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1.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(3 Supl): 314-319, jul.-set. 2019. tab, graf
Article in Portuguese | LILACS (Americas) | ID: biblio-1023191

ABSTRACT

O procedimento da medida indireta da pressão arterial (PA) é usado na prevenção, diagnóstico e tratamento de pacientes com hipertensão arterial nas diversas fases de evolução da doença. Embora o procedimento seja considerado simples e de fácil execução, muitos profissionais realizam-no de forma inapropriada e sem o devido conhecimento científico, o que pode interferir na fidedignidade dos resultados obtidos. Objetivo: Identificar na literatura as falhas no cumprimento da técnica de medida indireta da PA realizada por profissionais de saúde. Método: Trata-se de uma revisão integrativa que analisou estudos publicados entre 2013 e 2017, nas bases de dados Cumulative Index to Nursing and Allied Health Literature, Base de Dados de Enfermagem, Scientific Electronic Library Online, Medical Literature Analysis and Retrieval System, Literatura latino-americana e do Caribe em ciências da saúde, Índice Bibliográfico Espanhol em Ciências da Saúde e Biblioteca COCHRANE. Sete artigos compuseram a amostra do estudo, a qual foi analisada com relação à identificação do artigo, características metodológicas e avaliação do rigor metodológico. Resultados: Cinco estudos foram desenvolvidos no Brasil (71,5%), um no Egito (14,3%) e um nos Estados Unidos (14,3%). Os achados apontaram falhas relacionas à etapa do preparo do paciente, à etapa do procedimento e à etapa do registro da PA. Conclusão: Inúmeras falhas foram identificadas durante a realização do procedimento de medida indireta da PA, o que reforça a necessidade do desenvolvimento de estudos de intervenção que possam promover o conhecimento teórico-prático dos profissionais da saúde


The indirect blood pressure (BP) measurement procedure is used in the prevention, diagnosis and treatment of patients with arterial hypertension in the various phases of disease progression. Although the procedure is considered simple and easy to perform, many professionals perform it incorrectly and without adequate scientific knowledge, which may interfere with the reliability of the results obtained. Objective: To identify in the literature failures in compliance with the technique of indirect BP measurement performed by health professionals. Method: This is an integrated review that analyzed studies published between 2013 and 2017 in the Cumulative Index to Nursing and Allied Health Literature, the Brazilian Nursing Database (BDENF), the Scientific Electronic Library Online, the Medical Literature Analysis and Retrieval System, the Latin American and Caribbean Health Sciences Literature, the Spanish Bibliographical Health Sciences Index, and the COCHRANE Library databases. Seven articles made up the study sample, which was analyzed in terms of article identification, methodological characteristics and assessment of methodological rigor. Results: Five studies were developed in Brazil (71.5%), one in Egypt (14.3%) and one in the United States (14.3%). The findings pointed to failures related to the patient preparation stage, the procedure stage and the BP recording stage. Conclusion: Numerous failures were identified during the indirect BP measurement procedure, which reinforces the need to develop intervention studies that can promote the theoretical-practical knowledge of health professionals


Subject(s)
Humans , Male , Female , Blood Pressure Determination , Arterial Pressure , Blood Pressure , Brachial Artery , Cardiovascular Diseases , Health Personnel , Radial Artery , Evidence-Based Practice/methods , Hypertension/mortality , Nursing, Team/methods
2.
Rev. medica electron ; 41(1): 232-238, ene.-feb. 2019.
Article in Spanish | LILACS (Americas), CUMED | ID: biblio-991341

ABSTRACT

RESUMEN El control de la hipertensión arterial resulta la medida más efectiva para lograr disminuir la mortalidad total. Una propuesta de actualidad para alcanzar ese propósito es la implementación de regímenes de tratamiento estandarizados, asociados a la prevención secundaria de la cardiopatía isquémica. En este sentido es importante el acceso del paciente a los medicamentos, el trabajo en equipo y la vigilancia del control de la presión arterial y del progreso de los pacientes que reciben el tratamiento, para ello el monitoreo y la evaluación son elementos fundamentales.


ABSTRACT The arterial hypertension control is the most effective measure to reach the decrease of the total mortality. A current proposal to reach this goal is the implementation of standardized treatment regimes, associated to the secondary prevention of the ischemic heart disease. In this sense it is important the access of the patient to the medicines, the team work and the surveillance of the arterial pressure control and the progress of the patients receiving treatment, for what monitoring and assessment are main elements.


