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2.
Arq. bras. cardiol ; 118(1): 68-74, jan. 2022. tab
Article in English, Portuguese | LILACS | ID: biblio-1360106

ABSTRACT

Resumo Fundamento Apesar da grande proporção de octogenários com embolia pulmonar aguda, há pouca informação indicando a estratégia de manejo ideal, especialmente medidas terapêuticas, como a terapia lítica. Objetivos O número de pacientes idosos diagnosticados com embolia pulmonar aguda aumenta constantemente. Porém, o papel do tratamento trombolítico não está claramente definido entre os octogenários. Nosso objetivo é avaliar a efetividade da terapia lítica em pacientes octogenários diagnosticados com embolia pulmonar. Métodos Cento e quarenta e oito indivíduos (70,3% de mulheres, n=104) com mais de 80 anos foram incluídos no estudo. Os pacientes foram divididos em dois grupos: tratamento trombolítico versus não-trombolítico. As taxas de mortalidade hospitalar e episódios de sangramento foram definidos como desfechos do estudo. Valor de p <0,05 foi considerado como estatisticamente significativo. Resultados A mortalidade hospitalar reduziu significativamente no grupo trombolítico em comparação ao não-trombolítico (10,5% vs. 24,2%; p=0,03). Episódios de sangramento menores foram mais comuns no braço que recebeu o tratamento trombolítico, mas grandes hemorragias não diferiram entre os grupos (35,1% vs. 13,2%, p<0,01; 7% vs. 5,5% p=0,71, respectivamente). O escore de PESI alto (OR: 1,03 IC95%; 1,01-1,04 p<0,01), a terapia trombolítica (OR: 0,15 IC95%; 0,01-0,25, p< 0,01) e níveis altos de troponina (OR: 1,20 IC95%; 1,01-1,43, p=0,03) estiveram independentemente associados a taxas de mortalidade hospitalar na análise de regressão multivariada. Conclusão A terapia trombolítica esteve associada à mortalidade hospitalar reduzida em detrimento do aumento geral das complicações de sangramento em octogenários.


Abstract Background Despite the high proportion of octogenarians with acute pulmonary embolism, there is little information indicating the optimal management strategy, mainly therapeutic measures, such as lytic therapy. Objectives The number of elderly patients diagnosed with acute pulmonary embolism increases constantly. However, the role of thrombolytic treatment is not clearly defined among octogenarians. Our objective is to evaluate the effectiveness of lytic therapy in octogenarian patients diagnosed with pulmonary embolism. Methods One hundred and forty eight subjects (70.3% women, n=104) aged more than eighty years were included in the study. The patients were divided in two groups: thrombolytic versus non-thrombolytic treatment. In-hospital mortality rates and bleeding events were defined as study outcomes. P-value <0.05 was considered as statistical significance. Results In-hospital mortality decreased significantly in the thrombolytic group compared to the non-thrombolytic group (10.5% vs. 24.2% p=0.03). Minor bleeding events were more common in the arm that received thrombolytic treatment, but major hemorrhage did not differ between the groups (35.1% vs. 13.2%, p<0.01; 7% vs. 5.5% p=0.71, respectively). High PESI score (OR: 1.03 95%CI; 1.01-1.04 p<0.01), thrombolytic therapy (OR: 0.15 95%CI; 0.01-0.25, p< 0.01) and high troponin levels (OR: 1.20 95%CI; 1.01-1.43, p=0.03) were independently associated with in-hospital mortality rates in the multivariate regression analysis. Conclusion Thrombolytic therapy was associated with reduced in-hospital mortality at the expense of increased overall bleeding complications in octogenarians.


Subject(s)
Humans , Child , Adolescent , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Metabolic Syndrome/epidemiology , Pediatric Obesity/therapy , Body Composition , Weight Loss/physiology , Body Mass Index , Atrial Natriuretic Factor/metabolism
3.
Arq. bras. cardiol ; 118(1): 33-40, jan. 2022. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1360114

ABSTRACT

Resumo Fundamento A ação do peptídeo natriurético atrial (ANP) na natriurese, diurese e vasodilatação, resistência à insulina, fígado, rim e tecido adiposo pode contribuir para o desenvolvimento metabólico e cardiovascular saudável. Embora o nível circulante de ANP seja reduzido em pacientes com obesidade, sua resposta à perda de peso ainda é pouco explorada em populações pediátricas. Objetivo Avaliar os efeitos das variações do ANP em resposta à intervenção interdisciplinar para perda de peso na Síndrome Metabólica (SMet) e nos riscos cardiometabólicos em adolescentes com obesidade. Métodos 73 adolescentes com obesidade participaram de uma terapia interdisciplinar para perda de peso de 20 semanas, incluindo uma abordagem clínica, nutricional, psicológica e de exercícios físicos. A composição corporal, análises bioquímicas e pressão sanguínea foram avaliadas. A SMet foi classificada de acordo com a Federação Internacional de Diabetes (IDF) (2007). Após o tratamento, os voluntários foram divididos de acordo com os níveis de plasma do ANP aumento (n=31) ou ANP redução (n=19). Resultados Ambos os grupos apresentaram redução significativa de peso corporal, índice de massa corporal (IMC) e circunferências de cintura, pescoço e quadril (CC, CP e CQ, respectivamente), e aumento da massa livre de gordura (MLG). É interessante observar que houve uma redução significativa na gordura corporal, na razão de TG/HDL-c e na prevalência de SMet (de 23% para 6%) somente no grupo com ANP aumento. Conclusão Este estudo sugere que o aumento nos níveis séricos de ANP após a terapia para perda de peso pode estar associado a melhorias nos riscos cardiometabólicos e na prevalência reduzida de SMet em adolescentes com obesidade.


