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Oliveira GMMD, Brant LCC, Polanczyk CA, Malta DC, Biolo A, Nascimento BR, Souza MDFMD, Lorenzo ARD, Fagundes Júnior AADP, Schaan BD, Silva CGDSE, Castilho FMD, Cesena FHY, Soares GP, Xavier Junior GF, Barreto Filho JAS, Passaglia LG, Pinto Filho MM, Machline-Carrion MJ, Bittencourt MS, Pontes Neto OM, Villela PB, Teixeira RA, Stein R, Sampaio RO, Gaziano TA, Perel P, Roth GA, Ribeiro ALP. Cardiovascular Statistics - Brazil 2023. Arq Bras Cardiol 2024; 121:e20240079. [PMID: 38896747 PMCID: PMC11185831 DOI: 10.36660/abc.20240079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Affiliation(s)
- Gláucia Maria Moraes de Oliveira
- Instituto do Coração Edson Saad da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
| | - Luisa Campos Caldeira Brant
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
| | - Carisi Anne Polanczyk
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brasil
- Hospital Moinhos de Vento, Porto Alegre, RS - Brasil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS - Brasil
| | | | - Andreia Biolo
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brasil
- Hospital Moinhos de Vento, Porto Alegre, RS - Brasil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS - Brasil
| | - Bruno Ramos Nascimento
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- Hospital Madre Teresa, Belo Horizonte, MG - Brasil
| | | | - Andrea Rocha De Lorenzo
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
- Instituto Nacional de Cardiologia, Rio de Janeiro, RJ - Brasil
| | | | - Beatriz D Schaan
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brasil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS - Brasil
| | - Christina Grüne de Souza E Silva
- Instituto do Coração Edson Saad da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
| | - Fábio Morato de Castilho
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
| | | | - Gabriel Porto Soares
- Instituto do Coração Edson Saad da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
- Curso de Medicina da Universidade de Vassouras, Vassouras, RJ - Brasil
| | | | | | - Luiz Guilherme Passaglia
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
| | - Marcelo Martins Pinto Filho
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
| | | | | | - Octavio M Pontes Neto
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (USP), São Paulo, SP - Brasil
| | - Paolo Blanco Villela
- Instituto do Coração Edson Saad da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
| | | | - Ricardo Stein
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brasil
| | - Roney Orismar Sampaio
- Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP - Brasil
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Thomaz A Gaziano
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston - EUA
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston - EUA
| | - Pablo Perel
- World Heart Federation, Geneva - Suíça
- Centre for Global Chronic Conditions, London School of Hygiene & Tropical Medicine, Londres - Inglaterra
| | - Gregory A Roth
- Division of Cardiology, Department of Medicine, University of Washington, Washington - EUA
| | - Antonio Luiz Pinho Ribeiro
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
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Pirkle CM, Guerra RO, Gómez F, Belanger E, Sentell T. Socioecological Factors Associated with Hypertension Awareness and Control Among Older Adults in Brazil and Colombia: Correlational Analysis from the International Mobility in Aging Study. Glob Heart 2023; 18:66. [PMID: 38162526 PMCID: PMC10756159 DOI: 10.5334/gh.1282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024] Open
Abstract
Background Hypertension awareness and control are understudied among older adults in middle-income countries, with limited work contextualizing awareness and control across layers of influence (individual to the community). Research on hypertension in Latin America is acknowledged as insufficient. Objectives This study applies the socioecological model (SEM) to examine individual, interpersonal, institutional, and community factors related to hypertension awareness and control in older adults residing in Brazil and Colombia. It identifies groups of older adults more likely to be unaware of their condition and/or to have challenges achieving hypertension control. Methods We analyzed International Mobility in Aging Study data of 803 community-dwelling adults 65-74 years from study sites in the two most populous countries in South America. The study framework was the socioecological model. Logistic regression models identified factors associated with hypertension awareness and control. Conclusions Hypertension was prevalent in both samples (>70%), and awareness was high (>80%). Blood pressure control among diagnosed respondents was low: 30% in Brazil and 51% in Colombia. Factors across the socioecological model were associated with awareness and control, with notable differences across countries. Those with diabetes (OR 4.19, 95%CI 1.64-10.71) and insufficient incomes (OR: 1.85, 95%CI 1.03-3.31) were more likely to be aware of their hypertension. In Colombia, those reporting no community activity engagement were less likely to be aware compared to those reporting community activities. In Brazil, it was the opposite. Women (OR 1.66, 95%CI 1.12-2.46) and those reporting strolling shops and stores (OR 1.80, 95% CI 1.09-3.00) were significantly more likely to have their hypertension under control. In Brazil, those 70-75 were significantly less likely to have their hypertension under control compared to their younger counterparts. In Colombia, this was not observed. This paper highlights the importance of theory-based studies within unique Latin American contexts on hypertension and suggests novel opportunities for intervention.
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Affiliation(s)
- Catherine M. Pirkle
- Office of Public Health Studies, University of Hawaiʻi at Mānoa, 1960 East-West Road, BioMed T102A, Honolulu, HI 96822-2319, US
| | - Ricardo Oliveira Guerra
- Universidade Federal do Rio Grande do Norte, Departamento de Fisioterapia, Campus Universitário –Av. Salgado Filho S/N. 59078 970, Natal-RN Brasil, BR
| | - Fernando Gómez
- Research Group on Geriatrics and Gerontology, Faculty of Health Sciences, Universidad de Caldas, Manizales, CO
- Sede Principal Calle 65 No 26
| | - Emmanuelle Belanger
- Department of Health Services, Policy & Practice, Center for Gerontology and Healthcare Research, Brown University School of Public Health, 121 South Main Street, 6Floor, Providence, RI, US
| | - Tetine Sentell
- Office of Public Health Studies, University of Hawaiʻi at Mānoa, 1960 East-West Road, BioMed D209E, Honolulu, HI 96822-2319, US
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Malta DC, Bernal RTI, Ribeiro EG, Moreira AD, Felisbino-Mendes MS, Velásquez-Meléndez JG. Arterial hypertension and associated factors: National Health Survey, 2019. Rev Saude Publica 2023; 56:122. [PMID: 36629713 PMCID: PMC9749662 DOI: 10.11606/s1518-8787.2022056004177] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 03/14/2022] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To analyze the factors associated with self-reported arterial hypertension, as well as its prevalence in the Brazilian adult population. METHODS Data from 88,531 individuals aged 18 years or older who responded to the 2019 National Health Survey were analyzed. The outcome studied was self-reported arterial hypertension. Sociodemographic variables and clinical and lifestyle conditions were considered as exposures. The prevalence ratio (PR), crude and adjusted for sex, age, and schooling was used as a measure of association to verify the factors related to its prevalence, obtained by Poisson regression with robust variance. RESULTS The prevalence of self-reported arterial hypertension was of 23.9% (95%CI: 23.4-24.4). When adjusting for age, sex, and schooling, the adjusted Prevalence Ratios (APR) were higher among: regular health self-assessment (APR = 1.6; 95%CI: 1.5-1.6) and bad health self-assessment (APR = 1.7; 95%CI: 1.6-1.8); self-reference to heart disease (APR = 1.7; 95%CI: 1.6-1.7), diabetes (APR = 1.7; 95%CI: 1.6-1.8), high cholesterol (APR = 1.6; 95%CI: 1.6-1.7), overweight (APR = 1.4; 95%CI: 1.4-1.5), and obesity (APR = 2.0; 95%CI: 1.9-2.1); high salt intake (APR = 1.1; 95%CI: 1.0-1.1); higher among former smokers (APR = 1.1; 95%CI: 1.1-1.2) and lower among smokers (APR = 0.9; 95%CI: 0.8-0.9); and consumption of ultra-processed foods (APR = 0.9; 95%CI: 0.8-0.9). CONCLUSION A quarter of the Brazilian adult population claims to have arterial hypertension, more prevalent among women and associated with older age groups, Black, mixed-race, and others, low schooling, high salt intake, former smoking, presence of comorbidities, and worse health self-assessment.
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Affiliation(s)
- Deborah Carvalho Malta
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno Infantil e Saúde PúblicaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Regina Tomie Ivata Bernal
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno Infantil e Saúde PúblicaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Edmar Geraldo Ribeiro
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno Infantil e Saúde PúblicaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Alexandra Dias Moreira
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno Infantil e Saúde PúblicaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Mariana Santos Felisbino-Mendes
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno Infantil e Saúde PúblicaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Jorge Gustavo Velásquez-Meléndez
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno Infantil e Saúde PúblicaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
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Prevalence of Excess Sodium Intake and Their Corresponding Food Sources in Adults from the 2017–2018 Brazilian National Dietary Survey. Nutrients 2022; 14:nu14194018. [PMID: 36235671 PMCID: PMC9571186 DOI: 10.3390/nu14194018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/21/2022] [Accepted: 09/23/2022] [Indexed: 11/30/2022] Open
Abstract
Excessive sodium intake has been related to high blood pressure, a central risk factor for cardiovascular disease. In the present work, updated estimates of sodium intake, the main food sources, and the prevalence of excessive intakes in a nationwide multi-ethnic sample of Brazilian adults (2017–2018 Brazilian National Dietary Survey) were presented. Based on two 24-h recalls adjusted for the within-person variation, the overall median of sodium intake was 2432 mg. The prevalence of adults exceeding the recommended limits (tolerable upper limit, UL, and the chronic disease risk reduction cut-off point, CDRR) was 61% and 56%, respectively. The median sodium intake and proportion of individuals above the limits varied according to the subgroups evaluated. Males and adults (20–29 years) presented the highest excessive sodium intakes, and consequently, lowest adherence rates to UL and CDRR recommendations. The top food sources of sodium were white bread and toast (12.3%), beans (11.6%), white rice (10.6%), beef (7.7%), and poultry meat (5.5%). Given the health benefits of dietary sodium reduction, it would be advisable to enhance the current national initiatives of awareness and educational campaigns’ combined efforts to reduce sodium in processed foods to effectively decrease this micronutrient intake across the Brazilian population.
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Nascimento BR, Brant LCC, Naback ADN, Veloso GA, Polanczyk CA, Ribeiro ALP, Malta DC, Ferreira AVL, Oliveira GMMD. Burden of Cardiovascular Diseases Attributable to Risk Factors in Portuguese-Speaking Countries: Data from the "Global Burden of Disease 2019" Study. Arq Bras Cardiol 2022; 118:1028-1048. [PMID: 35703642 PMCID: PMC9345142 DOI: 10.36660/abc.20210680] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/19/2021] [Accepted: 12/08/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The impact of risk factors (RF) on morbidity and mortality from cardiovascular disease (CVD) for most Portuguese-speaking countries (PSC) is little known. OBJECTIVES We aimed to analyze the morbidity and mortality from CVD attributable to RF and its variation, from 1990 to 2019, in PSC, based on estimates from the Global Burden of Disease (GBD) 2019 study. METHODS We evaluated changes in cardiovascular RF, mortality rates and age-standardized disability-adjusted life years (DALYs) between 1990 and 2019. The correlation between percentage changes in mortality rates and the sociodemographic index (SDI) of each PSC was evaluated by the Spearman method. A p-value <0.05 was considered statistically significant. RESULTS Elevated systolic blood pressure (SBP) was the main RF for mortality and DALYs for CVD for all PSC. Mortality from CVD showed a downward trend in 2019, more accentuated in Portugal (-66.6%, 95%CI -71.0 - -61.2) and in Brazil (-49.8%, 95%CI -52.5 - -47.1). There was a trend towards an inverse correlation between SDI and the percent change in mortality, which was significant for dietary risks (r=-0.70, p=0.036), high LDL cholesterol (r=-0.77, p=0.015) and high SBP (r=-0.74, p=0.023). CONCLUSIONS In addition to SBP, dietary and metabolic RF justified a greater variation in the burden of CVD correlated with SDI in the PSC, suggesting the need to adopt health policies adapted to the reality of each country, aiming to reduce their impact on population.