Subject(s)
Humans , Health Programs and Plans , Myocardial Ischemia/mortality , Myocardial Ischemia/prevention & control , Hypertension/mortality , Hypertension/prevention & control , Journal Article
4.
Rev. Esc. Enferm. USP ; 53: e03457, 2019. tab
Article in English | LILACS (Americas), BDENF | ID: biblio-1003107

ABSTRACT

ABSTRACT Objective: To analyze hypertension and its relationship with the causes of death identified by the autopsy. Method: Cross-sectional study analyzed 356 participants belonging to the Brazilian Aging Brain Study Group, over 50 years of age, autopsied at the Sao Paulo Autopsy Service between 2004 to 2014. A clinical interview was conducted with the informant of the deceased. Hypertension was defined by reporting the disease and/or use of antihypertensive medication, by the informant of the deceased. Descriptive analyzes and bivariate and multivariable associations were performed. Results: The prevalence of hypertension was 66.2% and it was the second leading cause of death (25.6%) identified by autopsy, preceded by atherosclerosis (37.8%). The variables associated with hypertension were: female gender (OR=2.30 (1.34-3.90)); living with partner [OR=0.55 (0.32-0.92)]; Body Mass Index [OR=1.14 (1.08-1.22)] and history of diabetes [OR=2.39 (1.34-4.27)]. Conclusion: The prevalence of hypertension was high, and it was the second most common underlying cause of death. The gold standard for the definition of cause of death, the autopsy, shows important results, which confirmed the relevance of hypertension as a public health problem.


RESUMEN Objetivo: Analizar la hipertensión y su relación con las causas de muerte identificadas por la autopsia. Método: Estudio transversal, que analizó a 356 participantes del Biobanco para Estudios en el Envejecimiento, con edad mayor a 50 años, autopsiados en el Servicio de Verificación de Defunciones entre los años 2004 y 2014. Una entrevista clínica fue realizada con el informante del fallecido. La hipertensión fue definida por el relato de la enfermedad y/o uso de medicación antihipertensiva por el informante del fallecido. Se llevaron a cabo análisis descriptivos y asociaciones bivariadas y multivariables. Resultados: La prevalencia de hipertensión arterial fue del 66,2% y fue la segunda causa básica de defunción (25,6%) identificada en la autopsia, precedida de aterosclerosis (37,8%). Las variables asociadas con la hipertensión fueron: género femenino (OR = 2,30 (1,34-3,90); tener a una pareja [OR = 0,55 (0,32-0,92)]; índice de masa corporal [OR = 1,14 (1,08-1,22)] e historia de diabetes [OR = 2,39 (1,34-4,27)]. Conclusión: La prevalencia de hipertensión fue elevada y representó la segunda causa básica de defunción más frecuente. El uso de la autopsia como regla de oro para definir la causa de la muerte confirmó la relevancia de la hipertensión como un problema de salud pública.


RESUMO Objetivo: Analisar a hipertensão e sua relação com as causas de morte identificadas pela autópsia. Método: Estudo transversal, que analisou 356 participantes do Biobanco para Estudos no Envelhecimento, com idade maior do que 50 anos, autopsiados no Serviço de Verificação de Óbitos entre os anos de 2004 a 2014. Uma entrevista clínica foi realizada com o informante do falecido. A hipertensão foi definida pelo relato da doença e/ou o uso de medicação anti-hipertensiva pelo informante do falecido. Foram realizadas análises descritivas e associações bivariadas e multivariáveis. Resultados: A prevalência de hipertensão arterial foi de 66,2% e foi a segunda causa básica de óbito (25,6%) identificada na autópsia, precedida de aterosclerose (37,8%). As variáveis associadas à hipertensão foram: gênero feminino (OR = 2,30 (1,34-3,90); ter um parceiro [OR = 0,55 (0,32-0,92)]; índice de massa corporal [OR = 1,14 (1,08-1,22)] e história de diabetes [OR = 2,39 (1,34-4,27)]. Conclusão: A prevalência de hipertensão foi elevada e representou a segunda causa básica de óbito mais frequente. O uso da autópsia como padrão-ouro para definir a causa da morte confirmou a relevância da hipertensão como um problema de saúde pública.