Abstract Background The action of atrial natriuretic peptide (ANP) on natriuresis, diuresis and vasodilatation, insulin resistance, liver, kidney, and adipose tissue may contribute to the healthy metabolic and cardiovascular development. Even though the circulating level of ANP is reduced in patients with obesity, its response to weight loss remains poorly explored in pediatric populations. Objective To evaluate the effects of ANP variations in response to interdisciplinary weight loss intervention on metabolic syndrome (MetS) and cardiometabolic risks in adolescents with obesity. Methods 73 adolescents with obesity attended a 20-week clinical interdisciplinary weight loss therapy including clinical, nutritional, psychological and exercise training approach. Body composition, biochemical analyses and blood pressure were evaluated. MetS was classified according to the International Diabetes Federation (IDF) (2007). After the treatment, volunteers were divided according to Increasing (n=31) or Decreasing (n=19) ANP plasma levels. Results Both groups present significant reduction of body weight, Body Mass Index (BMI), waist, neck and hip circumferences (WC, NC and HC, respectively) and increasing fat-free mass (FFM). Interestingly, a significant reduction in body fat, TG/HDL-c ratio and MetS prevalence (from 23% to 6%) was observed in the Increased ANP group only. Conclusion This study suggests that an increase in ANP serum levels after weight loss therapy could be associated with improvements in cardiometabolic risks and the reduced prevalence of MetS in adolescents with obesity.


Subject(s)
Humans , Child , Adolescent , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Metabolic Syndrome/epidemiology , Pediatric Obesity/therapy , Body Composition , Weight Loss/physiology , Body Mass Index , Atrial Natriuretic Factor/metabolism
5.
Cad. Saúde Pública (Online) ; 38(2): e00346520, 2022. tab
Article in English | LILACS | ID: biblio-1360299

ABSTRACT

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 Aged
6.
Arch. latinoam. nutr ; 71(4): 281-289, dic. 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1355216

ABSTRACT

Conocer la asociación específica de las enfermedades metabólicas en la mortalidad por COVID-19, ocurrida en México durante el año crítico de la pandemia de marzo 2020 a marzo 2021. Método. Se utilizó la base nacional de COVID-19 de la Dirección General de Epidemiología. Se analizaron los casos positivos que presentaron las enfermedades metabólicas: cardiovasculares, hipertensión, diabetes y obesidad. Se realizó un análisis descriptivo para conocer la distribución de los casos fallecidos y no fallecidos. Se empleó la prueba de ji cuadrada para la diferencia de las proporciones. Se utilizaron análisis de regresión logística para conocer la asociación entre las enfermedades metabólicas y la mortalidad por COVID-19 en personas positivas al virus SARS-CoV-2. Los datos fueron ajustados por edad y sexo. Resultados. Se observó la asociación de las enfermedades metabólicas en la mortalidad. La diabetes tuvo mayor porcentaje de letalidad 18,4%. Cuando se conjuntaron las enfermedades cardiovasculares y diabetes el porcentaje de letalidad subió a 31,5%; la conjunción de las enfermedades cardiovasculares, con hipertensión y diabetes fue la de mayor porcentaje de letalidad 38,7%. La obesidad fue la que tuvo menor incidencia. Conclusiones. Las enfermedades metabólicas en México son un problema de salud pública que afectó la mortalidad por covid-19. Es prioritario atender con políticas públicas preventivas y efectivas en favor de un modelo de consumo alimentario sano, acorde con las necesidades nutrimentales de la población(AU)


To know the specific association of metabolic disease on COVID-19 mortality, occurred during the critical year of the pandemic, from march 2020 to march 2021. Method: The Covid-19 national base of the General Directorate of Epidemiology was used. Positive cases of metabolic diseases were analyzed: cardiovascular disease, hypertension, diabetes and obesity. A descriptive analysis was carried out to find out the distribution of deceased and non-deceased cases. The chi-square test was used for the difference in proportions. Logistic regression analysis was used to understand the association between metabolic diseases and COVID 19 mortality in people who tested positive for the SARS-CoV-2 virus. The data were adjusted for age and gender. Results: The association of metabolic diseases on mortality was observed. Diabetes had a higher percentage of lethality 18,4%. When cardiovascular disease and diabetes were combined, the fatality rate rose to 31,5%; the combination of cardiovascular diseases, with hypertension and diabetes was the highest percentage of lethality 38,7%. Obesity had the least incidence. Conclusions: Metabolic diseases in México are a public health problem that affected COVID-19 mortality. It is a priority to deal with preventive and effective public policies in favor of a healthy food consumption model, in line with the nutritional needs of the population(AU)


