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1.
Ciênc. Saúde Colet ; 26(supl.3): 5089-5098, Oct. 2021. tab, graf
Article in English | LILACS | ID: biblio-1345723

ABSTRACT

Abstract This article aims to investigate whether difficulty in taking medication is associated with stroke among older adults with Systemic Arterial Hypertension (SAH) and to explore their association with living arrangements. Cross-sectional study was based on 3,502 older adults with SAH from the four universities pole of Frailty in Brazilian Older People (Fibra) Study, Brazil, including 14 municipalities of the five Brazilian regions. We used the medical diagnosis of stroke and difficulty in taking medications (self-reported difficulty and financial difficulty affording prescribed medications). Multivariate analysis was performed using logistic regression. Differently from women, older men with SAH, which report difficulty in taking medication (unintentional non-adherence), have higher odds of stroke. When stratified by living arrangements, those living with a partner have even higher odds of stroke compared to those without difficulty in taking medication and living alone. None association was found for difficulty affording prescribed medication for both men and women. Unintentional difficulty in taking medication plays a role in SAH treatment among men. Primary care strategies for controlling blood pressure should not be focus only on patients but targeting spouses as well.


Resumo O objetivo deste artigo é investigar se a dificuldade em tomar medicamentos está associada ao acidente vascular encefálico (AVE) entre idosos com hipertensão arterial sistêmica (HAS) e explorar esta associação com arranjos familiares. Estudo seccional baseado em 3.502 idosos com HAS dos quatro polos do Estudo Fibra, Brasil, incluindo 14 cidades das cinco regiões brasileiras. Foi usado o diagnóstico médico de AVE e a dificuldade em tomar medicamentos (dificuldade autorrelatada e dificuldade financeira). Utilizou-se a regressão logística na análise multivariada. Diferentemente das mulheres, homens com HAS que relataram dificuldade em tomar medicamentos (não adesão não intencional) apresentam maior chance de ter AVE. Quando estratificado por arranjos familiares, homens que moravam com o cônjuge apresentaram chance ainda maior de ter AVE, quando comparados com aqueles sem dificuldade em tomar medicamentos e que vivem sozinhos. Nenhuma associação foi encontrada para dificuldade financeira, tanto para mulheres quanto para homens. Dificuldades não intencionais em tomar medicamentos têm um papel importante no controle da HAS entre homens. Estratégias de controle da pressão arterial realizadas na atenção primária não devem focar apenas nos pacientes, mas nos cônjuges destes pacientes.


Subject(s)
Humans , Male , Female , Aged , Stroke/epidemiology , Frailty , Hypertension/epidemiology , Blood Pressure , Cross-Sectional Studies , Medication Adherence
2.
Rev. inf. cient ; 100(4): e3484, 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1289658

ABSTRACT

RESUMEN Introducción: Las enfermedades cerebrovasculares agudas se consideran una epidemia vascular y un problema socio-sanitario de primer orden. Objetivo: Describir el comportamiento de la enfermedad cerebrovascular en pacientes de una zona rural perteneciente al Policlínico Comunitario "Juan Bruno Zayas"de Cifuentes, provincia Villa Clara, durante el año 2019. Método: Se realizó un estudio observacional de tipo descriptivo transversal. La muestra estuvo constituida por 32 pacientes que cumplieron los criterios de inclusión y exclusión. Se aplicó un cuestionario a pacientes y familiares cercanos, además, de la revisión de historias clínicas individuales y familiares con el propósito de identificar la etiopatogenia, mes en que ocurrió el evento cerebrovascular, factores de riesgo asociados, tipo de enfermedad cerebrovascular, variante, y forma de presentación clínica. Resultados: Predominó el grupo de edades de 60-69 años, sexo masculino y color de la piel negro. Los factores de riesgo más frecuentes fueron: hipertensión arterial sistémica, tabaquismo y dislipidemia. Marzo fue el mes donde hubo mayor número de casos diagnosticados como enfermedad cerebrovascular. Prevaleció el infarto cerebral como variante más frecuente. Conclusiones: La enfermedad cerebrovascular aguda siempre está asociada a los factores de riesgo clásicos. Existe predominio del ictus de origen isquémico sobre el hemorrágico. Más de la mitad de los pacientes tiene cifras elevadas de tensión arterial durante el evento cerebral. Se evidencia mayor frecuencia de casos durante los meses de menores temperaturas.


ABSTRACT Introduction: Acute cerebrovascular diseases are considered a vascular epidemic and a first-order social and health problem. Objective: To describe the behavior of cerebrovascular disease in patients who residing in a rural area associated to the Policlínico Comunitario "Juan Bruno Zayas" in Cifuentes, Villa Clara, period time 2019. Method: A cross-sectional, descriptive observational study was carried out. The sample selected envolved 32 patients who met the inclusion and exclusion criteria. A questionnaire was administered to patients and close relatives, and individual and family medical records were reviewed to identify the etiopathogenesis, month in which the cerebrovascular event occurred, associated risk factors, type of cerebrovascular disease, variant, and form of clinical presentation. Results: Group age 60 to 69 and male black patients, were predominant. Most common risk factors were: systemic arterial hypertension, smoking and dyslipidemia. March was the month with the highest number of cases diagnosed with cerebrovascular disease. Cerebral infarction prevailed as the most frequent variant. Conclusions: Acute cerebrovascular disease is always associated with classical risk factors. Ischemic stroke predominates over hemorrhagic stroke. More than half of patients have elevated blood pressure during the cerebral event. Arising cases were higher during the months with lower temperatures.


RESUMO Introdução: As doenças cerebrovasculares agudas são consideradas uma epidemia vascular e um problema sócio-sanitário de primeira ordem. Objetivo: descrever o comportamento da doença cerebrovascular em pacientes de uma área rural pertencente à Policlínico Comunitario "Juan Bruno Zayas", de Cifuentes, província de Villa Clara, durante o ano de 2019. Método: Foi realizado um estudo observacional descritivo transversal. A amostra foi composta por 32 pacientes que atenderam aos critérios de inclusão e exclusão. Foi aplicado questionário aos pacientes e familiares próximos, além da revisão dos prontuários individuais e familiares para identificação da etiopatogenia, mês em que ocorreu o evento cerebrovascular, fatores de risco associados, tipo de doença cerebrovascular, variante e forma de apresentação clínica. Resultados: Predominou a faixa etária de 60 a 69 anos, sexo masculino e cor da pele negra. Os fatores de risco mais frequentes foram: hipertensão arterial sistêmica, tabagismo e dislipidemia. Março foi o mês com maior número de casos diagnosticados como doença cerebrovascular. O infarto cerebral prevaleceu como a variante mais frequente. Conclusões: A doença cerebrovascular aguda está sempre associada a fatores de risco clássicos. Há predomínio do AVC de origem isquêmica sobre o hemorrágico. Mais da metade dos pacientes apresentam níveis elevados de pressão arterial durante o evento cerebral. Há maior frequência de casos nos meses de menor temperatura.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Stroke/etiology , Stroke/epidemiology , Hypertension/epidemiology , Cross-Sectional Studies , Observational Study
3.
Medicina (B.Aires) ; 81(4): 588-596, ago. 2021. graf
Article in English | LILACS | ID: biblio-1346511

ABSTRACT

Abstract Up to 15% of all strokes affect young patients and the incidence of ischemic stroke in this population is rising. Nevertheless, there is limited information of cerebrovascular events in this population both in our country and in Latin America. The aim of our study was to evaluate the clinical characteristics and risk factors of young adults with stroke in Argentina. This is a prospective, multicenter study of stroke in young adults (18 - 55 years) in Argentina. Patients presenting with a cerebrovascular event within 180 days were included. Stroke subtypes were classified according to TOAST criteria. A total number of 311 patients were enrolled (men 53.9%, mean age: 43.3 years). Ischemic strokes occurred in 91.8% (brain infarcts 82.6%, transient ischemic attack 9.2%) and hemorrhagic strokes in 8.2%. The most frequent vascular risk factors (including ischemic and hemorrhagic strokes) were: hypertension 120 (41%), smoking 92 (31.4%), dyslipidemia 81 (27.6%) and, over weight/obesity: 74 (25.3%). Stroke subtypes were: large artery disease 12.3%, cardioembolism 7.5, small artery occlusion 11.5%, other defined etiology 27.1%, and undetermined etiology 41.6%. Our study demonstrates that vascular risk factors are very frequent in young adults with stroke. Our findings underline that urgent strategies are required for primary and secondary stroke prevention in this group of patients.