Subject(s)
Humans , Autopsy , Cause of Death , Hypertension/mortality , Cross-Sectional Studies
10.
Rev. latinoam. enferm. (Online) ; 23(6): 1157-1164, Nov.-Dec. 2015. tab, graf
Article in Spanish, Portuguese | LILACS (Americas), BDENF | ID: lil-767106

ABSTRACT

Objectives: to identify the main causes for hospital admissions and deaths related to systemic arterial hypertension and diabetes mellitus (DM), and to analyze morbidity and mortality trends, in a municipality in São Paulo's countryside, by comparing two three-years periods, 2002 to 2004 and 2010 to 2012. Methods: cross-sectional study which used secondary data regarding deaths from the Information System on Mortality and concerning hospital admissions from the DataSus Hospital Information System. Univariate and multivariate statistical analyses were conducted. Results: from 2002 to 2012, 325,439 people were admitted to hospitals, 14.7% of them due to circulatory system diseases (CSD) and 0.7% due to DM. The deaths distributed as the following: 29,027 deaths (31.5%) were due to CSD; 8.06% due to cerebrovascular diseases (CVD); and 2.75% due to DM. There was a significant association between admittance and death causes and patients' gender and age in the three-year periods (p<0.001). The highest lethality in hospital admissions was found to be due to CVD (10%). That trend showed that mortality rates dropped, younger patients were admitted due to DM, and older patients were admitted due to CVD - they were more often females. Conclusion: the main causes for hospital admissions were the CSDs; main mortality causes were the CVDs in hypertensive and diabetic women. Those findings can back public policies which prioritize the promotion of health.


Objetivo: identificar o perfil epidemiológico, o conhecimento sobre a doença e a taxa de adesão ao tratamento de pacientes com hipertensão arterial sistêmica, internados no serviço de emergência. Métodos: estudo transversal, realizado com 116 pacientes internados no Serviço de Emergência de um Hospital Universitário, de ambos os gêneros e idade superior a 18 anos, no período de março a junho 2013. As variáveis pesquisadas foram os dados sociodemográficos, comorbidades, atividade física e conhecimento sobre a doença. A adesão do paciente ao tratamento e a identificação das barreiras foi avaliada pelo teste de Morisky e Brief Medical Questionnaire, respectivamente. Resultados: a maioria dos pacientes era de mulheres (55%), cor da pele branca (55%), casados (51%), aposentados ou pensionistas (64%) e com baixa escolaridade (58%). A adesão ao tratamento, na maioria das vezes (55%), foi moderada e a barreira de adesão mais prevalente foi a de recordação (67%). Quando a aquisição de medicamento era integral, houve maior adesão ao tratamento. Conclusão: os pacientes deste estudo apresentaram moderado conhecimento sobre a doença. A alta correlação entre o número de fármacos utilizados e a barreira de recordação sugere que a monoterapia seja uma opção para facilitar a adesão ao tratamento, para diminuir a taxa de esquecimento.


Objetivos: identificar las principales causas de ingresos y mortalidad por hipertensión arterial sistémica y Diabetes Mellitus (DM) y analizar la propensión a la morbimortalidad, comparando los trienios 2002-2004 y 2010-2012, de un municipio del interior paulista, en Brasil. Métodos: estudio transversal que utilizó datos secundarios de defunciones del Sistema de Información sobre Mortalidad y los ingresos del Sistema de Información Hospitalaria del Datasus. El análisis estadístico se realizó de forma univariada y multivariada. Resultados: de 2002 a 2012 ocurrieron 325.439 ingresos, el 14,7% por Enfermedades del Aparato Circulatorio (EAC) y el 0,7% por DM. Las defunciones fueron: 29.027, el 31,5% por EAC, el 8,06% por Enfermedades Cerebrovasculares (ECV) y el 2,75% por DM. Hubo asociación significativa entre las causas del ingreso y de las defunciones con respecto al sexo y a la edad de los pacientes en los trienios (p<0,001). La mayor letalidad en los pacientes ingresados fue por ECV (el 10%). La propensión mostró que hubo disminución de la mortalidad, los pacientes más jóvenes fueron ingresados debido a la DM y los de edad avanzada por ECV, con mayor frecuencia en el sexo femenino. Conclusión: las principales causas de ingresos hospitalarios fueron las EAC y de mortalidad, las ECV en las mujeres hipertensas y diabéticas. Estos hallazgos ofrecen subsidios a las políticas públicas que prioricen a la promoción de la salud.