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Affiliation(s)
- Bruno Ramos Nascimento
- Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil
| | - Luisa Campos Caldeira Brant
- Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil
| | - André Dias Nassar Naback
- Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil
| | - Guilherme Augusto Veloso
- Programa de Pós-Graduação em Estatística, Departamento de Estatística, Universidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil
| | - Carisi Anne Polanczyk
- Instituto Nacional de Avaliação de Tecnologias em Saúde, IATS/CNPq, Porto Alegre, RS - Brasil
- Faculdade de Medicina - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS - Brasil
- Hospital Moinhos de Vento, Porto Alegre, RS - Brasil
| | - Antonio Luiz Pinho Ribeiro
- Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil
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Malta DC, Gomes CS, Stopa SR, Andrade FMDD, Prates EJS, Oliveira PPVD, Ferreira SAM, Pereira CA. Inequalities in health care and access to health services among adults with self-reported arterial hypertension: Brazilian National Health Survey. CAD SAUDE PUBLICA 2022; 38Suppl 1:e00125421. [PMID: 35613254 DOI: 10.1590/0102-311xe00125421] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 12/10/2021] [Indexed: 11/22/2022] Open
Abstract
This study compared indicators of care and access to health services by adults who self-reported hypertension in 2013 and 2019, analyzing those indicators according to gender, age group, schooling level, and race/color. This is an analytic study with data from the Brazilian National Health Survey (PNS), conducted in 2013 and 2019 in Brazil. The indicators to care and access to health services by individuals with arterial hypertension in both surveys were compared. For 2019, those indicators were analyzed according to sociodemographic characteristics. This study estimated the proportions, prevalence ratio (PR), and their respective 95% confidence intervals (95%CI). In total, 60,202 individuals were evaluated in 2013 and 88,531 in 2019, of these 24.4% reported arterial hypertension in 2013 and 23.9% in 2019. Women received more medical care for hypertension within the last year (PR = 1.07; 95%CI: 1.04; 1.11), had the last physician appointment at an basic health unit (PR = 1.11; 95%CI: 1.05; 1.17) than men. About race/color, black people had more hospitalization for hypertension or some complication (PR = 1.2; 95%CI: 1.05; 1.38) and intense or very intense degree of limitation in performing daily activities (PR = 1.37; 95%CI: 1.06; 1.76). In 2019, inequalities were evidenced and worse indicators were observed for males, black, with low education and young age. Therefore, investments in the Brazilian Unified National Health System, as well as public policies and strategic actions are essential to reduce inequalities, promote health care.
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Guedes LFF, Felisbino-Mendes MS, Vegi ASF, Meireles AL, de Menezes MC, Malta DC, Machado ÍE. Health impacts caused by excessive sodium consumption in Brazil: results of the GBD 2019 study. Rev Soc Bras Med Trop 2022; 55:e0266. [PMID: 35107510 PMCID: PMC9022945 DOI: 10.1590/0037-8682-0266-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/24/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Excessive sodium consumption is associated with increased blood pressure, which is an important risk factor for non-communicable diseases (NCDs). This study therefore aimed to describe the burden of NCDs attributable to excessive sodium consumption among Brazilians. METHODS This observational study used mortality and Disability Adjusted Life Years (DALY) rates, and their respective uncertainty intervals (UI), from the Global Burden of Disease Study 2019 (GBD 2019). The burden was obtained by the population attributable fraction of each NCD, considering the minimum theoretical value of risk (intake of 0-3g of sodium/day); the excessive consumption proportion in the population, obtained through population inquiries; and the relative risks obtained through meta-analyses. RESULTS Excessive sodium consumption was the third highest dietary risk contributing to deaths (30,814; 95% UI = 2,034 - 84,130) and DALYs (699,119; 95% UI= 43,130 - 1,914,066) in 2019. States from the Northeast region had the highest age-standardized rates of deaths and DALYs, and the male population was more affected by NCDs caused by excessive sodium consumption. Cardiovascular diseases were the main contributing factors in the burden attributable to excessive sodium consumption. CONCLUSIONS Regardless of the progress in addressing NCDs related to this risk factor, the impact remains high, especially among men and in the Northeast region. More effective measures are needed to reduce sodium in industrialized products, such as health promotion actions to combat sodium consumption, in order to prevent and control NCDs in Brazil.
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Affiliation(s)
| | | | - Aline Siqueira Fogal Vegi
- Universidade Federal de Ouro Preto, Programa de Pós-Graduação em Saúde e Nutrição, Ouro Preto, MG, Brasil
| | - Adriana Lúcia Meireles
- Universidade Federal de Ouro Preto, Programa de Pós-Graduação em Saúde e Nutrição, Ouro Preto, MG, Brasil
- Universidade Federal de Ouro Preto, Departamento de Nutrição Clínica e Social, Ouro Preto, MG, Brasil
| | - Mariana Carvalho de Menezes
- Universidade Federal de Ouro Preto, Programa de Pós-Graduação em Saúde e Nutrição, Ouro Preto, MG, Brasil
- Universidade Federal de Ouro Preto, Departamento de Nutrição Clínica e Social, Ouro Preto, MG, Brasil
| | - Deborah Carvalho Malta
- Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Enfermagem, Belo Horizonte, MG, Brasil
| | - Ísis Eloah Machado
- Universidade Federal de Ouro Preto, Programa de Pós-Graduação em Saúde e Nutrição, Ouro Preto, MG, Brasil
- Universidade Federal de Ouro Preto, Departamento de Medicina de Família, Saúde Mental e Coletiva, Ouro Preto, MG, Brasil
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Brant LCC, Nascimento BR, Veloso GA, Gomes CS, Polanczyk C, de Oliveira GMM, Flor LS, Gakidou E, Ribeiro ALP, Malta DC. Burden of Cardiovascular diseases attributable to risk factors in Brazil: data from the "Global Burden of Disease 2019" study. Rev Soc Bras Med Trop 2022; 55:e0263. [PMID: 35107526 PMCID: PMC9009428 DOI: 10.1590/0037-8682-0263-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/05/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION To better understand trends in the main cause of death in Brazil, we sought to analyze the burden of cardiovascular risk factors (RF) and cardiovascular diseases (CVD) attributable to specific RFs in Brazil from 1990 to 2019, using the estimates from the GBD 2019 study. METHODS To estimate RF exposure, the Summary Exposure Value (SEV) was used, whereas for disease burden attributed to RF, mortality and disability-adjusted life-years (DALY) due to CVD were used. For comparisons over time and between states, we compared age-standardized rates. The sociodemographic index (SDI) was used as a marker of socioeconomic conditions. RESULTS In 2019, 83% of CVD mortality in Brazil was attributable to RF. For SEV, there was a reduction in smoking and environmental RF, but an increase in metabolic RF. High systolic blood pressure and dietary risks continue to be the main RF for CVD mortality and DALY. While there was a decline in age-standardized mortality rates attributable to the evaluated RF, there was also a stability or increase in crude mortality rates, with the exception of smoking. It is important to highlight the increase in the risk of death attributable to a high body mass index. Regarding the analysis per state, SEVs and mortality attributable to RF were higher in those states with lower SDIs. CONCLUSIONS Despite the reduction in CVD mortality and DALY rates attributable to RF, the stability or increase in crude rates attributable to metabolic RFs is worrisome, requiring investments and a renewal of health policies.
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Affiliation(s)
- Luisa Campos Caldeira Brant
- Universidade Federal de Minas Gerais, Faculdade de Medicina e Hospital das Clínicas, Belo Horizonte, MG, Brasil
| | - Bruno Ramos Nascimento
- Universidade Federal de Minas Gerais, Faculdade de Medicina e Hospital das Clínicas, Belo Horizonte, MG, Brasil
| | - Guilherme Augusto Veloso
- Universidade Federal de Minas Gerais, Departamento de Estatística, Programa de Pós-Graduação em Estatística, Belo Horizonte, MG, Brasil
| | - Crizian Saar Gomes
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Medicina Preventiva e Social, Programa de Pós-Graduação em Saúde Pública, Belo Horizonte, MG, Brasil
| | - Carisi Polanczyk
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS, Brasil
| | | | - Luisa Sorio Flor
- University of Washington, Institute of Health Metrics and Evaluation, Seattle, USA
| | - Emmanuela Gakidou
- University of Washington, Institute of Health Metrics and Evaluation, Seattle, USA
| | - Antonio Luiz Pinho Ribeiro
- Universidade Federal de Minas Gerais, Faculdade de Medicina e Hospital das Clínicas, Belo Horizonte, MG, Brasil
| | - Deborah Carvalho Malta
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Belo Horizonte, MG, Brasil
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Oliveira GMMD, Brant LCC, Polanczyk CA, Malta DC, Biolo A, Nascimento BR, Souza MDFMD, Lorenzo ARD, Fagundes AADP, Schaan BD, Castilho FMD, Cesena FHY, Soares GP, Xavier GF, Barreto JAS, Passaglia LG, Pinto MM, Machline-Carrion MJ, Bittencourt MS, Pontes OM, Villela PB, Teixeira RA, Sampaio RO, Gaziano TA, Perel P, Roth GA, Ribeiro ALP. Estatística Cardiovascular – Brasil 2021. Arq Bras Cardiol 2022; 118:115-373. [PMID: 35195219 PMCID: PMC8959063 DOI: 10.36660/abc.20211012] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/10/2021] [Indexed: 02/07/2023] Open
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Gomes CS, Gonçalves RPF, Silva AGD, Sá ACMGND, Alves FTA, Ribeiro ALP, Malta DC. Factors associated with cardiovascular disease in the Brazilian adult population: National Health Survey, 2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210013. [PMID: 34910067 DOI: 10.1590/1980-549720210013.supl.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/13/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to estimate the prevalence and investigate the sociodemographic, health, and lifestyle factors associated with the self-reported diagnosis of Cardiovascular Disease (CVD) in the adult Brazilian population. METHODS Data from the National Health Survey (PNS 2019) were analyzed. The presence of CVD was self-reported through the question: "Has any doctor ever given you a diagnosis of heart disease?". Sociodemographic factors, health conditions, and lifestyle were evaluated. For data analysis, Poisson Regression with robust variance was used. RESULTS 5.3% (95%CI 5.04-5.57) of Brazilian adults reported CVD, of which, 29.08% (95%CI 27.04-31.21) underwent coronary artery bypass surgery or angioplasty and 8.26% (95%CI 7.09-9.6) reported severe limitation in usual activities due to CVD. The factors associated with CVD were advanced age; being male; white race/color; complete middle school and incomplete high school education; have health insurance; self-assessing health as regular or bad/very bad; self-reported hypertension, high cholesterol, and diabetes; being a former smoker; consuming fruits and vegetables as recommended; not consuming alcohol in excess; and not practicing leisure-time physical activity. CONCLUSIONS CVD is associated with sociodemographic, health, and lifestyle factors. It is important to support public policies, programs, and goals for the reduction of cardiovascular diseases in Brazil, especially in the most vulnerable groups.
