ABSTRACT
Abstract The prevalence of depression varies from 1 to 17% in different geographic regions, and its incidence is 70% higher in women than men. Today, depression affects more than 300 million people worldwide, affecting twice as many women from adolescence to adulthood. In addition to this earlier onset, depression in women tends to be more severe. Cardiovascular disease and depression are chronic diseases that have a major impact on cardiovascular and all-cause morbidity and mortality, with evidence of a two-way relationship between them, in which depression is a predictor of cardiovascular disease and vice versa. In females, the degree of illness and prognosis are more severe when both diseases are present, than when diagnosed alone. In patients with acute or chronic cardiovascular disease, especially women, a systematic screening for depression should be considered as a preventive strategy of cardiovascular events, aiming to reduce the risk of future events. There are still no clinical studies designed to assess the impact of antidepressant treatment on cardiovascular outcomes in women.
Subject(s)
Humans , Female , Cardiovascular Diseases/complications , Depression/complications , Prognosis , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/epidemiology , Depression/diagnosis , Depression/epidemiologyABSTRACT
Antecedentes: aunque la enfermedad cardiovascular (ECV) es la principal causa de muerte de las mujeres en Uruguay, ellas no lo perciben. Objetivos: el propósito de este estudio fue evaluar la percepción, el conocimiento y las conductas de prevención de las ECV entre mujeres por grupos de edad, nivel socioeconómico (NSE) y región, así como su conocimiento sobre factores de riesgo, síntomas y comportamientos cardiosaludables. Métodos: en 2020 se encuestaron vía web 700 mujeres de entre 20 y 70 años, residentes en Uruguay (Montevideo: 301, interior del país: 399). Se pautó publicidad en redes sociales para convocar a la población objetivo a participar. Las integrantes de la muestra, que completaron una encuesta autoadministrada, presentaban distribución similar a la población general en cuanto al NSE y la edad. Resultados: las mujeres encuestadas percibieron a la ECV como principal problema de salud (PS) en el 10% y como primera CM en el 18%. Las montevideanas, comparadas con las del interior, tuvieron mayores niveles de percepción (PS: 13% vs. 7%-CM: 20% vs. 17%); así como las de NSE alto vs. las de medio-bajo (PS: 17% vs. 8%-CM: 29% vs. 14%). La percepción y el conocimiento sobre ECV son bajos, las jóvenes son las menos informadas (escasos/muy escasos: 62%). Los médicos advierten poco sobre síntomas (23%) y estrategias de prevención (48%). Conclusión: la percepción de las mujeres encuestadas sobre la ECV es baja, existiendo brechas por edad, NSE y región. En la consulta, los médicos informan poco sobre el tema. Es necesario un esfuerzo continuo para mejorar la percepción de las mujeres sobre la ECV en su propio género, intentando llegar principalmente a las poblaciones de mayor riesgo.
Background: although cardiovascular disease (CVD) is the main cause of death for women in Uruguay, they do not perceive it. Objectives: the purpose of this study was to evaluate the perception, knowledge, and prevention behaviors of CVD among women by age group, socioeconomic level (SEL), and region, as well as knowledge of risk factors, symptoms, and heart-healthy behaviors. Method and result: online survey of 700 women residents of Uruguay (Montevideo: 301, interior of the country: 399), was conducted in 2020, ages between 20 and 70 years. Advertising was scheduled on social networks, calling the target population to participate in that research by completing a selfadministered survey, obtaining a set of cases with a similar distribution to the general population in terms of SEL and age. CVD was perceived in 10% as the main health problem (HP) and 18% as the first CD. Women from Montevideo vs. interior had higher levels of perception (HP: 13% vs. 7%-CD: 20% vs. 17%); as well as those of high vs. those of mediumlow SEL (HP: 17% vs. 8%-CD: 29% vs. 14%). The perception and knowledge about CVD are low, with young women being the least informed (little/very little: 62%). Doctors report little on symptoms (23%) and prevention (48%). Conclusion: the perception of the women surveyed about CVD is low, with gaps by age, NSE and region. Doctors inform little about this topic during clinical visits. A continuous effort is necessary to improve women's perception of CVD in their own gender, trying to reach mainly the populations at greatest risk.
Antecedentes: embora a doença cardiovascular (DCV) seja a principal causa de morte das mulheres no Uruguai, elas não a percebem. Objetivos: o objetivo deste estudo foi avaliar a percepção, conhecimento e comportamentos de prevenção de DCV entre mulheres por faixa etária, nível socioeconômico (NSE) e região, bem como o conhecimento de fatores de risco, sintomas, doenças cardíacas e comportamentos saudáveis para o coração. Método e resultado: em 2020, 700 mulheres entre 20 e 70 anos, residentes no Uruguai, foram entrevistadas via web (Montevidéu: 301, interior do país: 399). A publicidade foi agendada nas redes sociais, convocando a população alvo a participar da referida pesquisa através do preenchimento de um inquérito autoaplicável, obtendose um conjunto de casos com distribuição semelhante à população geral em termos de NSE e idade. As mulheres pesquisadas perceberam a DCV como principal problema de saúde (PS) em 10% e como principal CM em 18%. As mulheres de Montevidéu vs. interior apresentaram níveis mais elevados de percepção (PS: 13% vs. 7%-CM: 20% vs. 17%); bem como as de NSE alto vs. as de médiobaixo (PS: 17% vs. 8%-CM: 29% vs. 14%). A percepção e o conhecimento sobre DCV são baixos, sendo as mulheres jovens as menos informadas (pouco/muito pouco: 62%). Os médicos informam pouco sobre síntomas (23%) e prevenção (48%). Conclusão: a percepção das mulheres pesquisadas sobre DCV é baixa, com diferenças por idade, NSE e região. Os médicos informam pouco sobre esse tema durante as consultas clínicas. É necessário um esforço contínuo para melhorar a percepção das mulheres sobre as DCV em seu próprio gênero, tentando atingir principalmente as populações de maior risco.
Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Young Adult , Perception , Cardiovascular Diseases/prevention & control , Health Knowledge, Attitudes, Practice , Socioeconomic Factors , Uruguay/epidemiology , Cardiovascular Diseases/epidemiology , Cross-Sectional Studies , Risk Factors , Health Surveys , Cause of Death , Age DistributionABSTRACT
Background: Coronary artery disease represents the condition with the highest prevalence worldwide. The treatment of this disease is through Percutaneous Coronary Intervention (PCI). Aiming: To outline the clinical epidemiological profile of health users who have undergone PCI, in a Hospital in the state of Rio Grande do Sul. Methods: Exploratory research, with a quantitative approach carried out on 188 medical records of health users who were submitted to elective or emergency PCI, with the use of stents or not in the year 2018. Values of p <0.05 represented significant statistical differences. Results: Users with a diagnosis of unstable angina (n = 16; 17.8%), diagnostic symptoms of unstable angina (n = 61; 67.8%) and a diagnosis of angina pectoris (n = 52; 57.8%) presented significantly more likely to be submitted to the PCI in elective way (p <0.001). Users diagnosed with Acute Myocardial Infarction - AMI (n = 59; 60.2%) and symptoms with evolution greater than 24 hours (n = 30; 30.6%) and less than 24 hours (n = 24; 24.5%), with dyslipidemia (n = 38; 38.8%) and who underwent catheterization on the same day (n = 87; 88.8%) are significantly more likely to perform emergency surgery (p <0.05). In addition, the data showed that the diagnosis of unstable angina potentiates new cardiomyopathies (n = 9, 47.4%; p <0.001) and restenosis (n = 5; 26.3%; p = 0.002). Conclusion: It is necessary to create strategies to strengthen the Health Care Network (HCN) with actions for prevention, promotion and rehabilitation to health, aiming quality in diagnosis, treatment and rehabilitation.
ntrodução: A doença arterial coronariana representa a afecção de maior prevalência mundial. O tratamento desta doença se dá pela intervenção coronária percutânea (ICP). Objetivo: Delinear o perfil clínico-epidemiológico dos usuários de saúde submetidos à ICP em um Hospital do estado do Rio Grande do Sul. Métodos: Pesquisa exploratória, de abordagem quantitativa realizada em 188 prontuários de usuários de saúde submetidos à ICP eletiva ou de urgência com uso de stent ou não no ano de 2018. Valores de p< 0,05 representaram diferenças estatísticas significativas. Resultados: Usuários com diagnóstico de angina instável (n=16; 17,8%), sintomas diagnósticos de angina instável (n= 61; 67,8%) e diagnóstico de angina pectoris (n=52; 57,8%) apresentaram significativamente maior probabilidade de serem submetidos à ICP em caráter eletivo (p<0,001). Usuários com diagnóstico para infarto agudo do miocárdio (n=59; 60,2%) e sintomatologia com evolução maior que 24 horas (n=30; 30,6%) e menor que 24 horas (n=24; 24,5%), com dislipidemia (n=38; 38,8%) e que fizeram cateterismo no mesmo dia (n=87; 88,8%) são significativamente mais propensos a realizar cirurgia de urgência (p<0,05). Além disso, os dados evidenciaram que o diagnóstico de angina instável potencializa novas cardiomiopatias (n=9, 47,4%; p<0,001) e reestenose (n=5; 26,3%; p= 0,002). Conclusão: É necessário criar estratégias para fortalecer a Rede de Atenção à Saúde (RAS) com ações de prevenção, promoção e reabilitação à saúde, visando a qualidade no diagnóstico, tratamento e reabilitação.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Health Profile , Coronary Artery Disease/surgery , Cardiovascular Diseases/epidemiology , Angioplasty , Percutaneous Coronary InterventionABSTRACT
Introducción: La disbiosis conocida como la alteración de la relación simbiótica entre la microbiota intestinal y el huésped están implicados en la patogenia de la enfermedad cardiovascular aterosclerótica. Objetivo: Realizar una revisión documental sobre los mecanismos fisiopatológicos que relacionan los metabolitos bioactivos generados por la disbiosis intestinal con el desarrollo y progresión de la enfermedad cardiovascular aterosclerótica. Métodos: Se utilizó el motor de búsqueda Google Académico y se consultaron artículos de libre acceso en las bases de datos Pubmed, SciELO, Lilacs, Cumed y Hinari desde septiembre 2020 hasta el mes de marzo 2021. Las palabras clave utilizadas para esta revisión fueron:microbioma, microbiota intestinal, disbiosis, aterosclerosis, enfermedad cardiovascular y sus equivalentes en inglés, según el descriptor de Ciencias de la Salud (DeCS). Se consideraron artículos originales, de revisión, revisiones sistemáticas y metaanálisis posteriores al año 2015. Se revisaron un total de 73 artículos. Desarrollo: Las relaciones fisiopatológicas entre la disbiosis intestinal y las enfermedades cardiovasculares son complejas, ya que se influyen mutuamente a través de los sus toxinas endógenas (metabolitos bioactivos), el sistema circulatorio, las respuestas inmunitarias y los cambios metabólicos. Las investigaciones futuras deberían centrarse en dilucidar los actores moleculares subyacentes e identificar si las vías que interconectan la disbiosis intestinal con la ECA son causales, correlacionales o consecuentes. Conclusiones: La evidencia acumulada sostiene que la disbiosis de la microbiota intestinal está involucrada en la síntesis de metabolitos proaterogénicos los cuales modulan los mecanismos implicados en la fisiopatología de la ECA(AU)
Introduction: Dysbiosis is known as the alteration of the symbiotic relationship between the intestinal microbiota and the host is involved in the pathogenesis of atherosclerotic cardiovascular disease. Objective: To carry out a documentary review on the pathophysiological mechanisms that relate the bioactive metabolites generated by intestinal dysbiosis with the development and progression of atherosclerotic cardiovascular disease. Methods: The Google Scholar search engine was used and free access articles were consulted in Pubmed, SciELO, Lilacs, Cumed and Hinari databases from September 2020 to March 2021. The keywords used for this review were microbiome, gut microbiota, dysbiosis, atherosclerosis, cardiovascular disease and their English equivalents, according to the Health Sciences (DeCS) descriptor. Original articles, review articles, systematic reviews and meta-analyses after 2015 were considered. A total of 73 articles were reviewed. Findings: The pathophysiological relationships between intestinal dysbiosis and cardiovascular diseases are complex, since they influence each other through their endogenous toxins (bioactive metabolites), the circulatory system, immune responses and metabolic changes. Future research should focus on elucidating the underlying molecular players and on identifying whether the pathways that interconnect gut dysbiosis with ACE are causal, correlational, or consequential. Conclusions: The accumulated evidence supports that the dysbiosis of the intestinal microbiota is involved in the synthesis of proatherogenic metabolites which modulate the mechanisms involved in the pathophysiology of ACE(AU)
Subject(s)
Humans , Male , Female , Cardiovascular Diseases/epidemiology , Metabolic Syndrome/epidemiology , Atherosclerosis/epidemiology , Dysbiosis , Gastrointestinal Microbiome/physiologyABSTRACT
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.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Cardiovascular Diseases/epidemiology , Cardiometabolic Risk Factors , Brazil , Logistic Models , Odds Ratio , Prevalence , Cross-Sectional Studies , Health Surveys , Morbidity , Age Factors , Diabetes Mellitus/epidemiology , Age and Sex Distribution , Dyslipidemias/epidemiology , Waist-Height Ratio , Hypertension/epidemiology , Obesity/epidemiologyABSTRACT