Subject(s)
Humans , Female , Diabetes Mellitus/mortality , Hospitalization/statistics & numerical data , Hypertension/mortality , Brazil/epidemiology , Cerebrovascular Disorders/epidemiology , Cross-Sectional Studies , Morbidity , Cause of Death , Sex Distribution , Diabetes Complications , Hypertension/complications
11.
Rev. méd. Chile ; 143(9): 1114-1120, set. 2015. tab
Article in Spanish | LILACS (Americas) | ID: lil-762681

ABSTRACT

Background: Acute Kidney Injury (AKI) increases morbidity, mortality and hospital stay in critical patients units (CPU). Aim: To determine the incidence and mortality of AKI in CPU. Material and Methods: Review of electronic medical records of 1,769 patients aged 61 ± 20 years (47% males) discharged from a CPU during one year. Acute Kidney Injury diagnosis and severity was established using the Acute Kidney Injury Network (AKIN) criteria. Results: A history of hypertension and Diabetes Mellitus was present in 44 and 22% of patients, respectively. APACHE II and SOFA scores were 14.6 ± 6.8 and 3.6 ± 2.1 respectively. AKI incidence was 28.9% (stage I, 16.7%, stage II, 5.3% and stage III, 6.9%). Mortality during the first 30 days and during the first year was 8.1 and 20.0% respectively. Patients with stage III AKI had the highest mortality (23.8 and 40.2% at 30 days and one year respectively). Compared with patients without AKI, the Odds ratio for mortality at 30 days and one year of patients with AKI stage III was 3.7 and 2.5, respectively. Conclusions: Thirty percent of patients admitted to UPC develop an AKI, which influences 30 days and one year mortality.


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Acute Kidney Injury/mortality , Intensive Care Units/statistics & numerical data , Tertiary Care Centers/statistics & numerical data , Acute Kidney Injury/epidemiology , Diabetes Mellitus/mortality , Hospital Mortality , Hospitalization/statistics & numerical data , Hypertension/mortality , Incidence , Prognosis , Retrospective Studies , Risk Assessment
12.
Rev. cuba. med ; 54(1): 14-26, ene.-mar. 2015. ilus
Article in Spanish | LILACS (Americas), CUMED | ID: lil-744006

ABSTRACT

INTRODUCCIÓN: la hipertensión arterial es una enfermedad y también un importante factor de riesgo para el resto de las enfermedades crónicas no trasmisibles que causan daño vascular, discapacidad y muerte. OBJETIVO: identificar las principales causas de muerte en pacientes hipertensos fallecidos de los que se contaba con estudios necrópsicos. MÉTODOS: se realiza un estudio descriptivo de todos los pacientes hipertensos fallecidos, entre el 2006 y el 2010, en el Hospital "Enrique Cabrera", municipio Boyeros, La Habana. Se recolectaron los datos y se analizaron las siguientes variables: edad, sexo, causas de muerte, según diagnóstico anatomopatológico, y si eran o no atribuibles a la hipertensión arterial. RESULTADOS: predominó el sexo masculino (52 %), más del 80 % sobrepasaba los 60 años. Atendiendo a la clasificación etiológica, las primeras causas de muerte fueron las circulatorias (43,4 %). Según criterio estricto de muerte por hipertensión arterial, el mayor número falleció por hemorragia cerebral (51,6 %). CONCLUSIONES: las complicaciones cerebrovasculares constituyen las principales causas de muerte según criterio estricto en el paciente hipertenso.


INTRODUCTION: hypertension is a disease and important risk factor for other chronic non-communicable diseases that cause vascular injury, disability and death. OBJECTIVE: identify the main causes of death in hypertensive patients who died and whose autopsy studies were kept. METHODS: a descriptive study of all hypertensive patients who died from 2006 to 2010, at "Enrique Cabrera" Hospital, in Boyeros, Habana. Data were collected and variables were analyzed such as age, sex, cause of death, pathologic diagnosis, and whether the cause of death was attributable to high blood pressure. RESULTS: male gender was significantly predominant (52 %), over 80 % were older than 60 years. The leading causes of death were circulatory (43.4 %), considering the etiologic classification. Most of them died from cerebral haemorrhage (51.6 %), according to strict criterion of death from hypertension. CONCLUSIONS: cerebro-vascular complications are the leading causes of death according to strict criteria in hypertensive patients.


