PREVALÊNCIA E FATORES DE RISCOS ASSOCIADOS À HIPERTENSÃO ARTERIAL EM IDOSOS HOSPITALIZADOS / PREVALENCE AND RISK FACTORS ASSOCIATED WITH HYPERTENSION IN HOSPITALIZED ELDERLY

Introdução: A hipertensão é o principal fator contribuidor para todas as causas de morte e invalidez. Alterações fisiopatológicas em razão do envelhecimento justificam alta incidência da hipertensão no idoso. Objetivo: Verificar a prevalência e fatores associados a hipertensão em idosos hospitalizados. Método: Estudo transversal, quantitativo, realizado com 233 idosos em hospital de ensino brasileiro de grande porte. Dados sociodemográficos/clínicos e hábitos de vida foram coletados. Análise bivariada e regressão logística foram realizadas, sendo considerado significativo p<0,05. Resultados: A média de idade foi 70,9±8,1anos, com prevalência do sexo masculino (63,1%), brancos (62,2%) e hipertensos (67%). Idade ≥80anos (OR:3,965, IC 95%:1,430- 10,995) e diabetes (OR:4,196, IC 95%:1,968-8,946) foram significativos para ocorrência de hipertensão. Conclusão: Indivíduos muito idosos e diabetes foram fatores significativos para hipertensão em idosos hospitalizados.

Introduction: Hypertension is the main contributing factor to all causes of death and disability. Pathophysiological changes due to aging justify a high incidence of hypertension in the elderly. Objective: To verify the prevalence and factors associated with hypertension in hospitalized elderly. Method: Cross-sectional, quantitative study conducted with 233 elderly people in a large Brazilian teaching hospital. Sociodemographic/clinical data and lifestyle habits were collected. Bivariate analysis and logistic regression were performed, and p<0.05 was considered significant. Results: The mean age was 70.9±8.1 years, with prevalence of males (63.1%), whites (62.2%) and hypertensive (67%). Age ≥80 years (OR:3.965, 95% CI:1.430-10.995) and diabetes (OR:4.196, 95% CI:1.968-8.946) were significant for the occurrence of hypertension. Conclusion: Very elderly individuals and diabetes were significant factors for hypertension in hospitalized elderly.

Risk Factors for In-Hospital Mortality from Cardiac Causes After Acute Myocardial Infarction

Abstract Background: Risk stratification on admission of patients with acute ST-elevation myocardial infarction (STEMI) is considered a clear strategy for effective treatment, early intervention, and survival. Objective: The purpose of this study was to determine the risk factors for in-hospital mortality from cardiac causes after STEMI. Methods: Observational, retrospective, longitudinal study, with a quantitative approach, based on data from the medical records of individuals diagnosed with STEMI treated at the Emergency Room of a large hospital in the state of Minas Gerais, Brazil, from January 2011 to July 2016. The outcome of interest was 30-day in-hospital mortality from after STEMI. For statistical analysis, the Pearson's chi-square test, Spearman's correlation and multivariable Cox-regression analysis were used, with a significance level of α = 0.05. Results: Of the 459 patients, 55 (12%) died from cardiac causes within 30 days after STEMI. Mean admission SBP of these patients was 109.08mmHg. The incidence of death was higher in women (23.7%), patients with systemic arterial hypertension (SAH) (13.8%) and elderly patients (16.5%). The elderly — heart rate (HR) = 3.54 — and women — HR = 2.55 — had a statistically significant higher risk of progressing to death when compared to younger adults and men. The highest admission SBP had a protective effect (HR = 0.97), reducing the chance of death by 3%. Conclusion: SBP on admission, female gender and advanced age were significant risk factors for death within 30 days after STEMI.