Subject(s)
Humans , Male , Female , Cardiovascular Diseases/etiology , Diabetes Mellitus , Eating , COVID-19/mortality , Metabolic Diseases/complications , Metabolic Diseases/mortality , Obesity/physiopathology , Dietary Fats, Unsaturated , Epidemiology , Industrialized Foods , Pandemics , Hypertension
7.
Arch. endocrinol. metab. (Online) ; 65(6): 811-820, Nov.-Dec. 2021. tab
Article in English | LILACS | ID: biblio-1349981

ABSTRACT

ABSTRACT Objective: Cardiovascular diseases represent the main cause of death in chronic kidney disease (CKD). We aimed to evaluate the prevalence and association of the hypertriglyceridemia-waist phenotype (HWP) and visceral adiposity index (VAI) with cardiometabolic risk factors (CR) in patients with CKD on hemodialysis (HD). Materials and methods: The study is based on a cross-sectional design with 265 HD patients in two cities in northeastern Brazil. The VAI was calculated considering the variables body mass index (BMI), waist circumference (WC), triglycerides (TG) and high density lipoprotein cholesterol (HDL-c). HWP was defined as the concomitant elevation of WC and TG. The Poisson Regression Model with robust variance estimation was adjusted considering a hierarchical approach for explanatory variables. Prevalence ratios (PR) were also estimated. The level of significance adopted was 5%. Results: In our study HWP and VAI prevalence's were 29.82% and 58.49%, respectively. In the final model, there was an association between VAI and female gender (PR = 1.46; p < 0.0001) and high body fat (% BF) (PR = 1.33; p < 0.0019). HWP was associated with females (PR = 1.80; p = 0.002), alcohol consumption (PR = 1.58; p = 0.033), obesity (PR = 1.89; p = 0.0001), high %BF (PR = 1.76; p = 0.012) and reduced HDL-c (PR = 1.48; p = 0.035). Conclusion: The HWP stood out as the association with more CR factors, representing a promising method for tracking cardiometabolic risk in HD patients, mainly female.


Subject(s)
Humans , Female , Cardiovascular Diseases/etiology , Cardiovascular Diseases/metabolism , Cardiovascular Diseases/epidemiology , Triglycerides , Body Mass Index , Cross-Sectional Studies , Risk Factors , Renal Dialysis/adverse effects , Intra-Abdominal Fat/metabolism , Adiposity , Waist Circumference , Heart Disease Risk Factors
8.
Arq. bras. cardiol ; 117(4): 666-675, Oct. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1345243

ABSTRACT

Resumo Fundamento Os resultados de estudos anteriores sobre a relação entre ácido úrico sérico (AUS) e o risco de doença cardiovascular (DCV) até agora são inconsistentes devido aos fatores de confusão causados por outros fatores de risco cardiovascular conhecidos. Objetivos Este estudo tem o objetivo de avaliar a relação entre o AUS e as DCV incidentes em chineses de meia-idade e idosos, que foram estratificados de acordo com o índice de massa corporal (IMC). Métodos Recrutamos 5.721 participantes com idades entre 40 e 75 anos que não tinham diagnóstico de DCV na linha de base, e que foram monitorados de 2008 a 2017. Os participantes foram categorizados em quintis de AUS. A regressão de Cox e a análise de sobrevivência de Kaplan-Meier foram utilizadas para comparar a incidência de DCV entre os grupos de AUS. As correlações entre AUS e a incidência de DCV em grupos com IMC e circunferência de cintura (CC) variados também foram analisadas. Um P valor <0,05 foi considerado estatisticamente significativo. Resultados Durante um período médio de monitoramento de 7,6 anos, a incidência de DCV aumentou com o AUS (teste de Log-rank p<0,001). Em comparação com o primeiro quintil, as razões de risco padronizadas (intervalos de confiança de 95%) para p desenvolvimento de DCV foram 1,08 (0,78-1,65), 1,17 (0,88-1,77), 1,47 (1,12-2,21), e 1,68 (1,28-2,44) para o segundo, terceiro, quarto e quinto quintis, respectivamente. Essa relação ficou mais clara em participantes com IMC e CC normais. A razão de risco ajustada para cada aumento de 100 μmol/L de AUS foi de 1,13 (intervalo de confiança de 95%: 1,02-1,39) para eventos de DCV. Conclusões O AUS alto é um fator de risco de DCV independente em pessoas de meia-idade e idosas do norte da China. Esse efeito é mantido mesmo depois da estratificação de acordo com medidas de magreza/obesidade.


