Overview of Cardiovascular Disease Risk Factors in Adults in São Paulo, Brazil: Prevalence and Associated Factors in 2008 and 2015

Abstract Background Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in Brazil. Objective To provide population-based data on prevalence and factors associated with CVD risk factors. Methods Individuals aged ≥20 years from two editions of the cross-sectional Health Survey of São Paulo focusing on Nutrition (ISA-Nutrition), performed in Sao Paulo city in 2008 (n=590) and 2015 (n=610), were evaluated for: obesity, central obesity, waist/height ratio, high blood pressure (HBP), dyslipidemia, diabetes, and number of CVD risk factors ≥3. Prevalence was estimated according to complex survey procedures. Factors associated with cardiovascular risk factors were assessed using logistic regression, with statistical significance of p<0.05. Results Obesity and older age were associated with higher odds of all cardiovascular risk factors investigated, except for dyslipidemia. HBP was positively associated with being Black/Brown and negatively associated with being physicaly active in leisure time. Women were more likely to have increased adiposity indicators and three or more cardiovascular risk factors than men. Those with higher education had lower chances of having diabetes, HBP and dyslipidemia, and those with higher income had higher chances of having three or more risk factors. Former smokers had higher odds of diabetes, obesity, and high waist/height ratio, and smokers had higher odds of high non-HDL cholesterol levels. From 2008 to 2015, there was an increase (p<0.001) in the prevalence of diabetes (6.9% to 17.3%), HBP (31.9% to 41.8%), dyslipidemia (51.3% to 67.6%), and number of CVD risk factors ≥3 (18.9% to 34.1%). Conclusion This study shows increasing prevalence of CVD risk factors in adult population in Sao Paulo and may support the definition of target groups and priority actions on CVD prevention and treatment.

Academias da saúde de Florianópolis: diferenças regionais na percepção dos idosos quanto aos serviços prestados, motivos de ingresso e permanência enível de atividade física / Academies of health of Florianopolis: regional differences in perception of older people as to the provided services, reasons of entry and stay and level of physical activity

O objetivo deste estudo foi verificar a percepçãodos idosos quanto aos serviços prestados, motivos deingresso e permanência e nível de atividade física (AF)dos participantes das Academias da Saúde em diferentesregiões de Florianópolis-SC. Participaram deste estudo38 idosos, com idade média de 68,7±0,9 anos, de11 academias das regiões Continente, Centro e Lestede Florianópolis-SC. Os instrumentos aplicados foram:ficha diagnóstica para as características sociodemográficas,percepção sobre os serviços prestados e motivosde ingresso e permanência, Questionário Internacionalde Atividade Física (IPAQ) para verificar o nível de AFno domínio transporte e lazer. Os dados quantitativosforam tratados por meio de estatística descritiva e inferencial(teste Qui-Quadrado e Kruskal-Wallis). Admitiu--se nível de significância de 5%. Os dados qualitativosforam tratados pela análise de conteúdo temática. Observou-se diferença significativa nos níveis de AF, nosdomínios transporte (p=0,02) e lazer (p=0,02) nas diferentesregiões, constatando-se os idosos da região Centrocomo os mais ativos nos dois domínios. Melhorar emanter a saúde foram, respectivamente, os motivos deingresso e permanência mais citados. Esses motivos foramsemelhantes entre as regiões. Em relação aos serviçosprestados, 50,0% dos idosos estavam insatisfeitosenquanto 97,4% estavam satisfeitos com a infraestrutura,tendo como sugestão a implantação de cobertura manutenção e aumento no número de aparelhos.Conclui-se que existem diferenças regionais quantoao nível de AF dos idosos e que a saúde é a principalmotivação para que frequentem essas academias. Osserviços prestados ainda demandam melhorias como asupervisão de profissionais de Educação Física.

