ABSTRACT
Given the aging global population, identifying heart failure (HF) phenotypes has become crucial, as distinct disease characteristics can influence treatment and prognosis in older adults. This study aimed to analyze the association between clustering of cardiovascular risk factors and HF in older adults. A cross-sectional epidemiological study was conducted with 1322 older adults (55% women, mean age 70.4) seen in primary health care. Diagnosis of HF was performed by a cardiologist based on diagnostic tests and medical history. Cardiovascular risk factors included hypertension, diabetes, hypercholesterolemia, and smoking. Using logistic regression, potential associations were tested. Individual risk factor analysis showed that older adults with hypertension, diabetes, or hypercholesterolemia had up to 7.6 times higher odds to have HF. The cluster where older adults had only one risk factor instead of none increased the odds of HF by 53.0%. Additionally, the odds of older patients having HF ranged from 3.59 times for the two-risk factor cluster to 20.61 times for the simultaneous presence of all four factors. The analysis of clusters substantially increasing HF risk in older adults revealed the importance of individualizing subgroups with distinct HF pathophysiologies. The clinical significance of these clusters can be beneficial in guiding a more personalized therapeutic approach.
ABSTRACT
PURPOSE: Childhood obesity has become a concern for the Brazilian Unified Health System, which has recently started to investigate children's eating habits in basic health units. This study examined the trends and ultra-processed foods (UPF) consumption in Brazilian children. DESIGN AND METHODS: This repeated cross-sectional study included 492,630 children (2-9 years old), from different Brazilian regions, in the years 2015 and 2019. The children's food consumption was assessed by nurses using a nationally standardized instrument. Information was provided by the Food and Nutrition Surveillance System Brazilian. RESULTS: The UPF consumption in Brazilian children is generally high and was higher among children in the South and Midwest regions. The consumption of sweetened beverages was more prevalent among all the UPF assessed and continues to increase among children in the Northeast region. Declining trends in UPF consumption were observed in children from all regions, except for the Northeast region, whose trends increased in almost all evaluated foods. PRACTICE IMPLICATIONS: Nurses, especially, have a primary role in guiding the reduction of UPF consumption, as they are the first health professionals to have access to this information. Increasing trends in UPF consumption can be mitigated by the inclusion of nutritionists in basic health units. Brazilian children need to be assisted by public policies that promote food education.
