large occupational population in Beijing was quite high. The prevalence of hypeflipemia had increased considerably over the past 20 years.Balanced nutrition and reasonable consumption should be undertaken to modify these situations.