Resumen Aproximadamente un 15% de todos los ataques cerebrovasculares afectan a pacientes jóvenes y su incidencia estaría en aumento. Existe escasa información sobre el ataque cerebral en esta población tanto en nuestro país como en Latinoamérica. El objetivo de nuestro estudio fue evaluar las características clínicas y los factores de riesgo de los adultos jóvenes con ictus en Argentina. Realizamos un estudio prospectivo y multicéntrico en adultos jóvenes (18-55 años) en Argentina, que presentaron un evento cerebrovascular dentro de los 180 días previos. Los subtipos de ictus se clasificaron según los criterios de TOAST. Se incluyeron un total de 311 pacientes (hombres 53.9%, edad media: 43,3 años). Los ataques cerebrovasculares isquémicos ocurrieron en el 91.8% (infartos cerebrales 82.6%, ataque isquémico transitorio 9.2%) y los eventos hemorrágicos correspondieron al 8.2%. Los factores de riesgo vascular más frecuentes (incluyendo los eventos isquémicos y hemorrágicos) fueron: hipertensión 120 (41%), tabaquismo 92 (31.4%), dislipidemia 81 (27.6%) y sobrepeso/obesidad: 74 (25.3%). Los subtipos de ictus isquémicos fueron: arteriopatía de gran vaso 12.3%, cardioembolismo 7.5%, oclusión de pequeña arteria 11.5%, otra etiología definida 27.1% y etiología indeterminada 41.6%. Los factores de riesgo vascular son muy frecuentes en los adultos jóvenes con ictus. Nuestros hallazgos subrayan que se requieren estrategias urgentes para la prevención primaria y secundaria del ictus en este grupo particular de pacientes en nuestro país.


Subject(s)
Humans , Male , Adult , Young Adult , Brain Ischemia/etiology , Brain Ischemia/epidemiology , Ischemic Attack, Transient , Stroke/epidemiology , Hypertension/complications , Hypertension/epidemiology , Argentina/epidemiology , Prospective Studies , Risk Factors , Stroke/etiology
4.
Rev. medica electron ; 43(3): 644-655, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289810

ABSTRACT

RESUMEN Introducción: la hipertensión arterial del adulto tiene sus inicios en la niñez, por lo que la percepción de riesgo debe aumentar en las edades pediátricas. Objetivo: elevar el nivel de conocimiento sobre hipertensión arterial en adolescentes de la Escuela Secundaria Básica Antonio Rodríguez, del municipio Colón, provincia de Matanzas. Materiales y métodos: se realizó un estudio de intervención educativa en 80 estudiantes de 8vo grado, en el período de febrero de 2017 a junio de 2018. Se aplicó un cuestionario para medir percepción de riesgo de enfermar, conocimientos sobre factores de riesgo y síntomas de hipertensión arterial antes y después de la intervención. Se crearon cuatro grupos de 20 adolescentes, que tuvieron una sesión semanal durante 6 semanas. Se desarrollaron seis temas relacionados con la enfermedad, en los que se utilizaron técnicas participativas de educación para la salud. Resultados: el 96,1 % de los adolescentes no percibían el riesgo de enfermar de hipertensión arterial antes de la intervención. Luego de esta, la percepción de riesgo se presentó en el 65,4 %. Un 43,6 % de los participantes desconocían los factores de riesgo, y el 69,2 % no conocían los síntomas. Después de la intervención, el 73 % de la muestra tenían un conocimiento parcial sobre los factores de riesgo; el 57,7 % conocían los síntomas, y el 37,2 % los conocían parcialmente. Conclusiones: la intervención educativa sobre hipertensión arterial contribuyó a elevar los conocimientos y la percepción de riesgo en los adolescentes. Se aportaron elementos para modificar estilos de vida poco saludables (AU).


ABSTRACT Introduction: the adults' arterial hypertension begins in childhood, therefore the risk perception must increase in pediatric ages. Objective: to raise knowledge level on arterial hypertension in adolescents from the high school Antonio Rodriguez, municipality of Colon, province of Matanzas. Materials and methods: an educational interventional study was carried out in 80 8th-grade students, in the period from February 2017 to June 2018. A survey was applied to measure risk perception of developing the disease, knowledge on risk factors and symptoms of arterial hypertension before and after intervention. Four groups of 20 teenagers were created, having a weekly session during six weeks. Six themes related to the disease were developed, using different participatory techniques of health education. Results: 96.1% of adolescents did not perceive the risk of developing hypertension before the intervention. After it, risk perception was present in 65.4% of them. 43.6% of participants did not know the risk factors, and 69.2 % did not know the symptoms. After the intervention, 73% of the sample had partial knowledge on risk factors; 57.7% knew the symptoms, and 37.2% knew them partially. Conclusions: the educational intervention on arterial hypertension contributed to raise knowledge and risk perception in adolescents. Elements were given to modify unhealthy lifestyles (AU).


Subject(s)
Humans , Male , Female , Adolescent , Early Intervention, Educational/methods , Hypertension/prevention & control , Chronic Disease/classification , Prevalence , Knowledge , Healthy Lifestyle , Hypertension/epidemiology
5.
Rev. cuba. med ; 60(2): e1530, tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1280346

ABSTRACT

Introducción: La enfermedad renal crónica constituye un gran problema de salud en el mundo y en Cuba. Para el año 2040 puede convertirse en la quinta causa más común de años de vida potencialmente perdidos a nivel mundial y es una importante causa de gastos para la salud, la economía y el seguro social de los países. Objetivo: Caracterizar la mortalidad en pacientes renales crónicos en edad laboral en Cuba, en los años 2011-2017, según variables sociodemográficas seleccionadas. Métodos: Investigación transversal descriptiva. El universo estuvo constituido por los 5 716 fallecidos con enfermedad renal crónica. La información fue tomada de las bases de datos de mortalidad de la Dirección Nacional de Estadísticas, del Ministerio de Salud Pública. Se estudiaron las variables: edad, sexo, ocupación y principales causas de muerte. Se calcularon tasas brutas, así como tasas de mortalidad específicas. Resultados: En la edad laboral la mortalidad por enfermedad renal crónica presentó oscilaciones del año 2011 al 2017. La edad media al morir fue 53.7 años, los mayores de 61 años, hombres, presentaron el mayor riesgo (16 por 10 000 habitantes). La tasa en la población económicamente activa desocupada fue de 33 por 10 000 habitantes. El riesgo fue mayor en las ocupaciones elementales (9 por 10 000 habitantes). La enfermedad renal hipertensiva fue la principal causa de muerte (17 por 100 000 habitantes). Conclusiones: Existe ligero incremento de la mortalidad, en hombres el riesgo es mayor, la tasa más alta es en población económicamente activa desocupada y en las ocupaciones elementales. La principal causa de muerte es la enfermedad renal hipertensiva(AU)


Introduction: Chronic kidney disease constitutes a major health problem in Cuba and worldwide. By 2040 it may become the fifth most common cause of years of life potentially lost, worldwide, and a major cause of health expenses, economy and social security. Objective: To describe mortality in chronic kidney patients of working ages in Cuba, from 2011to 2017, according to selected sociodemographic variables. Methods: This is descriptive cross-sectional research. The universe consisted of 5,716 deceased subjects with chronic kidney disease. The information was taken from the mortality databases of the National Directorate of Statistics, from the Ministry of Public Health. The variables were studied age, sex, occupation and main causes of death. Gross and specific mortality rates were calculated. Results: In working age, mortality from chronic kidney disease fluctuated from 2011 to 2017. The mean age at death was 53.7 years, those over 61 years of age, men, had the highest risk (16 per 10,000 inhabitants). The rate in the economically active unemployed population was 33 per 10,000 inhabitants. The risk was higher in basic occupations (9 per 10,000 inhabitants). Hypertensive kidney disease was the leading cause of death (17 per 100,000 population). Conclusions: There is a slight increase in mortality, the risk is higher in men, the highest rate is in the economically active unemployed population and in basic occupations. The leading cause of death is hypertensive kidney disease(AU)


