Fatores de risco para aterosclerose em uma populaçäo idosa ambulatorial na cidade de Säo Paulo / Risk factors for atherosclerosis in an elderly out patient population in the city of Säo Paulo

OBJECTIVE: To analyze in out clinic elderly patients of both sexes for the prevalence of risk factors for atherosclerosis and study their association with the complications of atherosclerosis. METHODS: Five hundred and sixteen outpatients, 152 men and 364 women, 60 years or older, were studied. The prevalences of hypertension, dyslipidemia, diabetes mellitus, cigarette smoking and obesity were determined in both sexes and compared using the chi-square test. The association between these factors and the presence of atherosclerotic complications was analyzed by logistic regression. RESULTS: The comparative analysis of the factors in both sexes showed that hypertension, total cholesterol ü240mg/dL, LDL-cholesterol ü160mg/dL, and body mass index >27.5 were more frequent among women, but HDL-cholesterol <35mg/dL and cigarette smoking were more frequent among men, and no difference occurred between sexes in relation to the frequency of triglycerides ü250mg/dL and diabetes mellitus. After adjustment of the variables in the regression model, we observed that in the total of elderly patients, risk factors for complications of atherosclerosis were: triglycerides ü250mg/dL, hypertension, and male sex. Among men, the risk factors were: LDL-cholesterol ü160mg/dL, diabetes mellitus, HDL-cholesterol <35mg/dL and hypertension. Among women, the risk factors were: tryglicerides ü250mg/dL and hypertension. CONCLUSION: The results showed that, in the elderly, the risk factors for atherosclerosis persist, but with different behaviors between men and women. The study suggests that the relative importance of the risk factors can change with the aging process.

Família com predominância do comprometimento cardíaco na doença de Steinert / Family with predominance of cardiac involvement in Steinert's disease

Estudaram-se mäe e dois filhos em que se diagnosticou doença de Steinert. A mäe, com 49 anos de idade, apresentava o envolvimento neuromuscular; atrofia muscular miotônica em face, pescoço e extremidades distais; e recebeu um marcapasso definitivo por 2 episódios sincopais e exame radiológico que evidenciava ECG com P-R de 250ms, QRS de 130ms com BRE e EEF evidenciando intervalos AH de 140ms PRE do NAV de 590ms, ponto de Wenckebach de 115 bpm, e intervalo HV de 80ms antes e 95ms após estresse pela procainamida. Em funçäo do caráter hereditário autossômico dominante com relativa raridade de manifestaçöes cardíacas täo evidentes (relata-se até 80%de alteraçöes eletrocardiográficas, mas menos de 15%com sintomas), procedeu-se à avaliaçäo de seus 2 filhos (F1 e F2): F1 (masc., 31 anos) com P-R de 180ms e QRS de 100ms; e F2 (fem., 27 anos) com P-R de 200ms e QRS de 100ms; ambos com HBAE. Os ecocardiogramas foram normais eo holter evidenciou bradicardia acentuada em ambos e BRE intermitente FC dependente (fase 3) em F2. O EEF revelou: F1 e F2 com funçäo AV normal; F1 com HV de 70ms antes e após procainamida e F2 com 80ms antes e 130ms após...