Introducción: La hipertensión arterial, por su influencia y afectación multisistémica, surge como un factor de riesgo potencial para el deterioro progresivo de las funciones cognitivas. Objetivo: Identificar las principales alteraciones cognitivas asociadas a la hipertensión arterial, específicamente en la atención y la memoria. Métodos: Se realizó revisión bibliográfica retrospectiva de 34 estudios, teniendo en cuenta los criterios de inclusión. Se estableció una ventana temporal en el período 2002 al 2019, incluyendo las bases de datos Pubmed, Scopus, Medline y SciELO. Los textos completos se sometieron a una lectura crítica y análisis documental mediante una matriz de rastreo. Conclusiones: Una de las consecuencias más importantes de esta enfermedad es la afectación en las funciones cognitivas particularmente la atención y la memoria, con una incidencia en el deterioro cognitivo leve, profundo y medio. Sin embargo, su impacto en la cognición es un área que recientemente ha despertado el interés en la neuropsicología y la neurociencia cognitiva. La hipertensión arterial está considerada como una de las enfermedades cardiovasculares que está vinculada con la demencia, proporciona en un 50 por ciento el desarrollo de dicha enfermedad(AU)
Introduction: Arterial hypertension, due to its influence and multisystemic involvement, emerges as a potential risk factor for the progressive deterioration of cognitive functions. Objective: To identify the main cognitive alterations associated with arterial hypertension, specifically in attention and memory. Methods: A retrospective literature review of 34 studies was carried out, taking into account inclusion criteria. A time window was established from 2002 to 2019, including the PUBMED, SCOPUS, MEDLINE and SCIELO databases. The full texts were subjected to critical reading and documental analysis using a tracking matrix. Conclusions: One of the most important consequences of this disease is the negative impact on cognitive functions, particularly attention and memory, with an incidence in mild, profound and medium cognitive impairment. However, its impact on cognition is an area that has recently aroused interest in neuropsychology and cognitive neuroscience. Arterial hypertension is considered one of the cardiovascular diseases linked to dementia, since it causes the development of this disease in 50 percent of cases(AU)
Subject(s)
Humans , Male , Female , Cardiovascular Diseases/epidemiology , Cognitive Dysfunction/etiology , Hypertension/epidemiology , Retrospective StudiesABSTRACT
Introducción: Las enfermedades del corazón, cerebrovasculares y de las arterias, arteriolas y vasos capilares ocuparon el primero, tercero y séptimo lugar, respectivamente, de las principales causas de muerte en Cuba en 2017 y 2018; ello denota la necesidad de implementar acciones inmediatas que favorezcan la modificación de esos indicadores. La evaluación del riesgo cardiovascular permite identificar de forma individual y estratificar a nivel de grupos los principales factores de riesgo de estas afecciones. Objetivo: Evaluar el riesgo cardiovascular en una muestra poblacional. Métodos: Se realizó un estudio transversal, descriptivo, para la evaluación del evaluación del riesgo cardiovascular en una población del área de salud 27 de Noviembre del municipio Marianao, La Habana, en el año 2018, según las tablas predictivas de la Organización Mundial de la Salud para las Américas región A (OMS AMR A) y las de Gaziano. Se confeccionó un cuestionario para la recogida de la información socio-demográfica y antecedentes patológicos personales. Se midió la presión arterial y se calculó el índice de masa corporal. Resultados: Según las tablas predictivas de la OMS AMR A, 80, 9 por ciento presentó riesgo cardiovascular bajo. Según las tablas predictivas de Gaziano, el riesgo alto y muy alto consolidados representó el 31,5 por ciento de los individuos. Conclusiones: Las tablas predictivas de Gaziano mostraron mayor sensibilidad en la evaluación del riesgo cardiovascular de esta población que las de OMS AMR A, lo que constituye un instrumento útil y de aplicación factible en el primer nivel de atención, para su predicción a nivel individual y de un grupo poblacional(AU)
Introduction: Heart, cerebrovascular and diseases of the arteries, arterioles and capillary vessels ranked first, third and seventh, respectively, as the leading causes of death in Cuba in 2017 and 201. This denotes the need to implement immediate actions that favor the modification of such indicators. Cardiovascular risk assessment allows for individual identification and stratification, at group level, of the main risk factors for these conditions. Objective: To assess cardiovascular risk in a population sample. Methods: A cross-sectional and descriptive study was carried out to assess cardiovascular risk in a population of the 27 de Noviembre health area of Marianao Municipality, Havana, in 2018, according to the predictive tables of the World Health Organization for the Americas region A (WHO AMR A) and those of Gaziano. A questionnaire was prepared for the collection of sociodemographic information and individual disease history. Blood pressure was measured and body mass index was calculated. Results: According to the WHO AMR A predictive tables, 80.9 percent presented low cardiovascular risk. According to Gaziano predictive tables, consolidated high and very high risk accounted for 31.5 percent of the individuals. Conclusions: Gaziano's predictive tables showed greater sensitivity in the assessment of cardiovascular risk in this population than those of the WHO AMR A, which makes it a useful instrument and of feasible application at the first level of care for prediction at the individual level and at the level of a population group(AU)
Subject(s)
Humans , Male , Female , Cardiovascular Diseases/epidemiology , Statistics as Topic , Heart Disease Risk Factors , Epidemiology, Descriptive , Cross-Sectional Studies , CubaABSTRACT
INTRODUCCIÓN: Se ha postulado la relación entre la presencia de enfermedades cardiometabólicas con problemas de salud mental, en particular la depresión. OBJETIVOS: Determinar la asociación entre la presencia de enfermedades cardiometabólicas y la presencia de sintomatología depresiva evaluada mediante el cuestionario PHQ-9 en pacientes atendidos en consultorios externos de medicina interna del Hospital Nacional Hipólito Unanue. METODOLOGÍA: Estudio observacional, analítico, transversal. Se definió enfermedad cardiometabólica como la presencia de diabetes mellitus, hipertensión arterial, dislipidemia, y/u obesidad. Se utilizó el cuestionario PHQ-9 para evaluar la presencia de síntomas sugerentes de depresión. Se evaluó la asociación cruda y ajustada a posibles confusores. Para el análisis multivariado se utilizó un modelo de regresión de Poisson para hallar razones de prevalencia con sus respectivos intervalos de confianza al 95%. Se consideró un p<0,05 como estadísticamente significativo. Resultados: Se incluyeron 252 pacientes, de los que 205 (81,4%) presentaron enfermedades cardiometabólicas y 181 (71,9%) presentaron síntomas consistentes con algún grado de depresión. La presencia de enfermedades cardiometabólicas se asoció a síntomas depresivos tanto en el análisis crudo (RPc 1,43; IC 95% 1,08-1,89; p=0,012) como en el ajustado (RPa 1,31; IC 95% 1,00-1,71; p=0,048). Adicionalmente se encontró asociación entre el sexo femenino y sintomatología depresiva (RPa 1,35; IC 95% 1,11-1,63; p=0,002). CONCLUSIONES: La presencia de enfermedades cardiometabólicas se asoció con la presencia de síntomas depresivos en pacientes atendidos en la consulta externa de medicina interna. El abordaje de la salud mental debe ser parte integral del manejo multidisciplinario del paciente con enfermedad cardiometabólica.