Subject(s)
Humans , Work , Diabetes Mellitus/epidemiology , Renal Insufficiency, Chronic/mortality , Hypertension/epidemiology , Epidemiology, Descriptive , Cross-Sectional Studies , Sick Leave , Cuba
6.
Online braz. j. nurs. (Online) ; 20: e20216534, 05 maio 2021. tab
Article in English, Spanish, Portuguese | LILACS, BDENF | ID: biblio-1284567

ABSTRACT

OBJETIVO: Identificar a prevalência dos fatores de risco modificáveis para doença crônica não transmissível de beneficiários hipertensos e diabéticos. MÉTODO: Estudo transversal, de 2019, com dados do prontuário eletrônico de 109 adultos, independentes para as atividades cotidianas, do gerenciamento clínico por telemonitoramento de operadora de plano de saúde, Paraná-PR. Realizou­se estatística descritiva, teste qui­quadrado e regressão logística binária bruta. RESULTADOS: Homens tiveram menor consumo inadequado de refrigerante (OR =0,37) e peso elevado como fator de risco (OR =3,57). Fatores de proteção dos adultos foram hipertensão arterial (OR =0,14) e boa prontidão para mudança comportamental (OR =0,21) e, dos idosos, hipertensão arterial concomitante ao diabetes mellitus (OR =0,16). Houve associação entre idade, hipertensão arterial (p =0,001; OR =0,14; IC =0,04-0,51) e boa prontidão para a mudança comportamental (p =0,023; OR =0,21; IC =0,06-0,76). CONCLUSÃO: Predominaram idosas com estilo de vida saudável, para as quais são recomendadas intervenções de prevenção secundária.


OBJECTIVE: To identify the prevalence of the modifiable risk factors for chronic non-communicable disease in hypertensive and diabetic beneficiaries. METHOD: A cross-sectional study, from 2019, with data from the electronic medical records of 109adults, independent for the daily activities, of clinical management through telemonitoring of a health plan operator, Paraná-PR. Descriptive statistics, chi-square test and unadjusted binary logistic regression were performed. RESULTS: Men had lower inadequate consumption ofsoft drinks (OR=0.37) and overweight as a risk factor (OR=3.57). Protective factors for adults were arterial hypertension (OR=0.14) and good readiness for behavioral change (OR=0.21) and, for older adults, arterial hypertension concomitant with diabetes mellitus(OR=0.16). There was an association between age, arterial hypertension (p=0.001; OR=0.14; CI=0.04-0.51) and good readiness for behavioral change(p=0.023; OR=0.21; CI=0.06-0.76). CONCLUSION: Aged women with a healthy lifestyle predominated, for whom secondary prevention interventions are recommended.


OBJETIVO: Identificar la prevalencia de factores de riesgo modificables de enfermedades crónicas no transmisibles en beneficiarios hipertensos y diabéticos. MÉTODO: Estudio transversal, de 2019, con datos de historias clínicas electrónicas de 109 adultos, con independencia para las actividades diarias, de seguimiento clínico por telemonitorización de un operador de plan de salud, Paraná-PR. Se realizó estadística descriptiva, prueba de chi-cuadrado y regresión logística binaria bruta. RESULTADOS: Los hombres presentaron menor consumo inadecuado de gaseosas (OR =0,37) y alto peso como factor de riesgo (OR =3,57). Los factores de protección para los adultos fueron hipertensión arterial (OR =0,14) y buena disposición para el cambio de comportamiento (OR =0,21), y para los adultos mayores, hipertensión arterial concomitante con diabetes mellitus (OR =0,16). Hubo una asociación entre edad, hipertensión (p =0,001; OR =0,14; IC =0,04-0,51) y buena disposición para el cambio de comportamiento (p =0,023; OR =0,21; IC =0,06-0,76). CONCLUSIÓN: Predominaron los adultos mayores del sexo femenino con estilo de vida saludable, para quienes se recomiendan intervenciones de prevención secundaria.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Risk Factors , Prepaid Health Plans , Diabetes Mellitus/epidemiology , Noncommunicable Diseases/epidemiology , Hypertension/epidemiology , Cross-Sectional Studies , Disease Management , Supplemental Health , Telemonitoring , Life Style
7.
Arq. gastroenterol ; 58(1): 77-81, Jan.-Mar. 2021. tab
Article in English | LILACS | ID: biblio-1248994

ABSTRACT

ABSTRACT BACKGROUND: The use of immunosuppressive drugs after liver transplantation (LT) is associated with the development of systemic arterial hypertension (SAH), in addition to other comorbidities of metabolic syndrome. OBJECTIVE: Therefore, the purpose of this study was to analyze the time after use immunosuppressive drugs the patient progresses to SAH, as well as to identify its prevalence and the factors that may be correlated to it. METHODS: A retrospective and longitudinal study was conducted, based on the analysis of medical records of 72 normotensive patients, attended in the transplant unit of a university hospital, between 2016 and 2019. RESULTS: It was observed, on average, 9±6.98 months after immunosuppressive use, the patients were diagnosed with hypertension, and the prevalence of transplanted patients who evolved to SAH in this study was 59.64% (41 patients). In addition, there was a correlation between serum dosage of tacrolimus and the development of SAH (P=0.0067), which shows that tacrolimus has a significant role in the development of SAH. Finally, it was noticed that the development of post-transplantation hypertension indicates a higher risk of the patient presenting the other parameters of metabolic syndrome, as well as a higher impairment in its renal function (P=0.0061). CONCLUSION: This study shows that the patients evolved to SAH in an average of 9±6.98 months after immunosuppressive drug use. We have also found high prevalence of systemic arterial hypertension (59.64%) in patients after liver transplantation, who used calcineurin inhibitors, especially when associated with the use of tacrolimus.


RESUMO CONTEXTO: O uso de imunossupressores pós-transplante de fígado (TF) está associado ao desenvolvimento de hipertensão arterial sistêmica (HAS), além de outras alterações da síndrome metabólica. OBJETIVO: Sendo assim, o objetivo deste estudo foi analisar a partir de quando tempo após o uso do imunossupressor o paciente evolui para HAS, assim como, identificar a sua prevalência e outros fatores que podem estar relacionados, como injuria renal. MÉTODOS: Realizou-se um estudo retrospectivo, longitudinal, baseado em análise de 72 prontuários de pacientes, atendidos na unidade de transplante de um hospital universitário, que não apresentavam hipertensão arterial prévia, entre período de 2016 a 2019. RESULTADOS: Observou-se que, em média, 9±6,98 meses após uso do imunossupressor, os pacientes foram diagnosticados com hipertensão arterial sistêmica, sendo que a prevalência de pacientes transplantados que evoluíram para HAS, neste estudo, foi de 59,64% (41 pacientes). Além disso, verificou-se uma correlação entre a dosagem sérica de tacrolimus e o desenvolvimento de HAS (P=0,0067), o que evidencia que o tacrolimus tem uma atuação significativa no desenvolvimento da hipertensão arterial sistêmica. Por fim, percebeu-se que o desenvolvimento de HAS pós-transplante indica um maior risco de paciente apresentar os outros parâmetros da síndrome metabólica, como também maior prejuízo na sua função renal (P=0,0061). CONCLUSÃO: Este estudo mostra que os pacientes evoluíram para HAS em média 9±6,98 meses após o início do uso do imunossupressor. Verificou-se também alta prevalência de hipertensão arterial sistêmica (59,64%) em pacientes pós-transplante de fígado, que usavam inibidores de calcineurina, principalmente, quando associado ao uso de tacrolimus.