Abstract Background The results of previous studies of the relationship between serum uric acid (SUA) and the risk of cardiovascular disease (CVD) have been inconsistent due to confounding factors caused by other known cardiovascular risk factors. Objectives This study aimed to evaluate the relationship between SUA and incident CVD in middle-aged and elderly Chinese people, who were stratified according to body mass index (BMI). Methods This study recruited 5,721 participants of 40-75 years of age, who were free of CVD at baseline and who underwent follow-up from 2008 to 2017. Participants were categorized in SUA quintiles. Cox proportional hazard and Kaplan-Meier survival analysis were used to compare CVD incidence among the SUA groups. The correlations between SUA and CVD incidence in groups with differing BMI and waist circumference (WC) were also analyzed. A P value <0.05 was considered statistically significant. Results During a mean follow-up period of 7.6 years, CVD incidence increased with SUA (log-rank test p<0. 001). Compared with the first quintile, the adjusted hazard ratios (95% confidence interval (CI)) for the development of CVD were 1.08 (0.78-1.65), 1.17 (0.88-1.77), 1.47 (1.12-2.21), and 1.68 (1.28-2.44) for the second to fifth quintiles, respectively. This relationship was clearer in participants with normal BMI and WC. The adjusted hazard ratio for each 100 μmol/L increase in SUA was 1.13 (95% CI: 1.02-1.39) for CVD events. Conclusions High SUA is an independent risk factor for CVD in middle-aged and elderly northern Chinese people. This effect is maintained even after stratification according to measures of leanness/obesity.


Subject(s)
Humans , Uric Acid , Cardiovascular Diseases/etiology , Cardiovascular Diseases/epidemiology , China/epidemiology , Risk Factors , Cohort Studies , Middle Aged
9.
Arch. latinoam. nutr ; 71(3): 164-177, sept. 2021. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1353177

ABSTRACT

Diversos estudios epidemiológicos y de intervención apuntan a una asociación fuerte y consistente entre la ingesta excesiva de azúcares y el riesgo de desarrollar caries dentales y enfermedades crónicas no transmisibles. El objetivo fue describir los 10 principales alimentos que contribuyen a la ingesta de azúcares añadidos en muestras representativas de poblaciones urbanas de ocho países latinoamericanos, y considerar diferencias por país, sexo, nivel socioeconómico (NSE) y grupo de edad. Se realizó una encuesta transversal multinacional en hogares de Argentina, Brasil, Chile, Colombia, Costa Rica, Ecuador, Perú y Venezuela (N=9218; 15­65 años). La contribución porcentual a la ingesta total del nutriente sirvió para identificar los alimentos aportadores. Los datos se estratificaron por país, sexo, NSE y grupo de edad y se compararon los gramos por día. Excepto en Perú y en el grupo de 50 a 65 años, los refrescos figuraron como el principal contribuyente a la ingesta de azúcares añadidos. Las bebidas caseras y las industrializadas también destacaron. Argentina fue el país con mayor ingesta de azúcares añadidos aportados por bebidas industrializadas, y Chile el país con menor frecuencia de bebidas como fuentes. Entre los 10 contribuyentes, la ingesta de azúcares añadidos fue mayor en el sexo masculino, excepto para sacarosa y pasteles dulces. Mayores ingestas de azúcares provenientes del jugo de fruta natural y sacarosa fueron observadas en el NSE más bajo. Las mayores y menores ingestas en los grupos de edad cambian de acuerdo con la fuente alimentaria. En conclusión, las bebidas azucaradas fueron los principales contribuyentes a la ingesta de azúcares añadidos, y la ingesta varió según la ubicación geográfica y los factores sociodemográficos(AU)


This study aimed to describe the top 10 foods that contribute to added sugars intake in representative samples of urban populations in eight Latin American countries, and consider differences by country, sex, socioeconomic level (SEL), and age group. A household-based, multinational, cross-sectional survey was conducted in Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela (N=9218; 15­65 years). Contributors to added sugars were identified and listed based on the percentage of contribution to total intake of this nutrient. Data were stratified by country, sex, SEL, and age group, and the grams per day compared. Except in Peru and in the 50 to 65 years age group, soft drinks were the leading contributor to added sugar intake. Homemade beverages together industrialized beverages have been a prominent position on ranking. In general, the highest intake of added sugars by industrialized beverages was from Argentina, and the lowest frequency of beverages as sources of added sugars was observed in Chile. Among the top 10 contributors, male sex had highest added sugar intake, except for sucrose and sweet cakes. Higher intakes of sugars from natural fruit juice and sucrose were observed in the lower SEL. The highest and lowest intakes in the age groups change according to the food source. In conclusion, sugar-sweetened beverages were main contributors to added sugar intake, and the intake vary with geographical location and sociodemographic factors(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Cardiovascular Diseases/etiology , Chronic Disease , Dental Caries/etiology , Sugar-Sweetened Beverages , Obesity/etiology , Exercise , Epidemiologic Studies , Family Characteristics , Surveys and Questionnaires , Eating , Sugars/adverse effects , Nutritional Sciences
10.
Arch. latinoam. nutr ; 71(3): 189-198, sept. 2021. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1353209