INTRODUCTION: It has been postulated the relationship between presence of cardiometabolic diseases with mental health problems, particularly depression. Objectives: To determine the association between cardiometabolic diseases and presence of depressive symptoms, evaluated by PHQ-9 questionnaire, in patients attended at the outpatient clinic of internal medicine service at Hospital Nacional Hipolito Unanue. METHODS: Observational analytical cross-sectional study. Cardiometabolic disease was defined as the presence of diabetes mellitus, high blood pressure, dyslipidemia, and/or obesity. The PHQ-9 questionnaire was used to evaluate the presence of symptoms suggestive of depression. The association was evaluated crude and adjusted for possible confounders. For the multivariate analysis, a Poisson regression model was used to find prevalence ratios with their respective 95% confidence intervals. A p<0.05 was considered statistically significant. RESULTS: 252 patients were included, of which 205 (81,4%) presented cardiometabolic diseases and 181 (71,9%) presented symptoms consistent with some grade of depression. The presence of cardiometabolic diseases was associated with depressive symptoms both in the crude analysis (PRc 1.43; CI 95% 1.08-1.89; p=0.012) and in the adjusted one (PRa 1.31; CI 95% 1.00-1.71; p=0.048). Additionally, an association was found between female sex and depressive symptoms (PRa 1,35; CI 95% 1,11-1,63; p=0,002). CONCLUSIONS: The presence of cardiometabolic diseases was associated with the presence of depressive symptoms in patients seen at the outpatient clinic of internal medicine. The mental health approach should be an integral part of the multidisciplinary management for the patient with cardiometabolic disease.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Cardiovascular Diseases/psychology , Cardiovascular Diseases/epidemiology , Metabolic Syndrome/psychology , Metabolic Syndrome/epidemiology , Depression/epidemiology , Peru , Cross-Sectional Studies , Multivariate Analysis , Surveys and Questionnaires , Diabetes Mellitus/psychology , Diabetes Mellitus/epidemiology , Dyslipidemias/psychology , Dyslipidemias/epidemiology , Hospitals , Hypertension/psychology , Hypertension/epidemiology , Obesity/psychology , Obesity/epidemiologyABSTRACT
Abstract Objective: To investigate the association between oral contraceptive use and cardiovascular risks, including metabolic syndrome and their components in Brazilian adolescents. Method: This study used data from the Study of Cardiovascular Risks in Adolescents (Estudo de Riscos Cardiovasculares em Adolescentes - ERICA), a nationwide, cross-sectional, school-based study with individuals aged 12-17 years. Sociodemographic variables and OC use were assessed by a self-administered questionnaire. International Diabetes Federation criteria were used to define metabolic syndrome. Descriptive statistics were reported as prevalence and their respective confidence interval of 95% of oral contraceptives according to variables. Logistic regression was performed. Crude and adjusted odds ratios were calculated. Results: This subsample was composed of 22,682 female adolescents, of which 12.65% reported using oral contraceptives and their use was associated with hypertension and hypertriglyceridemia. These associations remained statistically significant after adjusting for age, school region, race, and tobacco use with an increase of 2.68 (1.66 - 4.32) and 3.45 (2.56 - 4.65) times, respectively. Conclusion: The present study was the first to examine the association between the use of oral contraceptives and cardiovascular risk factors among the largest number of female Brazilian adolescents. This method was significantly associated with hypertension, hypertriglyceridemia. Teenagers using oral contraceptives should be monitored for side effects, including blood pressure measurements and advised to avoid smoking.