Factors Associated With Elevated Blood Pressure in Nursing Workers

Abstract Introduction Nurses from the night shift are exposed to sleep deprivation, which is associated with circadian rhythm alteration, lifestyle changes, psychosocial stress, and, consequently, increased risk of blood pressure (BP) deregulation and hypertension. Objective To analyze risk factors associated with elevated BP levels in nursing workers. Methods A transversal, quantitative study was conducted with 172 nursing professionals of a large hospital in the state of Minas Gerais, Brazil. The following data were collected: anthropometric and BP measurements, sociodemographic characteristics, clinical variables, and lifestyle habits. Results were evaluated by bivariate analysis and logistic regression. The level of significance adopted in the statistical analysis was 5%. Results Participants' average age was 42.7 ± 9.6 years old; 86.6% (n = 149) were female, and 20.3% (n = 35) had previous diagnosis of hypertension. Overweight and obesity (odds ratio [OR]: 2.187, 95% confidence interval [CI]: 1.060 - 4.509) and night shift (OR: 2.100, CI 95%: 1.061 - 4.158) were statistically significant (p < 0.05) for increased risk of elevated BP level. Conclusion Excessive weight and night shift were significant factors for increased BP in nursing workers.

Fatores de risco associados ao déficit neurológico em pessoas vítimas de acidente vascular cerebral isquêmico / Risk factors associated with neurological déficit in ischemic stroke victims / Factores de riesgo asociados al déficit neurológico en víctimas de ictus isquémico

Objetivo: Identificar os fatores de risco associados ao déficit neurológico em pessoas vítimas de acidente vascular cerebral isquêmico. Métodos: Trata-se de um estudo retrospectivo descritivo quantitativo realizado em um hospital no interior de Minas Gerais Brasil. Os dados foram coletados em 52 prontuários, através de um instrumento contendo variáveis sociodemográficas, clínicas e janelas de tempo de tratamento. Para avaliação do déficit neurológico utilizou-se National Institutes of Health Stroke Scale. Os testes de Shapiro-Wilk, Quiquadrado de Pearson, T Student e McNemar foram utilizados para a análise estatística. O nível de significância foi de 0,05. Resultados: Na admissão hospitalar houve prevalência do déficit neurológico moderado, e na alta hospitalar, o déficit neurológico leve. O valor do déficit neurológico na admissão hospitalar e alta hospitalar foram, respectivamente 13,10 (±7,2) e 7,58 (±8,3), p = (0,000). O período de internação foi de 7,78 dias para os indivíduos com déficit neurológico leve/moderado e 11,67 dias para déficit neurológico grave (p=0,044). O tempo de janela porta agulha foi 38 minutos nos pacientes com déficit neurológico leve/moderado e 55,3 minutos para o déficit neurológico grave (p=0,025). Conclusão: Destaca-se a influência da condição neurológica no tempo de internação e a importância do atendimento ágil por parte da equipe. (AU)

Objective: To identify the risk factors associated with neurological deficit in people who victims of ischemic stroke. Methods: This is a retrospective quantitative descriptive study carried out in a hospital in the interior of Minas Gerais Brazil. Data were collected from 52 medical records, using an instrument containing sociodemographic and clinical variables and treatment time windows. To assess neurological deficit, the National Institutes of Health Stroke Scale was used. The Shapiro-Wilk, Pearson Chi- square, T Student and McNemar testes were used for statistical analysis. The significance level was 0,05. Results: At hospital admission there was a prevalence of moderate neurological deficit, and at hospital discharge, mild neurological deficit. Neurological deficit values at hospital admission and discharge werw respectively 13,10 (±7,2) and 7,58 (±8,3), p = (0,000). The hospital stay was 7,78 days for individuals with mild/moderate neurological deficit and 11,67 days for severe neurological deficit (p=0,044). The needle door window time was 38 minutes for patients with mild/moderate neurological deficit and 55,3 minutes for severe neurological deficit (p=0,025). Conclusion: The influence of the neurological condition on the length of stay and the importance of prompt care by the team are highlighted. (AU)

