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Germano-Soares AH, Farah BQ, Da Silva JF, Barros MVG, Tassitano RM. Clustering of 24H movement behaviors associated with clinic blood pressure in older adults: a cross-sectional study. J Hum Hypertens 2024; 38:575-579. [PMID: 38890411 DOI: 10.1038/s41371-024-00925-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 06/20/2024]
Abstract
Physical activity (PA), sedentary behavior (SB), and sleep duration are known to have an individual effect on clinic blood pressure (BP) of older adults. However, whether different patterns of these so-called movement behaviors over the 24h-cycle on BP remains poorly investigated. The study aimed to identify movement behavior patterns associated with clinic BP among older adults with chronic diseases. Cross-sectional study with 238 older adults (80.3% female; mean age 68.8 ± 6.6) with at least one chronic disease. PA, SB, and sleep duration were measured by a triaxial accelerometer. Clinic systolic BP (SBP) and diastolic BP (DBP) were obtained through an automated method following standard procedures. Non-hierarchical K-means cluster and linear regression modeling were employed to identify the clusters of movement behaviors and to examine the associations. Two clusters were identified [active and non-sedentary, n = 103 (i.e., sufficient sleep duration, higher LPA and MVPA, and lower SB) and sedentary and inactive, n = 135 (i.e., sufficient sleep duration, lower LPA and MVPA, and higher SB). Active and non-sedentary older adults presented lower systolic BP compared to sedentary and inactive ones, even after adjustments for sociodemographic and clinical characteristics (β = 6.356; CI 95% from 0.932 to 11.779; P = 0.022). No associations were found for diastolic BP. In conclusion, higher PA and lower SB were associated with lower systolic BP in older adults with chronic diseases. However, sleep duration did not modify this association. Therefore, interventions focusing on concomitantly increasing PA levels and reducing SB should be the priority for controlling blood pressure.
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Affiliation(s)
- Antonio H Germano-Soares
- Graduate Program in Physical Education University of Pernambuco, Recife, Brazil
- Department of Physical Education Faculdade Pernambucana de Saúde, Recife, Pernambuco, Brazil
| | - Breno Q Farah
- Department of Physical Education Federal Rural University of Pernambuco, Recife, Brazil
| | - José F Da Silva
- Graduate Program in Physical Education University of Pernambuco, Recife, Brazil
| | - Mauro V G Barros
- Graduate Program in Physical Education University of Pernambuco, Recife, Brazil
| | - Rafael M Tassitano
- Department of Health and Kinesiology University of Illinois at Urbana-Champaign, Champaign, IL, USA.
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Pacheco JA, Molena KF, Veiga EV. Photobiomodulation for Blood Pressure and Heart Rate Reduction in Mastectomized Women on Hormone Blockers: A Randomized Controlled Trial. Photobiomodul Photomed Laser Surg 2024; 42:294-305. [PMID: 38530295 DOI: 10.1089/photob.2023.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
Objective: To assess the impact of intravascular laser irradiation of blood (ILIB) on the primitive carotid artery (PCA) hemodynamic variables, specifically blood pressure (BP) and heart rate (HR), in mastectomized patients undergoing hormone blocker treatments. Materials and methods: This study is a controlled, experimental, and randomized clinical trial. Patients were allocated into two groups: the experimental group (G1)-patients who received ILIB therapy using a 660 nm laser targeted at the PCA, and the control group (G2)-patients who did not receive ILIB therapy. Clinical research was conducted weekly, with measurements of systolic blood pressure (SBP), diastolic blood pressure (DBP), and HR. The Mann-Whitney U test for independent samples was used, with a significance level of α = 0.05. Results: Systemic photobiomodulation on the PCA did not demonstrate a statistically significant difference in relation to SBP and DBP. However, for HR, the p-value was <0.05, indicating a significant difference between G1 and G2. The initial mean p > decreased from 142.3 to 116.4 mmHg in G1, and from 130.4 to 119.8 mmHg in G2. The DBP varied from 78.8 to 72.8 mmHg in G1, and from 79.1 to 74.2 mmHg in G2. A statistically significant difference was observed in HR, decreasing from 81.3 to 62.06 bpm in G1, and changing minimally from 74.1 to 75.1 bpm in G2. A considerable reduction was present in the timing of application. Conclusions: ILIB therapy applied to the PCA induces a reduction in BP and, more notably, HR in mastectomized women using the tamoxifen or aromatase inhibitors.