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Affiliation(s)
- Crizian Saar Gomes
- Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Renata Patrícia Fonseca Gonçalves
- Postgraduate Program in Health Education, Department of Nursing, Universidade Federal dos Vales do Jequitinhonha e Mucuri - Diamantina (MG), Brazil
| | - Alanna Gomes da Silva
- Postgraduate Program in Nursing, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | | | | | - Antonio Luiz Pinho Ribeiro
- Hospital das Clínicas, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Deborah Carvalho Malta
- Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil.,Postgraduate Program in Nursing, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil.,Maternal and Child Department, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
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11
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Donato TAA, Silva RMA, Andrade ACDS, Kochergin CN, Medeiros DSD, Soares DA, Louzado JA, Silva KO, Cortes ML, Mistro S, Amorim WWCC, Oliveira MGGD, Bezerra VM. [Periodic occupational examination: an opportunity for diagnosis and monitoring of chronic noncommunicable diseases in men]. CAD SAUDE PUBLICA 2021; 37:e00298320. [PMID: 34816961 DOI: 10.1590/0102-311x00298320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 04/15/2021] [Indexed: 11/22/2022] Open
Abstract
The study aimed to estimate the prevalence of arterial hypertension as the principal marker of chronic noncommunicable diseases (NCDs) and to identify associated modifiable factors in male workers. Baseline data were used from a longitudinal study with a sample of 1,024 male workers 18 years or older in a municipality in Northeast Brazil. The marker for NCDs was arterial hypertension, defined as systolic pressure ≥ 140mmHg and/or diastolic pressure ≥ 90mmHg and/or prior diagnosis of arterial hypertension and/or use of antihypertensive medication. Poisson regression with robust variance was used, adopting hierarchical entry of variables. Population attributable fractions (PAFs) were calculated for the lifestyle variables to measure the impact of modifiable factors on workers' health. Prevalence of hypertension was 28.6% (95%CI: 25.9-31.5). Distal factors associated with hypertension were age > 40 years, black skin color, and family income ≥ 3 times the monthly minimum wage. Intermediate factors were alcohol abuse, smoking, high self-rated salt intake, and physical inactivity. Proximal factors were overweight and obesity. Calculation of PAFs showed that a reduction or elimination of unhealthy lifestyle habits and behaviors in this population group would reduce the prevalence of the target NCD, hypertension, by 56.1%. The identification of modifiable factors and the ways they can negatively impact male workers' health allows planning interventions in the workplace itself to reach the largest number of individuals, aimed at reducing the harmful effects of NCDs.
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Affiliation(s)
| | | | | | | | | | - Daniela Arruda Soares
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Brasil
| | - José Andrade Louzado
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Brasil
| | - Kelle Oliveira Silva
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Brasil
| | - Matheus Lopes Cortes
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Brasil
| | - Sóstenes Mistro
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Brasil
| | | | | | - Vanessa Moraes Bezerra
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Brasil
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Rey HCV. The Importance of Recognizing the Co-Occurrence of Cardiometabolic Risk Factors in the Population to Establish Priorities in Public Policies. Arq Bras Cardiol 2021; 117:49-50. [PMID: 34320067 PMCID: PMC8294716 DOI: 10.36660/abc.20210511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Helena Cramer Veiga Rey
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ - Brasil
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13
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Malta DC, Pinheiro PC, Andrade FMDD, Sardinha LMV, Matoso LF, Caixeta RDB, Ondarsuhu D. Population with high cardiovascular risk receiving drug therapy and counseling: Brazil's status regarding the global goal, 2014-2015. ACTA ACUST UNITED AC 2021; 30:e2020369. [PMID: 34133644 DOI: 10.1590/s1679-49742021000200016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 11/20/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To estimate the prevalence of high cardiovascular risk (CVR), the proportion of people with high CVR who receive treatment and counseling, and to investigate the sociodemographic factors associated with this outcome, in Brazil. METHODS This was a cross-sectional study, using subsample data from the National Health Survey, collected via biochemical tests, in 2014-2015. Poisson regression was used. RESULTS The proportion of high CVR in men was 11.2% (95%CI 9.6;12.9), and 10.4% (95%CI 9.2;11.8%) in women. In the group with high CVR, 68.8% (95%CI 63.7;73.4%) received counseling, 59.3% (95%CI 54.2;64.3%) received medication, and 55.6% (95%CI 50.4;60.7%) received both. In the multivariate analysis, receiving treatment and counseling was associated with being aged 50 years and over, and poor/very poor self-rated health (PR=1.26 - 95%CI 1.06;1.51). CONCLUSION The proportion of people with high CVR who had received treatment and counseling was over 50%.
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Affiliation(s)
- Deborah Carvalho Malta
- Universidade Federal de Minas Gerais, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Belo Horizonte, MG, Brasil
| | | | | | | | | | - Roberta de Betânia Caixeta
- Organização Mundial da Saúde para as Américas, Escritório Regional da Organização Pan-Americana da Saúde, Washington, DC, Estados Unidos
| | - Dolores Ondarsuhu
- Organização Mundial da Saúde para as Américas, Escritório Regional da Organização Pan-Americana da Saúde, Washington, DC, Estados Unidos
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14
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Malta DC, Pinheiro PC, Teixeira RA, Machado IE, dos Santos FM, Ribeiro ALP. Cardiovascular Risk Estimates in Ten Years in the Brazilian Population, a Population-Based Study. Arq Bras Cardiol 2021; 116:423-431. [PMID: 33909770 PMCID: PMC8159568 DOI: 10.36660/abc.20190861] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/12/2020] [Accepted: 06/24/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Cardiovascular diseases are the leading cause of morbidity and mortality, resulting in high health costs and significant economic losses. The Framingham score has been widely used to stratify the cardiovascular risk of the individuals, identifying those at higher risk for the implementation of prevention measures directed to this group. OBJECTIVE To estimate cardiovascular risk at 10 years in the adult Brazilian population. METHODS Cross-sectional study using laboratory data from a subsample of the National Health Survey. To calculate cardiovascular risk, the Framingham score stratified by sex was used. RESULTS Most women (58.4%) had low cardiovascular risk, 32.9% had medium risk and 8.7% had high risk. Among men, 36.5% had low cardiovascular risk, 41.9% had medium risk and 21.6% had high risk. The risk increased with age and was high in the low-educated population. The proportion of the components of the Framingham model, by risk and sex, shows that, among women at high risk, the indicators that mostly contributed to cardiovascular risk were: systolic blood pressure, total cholesterol, HDL, diabetes and tobacco. Among men, systolic blood pressure, total cholesterol, HDL, tobacco and diabetes. CONCLUSION The study estimates, for the first time in Brazil, the risk of developing cardiovascular disease in ten years. The risk score is useful to support the prevention practices of these diseases, considering the clinical and epidemiological context.
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Affiliation(s)
- Deborah Carvalho Malta
- Universidade Federal de Minas GeraisBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil.
| | - Pedro Cisalpino Pinheiro
- Universidade Federal de Minas GeraisBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil.
| | - Renato Azeredo Teixeira
- Universidade Federal de Minas GeraisBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil.
| | - Isis Eloah Machado
- Universidade Federal de Ouro PretoOuro PretoMGBrasilUniversidade Federal de Ouro Preto, Ouro Preto, MG - Brasil.
| | - Filipe Malta dos Santos
- Universidade Federal de Minas GeraisBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil.
| | - Antônio Luiz Pinho Ribeiro
- Universidade Federal de Minas GeraisBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil.
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Mill JG, Malta DC, Nilson EAF, Machado ÍE, Jaime PC, Bernal RTI, Cardoso LSDM, Szwarcwald CL. Factors associated with salt intake in the Brazilian adult population: National Health Survey. CIENCIA & SAUDE COLETIVA 2021; 26:555-567. [PMID: 33605333 DOI: 10.1590/1413-81232021262.37492020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 10/23/2020] [Indexed: 01/14/2023] Open
Abstract
This paper aims to identify the factors associated with high salt intake in the Brazilian adult population. This is a cross-sectional study with 8,083 adults participating in the National Health Survey (PNS, 2014/15). Salt intake was based on the estimation of 24-hour urinary sodium calculated from the sodium/creatinine ratio in spot urine samples. The highest quartile of the distribution was considered high salt intake. The relationship between high salt consumption and sociodemographic factors, lifestyles, morbidity, and self-rated health status was analyzed by calculating the crude prevalence ratios and the prevalence ratios adjusted for age and gender. Approximately 28.1% had an estimated salt intake higher than 10.56 g/day. Overweight (Adjusted Prevalence Ratio; 95%CI - PRadj 1.23; 1.09-1.39), obesity (PRadj 1.61; 1.43-1.83), and diabetes (PRadj 1.36; 1.17-1.58) were positively associated with high salt intake. Female gender (PRadj 0.73; 0.66-0.80), high schooling level (PRadj 0.88; 0.79-0.99), living in the North and chronic kidney disease (PRadj 0.71; 0.56-0.90) were protective factors. Salt consumption is elevated nationwide and in all population subgroups, requiring coordinated actions.
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Affiliation(s)
- José Geraldo Mill
- Centro de Ciências da Saúde, Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo. Av. Marechal Campos 1.468, Maruípe. 29040-090 Vitória ES Brasil.
| | - Deborah Carvalho Malta
- Departamento de Enfermagem Materno Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | | | - Ísis Eloah Machado
- Programa de Pós-Graduação em Saúde e Nutrição, Departamento de Medicina de Família, Universidade Federal de Ouro Preto. Ouro Preto MG Brasil
| | - Patrícia Constante Jaime
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo. São Paulo SP Brasil
| | - Regina Tomie Ivata Bernal
- Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | | | - Célia Landman Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil
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Khairy S, Aslan A, Samara AM, Mousa I, Alkaiyat AS, Zyoud SH. Factors associated with self-efficacy in patients with hypertension: a cross-sectional study from Palestine. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:1. [PMID: 33563337 PMCID: PMC7874607 DOI: 10.1186/s41043-021-00225-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/01/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Self-efficacy is a widely applied psychosocial concept that is commonly used in association with management of chronic diseases, including hypertension. The aim of this study was to assess self-efficacy of hypertension management and patient-physician communication, as well as the factors associated with self-efficacy and patient-physician communication among patients with hypertension in Palestine. METHODS We conducted face-to-face, questionnaire-based interviews using validated instruments to assess self-efficacy in managing hypertension (Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6C)) and patient-physician communication (Perceived Efficacy in Patient-Physician Interaction Questionnaire (PEPPI)) in patients with hypertension at the three main primary healthcare centers in Nablus district in northern West Bank, Palestine. We also performed a multiple linear regression analysis to determine the variables independently associated with PEPPI and SES6C scores. RESULTS We enrolled 377 participants with hypertension in this study. The average age (measured in years) was 56.8 with a standard deviation of 11.6. The mean PEPPI and SES6C scores were 20.0 (SD 4.4) and 41.1 (SD 10.6), respectively. In a multiple linear regression model, subjects who were city dwellers (B=3.597, p=0.004), and subjects with high education levels (B=4.010, p=0.001) achieved higher PEPPI scores, whereas subjects in the normal weight category (B=5.566, p<0.001) and those with higher PEPPI scores (B=0.706, p<0.001) achieved higher SES6C scores. CONCLUSIONS We found that impairment in self-efficacy was linked to overweight and obesity, as well as lower patient-physician communication. Moreover, our results showed that lower patient-physician communication was independently associated with low education level as well as non-city residency types. We recommend making the appropriate changes by both the policy-makers and the health care providers to improve the health facilities and its services, especially outside the cities. We also suggest holding specific counseling and training session on the management and control of hypertension.