ABSTRACT

El objetivo del estudio fue determinar la asociación de valores de presión arterial (PA) con parámetros de adiposidad y nivel de actividad física (NAF) en escolares y adolescentes en la región de la Araucanía en Chile. Materiales y métodos. Estudio descriptivo, transversal y correlacional que consideró una muestra de 1.125 niños, niñas y adolescentes de 6 a 13 años. Se analizaron parámetros de adiposidad: índice de masa corporal, perímetro de cintura y del brazo, pliegue bicipital, tricipital, subescapular y suprailíaco y porcentaje de masa grasa, PA sistólica (PAS), diastólica (PAD) y NAF. Resultados. 60,4% de la muestra esta normotenso; 23,6% pre HTA y 16,0% HTA, sin asociación significativa entre la PA con el sexo (p>0,05). Se encontró para el total de la muestra una correlación significativa entre la PAS con todos los parámetros de adiposidad estudiados (p<0,001; p<0,050). Para la PAD solo el grupo de 6 a 8 años presentó asociación significativa con todos estos parámetros (p<0,001; p<0,050). El NAF se asoció con la clasificación de la PA. Esta asociación tuvo significancia estadística en el grupo de 6 a 8 años (p<0,05). Conclusiones. Se evidencia una elevada frecuencia de PA alta en escolares de una región de Chile. Se identifican asociaciones significativas entre la PA con algunas medidas de adiposidad corporal y el NAF en la muestra de estudio. Esta información puede ser de gran importancia para la predicción de la hipertensión en la infancia en el contexto de atención primaria en salud(AU)


The objective of the study was to determine the association of blood pressure (BP) values with parameters of adiposity and level of physical activity (NAF) in schoolchildren and adolescents in the Araucanía region of Chile. Materials and methods. Descriptive, cross-sectional and correlational study that considered a sample of 1.125 subjects, boys and girls between 6 and 13 years old. Adiposity parameters were analyzed: body mass index, waist and arm circumference, bicipital, tricipital, subscapular and suprailiac fold and% fat mass. Systolic (SBP) and diastolic (DBP) and NAF were also analyzed. Results. 60.4% of the sample is normotensive; 23.6% preHTA and 16.0% HT, without significant association between BP and sex (p> 0.05). For the entire sample, there is a significant correlation between SBP and all the adiposity parameters studied (p <0.001; p <0.050). For DBP, only the 6 to 8-year-old group presented a significant association with all these parameters (p <0.001; p <0.050). The NAF was associated with the PA classification. This association is statistically significant in the 6 to 8-year-old group (p <0.050). Conclusions. A high frequency of high BP is evidenced in schoolchildren from a region of Chile. Significant associations were identified between BP with some measures of body adiposity and NAF in the study sample. This information can be of great importance for the prediction of hypertension in childhood in the context of primary health care(AU)


Subject(s)
Humans , Male , Female , Child , Adolescent , Cardiovascular Diseases/etiology , Body Mass Index , Arterial Pressure , Pediatric Obesity/complications , Exercise , Anthropometry , Adiposity , Waist-Height Ratio
11.
Arq. bras. cardiol ; 117(2): 352-362, ago. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1339164

ABSTRACT

Resumo Fundamento: Interrupções no tempo despendido em comportamento sedentário (breaks) têm sido associadas a melhores níveis de indicadores cardiometabólicos na população adulta. No entanto, em adolescentes, os achados sobre essa associação ainda são conflitantes. Objetivos: Analisar a associação do número de breaks por dia em comportamento sedentário com marcadores cardiometabólicos e avaliar se ela é moderada pelo estado nutricional e o tempo excessivo em comportamento sedentário em adolescentes. Métodos: Estudo transversal com 537 adolescentes (52,3% do sexo feminino), de 10 a 14 anos de idade, de escolas públicas de João Pessoa (PB). O número diário de breaks em comportamento sedentário (>100 counts/minutos) foi mensurado por meio de acelerômetros (Actigraph GT3X+). Os marcadores cardiometabólicos analisados foram: pressão arterial sistólica e diastólica (mmHg), glicose de jejum, colesterol total, triglicerídeos, HDL-c, LDL-c (todos em mg/dL) e índice de massa corporal (IMC) (kg/m2). Utilizou-se a regressão linear para analisar a associação do número de breaks com marcadores cardiometabólicos e avaliar se ela é moderada pelo estado nutricional e o tempo excessivo em comportamento sedentário. O nível de significância de p<0,05 foi adotado para todas as análises. Resultados: O número de breaks por dia se associou negativamente ao IMC (ß = −0,069; IC95%: −0,102; −0,035), mas não aos demais marcadores cardiometabólicos, e essa associação não foi moderada pelo estado nutricional dos adolescentes (p=0,221) e nem pelo tempo excessivo em comportamento sedentário (p=0,176). Conclusão: A inclusão de breaks no tempo em comportamento sedentário parece contribuir para valores mais baixos do IMC em adolescentes.