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Affiliation(s)
- Juliano Abreu Pacheco
- Department of General and Specialized Nursing, Postgraduate Program, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
- Ribeirão Preto Cancer Hospital, Sobeccan Hospital Foundation, Ribeirão Preto, Brazil
| | - Kelly Fernanda Molena
- Department of Pediatric Dentistry, Postgraduate Program in Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Eugenia Velludo Veiga
- Department of General and Specialized Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
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de Lima NX, da Silva RC, Vieira FVM, Guimarães JV, de Matos MA, Cavalcante AMRZ. Self-care Level of Adults With Arterial Hypertension in Outpatient Follow-up in Brazil: A Cross-sectional Study. J Cardiovasc Nurs 2024; 39:170-177. [PMID: 37364050 DOI: 10.1097/jcn.0000000000000978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
BACKGROUND Self-care is essential for minimizing the long-term progression of hypertension (HTN) and improving global health outcomes. However, little is known about the predictors of HTN self-care among adults with HTN in Brazil. OBJECTIVE The aim of this study was to evaluate the self-care practices and the association of sociodemographic and clinical factors of adults with HTN in Brazil. METHODS This was a cross-sectional study conducted by telephone with 120 adults with HTN monitored in a specialized outpatient clinic of a teaching hospital. Sociodemographic and clinical information was collected by a questionnaire survey. Self-care was assessed by the Self-care of Hypertension Inventory version 2. Multiple regression and Kendall's correlation analyses were performed to determine possible predictors. RESULTS Low levels of self-care were observed across maintenance, management, and confidence measures. A weak correlation was observed between self-care maintenance and education (-0.13), the time of diagnosis (0.16), and the number of medications (0.15); self-care management and family income (0.13) and cognitive function (0.17); and self-care confidence and systolic (-0.15) and diastolic (-0.18) blood pressure values and time of diagnosis (0.16). In multiple regression analysis, self-care confidence was a predictor of self-care maintenance ( β = 0.30; 95% confidence interval, 0.10-0.36) and management ( β = 0.20; 95% confidence interval, 0.03-0.46). CONCLUSION Confidence was essential in the maintenance and management of self-care and is central to the control of HTN. Self-care interventions must consider the different aspects that may affect self-care, highlighting improving self-care confidence as a main goal.
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Petracco AM, Mattiello R, Bortolotto CC, Ferreira RW, Matijasevich A, de Barros FCLF, Friedrich FO, Tovo‐Rodrigues L, de Barros AJD, Santos IS. Prevalence of and Factors Associated With High Blood Pressure at 15 Years of Age: A Birth Cohort Study. J Am Heart Assoc 2023; 12:e029627. [PMID: 38014655 PMCID: PMC10727349 DOI: 10.1161/jaha.123.029627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/13/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Arterial hypertension is the greatest cause of morbidity and mortality worldwide. Our aim was to investigate the prevalence of and factors associated with high blood pressure (HBP) among adolescents. METHODS AND RESULTS The Pelotas 2004 Birth Cohort included 4231 newborns from hospital births in Pelotas, Brazil. A digital automatic OMRON sphygmomanometer (model HEM 742) was used to measure blood pressure on 3 occasions (at 6, 11, and 15 years of age). Those with blood pressure ≥95th percentile for age, height, and sex on each of the 3 occasions were considered as presenting HBP. Independent variables included family (income and history of arterial hypertension), maternal (schooling, age, pregestational body mass index, and smoking during pregnancy), and adolescent characteristics at birth (sex, skin color, gestational age, intrauterine growth, and systolic