ABSTRACT
Abstract Background: The use of combined oral contraceptives (COC) is a risk factor for atherosclerotic disease, and physical exercise can minimize this condition. Objective: To verify if high intensity interval training (HIIT) promotes changes in the lipid and inflammatory profile of women using COC. Methods: Sequential crossover study with women aged 20-30 years, classified as irregularly active by the international physical activity questionnaire (IPAQ), when using COC. A physical-clinical assessment was performed with anthropometric measurements, VO2max, and analysis of lipid and inflammatory profile. Participants were divided into 2 groups: the initial intervention group (GII), which began practicing HIIT for 2 months, and the posterior intervention group (GIP), which remained inactive for the same period. The GII and GIP would then alternate their conditions. The collected data was divided into: Initial moment (IM), post-exercise moment (PEM) and post-inactivity (PIM). The statistical analyses were performed using the Statistical Package for the Social Sciences, adopting a significance level of p <0.05 . Results: Twelve women were evaluated. After crossing the GII and GIP data, there was a difference in the C-reactive protein values between the IM of 4 (1.6-6.3 mg/dL) vs. PEM 2 (1.5-5 mg/dL); as well as between the PEM vs. the PIM= 4 (1.5-5.8 mg/dL), with a p -value = 0.04 in the comparisons. There was no change between the "moments" of the lipid profile, although it was possible to notice a reduction in resting HR and an increase in indirect VO2max. Conclusion: The HIIT program was able to reduce the inflammatory profile, but it did not alter the lipid profile of irregularly active women using COC.
Subject(s)
Humans , Female , Adult , Young Adult , Contraceptives, Oral, Combined/adverse effects , Atherosclerosis/prevention & control , High-Intensity Interval Training , Cross-Sectional Studies , Atherosclerosis/etiology , Heart Disease Risk FactorsABSTRACT
Abstract Background: Atherosclerosis is a serious health problem, and several factors contribute to its occurrence. Longitudinal and qualified monitoring of primary health care (PHC) may contribute to the management of atherosclerosis and reduction of avoidable hospital admissions. Objectives: To estimate the trend in hospitalizations for atherosclerosis and the impact of PHC coverage on its evolution from 2008 to 2018 in Brazil. Methods: An ecological time series analytical study based on the outcomes of hospital admissions for atherosclerosis in Brazil. Time in years, PHC coverage, and Family Health Strategy (FHS) services were considered independent variables. A Prais-Winsten model was used to estimate the outcome trend, and α < 0.05 was adopted. Results: We observed a mean increase of 1.81 hospitalizations for atherosclerosis per 100 000 inhabitants annually (p = 0.002) in Brazil. This growth was evidenced in the Northeast (p < 0.001), Southeast (p = 0.003), and South (p < 0.001) regions, being stable in the North (p = 0.057) and Midwest (p = 0.62) regions. Men presented twice the growth in hospitalizations from the fifth decade of life on (p < 0.01). An inversely proportional relationship was observed for PHC coverage (B = -0.71; p < 0.001) and the proportion of FHS services (B = -0.59; p < 0.001) with the rate of admissions due to atherosclerosis in Brazil. Conclusions: Although hospitalizations for atherosclerotic complications are increasing in Brazil, they present regional and individual gender and age discrepancies, as well as a mitigating effect exerted by PHC coverage.