Subject(s)
Humans , Female , Child , Adolescent , Cardiovascular Diseases/chemically induced , Cardiovascular Diseases/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Risk Factors , Contraceptives, Oral/adverse effects , Heart Disease Risk FactorsABSTRACT
Abstract Background The COVID-19 pandemic has imposed measures of social distancing and, during this time, there has been an elevation in cardiovascular mortality rates and a decrease in the number of emergency visits. Objectives To assess and compare in-hospital mortality for cardiovascular diseases and emergency department visits during the COVID-19 pandemic and the same period in 2019. Methods Retrospective, single-center study that evaluated emergency visits and in-hospital deaths between March 16, 2020 and June 16, 2020, when the steepest fall in the number of emergency admissions for COVID-19 was registered. These data were compared with the emergency visits and in-hospital deaths between March 16 and June 16, 2019. We analyzed the total number of deaths, and cardiovascular deaths. The level of significance was set at p < 0.05. Results There was a 35% decrease in the number of emergency visits and an increase in the ratio of the number of deaths to the number of emergency visits in 2020. The increase in the ratio of the number of all-cause deaths to the number of emergency visits was 45.6% and the increase in the ratio of the number of cardiovascular deaths to the number of emergency visits was 62.1%. None of the patients who died in the study period in 2020 tested positive for COVID-19. Conclusion In-hospital mortality for cardiovascular diseases increased proportionally to the number of emergency visits during the COVID-19-imposed social distancing compared with the same period in 2019. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0)
Subject(s)
Humans , Male , Female , Cardiovascular Diseases/mortality , Hospital Mortality , Emergency Service, Hospital , Cardiovascular Diseases/epidemiology , Emergency Treatment/statistics & numerical data , Physical Distancing , COVID-19/complications , HospitalizationABSTRACT
BACKGROUND: Hypertension and diabetes are highly prevalent conditions in Chilean adults. AIM: To describe the demographic and clinical profiles, risk factors and complications associated with arterial hypertension (AH) and diabetes mellitus (DM) in patients ascribed to a cardiovascular health program at a public primary health care center in Santiago. MATERIAL AND METHODS: Review of medical records of 583 patients aged 37 to 95 years (56% women). Gender, age, smoking habits, blood pressure, glycated hemoglobin levels, LDL cholesterol and triglycerides levels, nutritional status in the last control carried out, and associated cardiovascular complications were recorded. RESULTS: Thirty four percent (201 participants) and 36% (210 participants) had a decompensated DM and AH, respectively. Dyslipidemia was the main associated cardiovascular risk factor. The prevalence of obesity was 43% (249 participants). Twenty percent had chronic kidney disease and 13% had diabetic retinopathy. CONCLUSIONS: These patients have a high frequency of obesity, dyslipidemia, and chronic kidney disease.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Cardiovascular Diseases/etiology , Cardiovascular Diseases/epidemiology , Diabetes Mellitus, Type 2 , Diabetic Retinopathy/complications , Renal Insufficiency, Chronic , Dyslipidemias , Hypertension/complications , Hypertension/epidemiology , Primary Health Care , Chile/epidemiology , Prevalence , Risk Factors , Obesity/complications , Obesity/epidemiologySubject(s)
Humans , Cardiovascular Diseases/epidemiology , Cardiovascular System , Brazil/epidemiology , HeartABSTRACT
Resumo O objetivo deste artigo é avaliar o risco nutricional e cardiovascular segundo medidas antropométricas em idosos quilombolas do estado do Maranhão. Trata-se de estudo transversal realizado em 11 comunidades remanescentes de quilombolas do município de Bequimão, Maranhão, Brasil. Realizou-se censo da população idosa que representou 205 pessoas. Foram estimados os riscos nutricional e cardiovascular por meio dos indicadores antropométricos segundo sexo e idade. Realizou-se Testes de Qui-quadrado de Pearson ou Exacto de Fisher e análises de variância. Diferenças foram consideradas estatisticamente significantes quando p<0,05. Idosos quilombolas vivem em precárias condições de moradia e de infraestrutura sanitária, com elevado risco nutricional e cardiovascular, mas com diferenças entre sexo e idade. O excesso de peso foi mais prevalente em mulheres e idosos mais jovens, enquanto os homens e idosos com 80 ou mais anos apresentaram-se mais desnutridos e com maior perda de massa corporal. O risco cardiovascular foi maior entre as mulheres e em todas as faixas etárias. Idosos quilombolas vivem em vulnerabilidade socioeconômica e apresentaram alta prevalência de baixo peso, perda de massa muscular e alto risco cardiovascular, sendo maior risco entre mulheres e idosos do grupo de maior idade.
Abstract This article aims to assess nutritional and cardiovascular disease (CVD) risk based on anthropometric measures among older persons living in Quilombola communities in the state of Maranhão, Brazil. We conducted a cross-sectional study with 205 older persons living in 11 Quilombola communities in Bequimão, Maranhão. Nutritional and CVD risk were estimated according to sex and age group based on anthropometric indicators using Pearson's chi-square or Fisher's exact tests and analysis of variance, adopting a significance level of p<0.05. The study participants suffer precarious housing, basic sanitation and social conditions. Prevalence of nutritional and CDV risk was high across the sample, showing differences between sexes and age groups. Prevalence of excess weight was higher in women and the youngest age group, while prevalence of malnourishment and loss of muscle mass was higher in men and individuals aged 80 years and over. Prevalence of CVD risk was high across all age groups and higher in women than men. The older persons living in the Quilombola communities investigated by this study are socially vulnerable and showed high prevalence of low weight, loss of muscle mass and CDV risk. The prevalence of CVD risk was higher among women and the oldest age group.
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Cardiovascular Diseases/epidemiology , Malnutrition , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Risk FactorsABSTRACT
Body fat distribution seems to have different effects in cardiovascular diseases (CVD). We aimed to estimate the associations between lower limbs and trunk fat ratio and the 10-year CVD risk, and isolated risk factors in men and women. A total of 10,917 participants from ELSA-Brasil were eligible for this cross-sectional study. Associations between lower limb/trunk fat ratio with the percentage of 10-year CVD risk - according to the Framingham Risk Score - and its risk factors (systolic blood pressure, total cholesterol and HDL-cholesterol, diabetes, and use of antihypertensive medication) were performed using generalized linear models, linear and logistic regressions. All analyses were stratified by gender and adjustments were made by age, self-reported skin color, educational attainment, alcohol consumption, leisure physical activity, hypolipidemic drug use and, for women, menopausal status. In this study, 55.91% were women, with a mean age of 52.68 (SD = 6.57) years. A higher lower limb/trunk fat ratio was related to lower 10-year CVD risk, as well as a reduction in systolic blood pressure, total cholesterol, and antihypertensive drug use, also an increasing HDL-cholesterol in both genders, but this relationship was stronger in women. Besides, a protective relationship to diabetes was observed in women. Higher fat accumulation in the lower body, when compared to the trunk, seems to have a lower risk of CVD and associated risk factors - even in the presence of fat in the abdominal region - with women presenting lower risks than men.