Abstract Background: The interruption of the time spent in sedentary behavior (breaks) has been associated with better levels of cardiometabolic indicators in the adult population, but in adolescents, further investigations are still needed to confirm these findings. Objectives: To analyze the association of the number of breaks per day in sedentary behaviors with cardiometabolic markers and whether it was moderated by nutritional status and excessive time on sedentary behavior in adolescents. Methods: This is a cross-sectional study of 537 adolescents (52.3% girls), aged between 10 and 14 years, enrolled in public schools in the city of João Pessoa, Paraíba state, Brazil. The number of daily breaks (>100 counts/minutes) in sedentary time was measured by Actigraph GT3X+ accelerometers. The following cardiometabolic markers were analyzed: systolic and diastolic blood pressure (mmHg), fasting blood glucose levels, total cholesterol, triglycerides, HDL-c, LDL-c (all in mg/dL) and body mass index (BMI) (kg/m2). Linear regression was used to analyze the association between the number of breaks and cardiometabolic markers and whether this association was moderated by nutritional status and excessive time in sedentary behavior. The significance level of p<0.05 was adopted for all analyses. Results: The number of daily breaks was negatively associated with BMI (boys - ß = −0.083; 95%CI: −0.132; −0.034 and girls - ß = −0.115; 95%CI: −0.169; −0.061), but not with the remaining cardiometabolic markers. The number of breaks per day was negatively associated with BMI (ß = −0.069; 95% CI: −0.102; −0.035), but not with the other cardiometabolic markers and this association was not moderated by the adolescents' nutritional status (p=0.221), or by excessive time in sedentary behavior (p=0.176). Conclusions: Including breaks in sedentary time seems to contribute to lower BMI values in adolescents.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Cardiovascular Diseases/etiology , Sedentary Behavior , Blood Pressure , Biomarkers , Body Mass Index , Cross-Sectional Studies , Risk Factors , Waist Circumference
13.
Arch. endocrinol. metab. (Online) ; 65(4): 479-487, July-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1339111

ABSTRACT

ABSTRACT Objective: Galanin is a neuropeptide which has effects not only on metabolic syndrome but also on reproduction. Glypican-4 is an adipokine associated with insulin sensitivity by interacting directly with the insulin receptor. This study evaluated serum concentrations of galanin and glypican-4 in relation with the hormonal profile as well as metabolic and cardiovascular risk factors in patients with and without polycystic ovary syndrome (PCOS). Subjects and methods: A total of 44 women with PCOS and 44 age-matched controls were eligible. Hirsutism scores, hormonal profile, metabolic and cardiovascular risk factors as well as galanin and glypican-4 levels were evaluated in each subject. Results: Women with PCOS exhibited lower levels of galanin (20.2 pg/mL versus 26.4 pg/mL, p = 0.002) and higher concentrations of glypican-4 (3.1 ng/mL versus 2.6 ng/mL, p < 0.001) than controls. Both adipokines were correlated positively with body mass index (BMI), insulin, triglyceride and Homeostasis Model Assessment (HOMA) index; glypican-4 also showed positive correlations with fasting blood glucose, free testosterone, modified Ferriman-Gallwey scores (p < 0.05). Multiple Linear Regression analyses showed that PCOS and BMI were the best predictors affecting galanin levels with a decreasing and increasing effect respectively; however BMI was the best predictor affecting glypican-4 levels with an increasing effect (p < 0.001). Conclusion: Galanin levels were lower and glypican-4 levels were higher in women with PCOS than controls. Further studies are needed to determine whether these adipokines could be used as additional markers for insulin sensitivity and lipid profile and whether they might play a role in the pathogenesis of PCOS, in which metabolic cardiovascular risks are increased.


Subject(s)
Humans , Female , Polycystic Ovary Syndrome/complications , Insulin Resistance , Galanin/blood , Glypicans/blood , Heart Disease Risk Factors , Cardiovascular Diseases/etiology , Body Mass Index , Case-Control Studies , Risk Factors
14.
Rev. Assoc. Med. Bras. (1992) ; 67(8): 1118-1123, Aug. 2021. tab
Article in English | LILACS | ID: biblio-1346969

ABSTRACT

SUMMARY OBJECTIVE: The aim of this study was to perform dosimetric analysis of radiotherapy (RT) plans with or without elective nodal irradiation (ENI) and estimate whether the increase in mean doses (MDs) in the heart and lungs with ENI may lead to late side effects that may surpass the benefits of treatment. METHODS: The dosimetric analysis of 30 treatment plans was done with or without ENI. The planning and dose-volume histograms were analyzed, and the impact on the mortality of cardiovascular and lung cancer was estimated based on the correlation of the dosimetric data with data from population studies. RESULTS: RT with ENI increased the doses in the lungs and heterogeneity in the plans compared to breast-exclusive RT. When the increase in MDs is correlated with the increase of late side-effect risks, the most important effect of ENI is the increased risk of lung cancer, especially in patients who smoke (average increase in absolute risk=1.38%). The increase in the absolute risk of cardiovascular diseases was below 0.1% in the all the situations analyzed. CONCLUSIONS: ENI increases the heterogeneity and the doses at the lungs. When recommending ENI, the risks and benefits must be taken into account, considering the oncology factors and the plan of each patient. Special attention must be given to patients who smoke as ENI may lead to a significant increase in MD in the lung and the increased risk of radiation-induced lung cancer may surpass the benefits from this treatment.