Subject(s)
Humans , Hypertension/etiology , Hypertension/mortality , Epidemiology, Descriptive , Cause of Death
13.
Rev. cuba. med. mil ; 44(1): 3-10, ene.-mar. 2015. tab
Article in Spanish | LILACS (Americas), CUMED | ID: lil-748787

ABSTRACT

INTRODUCCIÓN: la hipertensión arterial es una de las enfermedades más frecuentes a nivel mundial, pero se ha estudiado poco como causa básica de muerte y la obtención de información a partir de las autopsias. OBJETIVO: identificar la hipertensión arterial como causa básica de muerte y establecer su relación con las restantes causas de muerte y la clínica de los pacientes fallecidos incluidos en la base de datos de autopsias del Sistema Automatizado de Registro y Control de Anatomía Patológica (SARCAP). MÉTODOS: se extrajeron las 6 133 autopsias con diagnóstico de hipertensión arterial de la base de datos de autopsias del SARCAP del Hospital Militar Central "Dr. Luis Díaz Soto", de ellas se analizaron las 1 286 diagnosticadas con hipertensión arterial como causa básica de muerte. Se utilizó el SARCAP para el estudio y presentación de los resultados. RESULTADOS: se comprobó una elevada frecuencia de la hipertensión arterial. Predominó en el sexo masculino la hipertensión arterial como causa básica de muerte; en este grupo fue significativa una disminución de la esperanza vida. La mayoría de los casos estudiados fallecieron en Medicina Intensiva y de Emergencia. Predominó la estadía de 48 h o menos. La infección, el cáncer y el daño multiorgánico fueron menos frecuentes cuando la hipertensión arterial fue la causa básica de muerte. CONCLUSIONES: es necesario profundizar en el análisis realizado para precisar la enfermedad que da inicio al proceso (causa básica de muerte), las complicaciones que producen (causa indirecta de muerte) y el episodio final que ocasiona la muerte (causa directa de muerte); pues si se prevé este proceso en el paciente pueden tomarse acciones a tiempo y evitar la muerte.


INTRODUCTION: hypertension is one of the most common diseases worldwide, but it has been little studied as the underlying cause of death and obtaining information from autopsies. OBJECTIVE: identify hypertension as underlying cause of death and establish its relation to other causes of death and the deceased clinic patients included in the autopsy database of Automated System for Registration and Control of Pathology (SARCAP). METHODS: 6 133 autopsies were extracted with hypertension diagnosis from SARCAP autopsies database at "Dr. Luis Díaz Soto" Central Military Hospital, out of which, 1286 were analyzed due to hypertension diagnosis as the underlying cause of death. SARCAP was used for the study and presentation of results. RESULTS: a high prevalence of hypertension was found. Male hypertension predominated as underlying cause of death; in this group, decreased life expectancy was significantly. Most of the cases studied died in intensive and emergency medicine. The 48 h or less stay dominated. Infection, cancer and multiple organ damage were less frequent when hypertension was the underlying cause of death. CONCLUSIONS: it is necessary to deepen the analysis to pinpoint the disease that starts the process (the underlying cause of death), complications they produce (indirect cause of death) and the final episode that brings death (direct cause of death); because if this process is expected actions can be timely taken and avoid death.


Subject(s)
Humans , Male , Autopsy/statistics & numerical data , Cause of Death , Hypertension/diagnosis , Hypertension/mortality , Pathology Department, Hospital
14.
Article in English | WPRIM (Western Pacific) | ID: wprim-101090

ABSTRACT

OBJECTIVES: Recently, low systolic blood pressure (SBP) was found to be associated with an increased risk of death from vascular diseases in a rural elderly population in Korea. However, evidence on the association between low SBP and vascular diseases is scarce. The aim of this study was to prospectively examine the association between low SBP and mortality from all causes and vascular diseases in older middle-aged Korean men. METHODS: From 2004 to 2010, 94 085 Korean Vietnam War veterans were followed-up for deaths. The adjusted hazard ratios (aHR) were calculated using the Cox proportional hazard model. A stratified analysis was conducted by age at enrollment. SBP was self-reported by a postal survey in 2004. RESULTS: Among the participants aged 60 and older, the lowest SBP (<90 mmHg) category had an elevated aHR for mortality from all causes (aHR, 1.9; 95% confidence interval [CI], 1.2 to 3.1) and vascular diseases (International Classification of Disease, 10th revision, I00-I99; aHR, 3.2; 95% CI, 1.2 to 8.4) compared to those with an SBP of 100 to 119 mmHg. Those with an SBP below 80 mmHg (aHR, 4.5; 95% CI, 1.1 to 18.8) and those with an SBP of 80 to 89 mmHg (aHR, 3.1; 95% CI, 0.9 to 10.2) also had an increased risk of vascular mortality, compared to those with an SBP of 90 to 119 mmHg. This association was sustained when excluding the first two years of follow-up or preexisting vascular diseases. In men younger than 60 years, the association of low SBP was weaker than that in those aged 60 years or older. CONCLUSIONS: Our findings suggest that low SBP (<90 mmHg) may increase vascular mortality in Korean men aged 60 years or older.


