Burden of non-communicable diseases attributable to population aging in China, 1990‒2050 / 中华预防医学杂志

Objective: The direction and intensity of population aging on the burden of non-communicable diseases (NCDs) in China from 1990 to 2019 were analyzed, and the burden of NCDs in 2050 was predicted. Methods: The disease-specific disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) in the Chinese population from 1990 to 2019 were obtained from the Global Burden of Disease Study.The differences in indicators from 1990 to 2019 were attributed to the contribution of age structure, population size, and all other causes. The Bayesian age-time-cohort models were used to predict DALYs from NCDs to 2050. Results: The absolute level of DALYs caused by NCDs increased by 7.460 million from 1990 to 2019, and the age structure contributed 186.0% (95% Uncertainty Intervals (UIs): 178.4%-193.6%), population size contributed 77.0% (95% UIs: 69.5%-80.8%), all other causes contributed -163.0% (95% UIs:-163.1%- -159.3%). DALYs caused by NCDs consist of 2.527 million YLLs and 4.934 million YLDs, in which the contribution of age structure to YLLs and YLDs was 414.6% (95% UIs: 396.2%-432.5%) and 69.1% (95% UIs: 66.7%-71.4%), respectively. From 2019 to 2050, the diseases with increased DALYs due to changes in age structure are cardiovascular diseases, neoplasms, chronic respiratory diseases, neurological disorders, sense organ diseases, diabetes and kidney diseases, musculoskeletal disorders, digestive diseases, mental disorders, and skin and subcutaneous diseases in descending order. Conclusions: From 1990 to 2019, except for skin and subcutaneous diseases, the burden of other NCDs attributable to population aging increased, mainly due to disability. By 2050, the burden of NCDsattributable to population aging will continue to rise.

La dispensarización de pacientes hipertensos en el Policlínico Rafael Echezarreta / The classification of hypertensive patients at Rafael Echezarreta Polyclinic

Introducción: Uno de los principales problemas de salud que afectan a la población de Cuba y del mundo es la hipertensión arterial. En San José de Las Lajas aparece dispensarizada como hipertensa el 14 por ciento de su población, pero se observan múltiples deficiencias en su dispensarización. Objetivo: Determinar la situación de la dispensarización de las personas que padecen hipertensión arterial en los consultorios del médico y la enfermera de la familia del policlínico Rafael Echezarreta del municipio San José. Métodos: Se realizó una investigación descriptiva rápida de corte transversal, en enero de 2020. Se revisaron las historias clínicas individuales de una muestra de 379 pacientes hipertensos, que representaron el 11 por ciento de los 3446 hipertensos registrados en el policlínico. Resultados: Solo cerca del 20 por ciento de los hipertensos estaba dispensarizados. A excepción de los grupos de edades extremas, en el resto predominó el sexo femenino. Con el aumento de la edad aumentó la proporción de pacientes hipertensos. Ninguno de los pacientes tenía evidencia registrada en su historia clínica de haber sido atendido en los últimos cuatro meses y casi el 68 por ciento del total no había sido visto hacía más de un año. Conclusiones: La dispensarización mantiene insuficiencias que no garantizan atención médica integral a la población, no se cumple la frecuencia mínima de evaluación establecida para cada grupo dispensarial y el método clínico presenta fallas en su aplicación. Por lo que se puede afirmar que existe un número potencial de pacientes hipertensos aún sin controlar(AU)

Introduction: One of the main health problems that affect Cuban and worldwide population is high blood pressure. In San José de Las Lajas municipality, 14 percent of its population appears to be hypertensive, but there are multiple deficiencies in its classification. Objective: To determine the situation of the classification of people suffering from arterial hypertension in the Family Doctor´s Offices belonging to Rafael Echezarreta polyclinic, San José municipality. Methods: A rapid cross-sectional descriptive research was conducted in January 2020. The individual medical records (HCIs) of a sample of 379 hypertensive patients were reviewed, representing 11 percent of the 3446 hypertensive patients registered in the polyclinic. Results: Only about 20 percent of hypertensive patients were classified. With the exception of the extreme age groups, the female sex predominated in the rest. With increasing age, the proportion of hypertensive patients increased. None of the patients had evidence recorded in their medical records of having been attended in the last four months and almost 68 percent of the total had not been attended more than a year ago. Conclusions: The classification has insufficiencies that do not guarantee comprehensive medical care to the population, the minimum frequency of evaluation established for each classification group is not met and the clinical method presents failures in its application. So it can be said that there is a potential number of hypertensive patients still uncontrolled(AU)

Estados depresivos en pacientes con enfermedades crónicas no transmisibles / Depressive States in Patients with Chronic Noncommunicable Diseases