Subject(s)
Humans , Female , Breast Neoplasms/radiotherapy , Cardiovascular Diseases/etiology , Neoplasms, Second Primary , Carcinoma, Non-Small-Cell Lung , Radiotherapy, Conformal , Lung Neoplasms/etiology , Lung Neoplasms/radiotherapy , Radiotherapy Planning, Computer-Assisted , Risk Factors , Heart Disease Risk Factors , Lymph Nodes
16.
Rev. cuba. med ; 60(2): e1638,
Article in Spanish | LILACS, CUMED | ID: biblio-1280352

ABSTRACT

Introducción: Existen interrogantes sobre el daño cardiovascular que ocasiona la infección por coranavirus-2 (SARS-CoV-2), que causa la enfermedad conocida como la COVID-19, lo que motiva el interés por el tema. Objetivo: Describir las manifestaciones cardiovasculares en pacientes con infección por coronavirus-2. Método: Entre mayo y septiembre de 2020, en la Universidad de Ciencias Médicas de Guantánamo se realizó una revisión bibliográfica narrativa mediante el estudio documental de revisiones sistemáticas y artículos originales relacionados con las manifestaciones cardiovasculares de la COVID-19. La búsqueda se realizó en las bases de datos bibliográficas Pubmed, Infomed, Medline, Science Direct, y SciELO. Se utilizó el buscador Google Académico, y las palabras clave y conectores: COVID-19 AND cardiovascular disease; SARS-CoV-2 AND cardiovascular disease, y los términos en español. La extracción de datos se realizó según una planilla que resumía las preguntas de interés de acuerdo al objetivo de la revisión. Desarrollo: Se reconoce que la respuesta inflamatoria sistémica desencadenada el SARS-CoV-2 puede dañar el miocardio. Las manifestaciones cardiovasculares son frecuentes y variadas, las más comunes son la miocarditis, insuficiencia cardiaca, arritmias cardiacas y síndrome coronario agudo. Aquellos individuos con enfermedad cardiovascular tienen riesgo de descompensación, mayor riesgo de daño miocárdico por esta infección y mayor morbimortalidad. Conclusión: La pandemia COVID-19 determina un daño cardiovascular que se expresa por la presentación de miocarditis, insuficiencia cardiaca, arritmias cardiacas, síndrome coronario agudo, derrame pericárdico y taponamiento cardiaco; manifestaciones más comunes en los pacientes con antecedentes de enfermedad cardiovascular, y que desfavorecen su pronóstico(AU)


Introduction: There are questions around the cardiovascular damage caused by coranavirus-2 (SARS-CoV-2) infection, which causes the disease known as COVID-19, which motivates interest in the subject. Objective: To describe the cardiovascular manifestations in COVID-19 disease. Method: A narrative bibliographic review was carried out through the documentary study of systematic reviews and original articles related to the cardiovascular manifestations of COVID-19, from May to September 2020, at the University of Medical Sciences in Guantánamo. The search was carried out in the bibliographic databases Pubmed, Infomed, Medline, Science Direct, and SciELO. Google Academic search engine was used, and the keywords and connectors were COVID-19 AND cardiovascular disease; SARS-CoV-2 AND cardiovascular disease, and the terms in Spanish. Data extraction was carried out according to a template that summarized the questions of interest according to the objective of this review. Findings: It is recognized that the systemic inflammatory response triggered by SARS-CoV-2 can damage the myocardium. Cardiovascular manifestations are frequent and varied, the most common are myocarditis, heart failure, cardiac arrhythmias, and acute coronary syndrome. Those individuals with cardiovascular disease are at risk of decompensation, increased risk of myocardial damage from this infection, and increased morbidity and mortality. Conclusion: The COVID-19 pandemic determines cardiovascular damage that is expressed by the presentation of myocarditis, heart failure, cardiac arrhythmias, acute coronary syndrome, pericardial effusion and cardiac tamponade; most common manifestations in patients with a history of cardiovascular disease, which conditions unfavorable prognosis(AU)


Subject(s)
Humans , Cardiovascular Diseases/etiology , Coronavirus Infections/epidemiology , COVID-19/complications
18.
Arq. bras. cardiol ; 116(4): 706-712, abr. 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1285185

