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Silva BDPD, Neutzling MB, Camey S, Olinto MTA. Dietary patterns and hypertension: a population-based study with women from Southern Brazil. CAD SAUDE PUBLICA 2014; 30:961-71. [PMID: 24936813 DOI: 10.1590/0102-311x00146312] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Accepted: 11/04/2013] [Indexed: 11/22/2022] Open
Abstract
This study investigated the association between dietary pattern and hypertension using the rank reduced regression (RRR). It was a cross-sectional population-based study with a representative sample of 1,026 women living in the city of São Leopoldo, Rio Grande do Sul State, Brazil. In order to identify dietary patterns, dietary variables from a dietary frequency questionnaire were used as predictors and sodium, potassium and saturated fat consumption were selected as response variables. The RRR identified three dietary patterns: Factor 1, Factor 2 and Factor 3. The association between hypertension and factors 1, 2 and 3, after adjustment for socio-demographic, behavioral and obesity variables, was not significant. After stratification by age, the association between hypertension and factor 2 was present in 40-60 year-old women (tertile 2 compared to 3 RP = 0.62, 95%CI: 0.43-0.91; p = 0,05). The new statistical method (RRR), proved to be a useful tool for identifying dietary patterns. In this study, healthier dietary pattern was directly associated with hypertension in women between 40 and 60 years of age.
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Affiliation(s)
| | | | - Suzi Camey
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
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Silva ATD, Lima EMD, Caliman IF, Porto LLS, Nascimento AMD, Kalil IC, Lenz D, Bissoli NS, Endringer DC, Andrade TUD. Hypotensive effect and endothelium-dependent vascular action of leaves of Alpinia purpurata (Vieill) K. Schum. BRAZ J PHARM SCI 2014. [DOI: 10.1590/s1984-82502014000200010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aims of this study were to evaluate the chemical profile, vascular reactivity, and acute hypotensive effect (AHE) of the ethanolic extract of leaves of Alpinia purpurata (Vieill) K. Schum (EEAP). Its chemical profile was evaluated using HPLC-UV, ICP-OES, and colorimetric quantification of total flavonoids and polyphenols. The vascular reactivity of the extract was determined using the mesenteric bed isolated from WKY. AHE dose-response curves were obtained for both EEAP and inorganic material isolated from AP (IAP) in WKY and SHR animals. Cytotoxic and mutagenic safety levels were determined by the micronucleus test. Rutin-like flavonoids were quantified in the EEAP (1.8 ± 0.03%), and the total flavonoid and polyphenol ratios were 4.1 ± 1.8% and 5.1 ± 0.3%, respectively. We observed that the vasodilation action of EEAP was partially mediated by nitric oxide (·NO). The IAP showed the presence of calcium (137.76 ± 4.08 μg mg-1). The EEAP and IAP showed an AHE in WKY and SHR animals. EEAP did not have cytotoxic effects or cause chromosomic alterations. The AHE shown by EEAP could result from its endothelium-dependent vascular action. Rutin-like flavonoids, among other polyphenols, could contribute to these biological activities, and the calcium present in EEAP could act in a synergistic way.