Objetivo: Identificar los factores de riesgo asociados al déficit neurológico en personas víctimas de ictus isquémico. Métodos: Se trata de un estudio cuantitativo descriptivo retrospectivo realizado en un hospital del interior de Minas Gerais Brasil. Se recolectaron datos de 52 historias clínicas, utilizando un instrumento que contiene variables sociodemográficas y clínicas y ventanas de tiempo de tratamiento. Para evaluar el déficit neurológico, se utilizó la National Institutes of Health Stroke Scale. Para el análisis estadístico se utilizaron las pruebas de Shapiro-Wilk, Chi-cuadrado de Pearson, T de Student y McNemar. El nivel de significancia fue 0.05. Resultados: al ingreso hospitalario prevaleció déficit neurológico moderado y al alta hospitalaria déficit neurológico leve. Los valores de déficit neurológico al ingreso y al alta hospitalaria fueron respectivamente 13,10 (± 7,2) y 7,58 (± 8,3), p = (0,000). La estancia hospitalaria fue de 7,78 días para individuos con déficit neurológico leve / moderado y de 11,67 días para déficit neurológico severo (p = 0,044). El tiempo de ventana de la puerta de la aguja fue de 38 minutos para pacientes con déficit neurológico leve / moderado y de 55,3 minutos para déficit neurológico severo (p = 0,025). Conclusión: Se destaca la influencia de la afección neurológica en la duración de la estadía y la importancia de una atención inmediata por parte del equipo. (AU)

Características laborais associadas à pressão arterial elevada entre caminhoneiros / Labor characteristics associated with high blood pressure among truck drivers / Características laborales asociadas a la hipertensión arterial entre los camioneros

Objetivo: Avaliar a prevalência de pressão arterial elevada entre caminhoneiros e sua associação a características laborais. Métodos: coleta de dados realizada por meio de instrumento semi estruturado, com questões sobre variáveis sociodemográficas, hábitos de vida, laborais, e clínicos. Não foram incluídos caminhoneiros com história clínica de hipertensão arterial. Resultados: 184 caminhoneiros com idade média (±DP) de 41,3 (±10,2) anos; a maioria percorria ao menos 3.000 km por semana (58,7%) e dirigia por mais de 10 horas diariamente (63,0 %). PA elevada foi verificada em 73 (39,6%) participantes. Mediante a análise da Odds ratio ajustado, verificou-se que entre os caminhoneiros que rodavam 3000km ou mais por semana (n=76, 41,3%) a chance de PA elevada era 2,3 vezes maior comparado ao grupo que rodava menos de 3000Km por semana (p<0,05). Conclusão: A maior distância percorrida pelos caminhoneiros aumentou cerca de duas vezes a chance desse profissional ter sua PA elevada (AU).

Objective: To evaluate the prevalence of high blood pressure among truck drivers and its association with job characteristics. Methods: data collection performed using a semi-structured instrument, developed by the researchers, with questions about sociodemographic variables, life habits, work, and clinical. Blood pressure (BP) was measured, in addition to the measurement of body weight and height. Truck drivers with a medical history of high blood pressure were not included. Results: 184 truck drivers with a mean age (± SD) of 41.3 (± 10.2) years were included; the majority covered at least 3,000 km per week (58.7%) and drove for more than 10 hours daily (63.0%). Elevated BP was verified in 73 (39.6%) participants. Through the analysis of the adjusted Odds ratio, it was found that among truck drivers who traveled 3000km or more per week (n = 76, 41.3%) the chance of high BP was 2.3 times greater compared to the group who rode less than 3000 km per week (p <0.05). Conclusion: The greater distance traveled by truck drivers increased about twice the chance of this professional having his BP increased (AU).

Objetivo: Evaluar la prevalencia de hipertensión arterial en los camioneros y su asociación con las características laborales. Métodos: recolección de datos realizada mediante un instrumento semiestructurado, desarrollado por los investigadores, con preguntas sobre variables sociodemográficas, hábitos de vida, laborales y clínicos. Se midieron la presión arterial (PA), el peso corporal y la altura. No fueron incluidos los camioneros con antecedentes médicos de hipertensión arterial. Resultados: se incluyeron 184 camioneros con una edad media (± DE) de 41,3 (± 10,2) años; la mayoría recorría al menos 3.000 km por semana (58,7%) y conducía más de 10 horas diarias (63,0%). Se detectó PA elevada en 73 (39,6%) participantes. Mediante el análisis de la razón de probabilidades ajustada, se observó que los camioneros que viajaban más de 3000 km por semana (n = 76, 41,3%) tenían 2,3 veces más probabilidades de desarrollar PA elevada que los que viajaban menos de 3000 km por semana (p <0,05). Conclusión: Un aumento en la distancia que recorren los camioneros aumentó aproximadamente el doble las posibilidades de que la PA de los mismos subiera (AU).