Subject(s)
Humans , Liver Transplantation/adverse effects , Hypertension , Hypertension/epidemiology , Prevalence , Retrospective Studies , Longitudinal Studies , Tacrolimus/adverse effects , Immunosuppressive Agents/adverse effects
8.
Säo Paulo med. j ; 139(1): 46-52, Jan.-Feb. 2021. tab
Article in English | LILACS | ID: biblio-1156970

ABSTRACT

ABSTRACT BACKGROUND: Cardiovascular risk factors are frequently associated with lowered cognitive performance among elderly people, but rarely among middle-aged adults. OBJECTIVES: To investigate associations between cardiovascular risk factors (age, physical inactivity, smoking, alcohol use, hypertension and diabetes) and lower cognitive performance among middle-aged (45-64 years) Brazilian adults. DESIGN AND SETTING: Cross-sectional study nested within the Pró-Saúde cohort. From 2,876 baseline study participants (1999), we randomly selected 488 participants and gave them validated and standardized cognitive tests (2012). METHODS: We used multiple linear and logistic regression analyses to detect associations of cardiovascular risk factors with crude scores in cognitive tests on memory (word test) and executive function (verbal fluency tests), and with overall cognitive performance scores, respectively. RESULTS: All cognitive test scores presented statistically significant inverse associations with age and direct associations with education. There was no association between lower cognitive performance and smoking or alcohol use. In both 1999 and 2012, after adjusting for sex, age and schooling, being physically active was inversely associated with lower performance regarding late memory. For individuals with diabetes in 1999, there was an association with lower performance regarding executive function, while there was a borderline association for those reporting it only in 2012. Having a diagnosis of hypertension since 1999 was associated with lower performance regarding both memory and executive functions, while reporting hypertension in 2012 was associated with lower performance regarding executive function. CONCLUSIONS: Aging, low schooling and cardiovascular risk factors may represent life course disadvantages associated with cognitive decline even among middle-aged Brazilian adults.


Subject(s)
Humans , Adult , Middle Aged , Aged , Diabetes Mellitus/epidemiology , Hypertension/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Longitudinal Studies , Cognition , Neuropsychological Tests
9.
Chinese Medical Journal ; (24): 920-926, 2021.
Article in English | WPRIM | ID: wpr-878086

ABSTRACT

BACKGROUND@#Cumulative blood pressure (BP), a measure incorporating the level and duration of BP exposure, is associated with the risk of cardiovascular disease (CVD). However, the level at which cumulative BP could significantly increase the risk remains unclear. This study aimed to investigate the association of 15-year cumulative BP levels with the long-term risk of CVD, and to examine whether the association is independent of BP levels at one examination.@*METHODS@#Data from a 26-year follow-up of the Chinese Multi-provincial Cohort Study-Beijing Project were analyzed. Cumulative BP levels between 1992 and 2007 were calculated among 2429 participants free of CVD in 2007. Cardiovascular events (including coronary heart disease and stroke) occurring from 2007 to 2018 were registered. Adjusted hazard ratios (HRs) for CVD incidence associated with quartiles of cumulative systolic blood pressure (SBP) and diastolic blood pressure (DBP) were calculated.@*RESULTS@#Of the 2429 participants, 42.9% (1042) were men, and the mean age in 2007 was 62.1 ± 7.9 years. Totally, 207 CVD events occurred during the follow-up from 2007 to 2018. Participants with higher levels of cumulative SBP or DBP exhibited a higher incidence rate of CVD (P < 0.001). Compared with the lowest quartile of cumulative SBP, the HR for CVD was 1.03 (95% confidence interval [CI]: 0.59-1.81), 1.69 (95% CI: 0.99-2.87), and 2.20 (95% CI: 1.21-3.98) for the second to the fourth quartile of cumulative SBP, and 1.46 (95% CI: 0.86-2.48), 1.99 (95% CI: 1.18-3.35), and 2.08 (95% CI: 1.17-3.71) for the second to the fourth quartile of cumulative DBP, respectively. In further cross-combined group analyses with BP measurements in 2007, 15-year cumulative BP levels higher than the median, that is, 1970.8/1239.9 mmHg·year for cumulative SBP/DBP, which were equivalent to maintaining SBP/DBP levels of 131/83 mmHg or above on average in 15 years, were associated with higher risk of CVD in subsequent years independent of BP measurements at one-time point.@*CONCLUSION@#Cumulative exposure to moderate elevation of BP is independently associated with increased future cardiovascular risk.


Subject(s)
Aged , Asian Continental Ancestry Group , Blood Pressure/physiology , Cardiovascular Diseases/etiology , China/epidemiology , Cohort Studies , Humans , Hypertension/epidemiology , Incidence , Male , Middle Aged , Risk Factors
10.
Cad. Saúde Pública (Online) ; 37(11): e00298320, 2021. tab
Article in Portuguese | LILACS | ID: biblio-1350399

ABSTRACT

Objetivou-se estimar a prevalência de hipertensão arterial, como principal marcador de doença crônica não transmissível (DCNT), e identificar os fatores modificáveis associados, em trabalhadores homens. Foram utilizados dados da linha de base de um estudo longitudinal com uma amostra de 1.024 trabalhadores homens com 18 anos ou mais de um município do Nordeste do Brasil. O marcador de DCNT foi a hipertensão arterial, definida por pressão arterial sistólica ≥ 140mmHg e/ou pressão arterial diastólica ≥ 90mmHg e/ou diagnóstico prévio de hipertensão arterial e/ou uso de medicamentos anti-hipertensivos. Empregou-se a regressão de Poisson com variância robusta, adotando a entrada hierárquica de variáveis. Foram calculadas frações atribuíveis populacionais (FAP) para as variáveis de estilo de vida, a fim de dimensionar o impacto dos fatores modificáveis na saúde dos trabalhadores. A prevalência da hipertensão arterial nesta população foi de 28,6% (IC95%: 25,9-31,5), os fatores distais: idade > 40 anos, cor da pele preta e renda familiar ≥ 3 salários mínimos; fatores intermediários: consumo abusivo de álcool, consumo de tabaco, percepção de um consumo elevado de sal e inatividade física e o fator proximal: sobrepeso e obesidade associaram-se positivamente com a hipertensão arterial. O cálculo da FAP permitiu observar que se ocorresse a redução ou eliminação de hábitos e comportamentos relacionados ao estilo de vida deste público, reduziria em 56,1% a prevalência da DCNT estudada. A identificação de fatores modificáveis e como estes podem interferir negativamente na saúde de trabalhadores homens possibilita o planejamento de intervenções no próprio local de trabalho, a fim de alcançar o maior número de indivíduos, visando reduzir os efeitos deletérios das DCNT.


The study aimed to estimate the prevalence of arterial hypertension as the principal marker of chronic noncommunicable diseases (NCDs) and to identify associated modifiable factors in male workers. Baseline data were used from a longitudinal study with a sample of 1,024 male workers 18 years or older in a municipality in Northeast Brazil. The marker for NCDs was arterial hypertension, defined as systolic pressure ≥ 140mmHg and/or diastolic pressure ≥ 90mmHg and/or prior diagnosis of arterial hypertension and/or use of antihypertensive medication. Poisson regression with robust variance was used, adopting hierarchical entry of variables. Population attributable fractions (PAFs) were calculated for the lifestyle variables to measure the impact of modifiable factors on workers' health. Prevalence of hypertension was 28.6% (95%CI: 25.9-31.5). Distal factors associated with hypertension were age > 40 years, black skin color, and family income ≥ 3 times the monthly minimum wage. Intermediate factors were alcohol abuse, smoking, high self-rated salt intake, and physical inactivity. Proximal factors were overweight and obesity. Calculation of PAFs showed that a reduction or elimination of unhealthy lifestyle habits and behaviors in this population group would reduce the prevalence of the target NCD, hypertension, by 56.1%. The identification of modifiable factors and the ways they can negatively impact male workers' health allows planning interventions in the workplace itself to reach the largest number of individuals, aimed at reducing the harmful effects of NCDs.