A distribuição de gordura no corpo parece ter efeitos diferentes nas doenças cardiovasculares (DCV). Objetivou-se estimar as associações da razão de gordura entre membros inferiores e tronco com o risco de DCV em 10 anos e os fatores de risco independentes em homens e mulheres. Um total de 10.917 participantes do ELSA-Brasil eram elegíveis para este estudo transversal. As associações da razão de gordura entre os membros inferiores e tronco com o percentual de risco de DCV em 10 anos, de acordo com a Escala de Risco de Framingham, e os respectivos fatores de risco (pressão arterial sistólica, colesterol total e HDL colesterol, diabetes e uso de medicação anti-hipertensiva), foram avaliados com modelos lineares generalizados, lineares e de regressão logística. Todas as análises foram estratificadas por sexo, e os ajustes foram feitos por idade, raça/cor, escolaridade, consumo de álcool, atividade física, uso de medicação hipolipemiante e, para as mulheres, estado de menopausa. Na amostra do estudo atual, 55,91% eram mulheres, com média de idade de 52,68 anos (DP = 6,57). A maior diferença entre a gordura dos membros inferiores e tronco foi associada com menor risco de DCV em 10 anos e com redução na pressão arterial sistólica, colesterol total e uso de medicação anti-hipertensiva, assim como um aumento no HDL colesterol em ambos os sexos (mas essa correlação foi mais forte em mulheres). Além disso, foi observada uma relação protetora contra diabetes, apenas em mulheres. O acúmulo maior de gordura nos membros inferiores, comparado com o tronco, parece estar associado a um risco menor de DCV e aos fatores de risco, mesmo na presença de gordura na região abdominal, e esse efeito é mais forte nas mulheres que nos homens.
Las distribuciones de grasa corporal parecen tener diferentes efectos en las enfermedades cardiovasculares (ECV). Nuestro objetivo fue estimar las asociaciones entre extremidades inferiores/ratio de grasa troncal y el riesgo de ECV a los 10 años, y sus factores de riesgo aislados, en hombres y mujeres. Un total de 10.917 participantes de ELSA-Brasil fueron elegibles para este estudio transversal. Las asociaciones de la ratio de grasa entre la parte inferior del cuerpo y el tronco, con el porcentaje de riesgo de ECV a los 10 años, según la Escala de Riesgo de Framingham, y sus factores de riesgo (presión sanguínea sistólica, colesterol total y colesterol HDL, diabetes, y uso de medicación antihipertensiva), se realizaron usando modelos lineales generalizados, regresiones lineales y logísticas. Todos los análisis fueron estratificados por sexo y los ajustes se hicieron por edad, raza/color de piel autoinformado, nivel educativo, consumo de alcohol, actividad física durante el ocio, uso de medicamentos hipolipemiantes y, para mujeres, estatus menopáusico. En este estudio, un 55,91% fueron mujeres, con una media de edad de 52,68 (SD = 6,57) años. Una ratio de masa adiposa más alta entre las extremidades inferiores/tronco estuvo asociada a un riesgo menor de ECV en 10 años, también una reducción en la presión sistólica sanguínea, colesterol total, y el consumo de medicamentos antihipertensivos, también en un incremento del colesterol HDL en ambos sexos, pero esta relación fue más fuerte en mujeres. Asimismo, una relación protectora frente a la diabetes se observó solo en mujeres. Una acumulación más alta de grasa en las extremidades inferiores, comparada con la del tronco, parece tener un riego más bajo de ECV y sus factores de riesgo, incluso con la presencia de grasa en la región abdominal, además este efecto es más fuerte en mujeres comparadas con los hombres.
Subject(s)
Humans , Male , Female , Adult , Cardiovascular Diseases/etiology , Cardiovascular Diseases/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Risk Factors , Longitudinal Studies , Body Fat Distribution , Middle AgedABSTRACT
This study aims to describe the mean height of adolescents from the five regions of Brazil and to evaluate socioeconomic and nutritional factors associated with normal growth. This is a cross-sectional study conducted in the Brazilian urban and rural areas with students aged 12 to 17 years (n = 71,553). Anthropometry, socioeconomic variables, physical activity, and diet were evaluated. Height-for-age z-scores were calculated and multiple linear regression models were used to investigate the association of exposure variables with height (outcome) by sex and age (12-13, 14-15, and 16-17 years). We observed a lower mean height in adolescents from the North Region and in individuals with low socioeconomic status. At 17 years of age, the closest to the final height in this sample, mean heights for girls and boys were 160.9 ± 0.1cm and 173.7 ± 0.3cm, respectively. In multiple linear regression analysis, physical activity (girls β = 0.119, 95%CI: 0.035; 0.202; boys β = 0.092, 95%CI: 0.012; 0.172) and high level of maternal education (girls β = 0.103, 95%CI: 0.001; 0.204; boys β = 0.39, 95%CI: 0.245; 0.534) were positively associated with height-for-age z-score in 16- to 17-year-old boys and girls. Other factors positively associated with height-for-age z-score in older students include higher protein consumption (β = 0.022, 95%CI: 0.010; 0.035) and obesity (β = 0.217, 95%CI: 0.084; 0.350) for boys, and low weight (β = 0.205, 95%CI: 0.028, 0.382) for girls. We observed differences in the mean height among adolescents from the five Brazilian regions. Normal growth, especially among older adolescents, was associated with high maternal education, practice of physical activity, protein consumption, and body mass index (BMI) categories.
Buscou-se descrever a altura média dos adolescentes das cinco regiões do Brasil e avaliar os fatores socioeconômicos e nutricionais que estejam associados ao seu crescimento normal. Este é um estudo transversal realizado em ambientes urbanos e rurais no Brasil com estudantes de 12 a 17 anos (n = 71.553). Avaliamos antropometria, variáveis socioeconômicas, atividade física e dieta. Calculou-se os escores-z por idade e investigou-se a associação das variáveis de exposição com altura (desfecho) por sexo e idade (12-13, 14-15 e 16-17 anos) através de múltiplos modelos de regressão linear. Observou-se menor altura média em adolescentes da região Norte e em baixos níveis socioeconômicos. Aos 17 anos, o mais próximo da altura final nesta amostra, as alturas médias para meninas e meninos foram de 160,9 ± 0,1cm e 173,7 ± 0,3cm, respectivamente. Na análise de regressão linear múltipla, atividade física (meninas β = 0,119, IC95%: 0,035; 0,202; meninos β = 0,092, IC95%: 0,012; 0,172) e Ensino Médio materno (meninas β = 0,103, IC95%: 0,201; 0,204; meninos β = 0,39, IC95%: 0,245; 0,534) estiveram positivamente associados ao escore-z de altura por idade em meninos e meninas de 16-17 anos. Maior consumo de proteína (β = 0,022, IC95%: 0,010; 0,035) e obesidade (β = 0,217, IC95%: 0,084; 0,350) estiveram positivamente associados ao escore-z de altura para a idade meninos mais velhos, enquanto a variável associada às meninas foi baixo peso (β = 0,205, IC95%: 0,028; 0,382). Observou-se diferenças na altura média de adolescentes das cinco regiões brasileiras. O crescimento normal, especialmente entre adolescentes mais velhos, esteve associado à escolaridade materna, à prática de atividade física, ao consumo de proteínas e às categorias de índice de massa corporal (IMC).