Subject(s)
Humans , Primary Health Care/methods , Atherosclerosis/complications , Atherosclerosis/prevention & control , Brazil/epidemiology , Time Series Studies , Environmental Health , Ecological Studies , Atherosclerosis/epidemiologyABSTRACT
Introducción: El síndrome metabólico constituye un hito en la investigación de evaluar mejor y de manera óptima el riesgo de enfermedad cardiovascular aterosclerótica. Objetivo: Analizar la correlación entre la capacidad predictiva del riesgo global de enfermedad cardiovascular aterosclerótica del síndrome metabólico y las tablas de riesgo: Framingham Risk Score, la tabla de la OMS/ISH y las de Gaziano, la ecuación PROCAM y el algoritmo QRISK2. Métodos: Se realizó una revisión documental, para lo cual se empleó la bibliografía nacional e internacional, especialmente la publicada en los últimos 5 años. Se utilizó el motor de búsqueda Google Académico y se consultaron artículos de libre acceso en las bases de datos Pubmed y SciELO desde marzo 2020 hasta el mes de enero 2021. Se emplearon como palabras clave: síndrome metabólico, riesgo cardiovascular global, método de estimación de riesgo y sus equivalentes en inglés. Las unidades de análisis fueron artículos originales, de revisión, incluyendo revisiones sistemáticas publicadas en los idiomas español e inglés. Fueron seleccionados 38 artículos (23 en idioma español, 15 en inglés) y 31 (81,5 por ciento) corresponden a los últimos 5 años. Conclusiones: El síndrome metabólico y los sistemas de estimación del riesgo global de enfermedad cardiovascular aterosclerótica no deben ser utilizados como equivalentes a causa de que su concordancia, en sentido general, es muy cuestionable. No obstante, se puede considerar como una herramienta útil en prevención primaria de la enfermedad cardiovascular aterosclerótica, siempre y cuando no sustituyan el juicio clínico y se contemplen todas las excepciones y precauciones posibles en el momento de su aplicación(AU)
Introduction: Metabolic syndrome is a milestone within the research to assess better and optimally the risk of atherosclerotic cardiovascular disease. Objective: To analyze the correlation between the predictive capacity for the global risk of atherosclerotic cardiovascular disease of metabolic syndrome and the risk tables: Framingham Risk Score, the WHO/ISH and Gaziano tables, the PROCAM equation, and the QRISK2 algorithm. Methods: A documentary review was carried out, using national and international literature, especially published within the last five years. The Google Scholar search engine was used and open-access articles were consulted in the Pubmed and SciELO databases, from March 2020 to January 2021. The keywords used were síndrome metabólico [metabolic syndrome], riesgo cardiovascular global [global cardiovascular risk], método de estimación de riesgo [risk estimation method] and their English equivalents. The units of analysis were original review articles, including systematic reviews published in Spanish and English. Thirty-eight articles were selected (23 in Spanish and fifteen in English), 31 (81.5 percent) of which correspond to the last five years. Conclusions: Metabolic syndrome and global risk estimation systems for atherosclerotic cardiovascular disease should not be used as equivalents because their concordance, in general, is very questionable. Nevertheless, they can be considered a useful tool in the primary prevention of atherosclerotic cardiovascular disease, as long as they do not replace clinical judgment and all possible exceptions or precautions are considered at the time of their application(AU)
Subject(s)
Humans , Male , Female , Middle Aged , Global Health , Metabolic Syndrome/epidemiology , Atherosclerosis/prevention & control , Heart Disease Risk Factors , Algorithms , Health Status Indicators , Risk Assessment/methodsSubject(s)
Humans , Male , Female , Middle Aged , Aged , Diabetes Mellitus/diagnosis , Atherosclerosis/complications , Atherosclerosis/prevention & control , Dyslipidemias/prevention & control , Dyslipidemias/drug therapy , Heart Disease Risk Factors , Tobacco Use Disorder/prevention & control , Tomography, X-Ray Computed/methods , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Stroke/prevention & control , Hypertension/therapy , Cholesterol, HDL/toxicity , Cholesterol, LDL/toxicityABSTRACT
Atherosclerotic cardiovascular disease is the general name of a series of diseases based on atherosclerosis. With the development of the social economy and the progress of population aging in China, the burden of atherosclerotic cardiovascular disease is increasing. However, in recent years some clinical studies have proved that the traditional blood lipid indicators, including low-density lipoprotein cholesterol, have some limitations in the risk control of atherosclerotic cardiovascular disease, and the blood lipid indicators need to be further supplemented and improved. This consensus expounds non-traditional blood lipid indexes from the perspectives of test and clinic, mainly including apolipoprotein B and lipoprotein a, non-high density lipoprotein cholesterol and lipoprotein residue, and non-fasting blood lipid. This consensus systematically expounds the pathophysiological mechanism of non-traditional blood lipid indexes, the relationship with cardiovascular disease, detection methods and performance, intervention, control and application in the state of cardiovascular disease, and gives the corresponding clinical expert suggestion.