El objetivo fue estimar la prevalencia de hipertensão arterial, como principal marcador de enfermedad crónica no transmisible (ECNT), así como identificar factores modificables asociados, en hombres trabajadores. Se utilizaron datos de la línea de base, procedentes de un estudio longitudinal, con una muestra de 1.024 hombres trabajadores con 18 años o más de un municipio del Nordeste de Brasil. El marcador de ECNT fue la hipertensão arterial, definida por presión arterial sistólica ≥ 140mmHg y/o presión arterial diastólica ≥ 90mmHg y/o diagnóstico previo de hipertensão arterial y/o uso de medicamentos antihipertensivos. Se empleó la regresión de Poisson con varianza robusta, adoptando la entrada jerárquica de variables. Se calcularon fracciones atribuibles poblacionales (FAP) en las variables de estilo de vida, a fin de dimensionar el impacto de los factores modificables en la salud de los trabajadores. La prevalencia de la hipertensão arterial en esta población fue de 28,6% (IC95%: 25,9-31,5), los factores distales: edad > 40 años, color de piel negra y renta familiar ≥ 3 salarios mínimos; factores intermedios: consumo abusivo de alcohol, consumo de tabaco, percepción de un consumo elevado de sal e inactividad física y el factor proximal: sobrepeso y obesidad se asociaron positivamente con la hipertensão arterial. El cálculo de la FAP permitió observar que, si se produjese una reducción o eliminación de hábitos y comportamientos relacionados con el estilo de vida de este público, se reduciría en un 56,1% la prevalencia de la ECNT estudiada. La identificación de factores modificables y cómo pueden interferir negativamente en la salud de hombres trabajadores posibilita la planificación de intervenciones en el propio lugar de trabajo, con el fin de alcanzar al mayor número de individuos para reducir los efectos mortíferos de las ECNT.


Subject(s)
Humans , Male , Adult , Noncommunicable Diseases/epidemiology , Hypertension/diagnosis , Hypertension/epidemiology , Brazil/epidemiology , Prevalence , Risk Factors , Longitudinal Studies , Overweight
11.
Esc. Anna Nery Rev. Enferm ; 25(1): e20200055, 2021. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1114764

ABSTRACT

RESUMO Objetivo avaliar a síndrome metabólica e o risco cardiovascular de idosos hipertensos atendidos na atenção primária. Métodos estudo transversal realizado com 154 idosos hipertensos de uma Unidade Básica de Saúde do Distrito Federal. Um instrumento estruturado investigou o perfil dos idosos. Para a classificação da síndrome metabólica, consideraram-se os critérios propostos pela National Cholesterol Education Program - Adult Treatment Panel III. Para análise do risco cardiovascular, utilizou-se o escore de risco de Framingham. Foi realizada análise estatística e inferencial com a utilização da ANOVA, teste qui-quadrado e exato de Fisher, além da odds ratio e seu intervalo de confiança de 95% para estimar o risco cardiovascular entre os grupos. Resultados 64,9% dos idosos hipertensos eram obesos. Síndrome metabólica foi evidenciada em 70,8%. Observou-se que 27,2% apresentaram baixo, 46,8% moderado e 26,0% elevado risco cardiovascular, sendo que o sexo feminino e a idade avançada influenciaram negativamente o risco. Idosos com síndrome metabólica apresentaram 7,19 vezes mais chances de terem elevado risco cardiovascular. Considerações finais e implicações para a prática os idosos hipertensos apresentaram uma elevada prevalência de síndrome metabólica que aumentou significativamente o risco cardiovascular. Este resultado possibilita um melhor planejamento da assistência de enfermagem pelo enfermeiro da atenção primária à saúde.


RESUMEN Objetivo evaluar el síndrome metabólico y el riesgo cardiovascular de pacientes hipertensos de la tercera edad tratados en la atención primaria. Métodos estudio transversal realizado con 154 personas de la tercera edad hipertensas de una Unidad Básica de Salud del Distrito Federal. Se investigó el perfil de estas personas a través de un instrumento estructurado. Para clasificar el síndrome metabólico se utilizaron los criterios propuestos por el National Cholesterol Education Program - Adult Treatment Panel III. Para analizar el riesgo cardiovascular, se utilizó el escore de riesgo de Framingham. El análisis estadístico e inferencial se realizó mediante ANOVA, chi-cuadrado y la prueba exacta de Fisher, además de la odds ratio y su intervalo de confianza del 95% para estimar el riesgo cardiovascular entre los grupos. Resultados el 64,9% de las personas hipertensas de la tercera edad eran obesas. El síndrome metabólico se observó en el 70,8% de los casos. Se pudo observar que el 27,2% eran de riesgo cardiovascular bajo, 46,8% moderado y 26,0% alto, siendo que el sexo femenino y la edad avanzada influencian el aumento del riesgo. Las personas mayores de edad poseen 7,19 veces más probabilidades de tener un alto riesgo cardiovascular. Consideraciones finales e implicaciones para la práctica los pacientes hipertensos de edad avanzada tenían una prevalencia elevada de síndrome metabólico que aumentaba, considerablemente, el riesgo cardiovascular. Este resultado permite una mejor planificación de la atención de enfermería por parte de las enfermeras en la atención primaria de la salud.


ABSTRACT Objective To evaluate metabolic syndrome and cardiovascular risk for hypertensive elderly patients treated in primary care. Methods A cross-sectional study carried out with 154 hypertensive elderly from a Basic Health Unit in the Federal District. A structured instrument investigated the profile of the elderly. For classifying the metabolic syndrome, the criteria proposed by the National Cholesterol Education Program - Treatment Panel for Adults III were considered. For cardiovascular risk analysis, the Framingham risk score was used. Statistical and inferential analysis was performed using ANOVA, chi-square test and Fisher's exact test, in addition to Odds Ratio and its 95% confidence interval to estimate cardiovascular risk among the groups. Results 64.9% of the hypertensive elderly were obese. Metabolic syndrome was evidenced in 70.8%. It was noted that 27.2% had low, 46.8% moderate, and 26.0% high cardiovascular risk, and that being a woman and of advanced aged negatively influenced the risk. Older adults with metabolic syndrome showed 7.19 times more likelihood to have high cardiovascular risk. Final considerations and implications for the practice The hypertensive elderly patients had high metabolic syndrome prevalence, which significantly increased cardiovascular risk. This result allows for a better planning of nursing care by the nurses in primary health care.


Subject(s)
Humans , Male , Female , Aged , Primary Health Care , Metabolic Syndrome/epidemiology , Hypertension/epidemiology , Brazil/epidemiology , Chronic Disease/epidemiology , Prevalence , Risk Factors , Nurse Practitioners , Obesity/epidemiology
12.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 397-402, jan.-dez. 2021. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1150638

ABSTRACT

Objetivo: Traçar o perfil das mulheres que tiveram uma gestação tardia, admitidas no ano de 2016 em uma maternidade pública no Norte de Minas Gerais. Metodologia: Trata-se de uma pesquisa documental, retrospectiva, descritiva e de analise quantitativa. Fizeram parte dessa pesquisa as gestantes que foram admitidas em uma maternidade pública localizada em um município no norte de Minas Gerais em 2016, por meio do acesso aos prontuários. Resultados: Foram encontradas 24 complicações prévias à gestação, sendo a mais frequente, a hipertensão arterial. Das comorbidades associadas a mais prevalente foi hipertensão gestacional com 14,75% do total de mulheres. 41 complicações do parto e pós-parto foram identificadas, sendo a indução do parto a que mais acometeu as pesquisadas. Conclusão: Observa-se a necessidade de aprimoramento das informações em banco de dados como possibilitando a uma melhor atuação da equipe multidisciplinar frente ao binômio mãe-bebê, evitando assim possíveis doenças


Objective: To outline the profile of women who had a late pregnancy, admitted in 2016 to a public maternity hospital in northern Minas Gerais. Methodology: This is a documentary research, retrospective, descriptive and quantitative analysis. This study included pregnant women who were admitted to a public maternity ward located in a municipality in the north of Minas Gerais in 2016, through access to medical records. Results: 24 complications were found prior to gestation, with the most frequent being hypertension. Of the associated comorbidities the most prevalent was gestational hypertension with 14.75% of the total of women. 41 complications of childbirth and postpartum were identified, and the labor induction was the one that most affected those surveyed. Conclusion: It is necessary to improve the information in the database as it allows a better performance of the multidisciplinary team against the binomial mother-baby, thus avoiding possible diseases