and diastolic genetic factors), and at 15 years (sleep, physical activity, sodium intake, screen time, work, body mass index, fat mass index, fat-free mass index, growth pattern, and puberty status). The prevalence of HBP (95% CI) was calculated. Crude and adjusted odds ratios (ORs) stratified by sex were obtained by logistic regression. A total of 1417 adolescents with complete information on blood pressure on the 3 occasions were analyzed. The prevalence of HBP was 3.2% (95% CI, 1.9%-4.5%) in female adolescents and 4.3% (95% CI, 2.8%-5.8%) in male adolescents. Female adolescents with a family history of arterial hypertension had a 3 times higher chance of HBP than their counterparts (OR, 3.1 [95% CI, 1.26-7.54]). In male adolescents, excessive maternal pregestational weight was associated with a 2.3-fold increase in the chance of HBP. In both sexes, excessive adolescent weight was associated with HBP (ORs, 3.5 and 5.0, for female and male adolescents, respectively). A higher fat mass index and fat-free mass index in female (ORs, 1.4 and 1.2, respectively) and male adolescents (ORs, 2.5 and 3.0, respectively) increased the chance of HBP. Among male adolescents, the chance of HBP was higher among those with rapid weight gain between 48 months and 6 years and between 6 and 11 years and rapid height gain between 6 and 11 years. CONCLUSIONS Higher fat mass in both sexes and rapid weight gain in male adolescents are risk factors for HBP in adolescents aged 15 years, potentially amenable to prevention.
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Affiliation(s)
| | - Rita Mattiello
- Postgraduate Program in EpidemiologyUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| | | | | | | | | | | | | | | | - Iná S. Santos
- Postgraduate Program in EpidemiologyUniversidade Federal de PelotasPelotasBrazil
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Sobrinho ACS, Benjamim CJR, Luciano de Almeida M, Rodrigues GDS, Feitosa Lopes LG, Ribeiro de Lima JG, Bueno Júnior CR. Fourteen weeks of multicomponent training associated with flexibility training modifies postural alignment, joint range of motion and modulates blood pressure in physically inactive older women: a randomized clinical trial. Front Physiol 2023; 14:1172780. [PMID: 38028788 PMCID: PMC10664174 DOI: 10.3389/fphys.2023.1172780] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/09/2023] [Indexed: 12/01/2023] Open
Abstract
Background: Body relaxation and pain reduction are some of the reported benefits of flexibility training (through active stretching exercises), however their effects on posture and blood circulation are uncertain. We aimed to investigate the effects of flexibility training (through active stretching exercises) in combination with multicomponent training (MT) on blood pressure (BP), and the correlation with changes in body alignment and flexibility in physically inactive women. Methods: Women aged 60-70 years were into three groups: multicomponent training group (MT), multicomponent training plus flexibility training group (FT), and control group (CG). After randomization, the resting blood pressure was measured and the participants were reallocated into subgroups according to pressure values >130/80 mmHg (This classification is according to the American Heart Association (AHA), resulting in the subgroups: flexibility training (FT); flexibility training for hypertensive patients (FTSAH); multicomponent training (MT); multicomponent training for hypertensive patients (MTSAH); control group (CG); control group of hypertensive patients (CGSAH). The interventions lasted 14 weeks. Systolic (sBP) and diastolic (dBP) BP, range of motion (flexion and extension), and postural analysis by asymmetry in the frontal plane and asymmetry in the sagittal plane, displacement and the flexibility test were collected before (Pre) and after training (Post). In total, 141 women participated in the study (without SAH: FT = 23, MT = 20, and CG = 21; with SAH: FTSAH = 28, MTSAH = 23, and CGSAH = 26). Results: Systolic blood pressure, in