Daily sodium intake influences the relationship between angiotensin-converting enzyme gene insertion/deletion polymorphism and hypertension in older adults.

The angiotensin-converting enzyme insertion/deletion (I/D) gene polymorphism has been widely reported as being associated with hypertension; however, most studies do not consider environmental/behavioral factors. This study aimed to investigate the relationship among angiotensin-converting enzyme insertion/deletion gene polymorphism, environmental/behavioral factors, and hypertension in community-dwelling elderly individuals. All community-dwelling older adults from Aiquara, Bahia, Brazil, were invited to take part in this study. After exclusions, 234 elderly participants were submitted to a data collection, which included sociodemographics, lifestyle and health status questionnaires, clinical assessment, and blood withdrawal. From the blood samples, the gene polymorphism was identified through polymerase chain reaction and patients grouped as II or D allele carriers (ID and DD genotypes). Hypertension was defined by self-report of the condition and confirmed by antihypertensive drug treatment. Chi-square test was used to identify differences in the proportions distributed between groups of each dependent variable (ie, genotype, diagnosis of hypertension, and blood pressure state from medicated patients with hypertension). The prevalence of hypertension was 59.3% and was associated with diabetes mellitus and obesity, but not with angiotensin-converting enzyme insertion/deletion gene polymorphism. However, carriers of the II genotype, a salt-sensitivity genotype, exhibited a significantly greater estimated sodium intake. In addition, among medicated elderly patients with hypertension, II genotype carriers exhibited poor blood pressure control, despite similar antihypertensive drug treatment in D allele carriers, while exhibiting a greater estimated sodium intake. Our results provide new evidence regarding the interaction of genetic and environmental/behavioral factors in the genesis of hypertension among elderly patients, as well as in blood pressure control in medicated elderly patients with hypertension.

Relationship between diabetes mellitus and heart rate variability in community-dwelling elders.

BACKGROUND AND OBJECTIVE: Diabetes mellitus is one of the most common non-communicable diseases (NCDs) and may influence the autonomic nervous system. This study aims to analyze the autonomic control, through heart rate variability (HRV), from community-dwelling elders with (DM+) and without diabetes mellitus (DM-). MATERIALS AND METHODS: This cross-sectional study, in which 205 elders (≥ 60 years old), from the urban area of Aiquara municipality gave their written consent to participate. HRV data was collected through a Polar RS800CX monitor with a 5-min initial record at rest, followed by the command to quickly stand up. RESULTS: The mean age was 71 years (SD, 7.32). The population was mostly made up of women 121 (59%), with low or no schooling 123 (60%), and low income 166 (81%). HRV analysis in a frequency domain showed no difference when comparing the two groups of DM+ and DM-. Henceforth in a time domain, the rMSSD showed a median value of 16.09 (interquartile range, 9.91-30.68); pNN50 median of 0.79 (interquartile range, 0.00-6.62), with a statistical significance between the group of DM+ and DM-. CONCLUSIONS: There is a difference between the studied groups principally in what concerns the time domain, which reflects the parasympathetic activity, suggesting that elders with diabetes mellitus may have a worse parasympathetic control.

Dental caries of lifetime residents in Baixo Guandu, Brazil, fluoridated since 1953--a brief communication.

OBJECTIVES: This study aimed to verify the dental caries prevalence in Baixo Guandu, the first Brazilian city to fluoridate its public water supplies; to compare the findings with the data from the national survey; and also to compare the prevalence in the 12-year-old age group with the data obtained before the beginning of the fluoridation. METHODS: All the lifetime residents aged 5, 12, 15 to 19, and 35 to 44 years old were clinically examined (World Health Organization). RESULTS: The means of dmft/DMFT were lower than in the Brazilian population living in fluoridated communities. The DMFT Index in 12-year-old residents decreased between 1953 and 2005 from 8.61 to 1.55. CONCLUSIONS: The addition of fluoride to public water supplies was an important ally in the improvement of the oral health of Baixo Guandu inhabitants.