Impacto da cirurgia de revascularização miocárdica na qualidade de vida / Impact of myocardial revascularization surgery on quality of life

Objetivo: avaliar o impacto da Cirurgia de Revascularização do Miocárdio na qualidade de vida relacionada à saúde. Método: trata-se de um estudo quantitativo, observacional, longitudinal, prospectivo, com 51 participantes submetidos à CRVM, por meio da aplicação dos questionários para avaliar a qualidade de vida relacionada à saúde EuroQol-3L (EQ5D-3L) e MacNew QLMI. Organizaram-se os dados em planilha Excel®, validando-os por dupla digitação e exportando-os para o SPSS, versão 17.0. Resultados: incluíram-se 51 participantes, sendo 74,5% do sexo masculino, 54,9% compostos por idosos ≥ 60 anos, 62,7% com cor da pele autorreferida branca, 76,4% tiveram infarto agudo do miocárdio, 72,5% apresentavam Hipertensão Arterial Sistêmica, 82,4% eram sedentários, 54,9%, ex-tabagistas e 45,1%, etilistas. Evidenciou-se, nas dimensões do EQ-5D-3L, melhora da qualidade de vida quanto ao domínio ansiedade/depressão (p = 0,000) e a Escala Visual Analógica identificou melhora do estado de saúde (p = 0,005). Demonstrou-se, no questionário MacNew QLMI, melhora da qualidade de vida nos domínios: emocional (p = 0,000); físico (p = 0,000) e social (p = 0,000). Conclusão: evidenciou-se melhora da QVRS analisada pelos questionários genérico e específico após transcorrer seis meses do pós-operatório de CRVM.(AU)

Objective: to assess the impact of Myocardial Revascularization Surgery on health-related quality of life. Method: this is a quantitative, observational, longitudinal, prospective study, with 51 participants submitted to MRVS, through the application of questionnaires to assess health-related quality of life EuroQol-3L (EQ-5D-3L) and MacNew QLMI. Data was organized in an Excel® spreadsheet, validating them by double typing and exporting them to SPSS, version 17.0. Results: 51 participants were included, of which 74.5% were male, 54.9% were elderly ≥ 60 years old, 62.7% had selfreported skin color, 76.4% had acute myocardial infarction, 72 , 5% had Systemic Arterial Hypertension, 82.4% were sedentary, 54.9%, ex-smokers and 45.1%, alcoholics. In the dimensions of the EQ-5D-3L, there was an improvement in the quality of life regarding the anxiety / depression domain (p = 0.000) and the Visual Analogue Scale identified an improvement in health status (p = 0.005). The MacNew QLMI questionnaire demonstrated an improvement in the quality of life in the following domains: emotional (p = 0.000); physical (p = 0.000) and social (p = 0.000). Conclusion: there was an improvement in the HRQoL analyzed by the generic and specific questionnaires after six months after the MRVS operation.(AU)

Objetivo: evaluar el impacto de la cirugía de revascularización de miocardio en la calidad de vida relacionada con la salud. Método: este es un estudio cuantitativo, observacional, longitudinal, prospectivo, con 51 participantes sometidos a CRVM, mediante la aplicación de cuestionarios para evaluar la calidad de vida relacionada con la salud, EuroQol-3L (EQ-5D-3L) y MacNew QLMI. Los datos se organizaron en una hoja de cálculo Excel®, validada por doble tipeo y exportada a SPSS, versión 17.0. Resultados: se incluyeron 51 participantes, hombres (74.5%), ancianos ≥ 60 años (54.9%), color de piel autoinformado blanco (62.7%), infarto agudo de miocardio (76.4%), hipertensión arterial sistémica (72,5%), inactividad física (82,4%), tabaquismo (54,9%) y alcoholismo (45,1%). Las dimensiones del EQ-5D-3L mostraron una mejora en la calidad de vida con respecto al dominio de ansiedad / depresión (p = 0,000) y la Escala Analógica Visual identificó una mejora en el estado de salud (p = 0,005). El cuestionario MacNew QLMI demostró una mejora en la calidad de vida en los dominios: emocional (p = 0,000); física (p = 0.000) y social (p = 0.000). Conclusión: hubo una mejora en la CVRS analizada por los cuestionarios genéricos y específicos, seis meses después del postoperatorio de CABG.(AU)