Subject(s)
Aged , Asian Continental Ancestry Group , Blood Pressure , Cause of Death , Cohort Studies , Follow-Up Studies , Humans , Hypertension/mortality , Male , Middle Aged , Proportional Hazards Models , Prospective Studies , Republic of Korea , Surveys and Questionnaires , Vascular Diseases/mortality , Veterans Health
15.
ABC., imagem cardiovasc ; 27(3): 184-190, jul.-set. 2014. tab, graf
Article in Portuguese | LILACS (Americas) | ID: lil-719627

ABSTRACT

Fundamento: O Doppler tecidual é uma técnica que complementa a análise da função diastólica do ventrículo esquerdo. No entanto, alguns fatores podem influenciar suas medidas, entre estes a idade, cuja contribuição não está adequadamente esclarecida.Objetivo: Comparar o comportamento dos índices de função diastólica derivados do Doppler tecidual em indivíduos idosos hipertensos e não hipertensos.Métodos: Indivíduos com idade acima de 60 anos foram divididos em um grupo controle (GC), sem comorbidades cardiovasculares, e um grupo de hipertensos (HAS). Foram avaliadas as funções sistólica e diastólica (Doppler convencional e tecidual) do ventrículo esquerdo e obtidos os volumes do átrio esquerdo e massa ventricular. Resultados: Foram analisados 56 indivíduos (idade de 70,1 ± 6,6 anos), sendo 23 (41,1%) do GC e 33 (58,9%) do HAS. Os achados ecocardiográficos estruturais foram semelhantes entre os grupos, exceto para hipertrofia ventricular esquerda, mais frequente no HAS (34,4% versus 4,8%; p=0,017). A análise do Doppler tecidual não revelou diferenças entre os grupos (e’ septal: 8,0 ± 1,5 versus 7,2 ± 1,9cm/s; p=0,08 e e’ lateral: 9,8 ± 2,2 versus 8,7 ± 2,0cm/s; p=0,07, respectivamente para o GC e HAS). No HAS observou-se tempo de desaceleração da onda E (TD) mais prolongado (253 ± 62 versus 208 ± 36 ms no GC; p=0,003). Conclusão: Na análise da função diastólica em idosos, o Doppler tecidual não foi capaz de discriminar de forma acurada, indivíduos hipertensos, com maior potencial para a ocorrência de disfunção diastólica, de indivíduos não hipertensos. O TD revelou-se um parâmetro a ser valorizado nesta população.


Background: Tissue Doppler imaging is a technique that complements the analysis of left ventricular (LV) diastolic function. Some factors may influence these parameters, however the true influence of age on Tissue Doppler velocities remains unclear. Objective: To compare the indices of diastolic function derived from tissue Doppler imaging in hypertensive and non-hypertensive elderly individuals. Methods: Subjects aged over 60 years, divided into two groups were studied: a control group (GC) without cardiovascular comorbidities and a hypertensive group (HAS). Left ventricular systolic and diastolic function (conventional and tissue Doppler) was assessed, and measurements of left atrial volumes and LV mass were obtained. Results: The group consisted of 56 subjects (70.1 ± 6.6 years), 23 (41.1%) in the GC and 33 (58.9%) in the HAS. Except for LV hypertrophy, more frequent in the HAS group compared to HG (34.4% versus 4.8% respectively; p=0.017), all structural echocardiographic findings were similar. Tissue Doppler analysis revealed no differences between the groups (septal e’: 8.0 ± 1.5 vs. 7.2 ± 1.9 cm/s; p=0.083 and lateral e’: 9.8 ± 2.2 versus 8.7 ± 2.0 cm/s; p=0.074, respectively, for GC and HAS). A longer E-wave deceleration time was observed for HAS group (253 ± 62 versus 208 ± 36 ms in GC; p=0.003).Conclusion: In the analysis of diastolic function in elderly, tissue Doppler imaging was not able to discriminate hypertensive individuals, with the greatest potential for the occurrence of diastolic dysfunction, to the non-hypertensive individuals.The E-wave deceleration time proved to be a valuable parameter in this population.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Hypertension/physiopathology , Hypertension/mortality , Heart Failure/physiopathology , Heart Failure/mortality , Age Factors , Ventricular Dysfunction, Left/diagnosis , Cardiovascular Diseases/physiopathology , Cardiovascular Diseases/mortality , Echocardiography, Doppler/methods , ROC Curve
16.
Rev. eletrônica enferm ; 15(1): 162-171, jan.-mar. 2013.
Article in Portuguese | LILACS (Americas), BDENF | ID: lil-717900