The aim of this study was to investigate the perceptionand the services provided, reasons for entry andstay and level of physical activity (PA) among elderlyparticipants of the Academies of Health in differentregions of Florianopolis-SC. The study included 38 oldpeople (68,7±0,9 years), of 11 Academies of Health(Continent, Central and East). The instruments appliedwere: diagnostic to check sociodemographic characteristicsand perceptions about the services provided andreasons for entry and stay; International Physical ActivityQuestionnaire (IPAQ), to check the level of PA in the transportation and sports and leisure. Quantitativedata were analyzed by descriptive and inferential statistics(Chi-Square and Kruskal-Wallis), with significancelevel of 5%. Qualitative data were treated by the thematiccontent analysis. As a result, we found statisticallysignificant differences in PA levels in the transport domain(p=0,02) and leisure (p=0,02) between old peopleparticipants of the academies in different regions andthe most active in the Central two domains. Improveand maintain health were, respectively, the reasons ofentry and residence most cited. These reasons were similaramong regions. For the services rendered, 50,0%of the old people were dissatisfied while 97,4% weresatisfied with the infrastructure, with the suggestion forimproving the implementation of coverage, maintenanceand increase in the number of devices. We concludethat there?re regional differences in the level of PA andthat health is the main motivation for attending theseacademies. The services still require improvementssuch as supervision of physical education professionals.

Avaliação dos serviços de assistência ocular em população urbana de baixa renda da cidade de São Paulo - Brasil / Eye care services evaluation in a low-income urban population of São Paulo City - Brazil

OBJETIVO: Avaliar os serviços de assistência ocular do ponto de vista do usuário em população de baixa renda, na zona leste da cidade de São Paulo - Brasil. MÉTODOS: Estudo realizado por meio de inquérito domiciliar em uma amostra por conglomerados em três distritos de baixa renda da cidade de São Paulo - Brasil. No período de julho/2004 a janeiro/2005 foram realizadas 1.055 entrevistas com um representante do domicílio, sendo aplicado o questionário de responsividade aos serviços de assistência ocular em entrevista individual. RESULTADOS: Dos participantes, 71,56 por cento eram mulheres. A idade dos respondentes variou de 18 a 92 anos (41,42 ± 15,67 anos). Quanto à escolaridade, 525 (49,77 por cento) tinham 4 anos ou menos; 489 (46,35 por cento) entre 5 e 11 anos; 40 (3,79 por cento) 11 ou mais anos de estudo. Quanto à necessidade de utilização dos serviços de assistência ocular: 712 (67,49 por cento) relataram que algum morador do seu domicílio necessitou e obteve assistência ocular e 135 (12,80 por cento) nunca precisaram de assistência ocular. A barreira mais frequentemente citada para obtenção dos serviços de assistência ocular pelos respondentes foi o custo da consulta (77,29 por cento) seguida de tentativa frustrada de obtenção da assistência ocular (42,21 por cento). A frequência de avaliações positivas para os critérios contidos no questionário foi de 63,37 por cento. Dos 36,63 por cento respondentes insatisfeitos, o tempo de espera na sala de recepção dos serviços de assistência ocular foi o fator mais frequentemente apontado. CONCLUSÃO: As principais barreiras para obter assistência ocular foram o custo da consulta e a falta de acesso aos serviços, 63,37 por cento dos indivíduos que necessitaram e obtiveram assistência ocular nos últimos 12 meses mostraram-se satisfeitos.

PURPOSE: To evaluate eye care services from the user's perspective in a low income population from the east zone of the city of São Paulo - Brazil. METHODS: A household survey was performed using cluster sampling in three low income districts of the city of São Paulo - Brazil. From July/2004 to January/2005, 1055 interviews with an adult household representative were carried and an eye care system responsiveness questionnaire was administered through individual interview. RESULTS: 71.56 percent of the participants were women. Respondents' age ranged from 18 to 92 years (41.42 ± 15.67 years). Regarding schooling, 525 (49.77 percent) had four years or less; 489 (46.35 percent) between five and eleven years, 40 (3.79 percent) had eleven or more years of study. Eye care services need was reported as 712 (67.49 percent) declaring themselves or someone else of the household needing and obtaining services and 135 (12.80 percent) had never needed eye care. The most frequently cited barriers to obtain the eye care service by respondents was cost (77.29 percent), followed by unsuccessful attempt to obtain eye care (42.21 percent). General satisfaction for the criteria contained in the questionnaire was 63.37 percent. In the 36.63 percent dissatisfied respondents, the most frequently cited claim was the amount of time waited before consultation. CONCLUSION: The main barriers to obtain eye care services were cost of medical appointment and lack of access to the services. 63.37 percent of the individuals in need who had received eye care in last 12 months were satisfied with the service provided.