Introducción: La relación entre las enfermedades crónicas no transmisibles y los trastornos mentales, como ansiedad y depresión, ocurren de modo bidireccional, es decir, que la presencia de una condición predispone el desarrollo de la otra. Objetivo: Indagar en la literatura revisada acerca de los aspectos relacionados con los estados depresivos en pacientes con enfermedades crónicas no transmisibles de mayor impacto en salud pública. Métodos: Investigación tipo documental por revisión bibliográfica sistemática de estudios sobre los estados depresivos y el padecimiento de enfermedades crónicas no transmisibles, publicados en revistas médicas de acceso abierto en español o inglés, que contribuyan a la comprensión del por qué la comorbilidad de estas enfermedades. Conclusiones: Un diagnóstico y control deficiente de las enfermedades crónicas no transmisibles y de los estados depresivos, pueden llevar a la falta de adherencia al tratamiento, lo que aumenta la morbimortalidad de las enfermedades crónicas no transmisibles. En los estados depresivos y las enfermedades crónicas no transmisibles se comparten mecanismos biológicos de actividad inmunológica que, en un complejo equilibrio, determinado por la activación de genes específicos, en conjunto contribuyen con la aparición de estados depresivos y agravamiento de las enfermedades crónicas no transmisibles. Es necesaria una visión integral a nivel diagnóstico y de control que permitan en conjunto decidir el tratamiento más adecuado según las características del paciente, para proceder con la derivación oportuna y apropiada en cada caso(AU)

Introduction: The relationship between chronic noncommunicable diseases and mental disorders, such as anxiety and depression, occur in a bidirectional way, that is, the presence of one condition predisposes the development of the other. Objective: To investigate, in the literature reviewed, about the aspects related to depressive states in patients with chronic noncommunicable diseases of major impact on public health. Methods: Documental research that consisted in the systematic literature review of studies about depressive states and being affected by chronic noncommunicable diseases, published in open access medical journals in Spanish or English and that contribute to the understanding the comorbidity of these conditions. Conclusions: Poor diagnosis and control of chronic noncommunicable diseases and depressive states can lead to lack of adherence to treatment, which increases the morbimortality of chronic noncommunicable diseases. Depressive states and chronic noncommunicable diseases share biological mechanisms of immune activity that, in a complex balance, determined by the activation of specific genes, together contribute to the onset of depressive states and aggravation of chronic noncommunicable diseases. It is necessary to have a comprehensive vision at the diagnostic and control levels that allows to decide together the most adequate treatment according to the patient's characteristics, in order to proceed with the opportune and appropriate referral in each case(AU)

Fatores associados à hipertensão arterial sistêmica e diabetes mellitus na população atendida pelo Projeto Vozes das Ruas em Jundiaí / Factors associated with systemic arterial hypertension and diabetes mellitus in the population served by the Vozes das Ruas Project in Jundiaí / Factores asociados a la hipertensión arterial sistémica y la diabetes mellitus en la población atendida por el proyecto Vozes das Ruas en Jundiaí

Introdução: As doenças crônicas não transmissíveis (DCNT) ­ incluindo diabetes (DM) e hipertensão arterial sistêmica (HAS) ­ são responsáveis por grande parte das mortes mundiais atualmente, sendo a identificação de fatores associados uma ferramenta fundamental para sua prevenção e estratégias de promoção da saúde. Objetivo: Determinar a prevalência de HAS e DM na população adulta atendida pelo Projeto Vozes das Ruas (PVR) em Jundiaí (SP) e fatores associados. Métodos: Os participantes do estudo transversal, conduzido de março a novembro de 2019, foram adultos acima de 18 anos, voluntários das ações de promoção de saúde do PVR em 2019, que consistiram na aplicação de um questionário sociodemográfico e de comportamentos em saúde; na avaliação de glicemia capilar, pressão arterial, peso, altura e circunferência abdominal; e posterior aconselhamento em saúde. Realizou-se análise descritiva dos dados para verificar a associação dos desfechos DM e HAS com variáveis independentes. Utilizaram-se teste χ2 e regressão logística multivariada para variáveis com p<0,20, adotando-se a significância de 5%. Resultados: A amostra foi composta de 580 participantes, 50% do sexo feminino e com idade média de 48,56 anos. A prevalência autodeclarada de DM foi 16,2% e de HAS, 30,2%. Os fatores associados em comum foram: faixa etária acima de 39 anos e uso de medicação contínua. Associados à DM foram: antecedente familiar de DM, uso de unidade básica de saúde, histórico de tabagismo. Em relação à HAS as associações foram: menos de oito anos de estudo, sobrepeso e obesidade. Conclusões: Na população estudada houve elevada prevalência de duas das principais DCNT ­ HAS e DM ­ que apresentaram fatores associados de extrema relevância para o planejamento de estratégias de promoção da saúde e prevenção de doenças.