ABSTRACT

Resumo Fundamento Indivíduos com hipercolesterolemia grave apresentam alto risco de desenvolver doença cardiovascular aterosclerótica (DCVA). Muitos deles apresentam hipercolesterolemia familiar (HF). Objetivos Avaliar, a partir da perspectiva dos pacientes, o nível de conhecimento sobre a hipercolesterolemia grave, especialmente em relação a HF, DCVA, percepção de risco, desempenho do rastreamento em cascata e tratamento de indivíduos participantes de um programa de avaliação periódica de saúde. Métodos De um banco de dados de 70.000 brasileiros avaliados entre 2006 e 2016, 1.987 (2,8%) atenderam aos critérios de inclusão (idade ≥ 18 anos e LDL-C ≥ 190 mg/dL ou ≥ 160 mg/dL se sem uso de estatinas ou em terapia com estatinas, respectivamente). Desses, 200 foram aleatoriamente convidados a preencher um questionário extenso. A HF foi diagnosticada em caso de suspeita pelo médico responsável. Resultados Embora 97% da amostra (48±9 anos; 16% do sexo feminino; 95% com ensino superior; 88% em prevenção primária; LDL-C 209±47 mg/dL) tenha apresentado hipercolesterolemia grave, apenas 18% e 29,5% se consideravam de alto risco para desenvolver DCVA e relataram saber sua meta recomendada de LDL-C, respectivamente. Em relação à possibilidade de o colesterol alto ser uma doença hereditária, 58% relataram conhecimento sobre o fato; 24,5% (n = 49) já tinham ouvido falar em HF; e apenas 14% (n = 20) foram previamente identificados com suspeita de HF (idade ao diagnóstico de HF: 35±12 anos; 79% e 31% foram diagnosticados com > 30 e > 40 anos, respectivamente). Apenas 2,5% foram submetidos a testes genéticos; 17%, à rastreamento em cascata; e 17% não faziam uso de tratamento farmacológico. Conclusões Identificou-se uma importante lacuna na percepção de risco, no controle do colesterol e em aspectos relacionados à HF em indivíduos com hipercolesterolemia grave. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0)


Abstract Background Individuals with severe hypercholesterolemia are at a high risk of developing atherosclerotic cardiovascular disease (ASCVD). Many of them have familial hypercholesterolemia (FH). Objectives To assess from a patient perspective the degree of awareness about severe hypercholesterolemia, especially FH, ASCVD risk perception, cascade screening performance, and treatment of individuals participating in a routine health evaluation program. Methods From a database of 70,000 Brazilian individuals evaluated between 2006 and 2016, 1,987 (2.8%) met the inclusion criteria (age ≥ 18 years and LDL-C ≥ 190 mg/dL or ≥ 160 mg/dL, respectively, if not in use of statins or on statin therapy). Two-hundred individuals were randomly invited to complete an extensive questionnaire. FH was diagnosed if suspected by the attending physician. Results Although 97% of the sample (age 48±9 years; 16% women; 95% college/university education; 88% primary prevention; LDL-C 209±47 mg/dL) had severe hypercholesterolemia, only 18% and 29.5% believed to be at high ASCVD risk and reported knowledge of their recommended LDL-C goal, respectively. Fifty-eight percent reported being informed that high cholesterol could be a family disease, 24.5% (n = 49) had ever heard about FH, and merely 14% (n = 29) had been previously identified as suspected of having FH (age at FH diagnosis 35±12 years; 79% and 31% diagnosed, respectively, > 30 and > 40 years old). Only 2.5% underwent genetic tests, 17% underwent cascade screening, and 17% were not in use of pharmacological treatment. Conclusions An important gap in risk perception, cholesterol management, and aspects related to FH was encountered in individuals with severe hypercholesterolemia. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Hypercholesterolemia/drug therapy , Hyperlipoproteinemia Type II/drug therapy , Brazil , Risk Factors , Heart Disease Risk Factors , Cholesterol, LDL , Middle Aged
20.
Rev. urug. cardiol ; 36(1): e36104, abr. 2021. tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1252413

ABSTRACT

La diabetes mellitus es una de las principales causas de morbilidad y mortalidad a nivel mundial. Este grupo de pacientes generalmente representa una población con alto o muy alto riesgo cardiovascular, razón por la cual se realiza una estratificación precoz del riesgo, buscando enfocarse objetivamente en el abordaje farmacológico y no farmacológico con una estrategia intensiva. La enfermedad cardiovascular representa la principal causa de mortalidad, pero en los últimos años se han producido avances en la terapéutica que han demostrado reducir los eventos cardiovasculares mayores. Este artículo revisa la interacción entre diabetes, enfermedades cardiovasculares y su tratamiento.


Diabetes mellitus is one of the main causes of morbidity and mortality worldwide. This group of patients generally represents a population with high or very high cardiovascular risk, that is the reason for an early stratification of risk, seeking to objectively focus on pharmacological and non-pharmacological approach with an intensive strategy. Cardiovascular disease represents the main cause of mortality, but in recent years there have been advances in therapeutics that have been shown to reduce major cardiovascular events. This article reviews the interaction between diabetes, cardiovascular diseases and their treatment.


A diabetes mellitus é uma das principais causas de morbimortalidade em todo o mundo. Esse grupo de pacientes geralmente representa uma população com alto ou muito alto risco cardiovascular, razão pela qual se estratifica precocemente o risco, buscando enfocar objetivamente a abordagem farmacológica e não farmacológica com estratégia intensiva. A doença cardiovascular representa a principal causa de mortalidade, mas nos últimos anos houve avanços na terapêutica que mostraram reduzir os eventos cardiovasculares maiores. Este artigo analisa a interação entre diabetes, doenças cardiovasculares e seu tratamento.


Subject(s)
Humans , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/drug therapy , Diabetes Complications , Diabetes Mellitus/diagnosis , Diabetes Mellitus/drug therapy , Hypoglycemic Agents/adverse effects , Biomarkers , Cardiovascular Diseases/etiology , Risk Assessment , Diabetes Mellitus/epidemiology
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