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Burgos MS, Burgos LT, Camargo MD, Franke SIR, Prá D, da Silva AMV, Borges TS, Todendi PF, Reckziegel MB, Reuter CP. Relationship between anthropometric measures and cardiovascular risk factors in children and adolescents. Arq Bras Cardiol 2013; 101:288-96. [PMID: 23979777 PMCID: PMC4062364 DOI: 10.5935/abc.20130169] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 07/31/2012] [Accepted: 04/23/2013] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Obesity has been identified as an important risk factor in the development of cardiovascular diseases; however, other factors, combined or not with obesity, can influence cardiovascular risk and should be considered in cardiovascular risk stratification in pediatrics. OBJECTIVE To analyze the association between anthropometry measures and cardiovascular risk factors, to investigate the determinants to changes in blood pressure (BP), and to propose a prediction equation to waist circumference (WC) in children and adolescents. METHODS We evaluated 1,950 children and adolescents, aged 7 to 18 years. Visceral fat was assessed by WC and waist-hip relationship, BP and body mass index (BMI). In a randomly selected subsample of these volunteers (n = 578), total cholesterol, glucose and triglycerides levels were evaluated. RESULTS WC was positively correlated with BMI (r = 0.85; p < 0.001) and BP (SBP r = 0.45 and DBP = 0.37; p < 0.001). Glycaemia and triglycerides showed a weak correlation with WC (r = 0.110; p = 0.008 e r = 0.201; p < 0.001, respectively). Total cholesterol did not correlate with any of the variables. Age, BMI and WC were significant predictors on the regression models for BP (p < 0.001). We propose a WC prediction equation for children and adolescents: boys: y = 17.243 + 0.316 (height in cm); girls: y = 25.197 + 0.256 (height in cm). CONCLUSION WC is associated with cardiovascular risk factors and presents itself as a risk factor predictor of hypertension in children and adolescents. The WC prediction equation proposed by us should be tested in future studies.
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Affiliation(s)
- Miria Suzana Burgos
- Universidade de Santa Cruz do Sul - UNISC, Santa Cruz do Sul, RS -
Brazil
- Programa de Pós-graduação - Mestrado em Promoção da Saúde - UNISC,
Santa Cruz do Sul, RS - Brazil
| | | | - Marcelo Dias Camargo
- Grupo de Pesquisa em Cardiologia do Exercício HCPA/UFRGS, Porto Alegre,
RS - Brazil
| | - Silvia Isabel Rech Franke
- Universidade de Santa Cruz do Sul - UNISC, Santa Cruz do Sul, RS -
Brazil
- Programa de Pós-graduação - Mestrado em Promoção da Saúde - UNISC,
Santa Cruz do Sul, RS - Brazil
| | - Daniel Prá
- Universidade de Santa Cruz do Sul - UNISC, Santa Cruz do Sul, RS -
Brazil
- Programa de Pós-graduação - Mestrado em Promoção da Saúde - UNISC,
Santa Cruz do Sul, RS - Brazil
| | | | - Tássia Silvana Borges
- Universidade de Santa Cruz do Sul - UNISC, Santa Cruz do Sul, RS -
Brazil
- Programa de Pós-graduação - Mestrado em Promoção da Saúde - UNISC,
Santa Cruz do Sul, RS - Brazil
| | - Pâmela Ferreira Todendi
- Universidade de Santa Cruz do Sul - UNISC, Santa Cruz do Sul, RS -
Brazil
- Programa de Pós-graduação - Mestrado em Promoção da Saúde - UNISC,
Santa Cruz do Sul, RS - Brazil
| | | | - Cézane Priscila Reuter
- Universidade de Santa Cruz do Sul - UNISC, Santa Cruz do Sul, RS -
Brazil
- Programa de Pós-graduação - Mestrado em Promoção da Saúde - UNISC,
Santa Cruz do Sul, RS - Brazil
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Pinho NDA, Pierin AMG. Hypertension control in brazilian publications. Arq Bras Cardiol 2013; 101:e65-73. [PMID: 24061761 PMCID: PMC4032316 DOI: 10.5935/abc.20130173] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 04/30/2013] [Accepted: 04/30/2013] [Indexed: 11/20/2022] Open
Abstract
Hypertension is a major public health problem due to its high prevalence and cardiovascular complications. Its treatment is aimed at reducing cardiovascular morbidity and mortality, its goal being to maintain blood pressure levels below 140/90 mm Hg. Hypertension control in Brazil is low, and nationwide rates are unknown. The objective of this review was to provide an overview on hypertension control in Brazil from publications in a database. We identified 45 publications. In population-based studies, the highest control rate (57.6%) was reported in a multicenter study in 100 municipalities and the city of São José do Rio Preto, São Paulo state (52.4%), while the lowest rates (around 10%) were identified in microregions of the Rio Grande do Sul state and in the city of Tubarão, Santa Catarina state. In conclusion, the studies assessed showed a wide variation in hypertension control rates. It is worth noting that the comparison between studies was a major limiting factor, because of the different methods used.