Objetivo: Trazar el perfil de las mujeres que tuvieron una gestación tardia, ingresó en 2016 a un hospital público de maternidad en el norte de Minas Gerais. Metodología: Se trata de una investigación documental, retrospectiva, descriptiva y de análisis cuantitativo. Las mujeres embarazadas que fueron admitidas en una maternidad pública ubicada en un municipio en el norte de Minas Gerais en 2016, a través del acceso a los prontuarios. Resultados: Se encontraron 24 complicaciones previas a la gestación, siendo la más frecuente, la hipertensión arterial. De las comorbilidades asociadas a más prevalente fue hipertensión gestacional con el 14,75% del total de mujeres. Se identificaron 41 complicaciones del parto y posparto, siendo la inducción del parto la que más afectó a las investigadas. Conclusión: Se observa la necesidad de perfeccionamiento de las informaciones en base de datos como posibilitando una mejor actuación del equipo multidisciplinario frente al binomio madre-bebé, evitando así posibles enfermedades


Subject(s)
Humans , Female , Pregnancy , Adult , Middle Aged , Maternal Age , Pregnancy, High-Risk , Pregnant Women , Hypertension, Pregnancy-Induced/epidemiology , Postpartum Period , Hypertension/epidemiology , Obstetric Labor Complications
13.
Clinics ; 76: e2233, 2021. tab, graf
Article in English | LILACS | ID: biblio-1153991

ABSTRACT

OBJECTIVES: To explore the risk factors of essential hypertension with hyperhomocysteinemia (H-type hypertension) and design a nomogram to predict this risk. METHODS: A hospital-based study was conducted on 1,712 individuals, including 282 patients with H-type hypertension, 105 patients with simple hypertension, 645 individuals with hyperhomocysteinemia, and 680 healthy controls. Logistic regression and nomogram models were applied to evaluate the risk factors. RESULTS: Logistic regression showed that advanced age, male sex, high body mass index (BMI), high total cholesterol levels, high glucose levels, and high creatinine levels were risk factors of H-type hypertension in the healthy population and were integrated into the nomogram model. Advanced age, male sex, high BMI, high total cholesterol levels, and high glucose levels were shown to be risk factors of H-type hypertension in the hyperhomocysteinemia population. Male sex and high creatinine levels were shown to be risk factors of H-type hypertension in the hypertension population. Nomogram analysis showed that the total factor score ranged from 106 to 206, and the corresponding risk rate ranged from 0.05 to 0.95. CONCLUSIONS: Men are more likely to have H-type hypertension, and advanced age, high BMI, high total cholesterol levels, and high glucose levels are risk factors of H-type hypertension in healthy and hyperhomocysteinemia populations. Furthermore, high creatinine level is a risk factor of H-type hypertension in healthy and hypertension populations. Nomogram models may be used to intuitively evaluate H-type hypertension risk and provide a basis for personalized interventions.


Subject(s)
Humans , Male , Hyperhomocysteinemia/complications , Hyperhomocysteinemia/epidemiology , Hypertension/complications , Hypertension/epidemiology , Risk Factors , Nomograms , Essential Hypertension , Hospitals
14.
Clinics ; 76: e2370, 2021. tab, graf
Article in English | LILACS | ID: biblio-1153984

ABSTRACT

OBJECTIVES: To investigate the association among hypertension, tinnitus, and sensorineural hearing loss and evaluate the influence of other covariates on this association. METHODS: Baseline data (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were analyzed. Altogether, 900 participants were evaluated. The baseline assessment consisted of a 7-hour examination to obtain clinical and laboratory variables. Hearing was measured using pure-tone audiometry. RESULTS: Overall, 33.3% of the participants had hypertension. Participants with hypertension were more likely to be older, male, and diabetic compared to those without hypertension. The prevalence of tinnitus was higher among hypertensive participants and the odds ratio for tinnitus was higher in participants with hypertension than in those without hypertension. However, the difference was not significant after adjusting for age. Audiometric results at 250-8,000 Hz were worse in participants with hypertension than in those without hypertension in the crude analysis; however, the differences were not significant after adjustment for age, sex, diagnosis of diabetes, and exposure to noise. No significant difference was observed in hearing thresholds among participants having hypertension for <6 years, those having hypertension for ≥6 years, and individuals without hypertension. CONCLUSION: Hearing thresholds were worse in participants with hypertension. However, after adjusting for age, sex, diagnosis of diabetes, and exposure to noise, no significant differences were observed between participants with and without hypertension. A higher prevalence of tinnitus was observed in participants with hypertension compared to those without hypertension, but without significance after adjusting for age.


Subject(s)
Humans , Male , Adult , Tinnitus/epidemiology , Hearing Loss/diagnosis , Hearing Loss/epidemiology , Hypertension/complications , Hypertension/epidemiology , Audiometry, Pure-Tone , Auditory Threshold , Brazil/epidemiology , Longitudinal Studies
15.
Rev. cuba. salud pública ; 46(4): e2174, oct.-dic. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156624

ABSTRACT

Introducción: La hipertensión arterial del adulto tiene sus orígenes en la infancia. Los adolescentes copian los mismos estilos de vida del adulto que son desencadenantes potenciales de enfermedades cardiovasculares. Objetivo: Caracterizar los factores asociados a la hipertensión arterial en los adolescentes de San Juan y Martínez en el 2018. Métodos: Se realizó una investigación descriptiva, transversal. El universo estuvo constituido por 522 adolescentes de San Juan y Martínez y la muestra estuvo integrada por 203 adolescentes tomados al azar en los diferentes centros de estudio del Consejo Popular Pueblo. Resultados: El sexo femenino fue el más representativo, predominó el color de la piel negra, los antecedentes patológicos familiares más representativos fueron la hipertensión arterial y la diabetes mellitus, un elevado porcentaje de los adolescentes fuman e ingieren bebidas alcohólicas. Existe un predominio de los hábitos dietéticos malos y regulares, así como una tendencia sedentaria; gran número de ellos presentan obesidad o sobrepeso. Conclusiones: En los adolescentes de San Juan y Martínez se observa un aumento de los factores que predisponen a padecer una hipertensión arterial, lo que posibilita su desarrollo en edades tempranas de la vida. De ahí que los médicos generales integrales deban trabajar en su prevención para evitar el avance de esta enfermedad en este grupo etario(AU)


Introduction: Adult´s high blood pressure has its onset in the childhood. Adolescents copy the same lifestyles that adults have which are potential triggers for cardiovascular diseases. Objective: Characterize the factors associated with high blood pressure in the adolescents of San Juan y Martinez municipality in 2018. Methods: A descriptive, cross-sectional research was conducted. The group sample was formed by 522 teenagers from San Juan y Martínez municipality and the sample by 203 adolescents selected randomly in the different study centers of Pueblo district. Results: The female sex was the most representative; there was predominance of the black skin; the most representative family pathological history were high blood pressure and diabetes mellitus; a high percent of adolescents smoke and consume alcoholic beverages. There is a predominance of bad and regular dietary habits, as well as a sedentary trend; a large number of adolescents are obese or overweight. Conclusions: In the adolescents of San Juan y Martínez there is an increase in the factors that predispose to high blood pressure, which makes it possible to develop at an early stage of life. Hence, comprehensive general doctors must work on its prevention to stop the progression of this disease in this age group(AU)


Subject(s)
Humans , Male , Female , Adolescent , Alcoholism/prevention & control , Smoking Prevention , Hypertension/epidemiology , Obesity/epidemiology , Epidemiology, Descriptive , Cross-Sectional Studies , Risk Factors , Feeding Behavior
16.
Medicina (B.Aires) ; 80(supl.6): 25-29, dic. 2020. graf
Article in Spanish | LILACS | ID: biblio-1250315