Subject(s)
Humans , Atherosclerosis/prevention & control , Cardiovascular Diseases/prevention & control , Consensus , Lipids , Lipoproteins , Risk FactorsABSTRACT
El climaterio es una etapa fisiológica que permite al médico reconocer tempranamente los riesgos de patologías y la gran oportunidad de revertirlas. Este trabajo examinará la evidencia actual de la terapia hormonal en la prevención primaria de la enfermedad cardiovascular en mujeres, así como la importancia que igualmente tienen la indemnidad de los ovarios, el peso normal, el uso correcto de antibióticos, la preservación de la microbiota intestinal, las dietas antioxidantes, los estilos de vida saludables y el obligatorio abandono del hábito de fumar.
Subject(s)
Humans , Female , Climacteric/physiology , Menopause/physiology , Cardiovascular Diseases/prevention & control , Hormone Replacement Therapy , Heart Disease Risk Factors , Smoking/adverse effects , Andropause/physiology , Estradiol/therapeutic use , Atherosclerosis/prevention & control , Gastrointestinal Microbiome/drug effects , Healthy LifestyleABSTRACT
This study was designed to evaluate the role of short-chain fatty acid butyrate acid on intestinal morphology and function, and atherosclerotic plaque formation in apolipoprotein E-knockout (ApoE
Subject(s)
Animals , Humans , Mice , Apolipoproteins E/genetics , Atherosclerosis/prevention & control , Butyrates/pharmacology , Caco-2 Cells , Diet, High-Fat/adverse effects , Fatty Acids, Volatile , Mice, Inbred C57BL , Mice, Knockout , Plaque, AtheroscleroticABSTRACT
Abstract Cilostazol (CLZ) is a phosphodiesterase III inhibitor with antiplatelet and vasodilator properties. It has been recently verified that CLZ plays a significant role in the arteries by inhibiting the proliferation and growth of muscle cells, increasing the release of nitric oxide by the endothelium and promoting angiogenesis. Considering these promising effects, the use of nanocapsules may be an interesting strategy to optimize its pharmacokinetics and pharmacodynamics at the vascular level for preventing atherosclerosis. The aim of this study was to evaluate the effect of cilostazol-loaded nanocapsules in the abdominal aortic tunics and on the lipid profile of Wistar rats in order to investigate its potential role in the prevention of atherosclerosis. Thirty-two animals were divided into four groups of eight animals, with 30-day treatment. Group 1 received nanoencapsulated CLZ; Group 2, control nanocapsules with no drug; Group 3, propylene glycol and water; and Group 4, a solution of CLZ in propylene glycol and water. After 30 days, there was no statistically significant difference between the groups regarding the cellularity and thickness of the arterial tunics of the abdominal aorta. However, the group that received nanoencapsulated CLZ (Group 1) had an improvement in HDL-c and triglyceride values compared to unloaded nanocapsules (Group 2).