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Affiliation(s)
- Salam Khairy
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Asala Aslan
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ahmad M. Samara
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ibrahim Mousa
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Abdulsalam S. Alkaiyat
- grid.11942.3f0000 0004 0631 5695Public Health Department, College of Medicine and Health Sciences, An-Najah National University Hospital, An-Najah National University, Nablus, 44839 Palestine
| | - Sa’ed H. Zyoud
- grid.11942.3f0000 0004 0631 5695Clinical Research Centre, An-Najah National University Hospital, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
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Malta DC, Pinheiro PC, Azeredo RT, Santos FM, Ribeiro ALP, Brant LCC. Prevalence of high risk for cardiovascular disease among the Brazilian adult population, according to different risk calculators: a comparative study. CIENCIA & SAUDE COLETIVA 2021; 26:1221-1231. [PMID: 33886752 DOI: 10.1590/1413-81232021264.01592021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/18/2021] [Indexed: 11/22/2022] Open
Abstract
This study compares the proportion of the Brazilian adult population classified as being at high risk of cardiovascular disease (CVD) based on six different CVD risk calculators in order to assess the agreement across different tools. A cross-sectional study was conducted using laboratory data from the National Health Survey (NHS). The prevalence rates of high 10-year risk of CVD among individuals aged between 45 and 64 years were as follows: Brazilian Society of Cardiology (BSC) global risk score (GRS) - 38.1%; American College of Cardiology/American Heart Association (ACC/AHA) score - 44.1%; Framingham Heart Study/GRS - 19.4%; European Society of Cardiology SCORE - 14.6%; World Health Organization/International Society of Hypertension (WHO/ISH) score - 3.1%; and Lim et al. - 2.5%. The CVD calculators showed poor agreement for the identification of high-risk individuals and a high level of agreement for the identification of low/moderate risk individuals, except for the ACC/AHA risk score. The findings show that the proportion of individuals classified as eligible for preventive drug therapy varies from tool to tool, which could lead to the misinterpretation of risk, poor cost-effectiveness of therapy and difficulty implementing public policies.
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Affiliation(s)
- Deborah Carvalho Malta
- Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Pedro Cisalpino Pinheiro
- Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Renato Teixeira Azeredo
- Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Filipe Malta Santos
- Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Antonio Luiz Pinho Ribeiro
- Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Luisa Campos Caldeira Brant
- Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
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18
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Bazílio GS, Guimarães RA, Ribeiro GDMP, Morais FDO, Yamamoto RKR, Bernal RTI, Morais Neto OLD. Prevalence and factors associated with arterial hypertension in adults living in Senador Canedo, Goiás, Brazil: a population-based study, 2016. ACTA ACUST UNITED AC 2021; 30:e2019311. [PMID: 33656120 DOI: 10.1590/s1679-49742021000100009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 05/21/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To estimate prevalence and factors associated with hypertension in adults in Senador Canedo, Goiás, Brazil, in 2016. METHODS This was cross-sectional survey, with three-stage cluster sampling. A questionnaire was applied and weight, height, waist circumference, blood pressure and total cholesterol levels were measured. Poisson regression was used to estimate prevalence ratios (PR) and 95% confidence intervals (95%CI). RESULTS Hypertension prevalence was 23.6% (95%CI - 19.3;28.6) among the 709 participants. The associated factors were: sedentarism (PR=1.7 - 95%CI% 1.1;2.5); enlarged waist circumference (PR=5.9 - 95%CI 3.6;9.6); hypercholesterolemia (PR=2.6 - 95%CI 1.3;5.2); and age ≥60 years (PR=2.9 - 95%CI 1.3;6.2). CONCLUSION Hypertension prevalence was lower than that described for Brazil as a whole in 2013. Physical inactivity, accumulated abdominal fat and age were factors associated with hypertension.
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Affiliation(s)
| | - Rafael Alves Guimarães
- Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Goiânia, GO, Brasil
| | | | | | | | - Regina Tomie Ivata Bernal
- Universidade de São Paulo, Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, São Paulo, SP, Brasil
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Freire RS, Reis VMCP, Brito AB, Brito MFSF, de Pinho L, Silva RRV, Silveira MF. Analysis of the interrelationships between factors influencing blood pressure in adults. Rev Saude Publica 2020; 54:147. [PMID: 33331490 PMCID: PMC7726937 DOI: 10.11606/s1518-8787.2020054002123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 03/30/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate the interrelationships between sociodemographic, behavioral and clinical factors associated with high blood pressure in a population of Brazilian adults. METHODS Data from a cross-sectional population-based study conducted with adults were used. In the hypothetical model developed socioeconomic status, fruit and vegetable intake, adiposity and blood pressure were treated as latent variables and age, gender, glycemia, physical activity, smoking, alcohol consumption and control of arterial hypertension were considered observed variables. Confirmatory factorial analysis was used to construct the latent variables measurement models and the structural equation modeling was used to adjust the final model. RESULTS The study included 808 individuals, with mean age of 44.2 years (± 17.8), 52.7% being female. It verified that age exerted a positive direct effect on blood pressure (β = 0.39), adiposity (β = 0.44), glycemia (β = 0.26) and smoking (β = 0.30). Age had a negative direct effect on physical activity (β=-0.17) and alcohol consumption (β = -0.10). Males were positively associated with blood pressure (β = 0.13), smoking (β = 0.28; p < 0.001) and alcohol consumption (β = 0.18). Adiposity had a positive direct effect on blood pressure (β = 0.23) and glycemia (β = 0.16) and alcohol consumption produced a positive effect (β = 0.09) on adiposity. Fruit and vegetable intake had a negative direct effect on blood pressure (β = -0.11), while socioeconomic status had a positive direct effect on fruit and vegetable consumption (β = 0.47). We adjusted the structural model according to the variable medical control of arterial hypertension, which had a negative direct effect on blood pressure (β = -0.10). CONCLUSIONS Results suggest that increasing age is associated with increased blood pressure, adiposity, glycemia and smoking, as well as with reduced physical activity and alcohol consumption. Males were associated with increased blood pressure and greater use of alcohol and cigarettes. Higher adiposity indicators were correlated with increased blood pressure and glycemic levels; higher alcohol consumption was associated with increased adiposity. Higher consumption of fruits and vegetables, as well as active control of hypertension were associated with reduced blood pressure. Better socioeconomic status was associated with higher consumption of fruits and vegetables.
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Affiliation(s)
- Rafael Silveira Freire
- Faculdades Unidas do Norte de MinasInstituto de Ciências da SaúdeMontes ClarosMGBrasil Faculdades Unidas do Norte de Minas . Instituto de Ciências da Saúde . Montes Claros , MG , Brasil
| | - Vivianne Margareth Chaves Pereira Reis
- Universidade Estadual de Montes ClarosDepartamento de Educação FísicaMontes ClarosMGBrasil Universidade Estadual de Montes Claros . Departamento de Educação Física . Montes Claros , MG , Brasil
| | - Alexandre Botelho Brito
- Instituto Federal do Norte de Minas GeraisDepartamento de MatemáticaMontes ClarosMGBrasil Instituto Federal do Norte de Minas Gerais . Departamento de Matemática . Montes Claros , MG , Brasil
| | - Maria Fernanda Santos Figueiredo Brito
- Universidade Estadual de Montes ClarosPrograma de Pós-Graduação em Cuidado Primário em SaúdeMontes ClarosMGBrasil Universidade Estadual de Montes Claros . Programa de Pós-Graduação em Cuidado Primário em Saúde . Montes Claros , MG , Brasil
| | - Lucinéia de Pinho
- Universidade Estadual de Montes ClarosPrograma de Pós-Graduação em Cuidado Primário em SaúdeMontes ClarosMGBrasil Universidade Estadual de Montes Claros . Programa de Pós-Graduação em Cuidado Primário em Saúde . Montes Claros , MG , Brasil
| | - Rosângela Ramos Veloso Silva
- Universidade Estadual de Montes ClarosDepartamento de Educação FísicaMontes ClarosMGBrasil Universidade Estadual de Montes Claros . Departamento de Educação Física . Montes Claros , MG , Brasil
| | - Marise Fagundes Silveira
- Universidade Estadual de Montes ClarosPrograma de Pós-Graduação em Ciências da SaúdeMontes ClarosMGBrasil Universidade Estadual de Montes Claros . Programa de Pós-Graduação em Ciências da Saúde . Montes Claros , MG , Brasil
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Nascimento BR, Brant LCC, Yadgir S, Oliveira GMM, Roth G, Glenn SD, Mooney M, Naghavi M, Passos VMA, Duncan BB, Silva DAS, Malta DC, Ribeiro ALP. Trends in prevalence, mortality, and morbidity associated with high systolic blood pressure in Brazil from 1990 to 2017: estimates from the "Global Burden of Disease 2017" (GBD 2017) study. Popul Health Metr 2020; 18:17. [PMID: 32993676 PMCID: PMC7526365 DOI: 10.1186/s12963-020-00218-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/10/2020] [Indexed: 11/10/2022] Open
Abstract
Background Hypertension remains the leading risk factor for cardiovascular disease (CVD) worldwide, and its impact in Brazil should be assessed in order to better address the issue. We aimed to describe trends in prevalence and burden of disease attributable to high systolic blood pressure (HSBP) among Brazilians ≥ 25 years old according to sex and federal units (FU) using the Global Burden of Disease (GBD) 2017 estimates. Methods We used the comparative risk assessment developed for the GBD study to estimate trends in attributable deaths and disability-adjusted life-years (DALY), by sex, and FU for HSBP from 1990 to 2017. This study included 14 HSBP-outcome pairs. HSBP was defined as ≥ 140 mmHg for prevalence estimates, and a theoretical minimum risk exposure level (TMREL) of 110–115 mmHg was considered for disease burden. We estimated the portion of deaths and DALYs attributed to HSBP. We also explored the drivers of trends in HSBP burden, as well as the correlation between disease burden and sociodemographic development index (SDI). Results In Brazil, the prevalence of HSBP is 18.9% (95% uncertainty intervals [UI] 18.5–19.3%), with an annual 0.4% increase rate, while age-standardized death rates attributable to HSBP decreased from 189.2 (95%UI 168.5–209.2) deaths to 104.8 (95%UI 94.9–114.4) deaths per 100,000 from 1990 to 2017. In spite of that, the total number of deaths attributable to HSBP increased 53.4% and HSBP raised from 3rd to 1st position, as the leading risk factor for deaths during the period. Regarding total DALYs, HSBP raised from 4th in 1990 to 2nd cause in 2017. The main driver of change of HSBP burden is population aging. Across FUs, the reduction in the age-standardized death rates attributable to HSBP correlated with higher SDI. Conclusions While HSBP prevalence shows an increasing trend, age-standardized death and DALY rates are decreasing in Brazil, probably as results of successful public policies for CVD secondary prevention and control, but suboptimal control of its determinants. Reduction was more significant in FUs with higher SDI, suggesting that the effect of health policies was heterogeneous. Moreover, HSBP has become the main risk factor for death in Brazil, mainly due to population aging.