Introduction: Chronic noncommunicable diseases (NCDs) ­ including diabetes mellitus (DM) and systemic arterial hypertension (SAH) ­ are responsible for most of the worldwide deaths today, and the identification of associated factors is an essential tool for their prevention and health promotion strategies. Objective: To determine the prevalence of SAH and DM in the adult population served by Projeto Vozes das Ruas (PVR) in Jundiaí, SP, Brazil and associated factors. Methods: A cross-sectional study was carried out from March to November 2019, with a sample of adults over 18 years of age, participating in PVR's health promotion actions in 2019, which consisted in the application of a sociodemographic and health behavior questionnaire, evaluation of capillary glucose, blood pressure, weight, height and waist circumference and subsequent health counseling. Descriptive analysis of the data was performed to determine the association of the outcomes DM and SAH with independent variables. A chi-square test was carried out and variables with p<0.20 were included in multivariate logistic regression (p<0.05). Results: The sample consisted of 50% females with an average age of 48.56 years. The self-reported prevalence of DM was 16.2% and SAH 30.2%, with a relationship between them. The common associated factors were: age group over 39 years and continuous-use medications. Associated with DM were family history of DM, use of basic health unit and smoking history. In relation to SAH the associations were less than eight years of schooling, overweight and obesity and smoking. Conclusions: In the population studied, there was a high prevalence of two of the main NCDs, SAH and DM, which presented risk factors of extreme relevance for the planning of health promotion and disease prevention strategies

Sociodemographic determinants of multimorbidity in Brazilian adults and older adults: a cross-sectional study

ABSTRACT BACKGROUND: Multimorbidity due to non-communicable chronic diseases (NCDs) constitutes a significant challenge for healthcare systems. To attenuate its impacts, it is essential to identify the sociodemographic determinants of this condition, which can discriminate against population segments that are more exposed. OBJECTIVE: To identify associations between multimorbidity conditions and sociodemographic indicators among Brazilian adults and older adults. DESIGN AND SETTING: Cross-sectional telephone-based survey in 26 Brazilian state capitals and the federal district. METHODS: The Vigitel 2013 survey was used, with data collected via a questionnaire. The outcome was multimorbidity (2, 3 or 4 NCDs), and the exposures were sociodemographic indicators (age, sex, skin color, marital status and education). The analysis consisted of multinomial logistic regression (odds ratio), stratified by age. RESULTS: Among adults, multimorbidity comprising two, three or four diseases was associated with advancing age (P < 0.001); two and three diseases, with having a partner (P = 0.004 and P < 0.001, respectively); and two, three or four diseases, with lower education (P < 0.001). Among older adults, two, three or four diseases were associated with female sex (P < 0.001); three diseases, with living with a partner (P = 0.018); two diseases, with black skin color (P = 0.016); and two or three diseases, with lower education (P < 0.001). CONCLUSIONS: To control and prevent multimorbidity, strategies for individuals with existing chronic diseases, with partners and with lower education levels are needed. Particularly for adults, advancing age should be considered; and for older adults, being a woman and having black skin color.

Estratégias para enfrentamento da mortalidade precoce por doenças crônicas não transmissíveis / Strategies for coping with early mortality from non-communicable chronic diseases

As Doenças Crônicas Não Transmissíveis (DCNTs) tendem a ser de longa duração e são o resultado de uma combinação de fatores genéticos, fisiológicos, ambientais e comportamentais. Tais agravos matam 41 milhões de pessoas a cada ano, o equivalente a 74% de todas as mortes no mundo, principalmente mortes prematuras, além de acarretar a perda de qualidade de vida, limitações e incapacidades, constituindo a maior carga de morbimortalidade. Sendo assim, esta síntese de evidências traz alguns pontos do Plano de Ações Estratégicas para o Enfrentamento das Doenças Não Transmissíveis no Brasil (2011-2022), que tem o intuito de reduzir a carga de DCNTs e evitar mortes prematuras, além de promover o desenvolvimento e a implementação de políticas públicas efetivas, integradas, sustentáveis e baseadas em evidências para a prevenção e o controle das DCNTs e seus fatores de risco e fortalecer os serviços de saúde voltados às doenças crônicas

Chronic Noncommunicable Diseases (NCDs) tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioral factors. Such diseases kill 41 million people each year, equivalent to 74% of all deaths in the world, mainly premature deaths, in addition to causing a loss of quality of life, limitations and disabilities, constituting the highest burden of morbidity and mortality. Therefore, this synthesis of evidence presents some points of the Strategic Action Plan for Combating Noncommunicable Diseases in Brazil (2011-2022), which aims to reduce the burden of NCDs and prevent premature deaths, in addition to promoting the development and the implementation of effective, integrated, sustainable and evidence-based public policies for the prevention and control of CNCDs and their risk factors and to strengthen health services aimed at chronic diseases

Behavioral risk factors for noncommunicable diseases associated with depression and suicide risk in adolescence / Fatores de risco comportamentais para doenças não transmissíveis associados à depressão e ao risco de suicídio em adolescentes / Factores de riesgo comportamentales para las enfermedades no comunicables asociadas con la depresión y el riesgo de suicidio en la adolescencia

Noncommunicable diseases (NCDs) and mental disorders cooccur in adulthood, which is why their determinants and common risk factors should be addressed at an early age. Therefore, we estimated the association of the major risk factors for NCDs with depression and suicide risk by structural equation modeling considering pathways triggered by social vulnerability or mediated by obesity. This population-based study included 2,515 Brazilian adolescents. The following exposures were the major risk factors for NCDs: substance use behaviors (variable deduced from alcohol, tobacco, and drug use), physical inactivity, and components of unhealthy eating markers (added sugar and saturated fat). Obesity was assessed using the fat mass index. The outcomes were depression and suicide risk. Depression was associated with substance use behaviors (SC = 0.304; p < 0.001), added sugar (SC = 0.094; p = 0.005), and females (SC = 0.310; p < 0.001). Suicide risk was also associated with substance use behaviors (SC = 0.356; p < 0.001), added sugar (SC = 0.100; p = 0.012), and females (SC = 0.207; p < 0.001). In adolescents, these associations may help explain the cluster of NCDs and mental disorders in adulthood.