Subject(s)
Animals , Male , Rats , Vasodilator Agents/administration & dosage , Platelet Aggregation Inhibitors/administration & dosage , Nanocapsules/administration & dosage , Phosphodiesterase 3 Inhibitors/administration & dosage , Cilostazol/administration & dosage , Aorta, Abdominal , Propylene Glycols , Rats, Wistar , Disease Models, Animal , Atherosclerosis/prevention & control , Nitric OxideABSTRACT
Background: Functional foods such as flaxseed have been commonly consumed to prevent atherosclerosis. Objectives: To assess the effects of flaxseed in atherogenesis in rabbits consuming a high-cholesterol diet. Methods: Thirty male albino rabbits were randomized to three groups based on a 12-week dietary treatment: control group (G1), standard diet; high-cholesterol diet (G2), standard diet plus 0.25% cholesterol from lyophilized eggs; and high-cholesterol plus flaxseed (G3), similar diet as G2 plus flaxseed. Biochemical (total cholesterol [TC], high-density lipoprotein [HDL-C], low-density lipoprotein cholesterol [LDL-C], and triglycerides) and immunohistochemical (intercellular adhesion molecule 1 [ICAM-1] and tumor necrosis factor alpha [TNF- α ]) analyses were performed in all groups. P values < 0.05 indicated statistical significance. Results: At 12 weeks, serum TC levels increased significantly in G2 and G3 compared with G1. Serum LDL-C levels were higher in group G2, and the increase in group G3 was approximately six times lower than that in G2. HDL-C levels increased in all groups, with the highest increase observed in G2. Triglycerides levels in G3 decreased by ~70% and differed significantly in G1 and G3 (p = 0.034) and G2 and G3 (p = 0.015). ICAM-1 levels increased only in aortic segment 4 in G3. TNF- α levels in G3 were similar to those in the control group, while the levels in G2 were greater than twice as those in the control group (p < 0.05). Conclusions: The group fed with a functional diet (flaxseed) showed decreased development of atherosclerosis, reduced serum triglycerides levels, and lower TNF- α levels on immunohistochemistry
Fundamentos: Alimentos funcionais, como a linhaça, têm sido consumidos com frequência para prevenção da aterosclerose. Objetivos: Avaliar os efeitos da linhaça sobre a aterogênese em coelhos submetidos a uma dieta rica em colesterol. Métodos: Trinta coelhos albinos machos foram randomizados em três grupos com base em um tratamento dietético por 12 semanas: grupo controle (G1), dieta padrão; dieta rica em colesterol (G2), dieta padrão mais 0,25% de colesterol proveniente de ovos liofilizados; e dieta rica em colesterol mais linhaça (G3), dieta semelhante à do G2 adicionada de linhaça. Análise bioquímica (colesterol total [CT], lipoproteína de alta densidade [HDL-colesterol], lipoproteína de baixa densidade [LDL-colesterol] e triglicérides) e imunohistoquímica (molécula de adesão intercelular 1 [ICAM-1] e fator de necrose tumoral alfa [TNF- α ]) foram realizadas em todos os grupos. Valores de p < 0,05 indicaram significância estatística. Resultados: Às 12 semanas, os níveis séricos de CT aumentaram significativamente nos grupos G2 e G3 em comparação com o G1. Os níveis séricos de LDL-colesterol foram mais altos no grupo G2, e o aumento no grupo G3 foi cerca de seis vezes menor do que no G2. Os níveis de HDL-colesterol aumentaram em todos os grupos, com o maior aumento observado no G2. Os níveis de triglicérides no G3 reduziram em ~70% e diferiram significativamente entre o G1 e G3 (p = 0,034) e G2 e G3 (p = 0,015). Níveis de ICAM-1 aumentaram apenas no segmento aórtico 4 no G3. Os níveis de TNF- α no grupo G3 foram semelhantes aos do grupo controle, enquanto os níveis no G2 foram maiores do que o dobro em relação aos do grupo controle (p < 0,05). Conclusões: O grupo alimentado com uma dieta funcional (linhaça) mostrou redução no desenvolvimento de aterosclerose, níveis séricos mais baixos de triglicérides e níveis mais baixos de TNF- α à imunohistoquímica
Subject(s)
Animals , Rabbits , Flax , Hypercholesterolemia , Inflammation , Rabbits , Animal Experimentation , Atherosclerosis/etiology , Atherosclerosis/prevention & control , Cholesterol, Dietary , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Diet , Diet, Atherogenic/methods , Intervention Studies , Models, Animal , Obesity/therapy , Data Interpretation, StatisticalABSTRACT
Functional food intake has been highlighted as a strategy for the prevention of cardiovascular diseases by reducing risk factors. In this study, we compared the effects of oral treatment with soy milk and simvastatin on dyslipidemia, left ventricle remodeling and atherosclerotic lesion of LDL receptor knockout mice (LDLr-/-) fed a hyperlipidic diet. Forty 3-month old male LDLr-/- mice were distributed into four groups: control group (C), in which animals received standard diet; HL group, in which animals were fed a hyperlipidic diet; HL+SM or HL+S groups, in which animals were submitted to a hyperlipidic diet plus soy milk or simvastatin, respectively. After 60 days, both soy milk and simvastatin treatment prevented dyslipidemia, atherosclerotic lesion progression and left ventricle hypertrophy in LDLr-/- mice. These beneficial effects of soy milk and simvastatin were associated with reduced oxidative stress and inflammatory state in the heart and aorta caused by the hyperlipidic diet. Treatment with soy milk was more effective in preventing HDLc reduction and triacylglycerol and VLDLc increase. On the other hand, simvastatin was more effective in preventing an increase in total cholesterol, LDLc and superoxide production in aorta, as well as CD40L both in aorta and left ventricle of LDLr-/-. In conclusion, our results suggest a cardioprotective effect of soy milk in LDLr-/- mice comparable to the well-known effects of simvastatin.