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Affiliation(s)
- Bruno Ramos Nascimento
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. .,Hospital das Clínicas, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110, Belo Horizonte, MG, Brazil.
| | - Luísa Campos Caldeira Brant
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.,Hospital das Clínicas, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110, Belo Horizonte, MG, Brazil
| | - Simon Yadgir
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Gregory Roth
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Scott Devon Glenn
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Meghan Mooney
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Bruce Bartholow Duncan
- Programa de Pós-graduação em Epidemiologia e Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Diego Augusto Santos Silva
- Federal University of Santa Catarina, Research Center in Kinanthropometry and Human Performance, Florianópolis, SC, Brazil
| | - Deborah Carvalho Malta
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.,Departamento de Vigilância de Doenças e Agravos Não Transmissíveis e Promoção da Saúde, Ministério da Saúde, Brasília, Brazil
| | - Antonio Luiz Pinho Ribeiro
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.,Hospital das Clínicas, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110, Belo Horizonte, MG, Brazil
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21
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Oliveira LVA, Santos BNSD, Machado ÍE, Malta DC, Velasquez-Melendez G, Felisbino-Mendes MS. Prevalence of the Metabolic Syndrome and its components in the Brazilian adult population. CIENCIA & SAUDE COLETIVA 2020; 25:4269-4280. [PMID: 33175036 DOI: 10.1590/1413-812320202511.31202020] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 08/17/2020] [Indexed: 02/05/2023] Open
Abstract
We estimated the prevalence of the Metabolic Syndrome (MetS) and its components in the Brazilian population according to sociodemographic factors. This is a cross-sectional population-based study that used laboratory data from the National Health Survey. We estimated the prevalence of MetS and its components with 95% confidence intervals and the unadjusted and adjusted prevalence ratio (PR) with the Poisson regression. MetS prevalence ratio was 38.4%. High waist circumference (WC) (65.5%) and low HDL cholesterol (49.4%) were the most prevalent components, including in the youngest people. MetS and its components were more frequent among women (41.8%), individuals with low schooling (47.5%), and older adults (66.1%). In the adjusted analysis, females (PR = 1.16; 95% CI 1.08-1.24), older adults (PR = 3.69; 95% CI 3.26-4.17), and low schooling (PR = 1.32; 95% CI 1.17-1.49) were associated with MetS. MetS was prevalent in the Brazilian population, especially among women, individuals with low schooling, and older adults. High WC and low HDL cholesterol were the most prevalent components, with the aggravating high prevalence factor in young adults. These findings reveal the need to consider laboratory data for a more accurate analysis of this condition, which can be challenging at the national level.
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Affiliation(s)
- Laís Vanessa Assunção Oliveira
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Bruna Nicole Soares Dos Santos
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Ísis Eloah Machado
- Escola de Medicina, Universidade Federal de Ouro Preto. Ouro Preto MG Brasil
| | - Deborah Carvalho Malta
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Gustavo Velasquez-Melendez
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Mariana Santos Felisbino-Mendes
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
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Nilson EAF, Metlzer AB, Labonté ME, Jaime PC. Modelling the effect of compliance with WHO salt recommendations on cardiovascular disease mortality and costs in Brazil. PLoS One 2020; 15:e0235514. [PMID: 32645031 PMCID: PMC7347203 DOI: 10.1371/journal.pone.0235514] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/16/2020] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Cardiovascular diseases (CVDs) represent the main cause of death among non-communicable diseases (NCDs) in Brazil, and they have a high economic impact on health systems. Most populations around the world, including Brazilians, consume excessive sodium, which increases blood pressure and the risk of CVDs. OBJECTIVE To model the estimated deaths and costs associated with CVDs, which are mediated by increased blood pressure attributable to excessive sodium consumption in adults from the perspective of the Brazilian public health system in 2017. METHODS We employed two macrosimulation methods, using top-down approaches and based on the same relative risks. The models estimated the mortality and costs-of-illness attributable to excessive sodium intake and mediated by hypertension for adults aged over 30 years in 2017. Direct healthcare cost data (inpatient care, outpatient care and medications) were extracted from the Ministry of Health information systems and official records. RESULTS In 2017, an estimated 46,651 deaths from CVDs could have been prevented if the average sodium consumption had been reduced to 2 g/day in Brazil. Premature deaths related to excessive sodium consumption caused 575,172 Years of Life Lost and US$ 752.7 million in productivity losses to the economy. In the same year, the National Health System's costs of hospitalizations, outpatient care and medication for hypertension attributable to excessive sodium consumption totaled US$192.1 million. The main causes of death and costs associated with CVDs were coronary heart disease and stroke, followed by hypertensive disease, heart failure and aortic aneurysm. CONCLUSION Excessive sodium consumption is estimated to account for 15% of deaths by CVDs and to 14% of the inpatient and outpatient costs associated with CVD. It also has high societal costs in terms of premature deaths. CVDs are a leading cause of disease and economic burden on the global, regional and country levels. As a largely preventable and treatable conditions, CVDs require the strengthening of cost-effective policies, supported by evidence, including modeling studies, to reduce the costs relating to illness borne by the Brazilian public health system and society.
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Affiliation(s)
| | - Adriana Blanco Metlzer
- Costa Rican Institute of Research and Training in Nutrition and Health (INCIENSA), San Jose, Costa Rica
| | - Marie-Eve Labonté
- Institute of Nutrition and Functional Foods, Laval University, Québec City, Quebec, Canada
| | - Patrícia Constante Jaime
- Department of Global Health and Sustainability, School of Public Health, University of Sao Paulo, Sao Paulo, São Paulo, Brazil
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Boettiger DC, Escuder MM, Law MG, Veloso V, Souza RA, Ikeda MLR, deAlencastro PR, Tupinambás U, Brites C, Grinsztejn B, Ggomes JO, Ribeiro S, McGowan CC, Jayathilake K, Castilho JL, Grangeiro A. Cardiovascular disease among people living with HIV in Brazil. Trop Med Int Health 2020; 25:886-896. [PMID: 32306480 PMCID: PMC7547667 DOI: 10.1111/tmi.13405] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES There is a paucity of data on cardiovascular disease (CVD) among people living with HIV (PLHIV) in resource-limited countries. We assessed factors associated with CVD and the impact of prevalent CVD on all-cause mortality in PLHIV on antiretroviral therapy in Brazil. METHODS Competing risk regression to assess factors associated with CVD and all-cause mortality in the HIV-Brazil Cohort Study between 2003 and 2014. RESULTS Among 5614 patients, the rate of CVD was 3.5 (95% confidence interval [95% CI] 2.9-4.3) per 1000 person-years. CVD was associated with older age (adjusted hazard ratio [aHR] 6.4 for ≥55 years vs. <35 years, 95% CI: 2.5-16.3, P < 0.01), black race (aHR 1.8 vs. white race, 95% CI: 1.0-3.1, P = 0.04), past CVD (aHR 3.0 vs. no past CVD, 95% CI: 1.4-6.2, P < 0.01), hypertension (aHR 1.8 vs. no hypertension, 95% CI: 1.0-3.1, P = 0.04), high-grade dyslipidemia (aHR 9.3 vs. no high-grade dyslipidemia, 95% CI: 6.0-14.6, P < 0.01), ever smoking (aHR 2.4 vs. never, 95% CI: 1.2-5.0, P = 0.02) and low nadir CD4 cell count (aHR 1.8 for 100-250 cells/mm3 vs. >250 cells/mm3 , 95% CI: 1.0-3.2, P = 0.05). The rate of death was 16.6 (95% CI: 15.1-18.3) per 1000 person-years. Death was strongly associated with having had a past CVD event (aHR 1.7 vs. no past CVD event, 95% CI: 1.1-2.7, P = 0.01). CONCLUSIONS Traditional and HIV-specific factors associated with CVD among PLHIV in Brazil are similar to those identified among PLHIV in high-income countries. PLHIV in Brazil with a history of CVD have a high risk of death. CVD care and treatment remain priorities for PLHIV in Brazil as this population ages and antiretroviral therapy use expands.
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Affiliation(s)
- David C. Boettiger
- Institute for Health Policy Studies, University of California, San Francisco, CA, USA
- Kirby Institute, University of New South Wales, Sydney, Australia
| | | | - Matthew G. Law
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Valdiléa Veloso
- National Institute of Infectology – Evandro Chagas, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Rosa A. Souza
- São Paulo State Department of Health, AIDS Reference and Training Center, São Paulo, Brazil
| | - Maria L. R. Ikeda
- School of Health, University do Vale do Rio dos Sinos, Porto Alegre, Brazil
| | - Paulo R. deAlencastro
- Care and Treatment Clinic of the Hospital Sanatório Partenon, Rio Grande do Sul State Department of Health, Porto Alegre, Brazil
| | - Unai Tupinambás
- Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Carlos Brites
- Edgar Santos University Hospital Complex, Federal University of Bahia, Salvador, Brazil
| | - Beatriz Grinsztejn
- National Institute of Infectology – Evandro Chagas, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Jackeline O. Ggomes
- São Paulo State Department of Health, Institute of Health, São Paulo, Brazil
| | - Sayonara Ribeiro
- National Institute of Infectology – Evandro Chagas, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Catherine C. McGowan
- Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Karu Jayathilake
- Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jessica L. Castilho
- Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alexandre Grangeiro
- Department of Preventive Medicine, University of São Paulo School of Medicine, São Paulo, Brazil
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Marques AP, Szwarcwald CL, Pires DC, Rodrigues JM, Almeida WDSD, Romero D. [Factors associated with arterial hypertension: a systematic review]. CIENCIA & SAUDE COLETIVA 2020; 25:2271-2282. [PMID: 32520271 DOI: 10.1590/1413-81232020256.26972018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/03/2018] [Indexed: 01/11/2023] Open
Abstract
A systematic review of demographic, socioeconomic, behavioral and anthropometric factors associated with hypertension. We included observational studies, of populations aged 18 or older, from the past ten years, published in English, Portuguese or Spanish from Pubmed, Web of Science, Scopus and Lilacs bases. The most found factors related to the greater chance of having hypertension were age and the Body Mass Index (BMI). Other factors associated with the disease were: gender (male), education (lower education), income (lower income) and waist circumference (high). Never having smoked, never having consumed alcohol and white skin color were characteristics related to a lower chance of having hypertension. As demonstrated, demographic, socioeconomic, behavioral and anthropometric characteristics are important factors associated with a greater chance of having hypertension in the adult population. However, while most of the factors associated with it are amenable to intervention, broader health promotion policies will be needed to reduce socioeconomic inequalities in the prevalence of the disease.
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Affiliation(s)
- Aline Pinto Marques
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
| | - Célia Landmann Szwarcwald
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
| | - Débora Castanheira Pires
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
| | - Jéssica Muzy Rodrigues
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
| | - Wanessa da Silva de Almeida
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
| | - Dalia Romero
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.
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Nilson EAF, Andrade RDCS, de Brito DA, de Oliveira ML. [Costs attributable to obesity, hypertension, and diabetes in the Unified Health System, Brazil, 2018Costos atribuibles a la obesidad, la hipertensión y la diabetes en el Sistema Único de Salud de Brasil, 2018]. Rev Panam Salud Publica 2020; 44:e32. [PMID: 32284708 PMCID: PMC7147115 DOI: 10.26633/rpsp.2020.32] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 01/21/2020] [Indexed: 01/23/2023] Open
Abstract
Objetivo. Estimar os custos atribuíveis a hipertensão arterial, diabetes e obesidade no Sistema Único de Saúde (SUS) no Brasil em 2018. Métodos. Realizou-se uma estimativa dos custos atribuíveis a doenças crônicas não transmissíveis a partir dos riscos relativos e das prevalências populacionais de hipertensão, diabetes e obesidade, considerando custos de hospitalizações, procedimentos ambulatoriais e medicamentos distribuídos pelo SUS para tratamento dessas doenças. As informações de custo foram obtidas nos sistemas de informação em saúde disponíveis no SUS. A análise explorou os custos das doenças segundo sexo e idade na população adulta. Resultados. Os custos totais de hipertensão, diabetes e obesidade no SUS alcançaram 3,45 bilhões de reais (R$) (IC95%: 3,15 a 3,75) em 2018, ou seja, mais de 890 milhões de dólares (US$). Desses custos, 59% foram referentes ao tratamento da hipertensão, 30% ao do diabetes e 11% ao da obesidade. No total, 72% dos custos foram com indivíduos de 30 a 69 anos de idade e 56%, com mulheres. Considerando separadamente a obesidade como fator de risco para hipertensão e diabetes, os custos atribuíveis a essa doença chegaram a R$ 1,42 bilhão (IC95%: 0,98 a 1,87), ou seja, 41% dos custos totais. Conclusões. As estimativas dos custos atribuíveis às principais doenças crônicas associadas à alimentação inadequada evidenciam a grande carga econômica dessas doenças para o SUS. Os dados mostram a necessidade de priorizar políticas integradas e intersetoriais para a prevenção e o controle da hipertensão, do diabetes e da obesidade e podem apoiar a defesa de intervenções como medidas fiscais e regulatórias para alcançar os objetivos da Década de Ação das Nações Unidas sobre Nutrição.