Los objetivos fueron describir la estatura media de los adolescentes de las cinco regiones de Brasil y evaluar los factores socioeconómicos y nutricionales asociados al crecimiento normal. Estudio transversal realizado en entornos urbanos y rurales de Brasil con estudiantes de 12 a 17 años (n = 71.553). Se evaluaron la antropometría, las variables socioeconómicas, la actividad física y la dieta. Se calculó la puntuación Z de la altura para la edad y se utilizaron modelos de regresión lineal múltiple para investigar la asociación de las variables de exposición con la altura (resultado) por sexo y edad (12-13, 14-15 y 16-17 años). Se observó una estatura media más baja en los adolescentes de la región norte y en los de nivel socioeconómico bajo. A los 17 años, la edad más cercana a la estatura final en esta muestra, las estaturas medias de las chicas y los chicos eran de 160,9 ± 0,1cm y 173,7 ± 0,3cm, respectivamente. En el análisis de regresión lineal múltiple, la actividad física (chicas β = 0,119, IC95%: 0,035; 0,202; chicos β = 0,092, IC95%: 0,012; 0,172) y la madre con educación secundaria (chicas β = 0,103, IC95%: 0,001; 0,204; chicos β = 0,39, IC95%: 0,245; 0,534) se asociaron positivamente con la puntuación z de la altura para la edad en chicos y chicas de 16-17 años. En el caso de los chicos, el mayor consumo de proteínas (β = 0,022, IC95%: 0,010; 0,035) y la obesidad (β = 0,217, IC95%: 0,084; 0,350), mientras que, en el caso de las chicas, el bajo peso (β = 0,205, IC95%: 0,028; 0,382) también se asociaron positivamente con la puntuación z de la altura para la edad en los estudiantes mayores. Se observaron diferencias en la estatura media entre los adolescentes de las cinco regiones brasileñas. El crecimiento normal, especialmente entre los adolescentes de mayor edad, se asoció con la alta escolaridad de la madre, la práctica de actividad física, el consumo de proteínas y las categorías de índice de masa corporal (IMC).
Subject(s)
Humans , Male , Female , Adolescent , Aged , Cardiovascular Diseases/etiology , Cardiovascular Diseases/epidemiology , Socioeconomic Factors , Body Height , Brazil/epidemiology , Dietary Proteins , Body Mass Index , Cross-Sectional Studies , Risk Factors , Heart Disease Risk Factors , IncomeABSTRACT
RESUMO Objetivo: Descrever o perfil epidemiológico dos atendimentos pré-hospitalares realizados por um serviço móvel de emergência no município de Picos, Piauí, Brasil. Métodos: Trata-se de um estudo transversal, documental e retrospectivo com abordagem quantitativa, realizado nos meses de abril e maio de 2020. Foram analisados 4.220 registros com base nos atendimentos realizados pelo Serviço de Atendimento Móvel de Urgência às ocorrências que aconteceram no período de janeiro de 2019 a março de 2020. Os dados foram coletados das fichas de atendimento individuais da instituição, organizados por meio de um formulário e analisados à luz da estatística descritiva. Resultados: Foi observada frequência de ocorrências ligeiramente maior em indivíduos do sexo masculino (50,3%), predominância das faixas etárias de 20 a 30 anos (30,7%) e maior de 60 anos (34,2%), atendimentos realizados pela Unidade de Suporte Básico (65,9%). As ocorrências traumáticas provenientes de acidentes de transporte (68,5%) e as clínicas cardiológicas (18%) se apresentaram em maior percentual em relação às demais. As ocorrências traumáticas foram mais frequentes no período de outubro a dezembro e as clínicas nos meses de fevereiro e março. Conclusão: O perfil epidemiológico dos atendimentos corresponde à população do gênero masculino e faixa etária maior ou igual a 60 anos. Predominaram as ocorrências de natureza clínica, principalmente cardiológicas.
RESUMEN Objetivo: describir el perfil epidemiológico de la atención prehospitalaria realizada por un servicio de atención móvil de urgencia en el municipio de Picos, Piauí, Brasil. Métodos: se trata de un estudio transversal, documental y retrospectivo con enfoque cuantitativo, realizado en los meses de abril y mayo de 2020. Se analizaron 4.220 registros con base en las atenciones realizadas por el Servicio de Atención Móvil de Urgencia a los casos que ocurrieron en el período de enero de 2019 a marzo de 2020. Los datos fueron recolectados de las fichas de atención individuales de la institución, organizados por medio de un formulario y analizados a la luz de la estadística descriptiva. Resultados: fue observada frecuencia de casos ligeramente mayor en individuos del sexo masculino (50,3%), predominancia de las franjas etarias de 20 a 30 años (30,7%) y mayor de 60 años (34,2%), atenciones realizadas por la Unidad de Soporte Básico (65,9%). Los incidentes traumáticos provenientes de accidentes de transporte (68,5%) y las clínicas cardiológicas (18%) se presentaron en mayor porcentaje con relación a los demás. Los incidentes traumáticos fueron más frecuentes en el período de octubre a diciembre y las clínicas en los meses de febrero y marzo. Conclusión: el perfil epidemiológico de las atenciones corresponde a la población del género masculino y franja etaria mayor o igual a 60 años. Predominaron los incidentes de naturaleza clínica, principalmente cardiológicas.
ABSTRACT Objective: To describe the epidemiological profile of pre-hospital care performed by a mobile emergency service in the municipality of Picos, Piauí, Brazil. Methods: This is a cross-sectional, documentary and retrospective study with a quantitative approach, conducted in April and May 2020. We analyzed 4,220 records based on the visits performed by the Mobile Emergency Care Service to the occurrences that occurred between January 2019 and March 2020. Data were collected from the institution's individual care forms, organized through a form and analyzed in the light of descriptive statistics. Results: A slightly higher frequency of occurrences was observed in males (50.3%), predominance of the age groups from 20 to 30 years (30.7%) and higher than 60 years (34.2%), attendances performed by the Basic Support Unit (65.9%). Traumatic occurrences resulting from traffic accidents (68.5%) and cardiologic clinics (18%) were higher in percentage in relation to the other ones. Traumatic occurrences were more frequent from October to December and clinics in February and March. Conclusion: The epidemiological profile of the visits corresponds to the male population and age group greater than or equal to 60 years. Occurrences of a clinical nature, especially cardiac, predominated.