Subject(s)
Animals , Male , Mice , Anticholesteremic Agents/administration & dosage , Atherosclerosis/prevention & control , Diet , Receptors, LDL/blood , Simvastatin/administration & dosage , Soy Milk/administration & dosage , Ventricular Remodeling/physiology , Mice, KnockoutABSTRACT
O objetivo desta tese é identificar e discutir suficiências e insuficiências da estratégia preventiva conhecida como rastreamento a busca sistemática por casos em uma subpopulação assintomática e de alto risco. E de fazê-lo à luz dos novos conhecimentos e tecnologias trazidos com o século XXI, das necessidades de uma população mais velha, mais urbana e submetida a diferentes estressores, da realidade atual dos sistemas de saúde (mais especificamente do nosso Sistema Único de Saúde) e da disponibilidade finita de recursos para o seu financiamento. O grupo de doenças investigado foi o das Doenças Crônicas Não Transmissíveis em especial a doença cardiovascular aterosclerótica e o câncer de mama. A tese foi escrita como um ensaio acadêmico a partir de revisão narrativa. A literatura médica tem modificado os limites que definem importantes doenças relacionadas à aterosclerose, com grande impacto no cálculo de suas prevalências. A diminuição dos limites que definem hipercolesterolemia, em relação ao colesterol sérico total, de 240 para 200 mg/dl, somou mais 42.647.000 pessoas ao grupo de doentes (+86%). O diagnostico e o tratamento deste grupo populacional são chamados de overdiagnosis e overtreatment ou sobrediagnóstico e sobretratamento. O uso de equações preditivas pode estar superestimando os riscos cardiovasculares em mais de 150%. Essa estratégia pode ter pouco impacto na redução da carga populacional de doença em fase clínica e pode levar à sobreutilização dos serviços de saúde e, consequente, diminuição de sua eficiência. O sobrediagnóstico do câncer de mama em uma população rastreada é de cerca de 11 a 19%. Estima-se ser necessário rastrear 400 mulheres com idade entre 50 e 70 anos, com mamografias bianuais, durante mais de 30 anos, para se evitar 1 morte. Para cada morte por câncer de mama evitada, cerca de 3 casos de sobrediagnóstico serão identificados e tratados. Com o surgimento de novos recursos terapêuticos, nos últimos 40 anos a sobrevida em cinco anos do câncer de mama vem aumentando, chegando a 85% nos países desenvolvidos, e a 60% nos países em desenvolvimento. Esse ganho tira eficiência da estratégia de rastreamento. A assimilação de novas tecnologias diagnósticas ao processo ainda não encontra respaldo na literatura
Subject(s)
Humans , Breast Neoplasms/prevention & control , Mass Screening/statistics & numerical data , Chronic Disease/prevention & control , Early Diagnosis , Atherosclerosis/prevention & controlABSTRACT
This paper outlines the position of the Department of Cardiovascular Prevention from the Chilean Society of Cardiology regarding the use of the "polypill". The international and local evidence regarding the benefits of the polypill compared to conventional therapy is reviewed. The benefits and some limitations of the polypill are outlined, along with cost-effective considerations. The increased adherence to treatment and the better clinical results of this strategy are put forward. The used of the polypill in different groups of subjects, especially those recovered from a recent myocardial in-farction, is recommended for individual patients and in Chilean cardiovascular prevention programs from the Ministry of Health.