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Affiliation(s)
- Eduardo Augusto Fernandes Nilson
- Ministério da Saúde Coordenação-Geral de Alimentação e Nutrição Brasília (DF) Brasil Ministério da Saúde, Coordenação-Geral de Alimentação e Nutrição, Brasília (DF), Brasil
| | - Rafaella da Costa Santin Andrade
- Ministério da Saúde Coordenação-Geral de Alimentação e Nutrição Brasília (DF) Brasil Ministério da Saúde, Coordenação-Geral de Alimentação e Nutrição, Brasília (DF), Brasil
| | - Daniela Aquino de Brito
- Ministério da Saúde Coordenação-Geral de Alimentação e Nutrição Brasília (DF) Brasil Ministério da Saúde, Coordenação-Geral de Alimentação e Nutrição, Brasília (DF), Brasil
| | - Michele Lessa de Oliveira
- Ministério da Educação Fundo Nacional de Desenvolvimento da Educação (FNDE) Brasília (DF) Brasil Ministério da Educação, Fundo Nacional de Desenvolvimento da Educação (FNDE), Brasília (DF), Brasil
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Varellis MLZ, Gonçalves MLL, Pavesi VCS, Horliana ACRT, de Fátima Teixeira da Silva D, Motta LJ, Barbosa Filho VF, Bezerra CDS, da Silva FG, Bussadori SK, Deana AM. Evaluation of photobiomodulation in salivary production of patients with xerostomy induced by anti-hypertensive drugs: Study protocol clinical trial (SPIRIT compliant). Medicine (Baltimore) 2020; 99:e19583. [PMID: 32311925 PMCID: PMC7220222 DOI: 10.1097/md.0000000000019583] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 02/18/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Hypertension (systemic arterial hypertension [SAH]) is a systemic condition that affects about 30% of the world population, according to data from the World Health Organization (WHO). Drugs used to control this disease have the potential to induce xerostomia, an oral condition in which the decrease of the salivary flow is observed and whose presence leads to the increase of the index of caries, periodontal disease, loss of the teeth, dysgeusia, difficulty of mastication, dysphagia, bad breath and oral burning and impairment of prothesis installed in the buccal cavity, including retention of removable and total dentures. METHODS This is a randomized, placebo-controlled, blind clinical protocol that aims to analyze the impact of phobiomodulation (PBM) on salivary glands of patients with antihypertensive drug induced xerostomia. Patients will be divided into 2 groups: G1: older adults with xerostomia induced by antihypertensive drugs and treatment with PBM (n = 30); G2: placebo PBM (n = 30). The irradiation will be made using a diode laser emitting at 808 nm with 100 mW and 40 seconds of exposure per site at the salivary glands. Twenty sites will be irradiated weekly for 4 weeks. Non-stimulated and stimulated salivary flow will be analyzed before and after the treatment. RESULTS This protocol will determine the effectiveness of photodynamic therapy regarding the reduction of xerostomia in older adults using antihypertensive drugs. CONCLUSION This protocol will determine the effectiveness of photodynamic therapy regarding the reduction of xerostomia in older adults using antihypertensive drugs. TRIAL REGISTRATION Clinicaltrials.gov - NCT03632096.
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Fiório CE, Cesar CLG, Alves MCGP, Goldbaum M. Prevalência de hipertensão arterial em adultos no município de São Paulo e fatores associados. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200052. [DOI: 10.1590/1980-549720200052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 04/09/2019] [Indexed: 11/21/2022] Open
Abstract
RESUMO: Objetivo: Analisar o comportamento da prevalência de hipertensão arterial no município de São Paulo e seus fatores associados. Métodos: O presente trabalho utilizou os dados do Inquérito de Saúde no Município de São Paulo (ISA Capital), estudo transversal de base populacional executado no município de São Paulo. Foram utilizados dados de 1.667 e de 3.184 indivíduos em 2003 e 2015, respectivamente, com idade de 20 anos e mais. Fizeram-se análises descritivas das prevalências de hipertensão arterial com respectivos intervalos de 95% de confiança. Análises simples e múltiplas foram realizadas para analisar possíveis associações com as variáveis socioeconômicas, demográficas e de estilo de vida por meio de regressão de Poisson. Resultados: A prevalência de hipertensão arterial passou de 17,2% em 2003 para 23,2% em 2015. Os fatores associados à hipertensão foram: sexo feminino; idade (60 anos e mais); situação conjugal (casados, separados e viúvos); ter religião; baixa escolaridade; ter nascido no estado de São Paulo (exceto capital); estado nutricional (baixo peso, sobrepeso e obesidade); e ex-fumantes. Conclusão: A prevalência de hipertensão autorreferida aumentou significativamente no período estudado em São Paulo. Considerando o impacto dessa doença na sociedade, conhecendo sua atual prevalência e identificando seus principais fatores associados, evidencia-se a necessidade de intensificar atividades que contribuam para a prevenção desse agravo, atenuando os danos aos indivíduos e gastos públicos.
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Sudharsanan N, Geldsetzer P. Impact of Coming Demographic Changes on the Number of Adults in Need of Care for Hypertension in Brazil, China, India, Indonesia, Mexico, and South Africa. Hypertension 2019; 73:770-776. [PMID: 30739534 DOI: 10.1161/hypertensionaha.118.12337] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Over the coming decades, middle-income countries are expected to undergo substantial demographic changes. We estimated the consequences of these changes on the number of adults in need of hypertension care between 2015 and 2050 using nationally representative household-survey data collected in Brazil, China, India, Indonesia, Mexico, and South Africa (N=770 121). To reflect unmet need for healthcare, we defined hypertension as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg regardless of treatment status. Using a mathematical disease projection equation, we calculated the change in the number of individuals in need of hypertension care in each country that was due to changes in population size, age composition, and age-specific prevalence under various epidemiological scenarios. If the current age-specific prevalence schedule of hypertension remains unchanged until 2050, demographic changes alone will increase the number of adults in need of hypertension care by 319.7 million individuals, ranging from a relative growth of 55% in China to 151% in Mexico. Even if the age-specific prevalence of hypertension is reduced by 25% by 2050 among adults aged ≥40 years, the number of individuals in need of hypertension care will still increase by 145.9 million individuals, with relative increases ranging from 16% in China to 88% in Mexico. Overall, our results suggest that coming demographic changes in middle-income countries will overpower even ideal prevention efforts. Middle-income countries will need to massively expand healthcare services for aging-related diseases, such as hypertension, if they are to meet the virtually inevitable future increase in care needs for these conditions.
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Affiliation(s)
- Nikkil Sudharsanan
- From the Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA (N.S.).,Heidelberg Institute of Global Health, University of Heidelberg, Germany (N.S.)
| | - Pascal Geldsetzer
- Heidelberg Institute of Global Health, University of Heidelberg, Germany (N.S.)
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Prevalence, awareness, treatment and control of hypertension in rural and urban communities in Latin American countries. J Hypertens 2019; 37:1813-1821. [DOI: 10.1097/hjh.0000000000002108] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Cut-off points of anthropometric markers associated with hypertension in the Brazilian population: National Health Survey, 2013. Public Health Nutr 2019; 22:2147-2154. [DOI: 10.1017/s1368980019000533] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AbstractObjectiveTo identify cut-off points for waist circumference (WC), waist-to-height ratio (WHtR) and BMI associated with hypertension in the Brazilian adult and elderly population.DesignCross-sectional study. The receiver-operating characteristic (ROC) curve was used to determine the cut-off points of WC, WHtR and BMI in the prediction of hypertension. Those who had systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg and those who reported use of antihypertensive medication were considered hypertensive.SettingBrazil.ParticipantsParticipants from the National Health Survey, the Brazilian household-based survey conducted in 2013, of both sexes and age ≥20 years.ResultsCut-off points for WC and WHtR increased with age in both sexes. WC cut-off limits ranged between 88·0 and 95·9 cm in men and between 85·0 and 93·2 cm in women. For WHtR, cut-off scores ranged from 0·51 to 0·58 for men and from 0·53 to 0·61 for women. Additionally, the area under the ROC curve (AUC) for all age and sex groups was greater than 0·60 while the lower limit of the AUC 95 % CI for both WC and WHtR was not less than 0·50. The performance of BMI was similar to that of indicators of fat location.ConclusionsAll analysed anthropometric indicators had similar performance in identifying hypertension in the Brazilian population.
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Sekiyama FM, Rodrigues R, Mesas AE, González AD, de Andrade SM. Reading the Nutritional Information on Food Labels Among Teachers with and without Hypertension in Brazil. Int J Prev Med 2019; 10:1. [PMID: 30774835 PMCID: PMC6360847 DOI: 10.4103/ijpvm.ijpvm_40_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 09/26/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND To examine the associations among nutritional label use, medically diagnosed hypertension, and sociodemographic factors among teachers. METHODS A cross-sectional study of elementary and secondary school teachers in Londrina, Paraná, Brazil, was conducted. Data regarding sociodemographic variables, hypertension diagnosis, and the reading of nutritional information on food/beverage labels were collected in 2012-2013. Associations were analyzed using Chi-square test or Fisher's exact test, and multivariate binary logistic regression models were used to adjust for possible confounders; odds ratios (ORs), 95% confidence intervals (CIs), and adjusted P values were calculated. RESULTS Of the 978 teachers interviewed, 15% were diagnosed with hypertension, and 62.5% read nutritional information in the 12 months prior to the survey (41% frequently or always). No differences were found between teachers with and without hypertension with regard to frequent reading (frequently/always) of nutritional labels. The frequent use of nutritional labels was significantly associated with female sex (OR = 1.39; 95% CI = 1.04-1.85) and the highest monthly family income level (OR = 1.82; 95% CI = 1.07-3.11). Teachers with hypertension reported checking for sodium more frequently than those without (adjusted P value = 0.040). Medical advice (adjusted P value <0.001) and choosing healthier foods (adjusted P value = 0.002) were the major reasons for reading labels provided by teachers with and without hypertension, respectively. CONCLUSIONS Checking for sodium values on nutritional labels was significantly higher among teachers with hypertension, which most likely results from medical advice, and was the major reported reason for reading these labels.