ABSTRACT

O objetivo deste estudo foi identificar como as famílias de pessoas com hipertensão que foram a óbito em decorrência de doenças cerebrovasculares perceberam a assistência prestada aos mesmos na atenção básica. Os dados foram coletados em janeiro e fevereiro de 2008 em 16 municípios da macrorregião noroeste do Paraná, junto a familiares de 42 pessoas, a partir de entrevista semiestruturada. Os resultados mostraram que as famílias qualificam a assistência prestada na atenção básica considerando visitas domiciliares realizadas com frequência e a presença do médico e pelo apoio recebido dos profissionais na realização dos cuidados. Entretanto, identificaram a demora nos encaminhamentos para exames e consultas com especialistas e a indiferença de alguns profissionais durante a assistência como principais problemas. Os achados podem contribuir para a definição de ações assistenciais a serem adotadas pelos serviços de saúde, objetivando a melhora do acompanhamento à pessoa com hipertensão e sua família.


The objective of this study was to identify how families of people with hypertension who died due to cerebrovascular diseases realize the care they received at the primary healthcare service. Data collection was performed between January and February of 2008 in 16 cities covered by the macro-region of northwest Paraná, through a semi-structured interview with family members of 42 individuals. Results showed that families evaluated the primary healthcare based on frequent home visits and the presence of the physician, as well as the support received from healthcare professionals. The main problems identified, according to the interviewees, were the delay in referring patients for examinations and appointments with a specialist, as well as the indifference of some professionals. The findings may contribute with the establishment of health care actions to be adopted by health services, with the purpose to improve the follow up of individuals with hypertension and their families.


Se objetivó identificar el modo en que las familias de personas con hipertensión que fallecieron por consecuencia de enfermedades cerebrovasculares percibieron la atención ofrecida en la atención básica. Datos recolectados en enero y febrero 2008 en macro-región noroeste de Paraná-BR de familiares de 42 personas, utilizándose entrevista semiestructurada. Los resultados expresaron que las familias califican la asistencia brindada en la atención básica a partir de las visitas domiciliarias, cuando estas son realizadas con frecuencia y con presencia del médico; y por el apoyo recibido de los profesionales en la realización de cuidados. Sin embargo, identifican la demora en las derivaciones para exámenes y consultas con especialistas y la indiferencia de algunos profesionales durante la atención como principales problemas. Las conclusiones pueden contribuir a definir acciones asistenciales a ser adoptadas por los servicios de salud, apuntando a la mejora del seguimiento de las personas con hipertensión y sus familias.


Subject(s)
Humans , Male , Female , Middle Aged , Hypertension/nursing , Hypertension/mortality , Hypertension/psychology , Family Health , Family Nursing
18.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 22(2): 40-44, abr.-jun. 2012. tab, graf
Article in Portuguese | LILACS (Americas), SES-SP | ID: lil-681083

ABSTRACT

Devido à mistura de raças no Brasil, fica difícil se estabelecer, com precisão, a prevalência de hipertensão arterial na população afrobrasileira. Nos Estados Unidos, a prevalência de hipertensão arterial na população afrodescendentes é mais alta do que na população branca. A mortalidade por complicações da hipertensão é cinco a sete vezes maior na população americana afrodescendente em comparação à população branca. Da mesma forma, a morbidade representada por hipertrofia ventricular esquerda, doença arterial coronariana e acidente vascular encefálico é duas a quatro vezes maior nos afrodescendentes. Dessa forma, o controle da pressão arterial é fundamental na prevenção cardiovascular. Diferentes classes de medicamentos anti-hipertensivos podem ser utilizados no tratamento da hipertensão em afrodescendentes. Entretanto, existem diferenças nas respostas às classes de medicamentos nessa população. Monoterapia com bloqueadores do sistema renina angiotensina ( IECA ou BRAs ) é menos efetiva na redução da pressão do que diuréticos e/ou antagonistas dos canais de cálcio, mas existe uma grande variação de resposta anti-hipertensiva com diferentes classes de fármacos em todas as populações. Combinação de diurético ou antagonistas dos canais de cálcio com bloqueadores do sistema renina angiotensina é adequada em todos os perfis raciais. Inibidores da enzima de conversão e bloqueadores dos recptores AT1 da angiotensina II parecem ser menos efetivos nos afrodescedentes do que os diuréticos tiazídicos, tanto na redução da pressão arterial quanto na prevenção de complicações cardiovasculares decorrentes da hipertensão arterial.