As doenças não transmissíveis (DNT) e transtornos mentais podem ocorrer simultaneamente na vida adulta, razão pela qual seus determinantes e fatores de risco comuns devem ser abordados em idade precoce. Portanto, estimamos a associação entre os principais fatores de risco para DNT e a depressão e risco de suicídio através da modelagem de equações estruturais, considerando os caminhos desencadeados pela vulnerabilidade social ou mediados pela obesidade. Este estudo de base populacional incluiu 2.515 adolescentes brasileiros. As exposições foram os principais fatores de risco para DNT: comportamento de risco viciante (variável latente deduzida a partir do uso de álcool, tabaco e drogas), inatividade física e componentes da dieta não saudável (açúcar de adição e gordura saturada). A obesidade foi avaliada pelo índice de massa gorda. Os desfechos foram depressão e risco de suicídio. Comportamento de risco viciante (CP = 0,304; p < 0,001), açúcar de adição (CP = 0,094; p = 0,005) e sexo feminino (CP = 0,310; p < 0,001) estiveram associados à depressão. Comportamento de risco viciante (CP = 0,356; p < 0,001), açúcar de adição (CP = 0,100; p = 0,012) e sexo feminino (CP = 0,207; p < 0,001) também estiveram associados ao risco de suicídio. Comportamento de risco viciante e açúcar de adição estiveram associados à depressão e ao risco de suicídio em adolescentes, fato este que pode ajudar a explicar o agrupamento de DNT e transtornos mentais na vida adulta.

Las enfermedades no comunicables (ENTs) y los desórdenes mentales ocurren en la etapa adulta, un hecho que da impulso para dirigirse a sus determinantes y factores de riesgo comunes a una edad temprana. Por ello estimamos la asociación de los mayores factores de riesgo para ENTs con la depresión y riesgo de suicidio mediante un modelo de ecuación estructural, considerando trayectorias derivadas de la vulnerabilidad social o mediadas por la obesidad. Este estudio basado en población incluyó a 2.515 adolescentes brasileños. Las exposiciones fueron los mayores factores de riesgo para las ENTs: comportamiento en el uso de sustancias (variable latente deducida del alcohol, tabaco y consumo de drogas), inactividad física y componentes de marcadores de consumo de comida insana (azúcar añadido y grasas saturadas). La obesidad fue evaluada usando el índice de masa grasa. Los resultados fueron depresión y riesgo de suicidio. Los comportamientos en el uso de sustancias (CE = 0,304; p < 0,001), azúcar añadido (CE = 0,094; p = 0,005), y sexo femenino (CE = 0,310; p < 0,001) estuvieron asociados con depresión. Comportamientos en el consumo de sustancias (CE = 0,356; p < 0,001) y azúcar añadido (CE = 0,100; p = 0,012) y el sexo femenino (CE = 0,207; p < 0,001) estuvieron también asociados con el riesgo de suicidio. Los comportamientos en el consumo de sustancias y de azúcar añadido, estuvieron asociados con la depresión y el riesgo de suicidio en adolescentes, un hecho que puede ayudar a explicar la concentración de ENTs y desórdenes mentales en la etapa adulta.

Spatial lifecourse epidemiology in chronic non-communicable disease research / 中华流行病学杂志

In recent years, the research focus on determinants of chronic non-communicable diseases has shifted from non-spatial factors (e.g., lifestyle behaviors) to spatial factors (e.g., natural and built environments). As the intersection of lifecourse epidemiology and spatial epidemiology, spatial lifecourse epidemiology is a research area in the field of health geography. It combines advanced spatial technologies, including geographic information systems, surveying, remote sensing, location-based services and artificial intelligence, to accurately retrace, measure, and simulate individuals' exposures across the life course (i.e., exposome); and adopts lifecourse models, including the accumulation of risk model and critical/sensitive period models, to investigate the impact of individuals' exposures in the past on their health status at different stages of life. This paper introduces the theories, main analysis approaches and focus of spatial lifecourse epidemiology in the research of chronic non-communicable diseases for the purpose of better understanding and applications of spatial lifecourse epidemiology in the research of determinants of chronic non-communicable diseases, providing important reference for future research, facilitating the development of health geography to eventually achieve precise health management over the lifecourse.