ABSTRACT

Resumen El 20 de marzo fue implementado en Argentina el aislamiento social preventivo y obligatorio por COVID-19. Desde entonces se alertó acerca de la importancia del cuidado de las enfermedades cardiovasculares. El objetivo de este estudio de cohorte retrospectivo fue analizar la asociación entre aislamiento social e hipertensión arterial grave (sistólica ≥ 160 mmHg y/o diastólica ≥ 100 mmHg) en el Servicio de Emergencias del Hospital Universitario Fundación Favaloro. Se incluyeron pacientes mayores de 21 años durante los tres meses siguientes (20/3/20-25/6/20) y anteriores (13/12/19-19/3/20) a la implementación del aislamiento y los respectivos comparadores interanuales (21/3/19-27/6/19 y 14/12/18-20/3/19). Se comparó frecuencia de hipertensión arterial grave entre los distintos períodos mediante prueba de chi cuadrado. Se analizó asociación entre aislamiento e hipertensión arterial grave mediante regresión logística simple y multivariada. La población estudiada fue de 12 144 pacientes de 57.4 ± 17 años, 45.4% mujeres. Durante el periodo posterior a la implementación del aislamiento ingresaron 1634 pacientes, un 53.8% menos que en el periodo previo. El 23.9%, en el periodo post-aislamiento, registró hipertensión arterial grave, significativamente más que en el pre-aislamiento (15.5%) y en el comparador interanual (17.6%). La consulta durante el periodo de aislamiento se asoció con hipertensión arterial grave en el modelo simple (odds ratio 1.58) y en el multivariado (odds ratio ajustado 1.37). En conclusión, el aislamiento social se asoció con aumento de hipertensión arterial grave en el Servicio de Emergencias, de manera independiente de factores biológicos (edad, sexo) y otros potenciales confundidores.


Abstract On March 20, preventive and mandatory social isolation due to COVID-19 was implemented in Argentina. Since then, the importance of caring for cardiovascular diseases has been emphasized. The objective of this retrospective cohort study was to analyze the association between social isolation and severe arterial hypertension (systolic ≥ 160 mmHg and / or diastolic ≥ 100 mmHg) in the Emergency Service of the Hospital Universitario Fundación Favaloro. The study included patients older than 21 years, during the three months following (3/20/20206/25/2020) and prior (12/13/2019 03/19/2020) to the implementation of the isolation and the respective interannual comparators: (21/03/2019 06/27/2019 and 12/14/2018 03/20/2019). The frequency of severe arterial hypertension was compared between the different periods by chi-square test. The association between isolation and severe arterial hypertension was analyzed using simple and multivariate logistic regression. The population studied consisted of 12 144 patients 57.4 ± 17 years old, 45.4% women. During the period after the lockdown implementation, 1634 patients were admitted, 53.8% less than in the pre-lockdown implementation period; 23.9%, in the post-lockdown period, registered severe arterial hypertension, significantly more than in the pre-lockdown period (15.5%) and in the interannual comparator (17.6%). Consultation during the lockdown period was associated with severe arterial hypertension in the simple model (odds ratio 1.58) and in the multivariate model (adjusted odds ratio 1.37). In conclusion, social isolation was associated with an increase in severe arterial hypertension in the Emergency Service, independently of biological factors (age, sex) and other potential confounders.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , COVID-19 , Hypertension/epidemiology , Argentina/epidemiology , Communicable Disease Control , Retrospective Studies , SARS-CoV-2
17.
Rev. cuba. salud pública ; 46(3): e1623, jul.-set. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1144549

ABSTRACT

Introducción: La prevalencia de hipertensión arterial, diabetes y obesidad es un problema de salud pública en Colombia. Objetivo: Determinar la relación entre patrones alimentarios e hipertensión arterial, diabetes y obesidad según aspectos sociogeográficos en Colombia, 2010. Métodos: Estudio ecológico de grupos múltiples, muestra representativa 5216 sujetos entre 18 y 64 años. Se realizó análisis por regresión multinivel con los datos de frecuencia de consumo de alimentos disponibles en la Encuesta Nacional de Situación Nutricional de Colombia y la prevalencia por hipertensión arterial, diabetes y obesidad según edad, sexo y regiones geográficas de Colombia, a partir de los datos del Ministerio de Salud y Protección Social del año 2010. Resultados: Las mujeres entre 18 y 39 años son quienes más le aportan a la prevalencia de las tres enfermedades (diabetes, hipertensión arterial y obesidad), en Bogotá 5038 (p < 0,05; IC: 3246,2; 6829,8) y en la región Oriental 2891 (p < 0,05; IC: 1964,5; 3818). Las mujeres entre 18 y 49 años son quienes más contribuyen a la prevalencia de la obesidad en las regiones de Bogotá, Central y Oriental, destacándose el alto consumo de embutidos, golosinas, postres y bajo en alimentos integrales. No se encontró relación de la hipertensión arterial en ningún grupo de edad. Los resultados fueron ajustados por edad y sexo. Conclusiones: Los patrones alimentarios reportados en el estudio según región, sexo y grupos de edad son un acercamiento para ofrecer recomendaciones de consumo por grupos de alimentos de forma más específica, de tal manera que se prevengan las enfermedades no transmisibles como la hipertensión arterial, diabetes mellitus y la obesidad(AU)


Introduction: The prevalence of arterial hypertension, diabetes and obesity is a public health problem in Colombia. Objective: To determine the relation among food patterns and arterial hypertension, diabetes and obesity according to socio-demographic aspects in Colombia, 2010. Methods: Ecologic study in multiple groups; representative sample of 5216 individuals from 18 to 64 years old. It was carried out an analysis of multilevel regression with the data of food consumption's frequency available in the National Survey on Nutritional Situation of Colombia, and the prevalence of arterial hypertension, diabetes and obesity according to age, sex and geographical regions of Colombia from the data of the Ministry of Health and Social Welfare in 2010. Results: Women in the ages from 18 to 39 years are the ones with the highest prevalence in the three disease (diabetes, arterial hypertension and obesity), in Bogotá with 5038 (p<0,05; IC: 3246,2; 6829,8) and in the Eastern region with 2891 (p<0,05; IC: 1964,5; 3818). Women in the ages from 18 to 49 years are the ones with the highest prevalence of obesity in the regions of Bogotá, Central and East with predominance of a high consumption of cold meats, candies, desserts and a low consumption of integral food. There was not found relation of arterial hypertension in any age group. The results were adjusted according to age and sex. Conclusions: The reported food patterns in the study according to region, sex and age groups are a rapprochement to provide recommendations of consumption by food groups in a more specific way, so there can be prevented non-communicable diseases as arterial hypertension, diabetes mellitus and obesity(AU)


Subject(s)
Male , Female , Diabetes Mellitus/epidemiology , Feeding Behavior , Hypertension/epidemiology , Obesity/epidemiology , Colombia
18.
Rev. chil. obstet. ginecol. (En línea) ; 85(supl.1): S75-S89, set. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1138651

ABSTRACT

INTRODUCCIÓN: En Chile, los efectos maternos y perinatales de la pandemia por SARS-CoV-2 son aún desconocidos. GESTACOVID es un estudio multicéntrico que incluye embarazadas y puérperas hasta el día 42 con COVID-19. El objetivo de este estudio es presentar un informe preliminar, describiendo el impacto de la enfermedad en las embarazadas, factores de riesgo asociados y resultados perinatales. MÉTODOS: Estudio de cohorte descriptivo que incluye 661 pacientes enroladas entre el 7 de marzo y el 6 de julio de 2020, en 23 centros hospitalarios del país. Se analizaron variables demográficas, comorbilidades, características clínicas y del diagnóstico de COVID-19 y resultado materno y perinatal. RESULTADOS: Las pacientes hospitalizadas por COVID-19 tuvieron mayor prevalencia de hipertensión arterial crónica [10% vs 3%; OR=3,1 (1,5-6,79); p=0,003] y de diabetes tipo 1 y 2 [7% vs 2%; OR=3,2 (1,3-7,7); p=0,009] que las pacientes manejadas ambulatoriamente. Un IMC >40 kg/mt2 se asoció con un riesgo dos veces mayor de requerir manejo hospitalizado [OR=2,4 (1,2 - 4,6); p=0,009]. Aproximadamente la mitad de las pacientes (54%) tuvo un parto por cesárea, y un 8% de las interrupciones del embarazo fueron por COVID-19. Hasta la fecha de esta publicación, 38% de las pacientes continuaban embarazadas. Hubo 21 PCR positivas en 316 neonatos (6,6%), la mayoría (17/21) en pacientes diagnosticadas por cribado universal. CONCLUSIONES: Las embarazadas con COVID-19 y comorbilidades como diabetes, hipertensión crónica y obesidad mórbida deben ser manejadas atentamente y deberán ser objeto de mayor investigación. La tasa de transmisión vertical requiere una mayor evaluación para diferenciar el mecanismo y tipo de infección involucrada.