the pre and post moments were: FT (116 ± 6.7 vs. 114 ± 4.7); FTSAH (144 ± 16.5 vs. 121 ± 10.1); MT: (120 ± 6.8 vs. 121 ± 7.3); MTSAH: (137 ± 10.6 vs. 126 ± 13.0); CG: (122 ± 5.3 vs. 133 ± 19.2); and CGSAH: (140 ± 9.7 vs. 143 ± 26.2), presenting an F value (p-value - group x time) of 12.00 (<0.001), with improvement in the groups who trained. The diastolic blood pressure in the pre and post moments were: FT (71 ± 4.7 vs. 74 ± 6.8); FTSAH (88 ± 9.6 vs. 70 ± 12.0); MT: (74 ± 4.5 vs. 77 ± 11.7); MTSAH: (76 ± 10.4 vs. 76 ± 10.2); CG: (69 ± 7.11 vs. 82 ± 11.4); and CGSAH: (76 ± 13.4 vs. 86.6 ± 7.7), presenting an F value (p-value - group x time) of 8.00 (p < 0.001), with improvement in the groups who trained. In the Elastic Net Regression, sBP was influenced by height (β: -0.044); hip flexion (β: 0.071); Shoulder extension (β: 0.104); low back flexion (β: 0.119) and dBP (β: 0.115). In the Elastic Net Regression, dBP was influenced by asymmetry in the sagittal plane variables (0.040); asymmetry in the frontal plane (β: 0.007); knee flexion (β: -0.398); BM (β: 0.007); Shoulder flexion (β: -0.142); Hip flexion (β: -0.004); sBP (β: 0.155) and Ankle Flexion (β: -0.001). Conclusion: The displacement of the asymmetry in the frontal plane and asymmetry in the sagittal plane, and the increase in the flexion position in the hip, lumbar, head, and knee regions, influenced the highest-pressure levels. Multicomponent training associated with flexibility training promoted improvement in body alignment, COM, and joint angles, and decreased blood pressure.
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Affiliation(s)
| | | | | | | | | | | | - Carlos Roberto Bueno Júnior
- Ribeirão Preto Medical School, University of São Paulo (USP), São Paulo, Brazil
- College of Nursing of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil
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dos Santos VP, Cerutti CI, Alencar MJC, Queiroz AB, Ferreira LDM, Fidelis C, de Araújo JS, Alves CAS. Influence of atherosclerosis risk factors on the anatomical distribution of peripheral arterial disease in patients with chronic limb-threatening ischemia: a cross-sectional study. J Vasc Bras 2023; 22:e20230014. [PMID: 37576729 PMCID: PMC10421571 DOI: 10.1590/1677-5449.202300141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/18/2023] [Indexed: 08/15/2023] Open
Abstract
Background Atherosclerosis risk factors can have different impacts on cardiovascular diseases and on the anatomical distribution of Peripheral Arterial Disease (PAD). Objectives To study the influence of atherosclerosis risk factors on the anatomical distribution of PAD in patients with chronic limb-threatening ischemia (CLTI). Methods We performed an observational, cross-sectional, and analytical study that included 476 hospitalized patients with CLTI due to PAD. We compared the presence of atherosclerosis risk factors (age, gender, diabetes mellitus, smoking, and hypertension) in patients with PAD involving three different anatomic areas (aortoiliac, femoropopliteal, and infrapopliteal). Multivariate analysis was performed to identify associations between atherosclerosis risk factors and PAD distribution. Results The mean age of the 476 patients was 69 years, 249 (52%) were men, and 273 (57%) had diabetes. Seventy-four percent (353) had minor tissue loss. Multivariate analysis identified three risk factors associated with PAD anatomical distribution (gender, smoking, and DM). Women had a 2.7 (CI: 1.75-4.26) times greater chance of having femoropopliteal disease. Smokers had a 3.6-fold (CI: 1.54-8.30) greater risk of aortoiliac disease. Diabetic patients were 1.8 (CI: 1.04-3.19) times more likely to have isolated infrapopliteal occlusive disease. Conclusions The study showed that gender, DM, and smoking impact on the anatomical distribution of PAD in patients with CLTI. Diabetic patients were more likely to have only infrapopliteal disease, women had a greater risk of femoropopliteal PAD, and smokers had a greater risk of aortoiliac occlusive disease.