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Affiliation(s)
- Fábio Montagna Sekiyama
- Program of Medical Residency in Clinical Medicine, University Hospital of Londrina, State University of Londrina, State of Paraná, Brazil
| | - Renne Rodrigues
- Department of Pharmacy, University of North Paraná, State of Paraná, Londrina, Brazil
| | - Arthur Eumann Mesas
- Department of Public Health, State University of Londrina, Paraná State, Brazil
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Castilho JL, Escuder MM, Veloso V, Gomes JO, Jayathilake K, Ribeiro S, Souza RA, Ikeda ML, de Alencastro PR, Tupinanbas U, Brites C, McGowan CC, Grangeiro A, Grinsztejn B. Trends and predictors of non-communicable disease multimorbidity among adults living with HIV and receiving antiretroviral therapy in Brazil. J Int AIDS Soc 2019; 22:e25233. [PMID: 30697950 PMCID: PMC6351749 DOI: 10.1002/jia2.25233] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 12/19/2018] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION People living with HIV (PLHIV) on antiretroviral therapy (ART) experience high rates of non-communicable diseases (NCDs). These co-morbidities often accumulate and older adults may suffer from multimorbidity. Multimorbidity has been associated with loss of quality of life, polypharmacy, and increased risk of frailty and mortality. Little is known of the trends or predictors NCD multimorbidity in PLHIV in low- and middle-income countries. METHODS We examined NCD multimorbidity in adult PLHIV initiating ART between 2003 and 2014 using a multi-site, observational cohort in Brazil. NCDs included cardiovascular artery disease, hyperlipidemia (HLD), diabetes, chronic kidney disease, cirrhosis, osteoporosis, osteonecrosis, venous thromboembolism and non-AIDS-defining cancers. Multimorbidity was defined as the incident accumulation of two or more unique NCDs. We used Poisson regression to examine trends and Cox proportional hazard models to examine predictors of multimorbidity. RESULTS Of the 6206 adults, 332 (5%) developed multimorbidity during the study period. Parallel to the ageing of the cohort, the prevalence of multimorbidity rose from 3% to 11% during the study period. Older age, female sex (adjusted hazard ratio (aHR) = 1.30 (95% confidence interval (CI) 1.03 to 1.65)) and low CD4 nadir (<100 vs. ≥200 cells/mm3 aHR = 1.52 (95% CI: 1.15 to 2.01)) at cohort entry were significantly associated with increased risk of multimorbidity. Among patients with incident multimorbidity, the most common NCDs were HLD and diabetes; however, osteoporosis was also frequent in women (16 vs. 35% of men and women with multimorbidity respectively). CONCLUSIONS Among adult PLHIV in Brazil, NCD multimorbidity increased from 2003 to 2014. Females and adults with low CD4 nadir were at increased risk in adjusted analyses. Further studies examining prevention, screening and management of NCDs in PLHIV in low- and middle-income countries are needed.
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Affiliation(s)
- Jessica L Castilho
- Division of Infectious DiseasesVanderbilt University Medical CenterNashvilleTNUSA
| | - Maria M Escuder
- São Paulo State Department of HealthInstitute of HealthSão PauloBrazil
| | - Valdiléa Veloso
- National Institute of Infectology – Evandro ChagasOswaldo Cruz FoundationRio de JaneiroBrazil
| | - Jackeline O Gomes
- São Paulo State Department of HealthInstitute of HealthSão PauloBrazil
| | - Karu Jayathilake
- Division of Infectious DiseasesVanderbilt University Medical CenterNashvilleTNUSA
| | - Sayonara Ribeiro
- National Institute of Infectology – Evandro ChagasOswaldo Cruz FoundationRio de JaneiroBrazil
| | - Rosa A Souza
- São Paulo State Department of HealthAIDS Reference and Training CenterSão PauloBrazil
| | - Maria L Ikeda
- School of HealthUniversity do Vale do Rio dos SinosPorto AlegreBrazil
| | - Paulo R de Alencastro
- Care and Treatment Clinic of the Partenon SanatoriumRio Grande do Sul State Department of HealthPorto AlegreBrazil
| | - Unai Tupinanbas
- Medical SchoolFederal University of Minas GeraisBelo HorizonteBrazil
| | - Carlos Brites
- Edgar Santos University Hospital ComplexFederal University of BahiaSalvadorBrazil
| | - Catherine C McGowan
- Division of Infectious DiseasesVanderbilt University Medical CenterNashvilleTNUSA
| | - Alexandre Grangeiro
- Department of Preventive MedicineUniversity of São Paulo School of MedicineSão PauloBrazil
| | - Beatriz Grinsztejn
- National Institute of Infectology – Evandro ChagasOswaldo Cruz FoundationRio de JaneiroBrazil
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Marques AP, Szwarcwald CL, de PRB, Malta DC, Montilla DER. Prevalence of arterial hypertension in Brazilian adults and its associated factors and activity limitations: a cross-sectional study. SAO PAULO MED J 2019; 137:312-321. [PMID: 31691763 PMCID: PMC9744008 DOI: 10.1590/1516-3180.2018.0251220719] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 07/22/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Hypertension is a serious global public health problem that affects a large part of the Brazilian adult population and can cause limitations and losses of quality of life. OBJECTIVE The objective of this study was to analyze the association of hypertension and its correlated limitations, with sociodemographic and epidemiological factors. DESIGN AND SETTING Cross-sectional study analyzing information on 44,271 adults (30 years or older) from the Brazilian National Health Survey of 2013. METHODS The prevalence of hypertension and the degree of limitation of the patients' activities associated with hypertension, according to sociodemographic characteristics, anthropometric measurements and lifestyles, were calculated for both sexes. To analyze the strength of association, bivariate and multivariate Poisson regression were used. RESULTS Hypertension was the most prevalent risk factor among Brazilian adults aged 30 years or older (40.7%). It was strongly associated with the aging process (prevalence ratio, PR 3.51), obesity (PR 1.73), heart disease (PR 1.67) and stroke (PR 1.86). Furthermore, limitations associated with hypertension were more prevalent among those with comorbidities from noncommunicable diseases relating to hypertension complications (stroke PR 1.47; heart disease PR 1.69) and with incomplete elementary education (PR 1.19). CONCLUSIONS This study showed sociodemographic inequality in the prevalence of hypertension, especially in the population with some degree of limitation associated with hypertension. It showed that improvements in access to primary care services for controlling hypertension at its initial stages are essential in order to avoid comorbidities of greater severity and limitations and losses of quality of life, especially among socially disadvantaged people.
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Affiliation(s)
- Aline Pinto Marques
- PhD. Assistant Researcher, Laboratory of Health Information, Institute of Health Communication and Scientific and Technological Information, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro (RJ), Brazil.
| | - Célia Landmann Szwarcwald
- PhD. Researcher, Laboratory of Health Information, Institute of Health Communication and Scientific and Technological Information, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro (RJ), Brazil.
| | - Paulo Roberto Borges de
- PhD. Research Assistant, Laboratory of Health Information, Institute of Health Communication and Scientific and Technological Information, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro (RJ), Brazil.
| | - Déborah Carvalho Malta
- PhD. Professor, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.
| | - Dalia Elena Romero Montilla
- PhD. Researcher, Laboratory of Health Information, Institute of Health Communication and Scientific and Technological Information, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro (RJ), Brazil.
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Malta DC, Gonçalves RPF, Machado ÍE, Freitas MIDF, Azeredo C, Szwarcwald CL. Prevalence of arterial hypertension according to different diagnostic criteria, National Health Survey. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 21:e180021. [PMID: 30517472 DOI: 10.1590/1980-549720180021.supl.1] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 01/08/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To determine the population prevalence of arterial hypertension in adults according to different diagnostic criteria. METHODS This is a cross-sectional study, analyzing information from the Brazilian National Health Survey in 2013, consisted of interviews, physical and laboratory measurements (n = 60,202). The prevalence of hypertension was defined according to three diagnostic criteria: self-reported; measured by instrument (blood pressure ≥ 140/90 mmHg); measured and/or using medication. Prevalence and 95% confidence interval (95%CI) were estimated by the three diagnostic criteria of hypertension. RESULTS The high blood pressure measurements were: 21.4% (95%CI 20.8 - 22.0) using the criterion self-reported; 22.8% (95%CI 22.1 - 23.4) by measured hypertension; and 32.3% (95%CI 31.7 - 33.0) by measured hypertension and/or reported use of medication. Women presented higher prevalence for the self-reported criterion (24.2%; 95%CI 23.4 - 24.9) and men, for the measured criterion (25.8%; 95%CI 24.8 - 26.8). Hypertension increases with age and is more frequent in urban areas. Using these three criteria, the hypertension was higher in the Southeast and South regions, in relation to the average of the country and the other regions. Using these three criteria, hypertension increased with age, was more frequent in urban areas and in the Southeast and South regions, in relation to the average of the country and the other regions. CONCLUSION These findings are important to support policies that aim to achieve the World Health Organization's goal of reducing hypertension by 25% over the next decade.
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Affiliation(s)
- Deborah Carvalho Malta
- Escola de Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | | | - Ísis Eloah Machado
- Escola de Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | | | - Cimar Azeredo
- Coordenação de Trabalho e Rendimento, Instituto Brasileiro de Geografia e Estatística - Rio de Janeiro (RJ), Brasil
| | - Celia Landman Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz - Rio de Janeiro (RJ), Brasil
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Abstract
This study provides estimates of hypertension prevalence, awareness, treatment, and control in Brazil and assesses how well different modes of primary care delivery achieve each of these outcomes. Over one-third of the Brazilian adult population had measured hypertension or prior diagnosis. Nearly 90% of these had recent contact with the health system, but only 65% were aware of their condition. Only 62% of these regularly sought care for hypertension, but of these 92% received treatment. Hypertension control was 33% overall, but increased to 57% among those who received all levels of care.
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Cavalcanti AM, Kusma SZ, Chomatas ERDV, Ignácio SA, Mendes EV, Moysés ST, Pecoits-Filho R. Noncommunicable diseases and their common risk factors in Curitiba, Brazil: results of a cross-sectional, population-based study. Rev Panam Salud Publica 2018; 42:e57. [PMID: 31093085 PMCID: PMC6386061 DOI: 10.26633/rpsp.2018.57] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 11/22/2017] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE To describe the estimated prevalence of noncommunicable diseases and their common risk factors among the adult population of Curitiba, Paraná, Brazil, based on results of the EPIdemiology of CURitiba: EvaluAtion of Noncommunicable diseases (EPICUREAN) study. METHODS This was a cross-sectional, population-based survey of 1 103 residents of Curitiba, grouped by age (18 - 39 years of age, 40 - 59, and ≥ 60 years), conducted in August 2013 - August 2014. Household interviews, anthropometry, blood pressure measurements, and fasting capillary glycemia were performed during two visits to each participant. The analyses included frequency distribution and prevalence estimates of main outcomes. Prevalence estimates, weighted by age and sex, were presented as absolute numbers and percentages. RESULTS Prevalence estimates for self-reported depression were 21.2%; hypertension, 31.2%; diabetes, 9.1%; self-reported dyslipidemia, 21.7%; obesity, 21.2%; current smoking, 16.1%; binge drinking, 23.4%; and insufficient physical activity, 35.1%. Prevalences of diabetes and hypertension were higher among individuals with less schooling and the elderly. Binge drinking and leisure-time physical activity were more prevalent in young adults. Men presented higher prevalences of overweight, current smoking, and harmful use of alcohol. Obesity and moderate- to-severe risk of depression were more frequent among women and those with lower income. CONCLUSIONS The prevalence of NCDs and common risk factors among the adult population of Curitiba are high and reveal a gradient of vulnerabilities by age, sex, education level, and income. To address health inequities and meet the needs of different population groups, the health system should monitor NCDs and risk factors and implement equitable public health policies.
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Affiliation(s)
- Ana Maria Cavalcanti
- School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Paraná, Brazil
| | - Solena Ziemer Kusma
- School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Paraná, Brazil
| | - Eliane Regina da Veiga Chomatas
- Program in Health Sciences, Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | | | - Roberto Pecoits-Filho
- School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Paraná, Brazil
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Freire IV, Casotti CA, Ribeiro ÍJS, Silva JRD, Barbosa AAL, Pereira R. Daily sodium intake influences the relationship between angiotensin-converting enzyme gene insertion/deletion polymorphism and hypertension in older adults. J Clin Hypertens (Greenwich) 2018; 20:541-550. [PMID: 29521003 PMCID: PMC8031090 DOI: 10.1111/jch.13224] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/28/2017] [Accepted: 12/08/2017] [Indexed: 01/02/2023]
Abstract
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.