A comparative analysis on differences in school students health between urban and suburban areas in Beijing / 中华健康管理学杂志

Objective To explore whether differences in high school student health exist between urban and suburban areas in Beijing.Metheds To make comparative analysis on the related data collected from the physical examinations conducted in the 19 districts in Beijing for senior high school admission and college admission in 2007.Results Differences in student health(including height,weight,eyesight)exist between urban and suburban areas in Beijing.There is significant difference in eyesight(t=2.321,P=0.033)between urban and suburban junior school graduates in Beijing.There are significant difierences in height(t=2.617,P=0.018)and the incidence of overweight(t=4.650,P=0.000)between urban and suburban boys junior school graduates.There is significant difference in height(t=3.792,P=0.001)between girls.Conclusions The health condition of high school students is being affected by the overloaded study tasks and unhealthy lifestyle.which needs to be intervened.

Perfil dos diabéticos atendidos em unidades públicas de saúde / Profile of diabetic patients seen in public health units / Perfil de los pacientes diabéticos atendidos en unidades de salud pública

In Brazil, it is estimated that more than 7% of the population has diabetes, according to the new criteria recommended by the American Diabetes Association (1998) for diagnosis. The disease is associated with a sedentary lifestyle, obesity and increasing number of elderly persons. This study aimed to determine the profile of diabetic patients seen in public health services, to be certain interventions aimed at promoting health and improving quality of life. The study included 87 diabetic, 62% female and 38% male. Data were collected by a structured questionnaire and medical records. Most patients (79.3%) suffer from type 2 diabetes. About 41% had cardiovascular complications (30%), renal or visual, of which 80.3% were type 2 diabetics. The occurrence of hypertension and dyslipidemia was found in 24% and 2.5% of patients with cardiovascular complications, respectively. Kidney problems were observed in 5.7% of individuals. Approximately 7% had visual impairment.

No Brasil, estima-se que mais de 7% da população tenha diabetes, de acordo com o novo critério recomendado pela American Diabetes Association (1998) para diagnóstico da doença. A doença está associada ao sedentarismo, obesidade e número crescente da população idosa. Este estudo objetivou traçar o perfil dos diabéticos atendidos em serviços públicos de saúde, para que sejam determinadas intervenções, visando a promoção da saúde e melhoria da qualidade de vida. Participaram do estudo 87 diabéticos, 62% do sexo feminino e 38% do sexo masculino. Os dados foram coletados pela aplicação de questionário estruturado e de prontuário médico. A maioria dos pacientes estudados (79,3%) sofrem de diabetes do tipo 2. Cerca de 41% apresentaram complicações cardiovasculares (30%), renais ou visuais, entre os quais 80,3% eram diabéticos do tipo 2. A ocorrência de hipertensão arterial e dislipidemias foi identificada em 24% e 2,5% dos portadores de complicações cardiovasculares, respectivamente. Problemas renais foram observados em 5,7% dos indivíduos. Aproximadamente 7% do total apresentaram comprometimento visual.

En Brasil, se estima que más del 7% de la población tiene diabetes, según los nuevos criterios recomendados por la Asociación Americana de Diabetes (1998) para el diagnóstico. La enfermedad se asocia a un estilo de vida sedentario, la obesidad y el número cada vez mayor de personas de edad avanzada. Este estudio tuvo como objetivo determinar el perfil de los pacientes diabéticos atendidos en los servicios de salud pública, para ser ciertas intervenciones destinadas a promover la salud y mejorar la calidad de vida. En el estudio participaron 87 diabéticos, 62% mujeres y 38% hombres. Los datos fueron recolectados mediante un cuestionario estructurado y registros médicos. La mayoría de los pacientes (79,3%) sufren de diabetes tipo 2. Alrededor del 41% de complicaciones cardiovasculares (30%), renales o visuales, de los cuales 80,3% eran diabéticos tipo 2. La aparición de la hipertensión y la dislipidemia se encontró en 24% y el 2,5% de los pacientes con complicaciones cardiovasculares, respectivamente. Los problemas renales se observaron en el 5,7% de los individuos. Aproximadamente el 7% tienen discapacidad visual.