INTRODUCTION: In Chile, effects of the SARS-CoV-2 infection in pregnant women are unknown. GESTACOVID is a multicenter collaborative study including pregnant women and those in the postpartum period (until 42 days) who have had COVID-19. The purpose of this study is to report our preliminary results describing the clinical impact of COVID-19 in pregnant women, the associated risk factors and perinatal results. METHODS: Descriptive cohort study including 661 patients between April 7th and July 6th, 2020, in 23 hospitals. Demographical, comorbidities, clinical and diagnostic characteristics of COVID-19 disease and maternal and perinatal outcomes were analyzed. RESULTS: Pregnant women with COVID-19 admitted to the hospital were more likely to have chronic hypertension [10% vs 3%; OR=3.1 (1.5-6.79); p=0,003] and diabetes type 1 and 2 [7% vs 2%; OR=3.2 (1.3-7.7); p=0.009] than those with outpatient management. A body mass index of >40 kg/mt2 was associated with two-fold higher risk of hospitalization [OR=2.4 (1.2-4.6); p=0.009]. Almost half of patients (54%) were delivered by cesarean section, and 8% of the medically indicated deliveries were due to COVID-19. So far, 38% of the patients are still pregnant. Among 316 newborns, there were 21 positive PCR tests (6.6%), mostly from asymptomatic mothers undergoing universal screening. CONCLUSIONS: Pregnant women with COVID-19 and comorbidities such as diabetes, chronic hypertension and morbid obesity need a close follow up and should be a matter for further research. Vertical transmission of COVID-19 should be thoroughly studied to define the mechanisms and type of infection involved.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adult , Pneumonia, Viral/epidemiology , Pregnancy Complications, Infectious/epidemiology , Coronavirus Infections/epidemiology , Pandemics , Outpatients , Signs and Symptoms , Pregnancy Outcome , Comorbidity , Cesarean Section/statistics & numerical data , Chile/epidemiology , Mass Screening , Epidemiology, Descriptive , Risk Factors , Cohort Studies , Abortion, Induced/statistics & numerical data , Infectious Disease Transmission, Vertical/statistics & numerical data , Critical Care , Diabetes Mellitus/epidemiology , Betacoronavirus , Hospitalization , Hypertension/epidemiology , Obesity/epidemiology
19.
Säo Paulo med. j ; 138(4): 322-325, July-Aug. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1139703

ABSTRACT

ABSTRACT The aim of this study was to estimate the prevalence of non-vaccination against influenza among Brazilian older adults with systemic arterial hypertension and determine the main reasons for non-adherence. A cross-sectional study was conducted using data from older adults (≥ 60 years of age) with hypertension who participated in the 2013 National Health Survey and reported not having been vaccinated against flu over the previous 12 months (n = 1,295). The analyses were performed using the Stata 14.0 software. The data were weighted because of the sampling design. An estimated 3,026,080 older adults with hypertension had not received a flu vaccine over the 12 months prior to the survey (22.6%). No significant associations were found with sex, age group or schooling. The prevalence of unvaccinated older adults was lower in the southern and southeastern regions of Brazil than in the northern and northeastern regions, even after adjusting for age. The prevalence was higher among individuals without private health insurance. The main reasons for non-vaccination were fear of a reaction, rarely having the flu and not believing in the protection of the vaccine. The present findings underscore the need for healthcare professionals to explain to the population the benefits of the vaccine for preventing severe influenza (protective effect and possible reactions) and for secondary prevention of cardiovascular events. Increasing the prevalence of vaccination in older adults with hypertension and other cardiovascular diseases is of fundamental importance within the realm of public health as a strategy for reducing occurrences of complications and deaths associated with influenza.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Influenza Vaccines/administration & dosage , Health Knowledge, Attitudes, Practice , Vaccination/statistics & numerical data , Influenza, Human/prevention & control , Hypertension/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Patient Acceptance of Health Care/ethnology , Patient Acceptance of Health Care/psychology , Prevalence , Cross-Sectional Studies , Vaccination/psychology , Influenza, Human/psychology , Influenza, Human/epidemiology
20.
Medicina (B.Aires) ; 80(5): 453-461, ago. 2020. graf
Article in Spanish | LILACS | ID: biblio-1287198

ABSTRACT

Resumen La enfermedad cardiovascular y sus factores de riesgos como hipertensión arterial (HTA) y síndrome metabólico (SM), son una creciente causa de mortalidad entre los infectados con HIV. Nuestros objetivos fueron determinar la prevalencia HTA y SM en pacientes HIV positivos de la ciudad de Córdoba su asociación con el estado inmunológico, inflamación y terapia antirretroviral (TARAA). Fue un estudio aleatorizado de corte transversal. Se incluyeron 65 pacientes HIV positivos del programa provincial HIV-Córdoba, 57 (87%) recibían TARAA, 39 (60%) eran masculinos, con edad promedio de 44.7 ± 10 años. La concentración de linfocitos T CD4+ (LTCD4+) fue 404.4 ± 289.6 cel./ml. La carga viral (CV) fue indetectable en 56 (86.2%). La prevalencia de HTA fue de 40% (26/65) y se asoció a la duración de TARAA (p < 0.05). No hubo asociación entre años de infección por HIV, LTCD4+ y CV con HTA. La prevalencia de SM fue de 38.5% (25/65). El uso de TARAA fue más frecuente en aquellos con SM (OR: 1.80; IC95%: 1.43-2.28; p = 0.02). Pacientes bajo TARAA presentaron alta tasa de hipertrigliceridemia, intolerancia a la glucosa y niveles bajos de HDL (todos p < 0.01). SM se asoció a la duración de TARAA (p < 0.01). La TARAA se asoció a HTA y SM, no encontrándose relación con estado inmunológico, CV o marcadores de inflamación.


Abstract Cardiovascular diseases (CVD) are a growing cause of mortality between human immunodeficiency virus (HIV) infected patients. Hypertension (HTN) and metabolic syndrome (MS) are important causes of CVD. The prevalence of HTN and MS in HIV infected patients in Córdoba, Argentina is unknown. Our aim is to determine the prevalence of HTN and MS in HIV patients in Córdoba and their association with immunological state, inflammation and highly active antiretroviral therapy (HAART) in an observational study. Sixty-five HIV infected patients from the provincial HIV program were randomly selected. Fifty-seven (87%) were on HAART, 39 (60%) were males. The mean age was 44.7 ± 10 years. Mean CD4+ T lymphocytes (CD4+T) count was 404.4 ± 289.6 cells/ml. Viral load (VL) was undetectable in 56 (86.2%). The prevalence of HTN was 40%, and it was associated with the duration of HAART (p < 0.05). There was no association between years of HIV infection, CD4+T, VL and blood pressure. The prevalence of MS was 38.5% (25/65). MS was more frequent between those with HAART (OR: 1.80; CI 95%; 1.43-2.28; p = 0.02). Patients on HAART had higher rates of hypertriglyceridemia, impaired glucose tolerance and lower levels of HDLc (p < 0.01). MS was associated with the HAART duration (p < 0.01). HIV infected patients had a high prevalence of HTN and MS. HAART was associated with both HTN and MS, but there was no association between immunological status, VL or inflammatory markers.


Subject(s)
Humans , Male , Adult , Middle Aged , HIV Infections/epidemiology , Hypertension/epidemiology , Argentina/epidemiology , HIV Infections/complications , HIV Infections/drug therapy , Antiretroviral Therapy, Highly Active , Metabolic Syndrome/epidemiology
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