Education-related health inequities in noncommunicable diseases: an analysis of the Brazilian National Health Survey, 2013 and 2019 / Inequidades relacionadas à escolaridade na prevalência de doenças crônicas não transmissíveis: uma análise da Pesquisa Nacional de Saúde, 2013 e 2019 / Inequidades de salud relacionadas con la educación en enfermedades no transmisibles: un análisis de la Encuesta Nacional de Salud brasileña, 2013 y 2019

This study assesses changes in the prevalence and distribution of noncommunicable diseases (NCDs) and related risk factors among Brazilian adults from the 2013 and 2019 Brazilian National Health Surveys (PNS). It is based on the hypothesis that deteriorating socioeconomic conditions over this period would lead to increased NCDs among the least advantaged populations. We estimated adjusted prevalence ratios by education category and three inequality measures - the slope index of inequality (SII), the relative index of inequality (RII), and population attributable fraction (PAF) - for obesity, hypertension, arthritis, asthma, cancer, depression, diabetes, heart disease, having any chronic condition, and multimorbidity by survey year. We also estimated the 27 Brazilian Federative Units RII and prevalence rates for diabetes and multimorbidity per year and plotted the RII against prevalence by year. Results showed that all NCDs increased over the period observed, ranging from an 8% increase in the adjusted prevalence of arthritis to a 24% increase in the adjusted prevalence of obesity. Measures of inequality showed that most conditions exhibited significant educational inequities in both 2013 and 2019. However, on average, education-based inequities did not significantly change between the two periods. Considering the deterioration of the socioeconomic conditions of most Brazilians, the erosion of social protections, and the continuing economic, political, and health crises occurring in the nation, we observed an urgent need for discussion about the best way to adopt equity-promoting health policies and programs and action to reduce socioeconomic and geographic inequalities in NCDs throughout the country.

O artigo avalia mudanças na prevalência e distribuição de doenças crônicas não transmissíveis (DCNTs) e fatores de risco associados entre adultos brasileiros nas edições de 2013 e 2019 da Pesquisa Nacional de Saúde (PNS), com base na hipótese de que a piora das condições socioeconômicas durante o período tenha levado a um aumento das DCNTs entre as populações mais vulneráveis. Estimamos razões de prevalência ajustadas por categoria de escolaridade e três medidas de desigualdade - índice de desigualdade absoluta (SII), índice relativo de desigualdade (RII) e fração atribuível à população (PAF) - para obesidade, hipertensão, artrite, asma, câncer, depressão, diabetes, doenças cardíacas, qualquer condição crônica e multimorbidade, por ano da pesquisa. Para as 27 Unidades da Federação, estimamos também as taxas de prevalência de diabetes e de multimorbidade por ano e cotejamos os RII com as taxas de prevalência por ano. Os resultados mostram que todas as DCNTs aumentaram ao longo do período de observação, desde um aumento de 8% na prevalência ajustada de artrite a um aumento de 24% na prevalência ajustada de obesidade. As medidas de desigualdade revelam que a maioria das DCNTs mostrou inequidades significativas em relação à escolaridade, tanto em 2013 quanto em 2019. Entretanto, em média, as inequidades com base na escolaridade não mudaram entre os dois períodos. Devido à deterioração das condições socioeconômicas para a maioria dos brasileiros, à erosão das proteções sociais e à continuação das crises econômica, política e sanitária enfrentadas pela nação, há necessidade urgente de um debate sobre as melhores políticas e programas de saúde para promover a equidade e reduzir desigualdades socieconômicas e geográficas das DCNTs em todo o país

Este trabajo evalúa los cambios en la prevalencia y distribución de las enfermedades no transmisibles (ENT) y factores de riesgo relacionados entre adultos brasileños en las Encuestas Nacionales de Salud (PNS) de 2013 y 2019 , basadas en la hipótesis de que las condiciones económicas en deterioro durante este período conducirían a ENTs entre los grupos de población menos favorecidos. Estimamos las ratios de prevalencia ajustados por categoría de educación y tres medidas de desigualdad -la curva del índice de desigualdad (SII), el índice relativo de desigualdad (RII), y la fracción atribuible de población (PAF)- para obesidad, hipertensión, artritis, asma, cáncer, depresión, diabetes, enfermedad cardiovascular, padeciendo alguna condición crónica, y multimorbilidad por año de encuesta. También estimamos 27 estados de RII y tasas de prevalencia para la diabetes y multimorbilidad por año, y se plantearon los RII frente a la prevalencia por año. Los resultados muestran que todas las ENTs se incrementaron durante el período observado, yendo desde un 8% de incremento en la prevalencia ajustada por artritis hasta un 24% de incremento en la prevalencia ajustada por obesidad. Las medidas de desigualdad muestran que la mayoría de las condiciones expuestas presentan inequidades educacionales significativas, tanto en 2013, como en 2019. No obstante, como promedio, las inequidades relacionadas con la educación no cambiaban significativamente durante los dos períodos. Debido al deterioro de las condiciones socioeconómicas de la mayoría de los brasileños, la erosión de la protección social, y las continuas crisis económicas, políticas, y de salud, que enfrenta la nación, existe una urgente necesidad de debatir sobre el mejor camino para adoptar medidas que promuevan la equidad en las políticas de salud y sus programas, así como acciones para conseguir reducciones en las desigualdades socioeconómicas y geográficas en las ENTs en todo el país.