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Affiliation(s)
- Ivna V. Freire
- Postgraduate Program in Nursing & HealthState University of Southwest Bahia (UESB)JequieBABrazil
- Department of Biological SciencesIntegrative Physiology Research CenterState University of Southwest Bahia (UESB)JequieBABrazil
- Human Genetics LaboratoryDepartment of Biological SciencesState University of Southwest Bahia (UESB)JequieBABrazil
| | - Cezar A. Casotti
- Postgraduate Program in Nursing & HealthState University of Southwest Bahia (UESB)JequieBABrazil
| | - Ícaro J. S. Ribeiro
- Postgraduate Program in Nursing & HealthState University of Southwest Bahia (UESB)JequieBABrazil
- Department of Biological SciencesIntegrative Physiology Research CenterState University of Southwest Bahia (UESB)JequieBABrazil
| | - Jonas R. D. Silva
- Department of Biological SciencesIntegrative Physiology Research CenterState University of Southwest Bahia (UESB)JequieBABrazil
| | - Ana A. L. Barbosa
- Human Genetics LaboratoryDepartment of Biological SciencesState University of Southwest Bahia (UESB)JequieBABrazil
| | - Rafael Pereira
- Postgraduate Program in Nursing & HealthState University of Southwest Bahia (UESB)JequieBABrazil
- Department of Biological SciencesIntegrative Physiology Research CenterState University of Southwest Bahia (UESB)JequieBABrazil
- Human Genetics LaboratoryDepartment of Biological SciencesState University of Southwest Bahia (UESB)JequieBABrazil
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Lotufo PA. Lowering blood pressure is a priority in Brazil and worldwide. SAO PAULO MED J 2017; 135:509-510. [PMID: 29267514 PMCID: PMC10016011 DOI: 10.1590/1516-3180.2017.1356211117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Paulo Andrade Lotufo
- MD, DrPH. Full Professor, Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo (SP), Brazil.
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de Faria HD, Bueno CT, Krieger JE, Krieger EM, Pereira AC, Santos PCJL, Figueiredo EC. Online extraction of antihypertensive drugs and their metabolites from untreated human serum samples using restricted access carbon nanotubes in a column switching liquid chromatography system. J Chromatogr A 2017; 1528:41-52. [PMID: 29102378 DOI: 10.1016/j.chroma.2017.10.072] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/27/2017] [Accepted: 10/30/2017] [Indexed: 02/03/2023]
Abstract
A novel analytical method was developed to determine 5 antihypertensive drugs of different pharmacological classes (angiotensin-converting enzyme inhibitors, calcium channel blockers, α-2 adrenergic receptor agonists, angiotensin II receptor blockers, and aldosterone receptor antagonists) and some of their metabolites in human serum. The untreated samples were directly analyzed in a column switching system using an extraction column packed with restricted access carbon nanotubes (RACNTs) in an ultra-high performance liquid chromatography coupled to a mass spectrometer (UHPLC-MS/MS). The RACNTs column was able to exclude approximately 100% of proteins from the samples in 2.0min, maintaining the same performance for about 300 analytical cycles. The method was validated in accordance with Food and Drug Administration (FDA) guidelines, being linear for all the determined analytes in their respective analytical ranges (coefficients of determination higher than 0.99) with limits of detection (LODs) and quantification (LOQs) ranging from 0.09 to 10.85μgL-1 and from 0.30 to 36.17μgL-1, respectively. High recovery values (88-112%) were obtained as well as suitable results for inter and intra-assay accuracy and precision. The method provided an analytical frequency of 5 samples per hour, including the sample preparation and separation/detection steps. The validated method was successfully used to analyze human serum samples of patients undergoing treatment with antihypertensive drugs, being useful for pharmacometabolomic, pharmacogenomic, and pharmacokinetic studies.
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Affiliation(s)
- Henrique Dipe de Faria
- Laboratory of Toxicant and Drug Analysis, Federal University of Alfenas - UNIFAL-MG, Alfenas, MG, Brazil
| | - Carolina Tosin Bueno
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Jose Eduardo Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Eduardo Moacyr Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Alexandre Costa Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Paulo Caleb Júnior Lima Santos
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil; Department of Pharmacology - Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Eduardo Costa Figueiredo
- Laboratory of Toxicant and Drug Analysis, Federal University of Alfenas - UNIFAL-MG, Alfenas, MG, Brazil.
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Douine M, Mosnier E, Le Hingrat Q, Charpentier C, Corlin F, Hureau L, Adenis A, Lazrek Y, Niemetsky F, Aucouturier AL, Demar M, Musset L, Nacher M. Illegal gold miners in French Guiana: a neglected population with poor health. BMC Public Health 2017; 18:23. [PMID: 28716015 PMCID: PMC5513330 DOI: 10.1186/s12889-017-4557-4] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 06/30/2017] [Indexed: 11/17/2022] Open
Abstract
Background In French Guiana, a French overseas territory in South America, 6 to 10 thousands undocumented persons work illegally in gold mining sites in the Amazonian forest. Precarious life conditions lead to poor health but few data exist on the health status of illegal gold miners in French Guiana. The objective of this article was to describe the sociodemographic and health status of this vulnerable population. Method A prospective cross-sectional survey was conducted in 2015 on gold mine supply sites at the border between French Guiana and Suriname. Health status was assessed through medical examination, past medical history, haemoglobin concentration, and HIV and malaria testing. A questionnaire was used to collect data about the migration itinerary and life conditions on mining sites. Results Among the 421 adults included in the study, 93.8% (395/421) were Brazilian, mainly from Maranhão (55.7%, 220/395), the poorest Brazilian state. The sex ratio was 2.4. Overall, 48% of persons never went to school or beyond the primary level. The median time spent in gold mining was quite long (10 years), with a high turn-over. One third of the surveyed population (37.1%, 156/421) had high blood pressure, and only two had a medical follow-up. Most persons had experienced malaria (89.3%, 376/421). They declared frequent arboviroses and digestive disorders. Active leishmaniasis was observed in 8.3% of gold miners. Among women, 28.5% were anemic. Concerning HIV, 36.6% (154/421) of persons, mainly men, never got tested before and 6 were tested positive, which represented an HIV prevalence of 1.43% (95%CI =0.29–2.5). Conclusion These findings support the hypothesis that mining in remote areas is linked to several specific illnesses. Theoretically, gold miners would be presumed to start their economical migration to French Guiana as a healthy group. However, their strenuous working and living conditions there lead to poor health caused by infectious and non infectious diseases. This description of their health status is precious for health policy planners in French Guiana given the importance of controlling communicable disease, and the severity and range of specific illnesses acquired by this neglected population. Trial registration Clinical trial registration PRS N° NCT02903706. Retrospectively registered 09/13/2016.
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Affiliation(s)
- Maylis Douine
- Centre d'Investigation Clinique Antilles-Guyane (Inserm 1424), Cayenne Hospital, Av des Flamboyant, BP 6006, 97306 cedex, Cayenne, French Guiana, France. .,Epidemiology of Tropical Parasitoses, EA 3593, Université de Guyane, Cayenne, French Guiana, France.
| | - Emilie Mosnier
- Epidemiology of Tropical Parasitoses, EA 3593, Université de Guyane, Cayenne, French Guiana, France.,Centres Délocalisés de Prévention et de Soins, Cayenne Hospital, Cayenne, French Guiana, France
| | - Quentin Le Hingrat
- INSERM UMR1137, IAME Université Paris Diderot Sorbonne Paris Cité, AP-HP, Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Paris, France
| | - Charlotte Charpentier
- INSERM UMR1137, IAME Université Paris Diderot Sorbonne Paris Cité, AP-HP, Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Paris, France
| | - Florine Corlin
- Centre d'Investigation Clinique Antilles-Guyane (Inserm 1424), Cayenne Hospital, Av des Flamboyant, BP 6006, 97306 cedex, Cayenne, French Guiana, France
| | - Louise Hureau
- Centre d'Investigation Clinique Antilles-Guyane (Inserm 1424), Cayenne Hospital, Av des Flamboyant, BP 6006, 97306 cedex, Cayenne, French Guiana, France
| | - Antoine Adenis
- Centre d'Investigation Clinique Antilles-Guyane (Inserm 1424), Cayenne Hospital, Av des Flamboyant, BP 6006, 97306 cedex, Cayenne, French Guiana, France.,Epidemiology of Tropical Parasitoses, EA 3593, Université de Guyane, Cayenne, French Guiana, France
| | - Yassamine Lazrek
- Laboratoire de parasitologie, WHO Collaborating Center for Surveillance of Anti-Malarial Drug Resistance, Centre National de Référence du paludisme, Institut Pasteur de la Guyane, Cayenne, French Guiana, France
| | - Florence Niemetsky
- Centres Délocalisés de Prévention et de Soins, Cayenne Hospital, Cayenne, French Guiana, France
| | - Anne-Laure Aucouturier
- Centre d'Investigation Clinique Antilles-Guyane (Inserm 1424), Cayenne Hospital, Av des Flamboyant, BP 6006, 97306 cedex, Cayenne, French Guiana, France.,Centres Délocalisés de Prévention et de Soins, Cayenne Hospital, Cayenne, French Guiana, France
| | - Magalie Demar
- Academic Laboratory of Parasitology - Mycology, Cayenne Hospital, Cayenne, French Guiana, France
| | - Lise Musset
- Laboratoire de parasitologie, WHO Collaborating Center for Surveillance of Anti-Malarial Drug Resistance, Centre National de Référence du paludisme, Institut Pasteur de la Guyane, Cayenne, French Guiana, France
| | - Mathieu Nacher
- Centre d'Investigation Clinique Antilles-Guyane (Inserm 1424), Cayenne Hospital, Av des Flamboyant, BP 6006, 97306 cedex, Cayenne, French Guiana, France.,Epidemiology of Tropical Parasitoses, EA 3593, Université de Guyane, Cayenne, French Guiana, France
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Body Composition and Metabolic Syndrome Components on Lipodystrophy Different Subtypes Associated with HIV. J Nutr Metab 2017; 2017:8260867. [PMID: 28540084 PMCID: PMC5429929 DOI: 10.1155/2017/8260867] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/05/2017] [Accepted: 04/09/2017] [Indexed: 12/19/2022] Open
Abstract
HIV-associated lipodystrophy syndrome (HALS) is characterized by body fat redistribution as a consequence of the antiretroviral therapy (ART) introduction, associated with an increased risk of cardiovascular disease development. Subjective diagnosis, classified between three subtypes according to the body region on which fat is lost and/or accumulated, named lipoatrophy, lipohypertrophy, and mixed lipodystrophy, is possibly accompanied with metabolic alterations. Forty people living with HIV/AIDS (PLHA), with clinical diagnosis of HALS and from both genders, were assessed. They performed ambulatorial follow-up and used ART regularly. The main findings were greater lipid profile alterations among women, while no metabolic profile differences were found between the HALS subtypes. The lipohypertrophy group showed major alterations, with higher values for total body fat percent, visceral fat area (VFA), body mass index (BMI), and abdominal and neck circumferences when compared to the other groups. Lean body mass was superior only compared to the mixed lipodystrophy group, and fat mass only compared to the lipoatrophy group. BMI showed strong correlation with the VFA. In conclusion, despite anthropometric alterations related to HALS these individuals present, those are not accompanied with metabolic alterations. Strategies, as behavioral changes and disorders prevention, are important to decrease the risk of cardiovascular disease development.
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