Due to the mixtures of races in Brazil it is difficult to assess the prevalence of hypertension in the Afro-Brazilian population. In the United States the prevalence of hypertension in Afro-American is higher than in whites and Mexican American. Hypertension mortality is five to seven times higher in Afro-American than in whites, as well as, morbidity represented by left ventricular hypertrophy, coronary heart disease, and stroke; two to four times higher than in whites. Therefore, control of blood pressure is a keystone in the prevention od cardiovascular disease. Differente classes of antihypertensive drugs can be used in the treatment of hypertension in Afro-American individuals. Monotherapy in Afro-American with rennin-angiotensin system blockers are somewhat less effective in lowering blood pressure than monotherapy with diuretic or calcium channel blockers, but there is a broad variation in response to all antihyprtensive classes in all populations. The combination of a diuretic or a calcium channel blocker with a rennin-angiotensin system blocker is equally effective in all racial groups. ACE inhibitors and ARBs appear to be less effective than thiazide diuretics or calcium channel blockers in preventing cardiovascular complications in hypertensive African descedents.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Antihypertensive Agents/administration & dosage , Diuretics/administration & dosage , African Continental Ancestry Group/genetics , Hypertension/epidemiology , Hypertension/mortality , Diet/methods , Diet , Cardiovascular Diseases/complications , Cardiovascular Diseases/mortality , Risk Factors
20.
Cad. saúde pública ; 27(10): 1986-1996, Oct. 2011.
Article in English | LILACS (Americas) | ID: lil-602695

ABSTRACT

This study aimed to verify which anthropometric measure of abdominal obesity was the best predictor of all-cause and cardiovascular mortality in Japanese-Brazilians. The study followed 1,581 subjects for 14 years. Socio-demographic, lifestyle, metabolic, and anthropometric data were collected. The dependent variable was vital status (alive or dead) at the end of the study, and the independent variable was presence of abdominal obesity according to different baseline measures. The mortality rate was estimated, and Poisson regression was used to obtain mortality rate ratios with abdominal obesity, adjusted simultaneously for the other variables. The mortality rate was 10.68/thousand person-years. Male gender, age > 60 years, and arterial hypertension were independent risk factors for mortality. The results indicate that prevalence of abdominal obesity was high among Japanese-Brazilians, and that waist/hip ratio was the measure with the greatest capacity to predict mortality (especially cardiovascular mortality) in this group.


O objetivo foi verificar qual medida antropométrica de obesidade abdominal melhor prediz mortalidade geral e por doenças cardiovasculares entre nipo-brasileiros. Foram seguidos, por 14 anos, 1.581 sujeitos. Coletaram-se dados sociodemográficos, de estilo de vida, metabólicos e antropométricos. Considerou-se vivo ou óbito ao final do estudo como variável dependente e a presença de obesidade abdominal por diferentes medidas na linha de base como variável independente. Estimou-se o coeficiente de mortalidade e se usou o modelo de Poisson para obtenção das razões entre eles e a obesidade abdominal, ajustados simultaneamente às demais variáveis. O coeficiente de mortalidade foi de 10,68/mil pessoas-ano. O gênero masculino, a idade > 60 anos e ter hipertensão arterial foram fatores de risco independentes para mortalidade. Os resultados indicaram que entre nipo-brasileiros a prevalência de obesidade abdominal foi elevada e que a razão cintura quadril foi a medida que apresentou maior capacidade de predizer a mortalidade, especialmente cardiovascular, entre tais indivíduos.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Anthropometry , Cardiovascular Diseases/mortality , Obesity, Abdominal/mortality , Body Mass Index , Brazil , Cardiovascular Diseases , Hypertension , Hypertension/mortality , Japan/ethnology , Obesity, Abdominal , Predictive Value of Tests , Prevalence , Risk Factors , Waist-Hip Ratio
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