Subject(s)
Humans , Male , Adult , Middle Aged , Health Profile , Emergency Medical Services/statistics & numerical data , Prehospital Care , Health Services Research/statistics & numerical data , Wounds and Injuries/epidemiology , Cardiovascular Diseases/epidemiology , Accidents, Traffic/statistics & numerical data , Health Centers , Medical Records/statistics & numerical data , Cross-Sectional Studies , Answering Services , Emergencies/epidemiology , Intensive Care Units/statistics & numerical dataABSTRACT
As ondas de calor têm sido associadas a morbimortalidade por doenças do aparelho circulatório em diferentes locais, principalmente nos grupos considerados vulneráveis. Esta tese apresenta estudos sobre as características das ondas de calor e abordou seus efeitos nas doenças do aparelho circulatório nas capitais brasileiras no período de 2000 a 2016. O primeiro estudo teve como objetivo examinar a intensidade, a frequência e a duração dos eventos de ondas de calor nas capitais brasileiras, por meio das análises de séries temporais foi possível caracterizar a ocorrência das ondas de calor, os resultados mostraram que estão mais frequentes, duradouras e intensas e ocorrem durante todo o ano, inclusive no inverno em cidades das regiões Sudeste e Sul. O segundo estudo teve como objetivo identificar as capitais brasileiras que apresentaram desconforto térmico para população, por meio da caracterização do índice de calor. Os resultados mostraram que se utilizando as definições de temperatura aparente e conforto e desconforto térmico do diagrama do conforto humano, na maioria das capitais foram constatadas condições de desconforto para a saúde humana. Algumas capitais localizadas no Sudeste e no Sul apresentaram condições definidas por conforto térmico. O terceiro estudo teve como objetivo estimar os efeitos de ondas de calor na mortalidade do aparelho circulatório no município do Rio de Janeiro no ano de 2010. A análise de séries temporais foi utilizada para estimar o percentual do Risco Relativo (%RR) do efeito das ondas de calor na mortalidade de pessoas adultas a partir de ≥ 30 anos de idade. Os resultados deste estudo evidenciaram o aumento do %RR nas mortalidades por DAC associadas às ondas de calor no município do Rio de Janeiro. O quarto estudo teve como objetivo estimar os efeitos de ondas de calor na mortalidade por doenças do aparelho cardiovascular nas capitais brasileiras, a análise de séries temporais foi utilizada para estimar o percentual do Risco Relativo (%RR) do efeito das ondas de calor na mortalidade de pessoas adultas ≥ 30 anos de idade. Os resultados indicam uma associação entre ondas de calor e a mortalidade por doenças cerebrovasculares e doenças isquêmicas do coração na população adulta. Os achados deste conjunto de estudo permitem concluir que as ondas de calor estão mais frequentes, intensas e duradouras nas capitais brasileiras e, as doenças do aparelho circulatório estão associadas com este fenômeno.
Heat waves have been associated with circulatory disease morbidity and mortality in different locations, especially in groups considered vulnerable. This thesis present studies on the characteristics of heat waves and addressed its effects on circulatory diseases in Brazilian capitals from 2000 to 2016. The first study aimed to examine the intensity, frequency and duration of heat wave events in the Brazilian capitals, through temporal series analysis, it was possible to characterize the occurrence of heat waves, the results showed that they are more frequent, lasting and intense and occur throughout the year, including winter in cities in the Southeast and South regions. The second study aimed to identify the Brazilian capitals that presented thermal discomfort for the population, through the characterization of the heat index. The results showed that using the apparent temperature definitions and comfort and thermal discomfort of the human comfort diagram, most capitals were found conditions of discomfort for human health. Some capitals located in the Southeast and South had conditions defined by thermal comfort. The third study aimed to estimate the effects of heat waves on the mortality of the circulatory system in the municipality of Rio de Janeiro in 2010. Time series analysis was used to estimate the percentage of relative risk (%RR) of the effect of heat waves on adult mortality from ≥ 30 years of age. The results of this study showed the increase of %RR in DAC mortality associated with heat waves in the municipality of Rio de Janeiro. The fourth study aimed to estimate the effects of heat waves on mortality from cardiovascular disease in Brazilian capitals, timely series analysis was used to estimate the percentage of relative risk (%RR) of the effect of heat waves on mortality of adults ≥ 30 years of age. The results indicate an association between heat waves and mortality from cerebrovascular diseases and ischemic heart disease in the adult population. The findings of this study set allow you to conclude that heat waves are more frequent, intense and lasting in Brazilian capitals and circulatory diseases are associated with this phenomenon.
Subject(s)
Cardiovascular Diseases/mortality , Cardiovascular Diseases/epidemiology , Hot Temperature , Brazil , Time Series StudiesABSTRACT
Objective: To explore the association between occupational noise exposure and cardiovascular disease (CVD) risk in a large Chinese population. Methods: In December 2019, the study included 21412 retired participants from the Dongfeng-Tongji Cohort Study at baseline from September 2008 to June 2010, occupational noise exposure was evaluated through workplace noise level and/or the job titles. In a subsample of 8931 subjects, bilateral hearing loss was defined as a pure-tone mean of 25 dB or higher at 0.5, 1 , 2, and 4 kHz in both ears. Logistic regression models were used to explore the association of occupational noise exposure, bilateral hearing loss with 10-year CVD risk. Results: Compared with participants without occupational noise exposure, the 10-year CVD risk was significantly higher for noise exposure duration ≥20 years (OR=1.20, 95%CI:1.01-1.41 , P=0.001) after adjusting for potential confounders. In the sex-specific analysis, the association was only statistically significant in males (OR=2.34, 95%CI: 1.18-4.66, P<0.001) , but not in females (OR=1.15, 95%CI:0.97-1.37, P=0.153). In the subsample analyses, bilateral hearing loss, which was an indicator for exposure to loud noise, was also associated with a higher risk of 10-year CVD (OR= 1.17, 95% CI:1.05-1.44, P <0.001) , especially for participants who were males (OR =1.24, 95% CI:1.07-2.30, P<0.001) , aged equal and over 60 years old (OR=2.30, 95%CI: 1.84-2.88, P<0.001) , and exposed to occupational noise (OR=1.66, 95%CI: 1.02-2.70, P=0.001). Conclusion: Occupational noise exposure may be a risk factor for CVD.