Prevalência de consumo de alimentos ultraprocessados, álcool, tabaco e doenças crônicas não transmissíveis em Rio Branco, Acre, 2019: análise comparativa de dois inquéritos epidemiológicos / Prevalencia de consumo de alimentos ultraprocesados, alcohol, tabaco y enfermedades crónicas no transmisibles en Rio Branco, Acre, Brasil, 2019: análisis comparativo de dos encuestas epidemiológicas / Prevalence of ultra-processed food, alcohol and tobacco consumption and chronic non-communicable diseases in Rio Branco, capital city of the state of Acre, Brazil, 2019: comparative analysis of two epidemiological surveys

Objetivo: Descrever, comparativamente, as prevalências de doenças crônicas não transmissíveis, consumo de alimentos ultraprocessados, álcool e tabaco, estimadas pelo Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel) e pela Pesquisa Nacional de Saúde (PNS), em Rio Branco, Acre, Brasil. Métodos: Estudo transversal, sobre dados sociodemográficos, de saúde e estilo de vida de inquéritos realizados em 2019. Foram descritas as prevalências e intervalos de confiança de 95% (IC95%), e calculadas as diferenças percentuais. Resultados: Dos 3.037 indivíduos avaliados, observaram-se prevalências similares com diferença para pessoas de raça/cor da pele parda, entre Vigitel (60,3%; IC95% 56,2;64,3) e PNS (70,8%; IC95% 67,4;73,9). Na estratificação por sexo, diferenças percentuais entre os inquéritos foram observadas para obesidade (masculino= 6,5%; feminino= 0,4%), tabagismo (masculino= 4,0%; feminino= -1,5%) e consumo abusivo de álcool (masculino= 6,9%; feminino= -2,5%), embora com IC95% sobrepostos. Conclusão: As estimativas avaliadas em ambos os inquéritos foram similares.

Objetivo: Comparar la prevalencia de enfermedades crónicas no transmisibles, consumo de alimentos ultraprocesados, alcohol y tabaco, según el Sistema de Vigilancia de Factores de Riesgo y Protección de Enfermedades Crónicas por Encuesta Telefónica (Vigitel) y por la Encuesta Nacional de Salud (PNS), en Rio Branco, Acre. Métodos: Estudio transversal, utilizando variables sociodemográficas, salud y estilo de vida de encuestas de 2019. Se describieron prevalencias e intervalos de confianza al 95% (IC95%) y se calcularon diferencias porcentuales. Resultados: En los 3.037 individuos evaluados, hubo similitud en la prevalencia, con diferencia en raza/color de piel parda en Vigitel (60,3%; IC95% 56,2;64.3) y en PNS (70,8%; IC95% 67,4;73,9). En la estratificación por sexo, se observaron diferencias porcentuales entre las encuestas para obesidad (hombres= 6,5%; mujeres= 0,4%), tabaquismo (hombres= 4,0%; mujeres= -1,5%) y abuso de alcohol (hombres= 6,9%; mujeres= -2,5%), pero con IC95% superpuesto. Conclusión: Las encuestas arrojaron estimaciones similares.

Objective: To describe, in a comparative manner, the prevalence of chronic non-communicable diseases and ultra-processed food, alcohol and tobacco consumption, estimated by the Chronic Disease Risk and Protective Factors Surveillance Telephone Survey (Vigitel) and National Health Survey (PNS), in Rio Branco, capital city of the state of Acre, Brazil. Methods: This was a cross-sectional study on sociodemographic, health and lifestyle data from surveys conducted in 2019. Prevalence and 95% confidence intervals (95%CI) were described, and percentage difference was calculated. Results: Of the 3,037 individuals assessed, similar prevalence, with difference between Vigitel (60.3%; 95%CI 56.2;64.3) and PNS (70.8%; 95%CI 67.4;73.9) regarding people of Brown race/skin color was found. In the stratification by sex, it could be seen percentage difference between the surveys, regarding obesity (male= 6.5%; female= 0.4%), smoking (male= 4.0%; female= -1.5%) and alcohol abuse (male= 6.9%; female= -2.5%), although with overlapping 95%CI. Conclusion: The estimates assessed in both surveys were similar.

Clustering of behavioral risk factors for chronic noncommunicable diseases in climacteric women

ABSTRACT Objective To estimate the prevalence of clustering of behavioral risk factors for chronic non-communicable diseases, as well as the associated factors in climacteric women. Methods This is a cross-sectional, analytical study, with random selection of climacteric women, aged between 40 and 65 years, and registered in Family Health Strategy units. The dependent variable was clustering of three or more behavioral risk factors for chronic non-communicable diseases. The definition of associated variables was made after Poisson multiple regression analysis with robust variance. Results We evaluated 810 women, and 259 (32.0%) had a clustering of risk factors. The main risk behaviors were physical inactivity and low fruit consumption. The variables associated with clustering of behavioral factors were age group 52-65-years, marital status without a partner, overweight/obesity, moderate to severe anxiety and depression symptoms. Conclusion There was a considerable prevalence of women with three or more behavioral risk factors for chronic non-communicable diseases. Demographic variables and those related to health conditions were shown to be associated. Considering the results recorded, health services must provide differentiated care policies to climacteric women, seeking to alleviate high morbidity and mortality of chronic non-communicable diseases.