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Fischer A, Fuster V. The Changing Epidemiology of Sudden Cardiac Death. Card Electrophysiol Clin 2009; 1:1-11. [PMID: 28770776 DOI: 10.1016/j.ccep.2009.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Sudden cardiac death (SCD) is a devastating complication of myocardial infarction. The global incidence of coronary artery disease and heart failure has been increasing greatly in recent years. As a consequence, there is expected to be an increase in the incidence of SCD manifesting as a shared worldwide public health problem. This article summarizes SCD epidemiology, with a focus on the anticipated global rise in incidence.
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Affiliation(s)
- Avi Fischer
- The Zena and Michael A. Wiener Cardiovascular Institute, Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, The Mount Sinai Medical Center, One Gustave L Levy Place, Box 1030, New York, NY 10029, USA
| | - Valentin Fuster
- The Zena and Michael A. Wiener Cardiovascular Institute, Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, The Mount Sinai Medical Center, One Gustave L Levy Place, Box 1030, New York, NY 10029, USA; The Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
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Lehane E, McCarthy G. An examination of the intentional and unintentional aspects of medication non-adherence in patients diagnosed with hypertension. J Clin Nurs 2007; 16:698-706. [PMID: 17402951 DOI: 10.1111/j.1365-2702.2005.01538.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS The primary aim of this study was to describe the unintentional and intentional aspects of non-adherence in patients diagnosed with hypertension. A secondary aim was to examine the relationships between medication adherence and purposeful actions (intentional non-adherence), patterned behaviours (unintentional non-adherence) and demographic questionnaire variables. BACKGROUND Non-adherence to medications continues to be a significant health-care issue, the extent and consequences of which have been well documented. Despite considerable research over the past five decades, little progress has been made in solving this healthcare problem. Recent literature indicates that this lack of progress can be attributed to the fact that past research has concentrated solely upon either the unintentional or the intentional aspects of non-adherence, instead of addressing both facets simultaneously. METHODS A quantitative, descriptive, correlation research design was employed using Johnson's (2002) Medication Adherence Model as a theoretical framework. A convenience sample of 73 participants with hypertension, attending the outpatients' clinics of two university hospitals was recruited. Data were collected by means of a researcher administered questionnaire and analysed using the Statistical Package for Social Sciences. RESULTS High levels of medication adherence with a mean adherence score of 4.75 (maximum 5) were reported. Low and medium levels of purposeful actions and medium and high levels of patterned behaviours towards medication taking were found. Correlational analyses did not demonstrate statistically significant associations. CONCLUSIONS Both the intentional and unintentional dimensions of medication-taking are simultaneously considered by patients to varying levels when adhering to therapeutic regimens. This is an important research area for nurses as it facilitates an increased understanding of non-adherence and, in so doing, aids the uncovering of more effective interventions aimed at sustaining lifelong pharmacotherapy. RELEVANCE TO CLINICAL PRACTICE By acknowledging a broader approach to patient medication-taking, nurses will be able more effectively to assess and intervene in non-adherent behaviours and actions.
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Affiliation(s)
- Elaine Lehane
- Catherine McAuley School of Nursing and Midwfery, Cork, Ireland.
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Greenberg H, Raymond SU, Leeder SR. Cardiovascular disease and global health: threat and opportunity. Health Aff (Millwood) 2006; Suppl Web Exclusives:W-5-31-W-5-41. [PMID: 15671084 DOI: 10.1377/hlthaff.w5.31] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The transition in global health from infectious to chronic disease, especially cardiovascular disease, poses a threat to the economies of the less developed world. As a more sophisticated workforce becomes a highly valued and harder-to-replace economic investment, the increasing prevalence of cardiovascular risk factors becomes a threat to economic development. The next two decades offer a critical period for intervention to blunt the impact of these diseases. The response of the global assistance community has been inadequate and without impact. A new global health assistance paradigm is needed to support long-term prevention strategies to combat this epidemic.