Subject(s)
Humans , Atherosclerosis/prevention & control , Cardiovascular Agents/administration & dosage , Cardiovascular Diseases/prevention & control , Medication Adherence/statistics & numerical data , Atherosclerosis/epidemiology , Cardiovascular Diseases/epidemiology , Chile/epidemiology , Cost-Benefit Analysis , Risk Factors , Secondary PreventionSubject(s)
Male , Female , Humans , Adult , Middle Aged , Aged , Carotid Artery Diseases/epidemiology , Carotid Artery Diseases/prevention & control , Carotid Artery Diseases/therapy , Atherosclerosis/prevention & control , Atherosclerosis/therapy , Aspirin/adverse effects , Hydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacologyABSTRACT
Aims The present study verified the effect of propolis alone and its association with swimming in dyslipidemia, left ventricular hypertrophy and atherogenesis of hypercholesterolemic mice. Methods and Results The experiments were performed in LDLr–/– mice, fed with high fat diet for 75 days, and were divided into four experimental groups (n=10): HL, sedentary, subjected to aquatic stress (5 min per day, 5 times per week); NAT submitted to a swimming protocol (1 hour per day, 5 times per week) from the 16th day of the experiment; PRO, sedentary, submitted to aquatic stress and which received oral propolis extract (70 uL/animal/day) from the 16th day of the experiment; HL+NAT+PRO, submitted to swimming and which received propolis as described above. After 75 days, blood was collected for analysis of serum lipids. The ratio between the ventricular weight (mg) and the animal weight (g) was calculated. Histological sections of the heart and aorta were processed immunohistochemically with anti-CD40L antibodies to evaluate the inflammatory process; stained with hematoxylin/eosin and picrosirius red to assess morphological and morphometric alterations. The HL animals showed severe dyslipidemia, atherogenesis and left ventricular hypertrophy, associated with a decrease in serum HDLc levels and subsequent development of cardiovascular inflammatory process, characterized by increased expression of CD40L in the left ventricle and aorta. Swimming and propolis alone and/or associated prevented the LVH, atherogenesis and arterial and ventricular inflammation, decreasing the CD40L expression and increasing the HDLc plasmatic levels. Conclusion Propolis alone or associated with a regular physical activity is beneficial in cardiovascular protection through anti-inflammatory action. .
Objetivos O presente estudo verificou o efeito do própolis associação ou não com a natação na dislipidemia, na hipertrofia ventricular esquerda e aterogênese de camundongos hipercolesterolêmicos. Métodos e Resultados Os experimentos foram realizados em camundongos LDLr–/–, alimentados com dieta hiperlipídica por 75 dias, e divididos em quatro grupos experimentais (n = 10): HL, sedentários, foram submetidos ao estresse aquático (5 min por dia, cinco vezes por semana); NAT foram submetidos a um protocolo de natação (1 hora por dia, cinco vezes por semana) a partir do 16° dia do experimento; PRO, sedentários, submetidos a estresse aquático e que receberam extrato de própolis oral (70 uL / animal / dia) a partir do 16° dia do experimento; HL + NAC + PRO, submetidos a natação e que recebeu a própolis, como descrito acima. Após 75 dias, foi coletado sangue para análise do perfil lipídico. Calculou-se a relação entre o peso ventricular (mg) e o peso do animal (g). Os cortes histológicos do coração e aorta foram processados imunohistoquímicamente com anticorpos anti-CD40L para avaliar o processo inflamatório, corados com hematoxilina / eosina e picrossírius red, para avaliar as alterações morfológicas e morfométricas. Os camundongos HL apresentaram dislipidemia grave, aterogênese e hipertrofia do ventrículo esquerdo, associada a uma diminuição dos níveis plasmáticos de HDLc e o desenvolvimento subsequente do processo inflamatório cardiovasculares, caracterizada pelo aumento da expressão do CD40L no ventrículo esquerdo e na aorta. Natação e a própolis isolado e / ou associados preveniram a HVE, a aterogênese e a inflamação tanto na artéria quanto no ventrículo, diminuindo a expressão de CD40L, aumentando os níveis plasmáticos de HDLc. Conclusão A Própolis isolada ou associada a uma atividade física regular é benéfica na proteção cardiovascular através da ação anti-inflamatória. .