Desigualdades nos comportamentos de risco para doenças crônicas não transmissíveis: Vigitel, 2019 / Inequalities in risk behaviors for chronic noncommunicable diseases: Vigitel, 2019 / Desigualdades en los comportamientos de riesgo sobre las enfermedades crónicas no transmisibles: Vigitel, 2019

O objetivo foi analisar as desigualdades econômica, racial e geográfica nos comportamentos de risco para doenças crônicas não transmissíveis dos adultos brasileiros. Estudo transversal realizado com os dados do Vigitel (Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico) de 2019. Os comportamentos de risco analisados foram tabagismo, consumo abusivo de álcool, inatividade física, excesso de peso, consumo regular de refrigerante ou suco artificial e consumo não regular de frutas, legumes e verduras. As desigualdades nos comportamentos de risco foram avaliadas considerando escolaridade e macrorregião de moradia dos brasileiros, por meio do índice de desigualdade absoluta (slope index of inequality - SII). Gráficos equiplots também foram construídos para melhor ilustrar as desigualdades. Para todas as análises, foi utilizado o comando svy do Stata devido à complexidade do processo amostral. Foram avaliados 52.395 indivíduos. Desigualdades importantes nos comportamentos de risco para doenças crônicas não transmissíveis foram observadas: ter baixa escolaridade concentrou a grande maioria dos comportamentos de risco. Tabagismo e consumo de refrigerante foram mais observados na Macrorregião Sul do país. São necessárias políticas públicas que visem reduzir as desigualdades encontradas, permitindo a melhoria nos indicadores de saúde da população brasileira.

This study analyzes the economic, racial, and geographic inequalities in risk behaviors for chronic non-communicable diseases of Brazilian adults. This is a cross-sectional study conducted with data from the 2019 Vigitel (Risk and Protective Factors Surveillance System for Chronic Noncomunicable Diseases Through Telephone Interview). The analyzed risk behaviors were smoking, alcohol abuse, physical inactivity, overweight, regular consumption of soft drinks or artificial juice drinks, and non-regular consumption of fruits, legumes, and vegetables. Inequalities in risk behaviors were assessed considering Brazilian's schooling level and their dwelling region, via the slope index of inequality (SII). Equiplots graphs were also built to better illustrate the inequalities. Stata svy command was used for all analyses due to the complexity of the sampling process. In total, 52,395 patients were evaluated. Significant inequalities in risk behaviors for chronic non-communicable diseases were observed: most risk behaviors were concentrated in those with low schooling. Smoking and soft drinks consumption were more observed in the Southern region of Brazil. Public policies are necessary to reduce the inequalities found, allowing for improvement in health indicators of the Brazilian population.

El objetivo fue analizar las desigualdades económicas, raciales y geográficas en los comportamientos de riesgo sobre las enfermedades crónicas no transmisibles entre los adultos brasileños. Estudio transversal, realizado con los datos de Vigitel (Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas No Transmisibles por Entrevista Telefónica) 2019. Los comportamientos de riesgo analizados fueron el tabaquismo, el abuso del alcohol, la inactividad física, el sobrepeso, el consumo habitual de refrescos o zumos artificiales y el consumo no habitual de frutas, verduras y legumbres. Las desigualdades en los comportamientos de riesgo se evaluaron teniendo en cuenta la educación y el macrorregión de residencia de los brasileños, mediante el índice de inequidad absoluto (slope index of inequality - SII). También se construyeron gráficos equiplot para ilustrar mejor las desigualdades. Para todos los análisis, se utilizó el comando svy de Stata debido a la complejidad del proceso de muestreo. Se evaluó a un total de 52.395 personas. Se observaron importantes desigualdades en los comportamientos de riesgo para las enfermedades crónicas no transmisibles: tener un bajo nivel educativo concentró la gran mayoría de los comportamientos de riesgo. El tabaquismo y el consumo de refrescos se observaron más en la región Sur del país. Se necesitan políticas públicas para reducir las desigualdades encontradas, permitiendo la mejora de los indicadores de salud de la población brasileña.

Riesgo cardiovascular global en tres casas de abuelos del municipio Boyeros / Global Cardiovascular Risk in three Elderly Homes from Boyeros Municipality

Introducción: En Cuba, las enfermedades cardiovasculares constituyen la primera causa de muerte. La estratificación del riesgo cardiovascular mediante escalas es un pilar fundamental para tomar decisiones terapéuticas en el primer nivel de atención. Objetivos: Determinar el riesgo cardiovascular global en personas mayores de 60 años de las tres casas de abuelos del municipio Boyeros, La Habana. Métodos: Se realizó un estudio observacional descriptivo de corte transversal. El universo de estudio lo constituyeron 130 personas pertenecientes a tres casas de abuelos del municipio Boyeros, La Habana. De ellas se entrevistaron a 103 de las personas en el período de enero del 2016 a febrero del 2017. Se realizó el cálculo del riesgo cardiovascular global siguiendo los criterios de las tablas de predicción del riesgo cardiovascular global de la Organización Mundial de la Salud. Las variables descriptivas se expresaron en porcentajes y para la comparación de dos variables en estudio se utilizó el método estadístico no paramétrico de Ji cuadrado con un nivel de significación de 0,05. Resultados: De las personas estudiadas, 61,17 por ciento fueron del sexo femenino, 53,4 por ciento tenía entre 60 y 69 años; 65,05 por ciento presentó hipertensión arterial; 47,57 por ciento presentó riesgo moderado y 55,34 por ciento tenía cifras de colesterol total por encima de 6 mmol/L. Conclusiones: Predominó el riesgo cardiovascular global moderado. Las cifras elevadas de presión arterial, la diabetes mellitus y la hipercolesterolemia fueron los factores de riesgo modificables que más se asociaron con el aumento del riesgo cardiovascular global(AU)