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Affiliation(s)
- Henry Greenberg
- College of Physicians and Surgeons, Columbia University, New York City, USA.
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Lawes CMM, Vander Hoorn S, Law MR, Elliott P, MacMahon S, Rodgers A. Blood pressure and the global burden of disease 2000. Part 1: Estimates of blood pressure levels. J Hypertens 2006; 24:413-22. [PMID: 16467639 DOI: 10.1097/01.hjh.0000199801.72563.6f] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To provide global estimates of blood pressure by age and sex for adults aged > or = 30 years, by WHO subregion. DESIGN AND METHODS Data were obtained from studies identified in a literature review of population-based surveys. These were complemented by data from MONICA and INTERSALT studies. Estimates of the shape of the age-systolic blood pressure (SBP) association were made from survey data utilizing parametric and non-parametric analyses. A linear sex-specific association of SBP with age was demonstrated from 30 to 70 years in females and 20 to 70 years for males in each subregion. Mean age- and sex-specific estimates of SBP were estimated for each WHO subregion separately, based on study and country-weighted SBP data. RESULTS Analyses were based on data from about 230 surveys and over 660 000 participants. Age-specific mean SBP values ranged from 114 to 164 mmHg for females, and 117-153 mmHg for males. Females typically had lower SBP levels than males in the 30-44-year age groups, but in all subregions, SBP levels rose more steeply with age for females than males. Therefore, SBP levels in those aged > or = 60 years tended to be higher in females. Subregions with consistently high mean SBP levels included parts of eastern Europe and Africa. Mean SBP levels were lowest in south-east Asia and parts of the western Pacific. CONCLUSIONS These global estimates of blood pressure by age, sex and subregion show considerable variation in estimated levels. The lack of data in developing countries is substantial, and this is an important limitation given the role of blood pressure in increasing cardiovascular disease levels.
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Affiliation(s)
- Carlene M M Lawes
- Clinical Trials Research Unit, University of Auckland, Auckland, New Zealand.
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Sakuma T, Hirata RD, Hirata MH. Five polymorphisms in gene candidates for cardiovascular disease in Afro-Brazilian individuals. J Clin Lab Anal 2005; 18:309-16. [PMID: 15543563 PMCID: PMC6807947 DOI: 10.1002/jcla.20044] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Associations of polymorphisms in the angiotensin I-converting enzyme (ACE), apolipoprotein B (APOB) and apolipoprotein E (APOE) genes with hypertension and variations in lipid serum levels were evaluated in 184 Afro-Brazilians with a familial history of coronary artery disease (CAD). ACE (Ins/Del) and APOB (Ins/Del, XbaI, and EcoRI) and APOE (HhaI) polymorphisms were determined by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analyses on agarose, and polyacrylamide gel electrophoresis. Serum lipids were measured by means of routine enzymatic assays. The results showed a high frequency of hypertension (44%) in Afro-Brazilians that was increased in subjects >40 years old and those with a blood mass index (BMI) higher than 25 kg/m(2) (P<0.001). The ACE Del allele was associated with hypertension in men >40 years old (P<0.05). APOE (HhaI) and APOB (XbaI and Ins/Del) polymorphisms were not associated with hypertension or variations in serum concentrations of lipids, while subjects with the APOB E- allele had higher low-density lipoprotein cholesterol (LDL-C) levels than E+ carriers (P<0.05). These results suggest that ACE Ins/Del polymorphism is associated with hypertension, and APOB EcoRI polymorphism is associated with LDL-C variation in Afro-Brazilians.
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Affiliation(s)
- Tatsuya Sakuma
- Universidade do Mato Grosso do Sul, Campo Grande, Brasil
| | - Rosario D.C. Hirata
- Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, Brasil
| | - Mario H. Hirata
- Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, Brasil
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