Subject(s)
Animals , Male , Mice , Atherosclerosis/prevention & control , Hypercholesterolemia/complications , Hypertrophy, Left Ventricular/prevention & control , Physical Conditioning, Animal , Propolis/administration & dosage , Swimming , Atherosclerosis/etiology , Hypertrophy, Left Ventricular/etiologyABSTRACT
Introdução: A morbi-mortalidade por DCV representa relevante problema de saúde pública da atualidade. Os mecanismos envolvidos na aterogênese envolvem a inflamação e resistência à insulina. Diante das evidências de que hábitos saudáveis são capazes reduzir eventos cardiovasculares e da baixa adesão à dieta saudável, foi elaborada a Dieta Cardioprotetora Brasileira DICA-Br, utilizando conceitos de densidade energética e de nutrientes para auxiliar a orientação dietética. Objetivo: Comparar os efeitos da DICA-Br com a orientação alimentar habitual do sistema de saúde pública quanto a fatores de risco tradicionais, biomarcadores circulantes de aterogênese e índice de resistência à insulina em sub-amostra do estudo matriz. A amostra incluiu 212 adultos que apresentaram prévio evento cardiovascular, alocados aleatoriamente para o grupo DICA-Br ou Controle (orientações alimentares habitualmente usadas no SUS). A DICA-Br diferencia-se pelo fato de incluir alimentos brasileiros e pela estratégia educacional. No basal e após 6 meses das intervenções foram obtidos dados clínicos e as concentrações de glicose de jejum, insulina, perfil lipídico, PCR, MCP-1,VCAM-1, ICAM-1 e selectina-E, comparados por testes t de Student ou equivalentes não paramétricos.
Background: Nowadays, morbidity and mortality due to CVD represent relevant public health problem. The mechanisms of atherogenesis involve inflammation and insulin resistance. Considering that healthy habits are able to reduce cardiovascular events and the low compliance to healthy diet, the Brazilian Cardioprotective Diet DICA-Br was proposed using concept of energy and nutrients density to help dietary guidance. Objective: To compare the effects of DICA-Br with the usual food orientation delivered by the public health system to traditional risk factors, circulating biomarkers of atherogenesis and insulin resistance index, in sub-study sample of the main study. The sample consisted of 212 adults with overt atherosclerosis, randomly allocated to the DICA-Br or Control group (usual dietary guidelines used in SUS). The differential of DICA-Br is that it includes Brazilian foods and the innovative educational strategy. At baseline and after 6 months of interventions, clinical data and fasting glucose, insulin, lipids, CRP, MCP-1, VCAM-1, ICAM-1 and E-selectin concentrations were obtained and compared by Student t test or the non-parametric correspondent ones.
Subject(s)
Atherosclerosis/prevention & control , Biomarkers/metabolism , Diet , Cardiovascular Diseases/prevention & control , Insulin Resistance , Secondary Prevention , Nutrition Programs , Randomized Controlled TrialABSTRACT
INTRODUCCIÓN: actualmente hay consenso en que el proceso aterosclerótico se inicia en la infancia, y la dislipidemia es uno de los principales factores de riesgo aterogénicos que deben ser estudiados, así como la valoración nutricional para una adecuada prevención. OBJETIVO: identificar algunas señales de aterosclerosis tempranas como el sobrepeso y las dislipidemias en adolescentes. MÉTODOS: se realizó un estudio descriptivo transversal de 372 adolescentes de la Secundaria Básica "Protesta de Baraguá". Se hicieron mediciones de peso, talla, índice de masa corporal y circunferencia de la cintura. Se tomó muestra de sangre venosa con ayuno de 12 horas. Se midió el colesterol total, el colesterol unido a lipoproteína baja y alta densidad, y triglicéridos. En el análisis estadístico se realizaron prueba de comprobación de media entre variables de valoración nutricional y lipídicas entre sexos (prueba t), y se trabajó con una probabilidad de error menor de 0,05. RESULTADOS: la media del peso, talla y circunferencia de la cintura fueron mayores en el sexo masculino (p< 0,05). El exceso de peso fue 23,7 %, y a partir del percentil 90-97 hubo un 21,8 % de exceso de grasa abdominal. La media del colesterol total, lipoproteínas de alta y baja densidad y triglicéridos, fue similar en los diferentes sexos, sin relación significativa (p> 0,05). El 18,5 % presentó colesterol total limítrofe alto, el 26,6 % tenía triglicéridos limítrofe alto y 7,5 % alto, con predominio del sexo femenino. CONCLUSIONES: alrededor de la cuarta parte de los adolescentes tenían exceso de peso e incremento de la grasa abdominal, casi la cuarta parte tenía el colesterol total limítrofe y alto, y la alteración lipídica observada con mayor frecuencia fue la hipertrigliceridemia.