Introduction: In Cuba, cardiovascular diseases are the leading cause of death. Cardiovascular risk stratification by means of scores is a significant tool for making therapeutic decisions at the first level of healthcare. Objectives: To determine global cardiovascular risk in people older than sixty years from the three elderly homes of Boyeros Municipality, Havana. Methods: A descriptive, cross-sectional and observational study was carried out. The study universe was made up of 130 people belonging to three elderly homes from Boyeros Municipality, Havana. Of the participants, 103 were interviewed in the period from January 2016 to February 2017. Calculation of global cardiovascular risk was performed following the criteria of the World Health Organization's prediction tables for global cardiovascular risk. Descriptive variables were expressed in percentages, while, for the comparison of two variables under study, the nonparametric chi-square statistical method was used with a significance level of 0.05. Results: Of the people studied, 61.17 percent were female, 53.4percent were between aged 60-69 years, 65.05percent presented arterial hypertension, 47.57percent presented moderate risk, and 55.34percent had total cholesterol levels above 6 mmol/L. Conclusions: Moderate global cardiovascular risk predominated. Elevated blood pressure, diabetes mellitus and hypercholesterolemia were the modifiable risk factors most associated with increased overall cardiovascular risk(AU)

Hábitos tóxicos y enfermedades crónicas no transmisibles en una población de la tercera edad / Toxic Habits and Chronic Noncommunicable Diseases in an Aged Population

Introducción: Los hábitos tóxicos son uno de los principales factores que convierten a las enfermedades crónicas no transmisibles en una importante causa de morbilidad y mortalidad. Objetivo: Describir la presencia de enfermedades crónicas no transmisibles y hábitos tóxicos como el consumo de café, alcohol y tabaco en una población de la tercera edad. Métodos: Se realizó un estudio descriptivo en el Consultorio médico 20 del municipio Arroyo Naranjo de La Habana entre octubre de 2018 y mayo de 2019. La población en estudio estuvo conformada por 365 pacientes geriátricos con diagnóstico de enfermedades crónicas no transmisibles. Las variables analizadas fueron edad, sexo, enfermedades crónicas no transmisibles asociadas y sustancias tóxicas consumidas. Los datos fueron obtenidos mediante revisión de historias clínicas y entrevistas realizadas a cada paciente. Los resultados se expresaron mediante tablas y gráficos estadísticos. Resultados: Predominó el sexo femenino y la hipertensión arterial como enfermedad de mayor prevalencia. La enfermedad pulmonar obstructiva crónica fue mayor en hombres y fueron estos los más fumadores. La presencia de úlceras y el consumo de café fueron mayores en las mujeres. En los pacientes entre 60-71 años fue donde se encontró el mayor número de hipertensos y los mayores consumidores de bebidas alcohólicas. Los del grupo 72-82 años fueron los mayores consumidores de tabaco y los más afectados por el asma bronquial. Conclusiones: Las enfermedades crónicas no transmisibles constituyen un problema de salud en la población estudiada. Los hábitos tóxicos detectados se asocian a la presencia de dichas enfermedades en los pacientes estudiados(AU)

Introduction: Toxic habits are one of the main factors that make chronic noncommunicable diseases an important cause of morbidity and mortality. Objective: To describe the presence of chronic noncommunicable diseases and toxic habits such as consumption of coffee, alcohol and tobacco in an elderly population. Methods: A descriptive study was carried out in the family medical office # 20 of the Arroyo Naranjo Municipality, Havana, between October 2018 and May 2019. The study population consisted of 365 geriatric patients diagnosed with chronic noncommunicable diseases. The variables analyzed were age, sex, associated chronic noncommunicable diseases and toxic substances consumed. The data were obtained by reviewing medical records and through interviews with each patient. The results were expressed using statistical tables and graphs. Results: In the research, the female sex predominated, together with arterial hypertension as the most prevalent disease. Chronic obstructive pulmonary disease was higher in men, who also accounted for the higher number of smokers. The presence of ulcers and coffee consumption were higher among women. It was in patients aged 60-71 years where the highest number of hypertensive patients and the highest consumers of alcoholic beverages were found. Those in the 72-82 age group were the greatest tobacco consumers and the most affected by bronchial asthma. Conclusions: Chronic noncommunicable diseases are a health concern in the studied population. The toxic habits detected are associated with the presence of these diseases in the patients studied(AU)