Perceptions of barriers to cardiac rehabilitation use in Brazil.

UNLABELLED: Cardiovascular diseases (CVD) are the leading cause of mortality in middle-income countries, such as Brazil. However, given the diversity in health care systems in Brazil, access to proven services, such as cardiac rehabilitation (CR), varies widely. PURPOSE: To describe and compare multilevel barriers to CR enrollment and participation in three Brazilian cohorts: (1) cardiac outpatients not attending CR (public or private system); (2) cardiac outpatients paying for CR; and (3) residents at high-risk of CVD with access to a free comprehensive exercise program but not making use of the program. METHODS: Brazilian residents from two cities were invited to participate - Florianopolis, an urban center; and Luzerna, a rural center. Respondents completed a survey including the Cardiac Rehabilitation Barriers Scale. Mann-Whitney U tests were used to compare barriers between cohorts cross-sectionally. RESULTS: Six hundred twenty-eight Brazilians consented to participate: 237 (37.7%) from Florianopolis, of which 139 (22.1%) participated in CR; and 391 (62.3%) from Luzerna. The mean total CR barriers for the sample were 1.66 ± 0.6 and differed significantly by cohort (P < 0.001). CR nonattendees from Florianopolis (eg, distance and not knowing about CR) and participants from Luzerna (eg, work and family responsibilities) reported significantly higher barriers than CR attendees from Florianopolis. CONCLUSION: CR nonattendees reported significantly greater barriers than CR attendees. It is hoped that the provision of CR will increase, and that the development of the programs will be in a manner which mitigates the chief barriers identified herein.

Prevalence of cardiovascular risk factors in adults living in Luzerna, Santa Catarina, in 2006.

OBJECTIVES: To estimate the prevalence of cardiovascular risk factors in the adult population of Luzerna, in the state of Santa Catarina. METHODS: A cross-sectional study with adults of both genders aged 20 to 59 years (n = 411). The prevalence of hypertension, diabetes, dyslipidemia, obesity, increased waist circumference, and smoking was estimated. Study variables were checked for frequency distribution, and a chi-square test for association was performed. RESULTS: The response rate was 85.9%. The following prevalences were found: hypertension: 14.7%; diabetes: 2.3%; dyslipidemia: 18.7%; obesity: 15.6%; increased waist circumference: 24.1%; and smoking: 15.6%. A total of 52.4% of the subjects had none of the risk factors; 22.4% had one risk factor, and 13.6%, 6.8%, and 4.9% had two, three, and four or more associated risk factors, respectively. CONCLUSION: The study sample showed low prevalence of hypertension and diabetes and less clustering of risk factors in the same individual, as compared with other data reported in the literature.

Prevalência de Fatores de risco cardiovascular em adultos de Luzerna, Santa Catarina, 2006 / Prevalence of cardiovascular risk factors in adults living in Luzerna, Santa Catarina, in 2006

OBJETIVO: Estimar a prevalência de fatores de risco cardiovasculares na população adulta do município de Luzerna, Santa Catarina. MÉTODOS: Estudo transversal com adultos de 20 a 59 anos (n = 411), de ambos os sexos. Foi estimada a prevalência de hipertensão arterial sistêmica, diabetes, dislipidemia, obesidade, circunferência abdominal alterada e tabagismo. Realizou-se a distribuição de freqüência simples das variáveis de interesse e teste de associação do Qui-quadrado. RESULTADOS: A taxa de resposta foi igual a 85,9 por cento. As seguintes prevalências foram encontradas: hipertensão arterial sistêmica: 14,7 por cento; diabetes: 2,3 por cento; dislipidemia: 18,7 por cento; obesidade: 15,6 por cento; circunferência abdominal alterada: 24,1 por cento; e tabagismo: 15,6 por cento. Verificamos que 52,4 por cento dos indivíduos não possuíam nenhum dos fatores de risco; 22,4 por cento apresentavam um fator e 13,6 por cento, 6,8 por cento, e 4,9 por cento apresentavam dois, três e quatro ou mais fatores associados, respectivamente. CONCLUSÃO: A população analisada apresentou prevalências baixas de hipertensão, diabetes e menor agrupamento de fatores de risco em um mesmo indivíduo, quando comparada a outros dados relatados na literatura.

OBJECTIVES: To estimate the prevalence of cardiovascular risk factors in the adult population of Luzerna, in the state of Santa Catarina. METHODS: A cross-sectional study with adults of both genders aged 20 to 59 years (n = 411). The prevalence of hypertension, diabetes, dyslipidemia, obesity, increased waist circumference, and smoking was estimated. Study variables were checked for frequency distribution, and a chi-square test for association was performed. RESULTS: The response rate was 85.9 percent. The following prevalences were found: hypertension: 14.7 percent; diabetes: 2.3 percent; dyslipidemia: 18.7 percent; obesity: 15.6 percent; increased waist circumference: 24.1 percent; and smoking: 15.6 percent. A total of 52.4 percent of the subjects had none of the risk factors; 22.4 percent had one risk factor, and 13.6 percent, 6.8 percent, and 4.9 percent had two, three, and four or more associated risk factors, respectively. CONCLUSION: The study sample showed low prevalence of hypertension and diabetes and less clustering of risk factors in the same individual, as compared with other data reported in the literature.