INTRODUCTION: there is a current consensus that the atherosclerotic process begins at childhood and that dyslipidemia is one of the atherogenic risk factors to be studied together with the nutritional assessment for the adequate prevention of atherosclerosis. OBJECTIVE: to identify some early signs of atherosclerosis such as overweight and dyslipidemias in teenagers. METHODS: a cross-sectional descriptive study of 372 teenagers from "Protesta de Baragua" junior high school. Weight, height, body mass index and waist circumference were measured. Blood samples were taken after 12 hour fasting. Total cholesterol, low and high density lipoprotein cholesterol and triglyceride were all measured. The statistical analysis included the t test among nutritional assessment and lipid variables between sexes and the error probability was lower than 0.05. RESULTS: weight, height and waist circumference means were higher in males (p< 0.05). Overweight was 23.7 % and from the 90-97th percentile, the excessive abdominal fat was 21.8 %. The mean of total cholesterol, high and low density lipoproteins and triglycerides was similar in both sexes, with no significant relation (p> 0.05). In this group, 18.5 % of adolescents presented with borderline high total cholesterol, 26.6 % showed borderline high triglyceride rate and 7.5 % had high cholesterol, being females predominant. CONCLUSIONS: one fourth of adolescents approximately exhibited overweight and increased abdominal fat; almost 25 % had reached borderline and high total cholesterol whereas the most observed lipid disorder was hypertrigliceridemia.
Subject(s)
Humans , Adolescent , Hypertriglyceridemia/diagnosis , Hypertriglyceridemia/prevention & control , Weight Gain/physiology , Abdominal Fat/growth & development , Atherosclerosis/prevention & control , Dyslipidemias/prevention & control , Epidemiology, Descriptive , Cross-Sectional StudiesABSTRACT
Diferentes autores han descrito a la enfermedad periodontal como un factor de riesgo de ateroesclerosis. Este estudio tuvo como objetivo determinar la posible relación entre las bacterias periodontopatógenas y alteraciones cardiovasculares en modelos murinos con ingesta hiperlipídica. Se utilizaron 30 ratas Wistar divididas en un grupo control (n=5) y tres grupos experimentales (n=15): Grupo I (n=5): dieta normal e infectados; Grupo II (n=5): dieta hiperlipídica y sin infectar y Grupo III (n=5): dieta hiperlipídica e infectados. La infección del surco gingival se logró previa sedación a través de hilos de sutura contaminados, colocados durante 6 días consecutivos, con Pophyromonas gingivalis (P. gingivalis) (5x10a-4 UFC) y Agregatibacter actinomycetemcomitans (A. actinomycetemcomitans) (5x10-4 UFC) obtnidas de muestras de pacientes con periodontitis crónica. A los 30 días posinfección se fijaron muestras de corazón y arteria aorta para su procesamiento. En el grupo control no se encontraron alteraciones. En el grupo I se observó en el endocardio valvular abundante exudado fibrinoleucocitario y focos hemorrágicos. En el miocardio, neovascularización y sufusiones hemorrágicos y en la pared de vasos arteriales, engrosamiento intimal. En el grupo II se observaron depósitos lipídicos en el interior de las células endoteliales, estrías grasas y pequeños ateromas. El grupo III mostró en un 100 por ciento de los casos, placas ateromatosas bien detalladas con abundante depósito de colesterol, calcificaciones, hemorragias y neovascularización. La suma de estos factores de riesgo: dieta hiperlipídica e infección con bacterias periodontopatógenas, potenciarían la expresión de alteraciones cardíacas y coronarias, incrementando la formación de ateromas