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Affiliation(s)
- Vanessa Prado dos Santos
- Universidade Federal da Bahia - UFBA, Hospital Universitário Professor Edgard Santos - HUPES, Salvador, BA, Brasil.
| | - Camila Izabel Cerutti
- Universidade Federal da Bahia - UFBA, Hospital Universitário Professor Edgard Santos - HUPES, Salvador, BA, Brasil.
| | - Marcelo José Carlos Alencar
- Universidade Federal da Bahia - UFBA, Hospital Universitário Professor Edgard Santos - HUPES, Salvador, BA, Brasil.
| | - André Brito Queiroz
- Universidade Federal da Bahia - UFBA, Hospital Universitário Professor Edgard Santos - HUPES, Salvador, BA, Brasil.
| | - Lucas de Mello Ferreira
- Universidade Federal da Bahia - UFBA, Hospital Universitário Professor Edgard Santos - HUPES, Salvador, BA, Brasil.
| | - Cícero Fidelis
- Universidade Federal da Bahia - UFBA, Hospital Universitário Professor Edgard Santos - HUPES, Salvador, BA, Brasil.
| | - José Siqueira de Araújo
- Universidade Federal da Bahia - UFBA, Hospital Universitário Professor Edgard Santos - HUPES, Salvador, BA, Brasil.
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Dos Santos Sena B, da Silva Pastich Gonçalves FCL, Maio R, Silva RPP, da Conceição Chaves de Lemos M, de Arruda IKG. Visceral adiposity indices and cardiometabolic risk markers in patients with hypertension. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:224-232. [PMID: 36468922 PMCID: PMC10689027 DOI: 10.20945/2359-3997000000536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/05/2022] [Indexed: 12/12/2022]
Abstract
Objective Arterial hypertension (AH) is a risk factor for cardiovascular diseases (CVD). We sought to evaluate the association between two adiposity indices (visceral adiposity index [VAI] and lipid accumulation product [LAP]) with traditional markers of cardiometabolic risk in hypertensive patients. Materials and methods This is a cross-sectional study with 1,273 subjects with hypertension treated as outpatients at a university hospital. The VAI and LAP were calculated using formulas stratified by sex. Cardiometabolic risk variables were considered: overweight, risk for waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHA), and altered biochemical test values. The predictive effect of independent variables on outcomes was assessed by multivariate linear regression analysis. There was statistical significance when p ≤ 0.05. Results Higher cardiometabolic risk (according to BMI, WHR, WHA, and altered biochemical parameters) was associated with higher values of VAI and LAP with statistical significance (p ≤ 0.05). The regression models used explained 30.7% and 10.5% of the changes in LAP and VAI, respectively. Conclusion LAP and VAI are associated with cardiometabolic risk parameters in the individuals evaluated, suggesting that these indices can be used to screen for CVD risk in individuals with AH.
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Affiliation(s)
| | | | - Regiane Maio
- Departamento de Nutrição, Universidade Federal de Pernambuco, Recife, PE, Brasil
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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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Brandão TO, Veiga ECDA, Levy RF, Damaso EL, Sandrim VC, Cavalli RC. Assessment by ABPM verified the presence of hypertension in patients with self-reported hypertension, pregnant women, as well as differences between ethnicities in women aged 39–39 years in the Ribeirão Preto cohort. Front Pharmacol 2022; 13:992595. [DOI: 10.3389/fphar.2022.992595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/20/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction: Arterial hypertension is a global health problem and one of the main risk factors for cardiovascular diseases (CVD), and therefore for morbidity and mortality among adult men and women. Factors related to obstetric history, family history, sociodemographic characteristics, and lifestyle habits are known determinants of arterial hypertension.Methods: Case-control study of women belonging to the 1978/79 birth cohort conducted in the city of Ribeirão Preto/SP. Sociodemographic data, presence of comorbidities, maternal comorbidities, paternal comorbidities, comorbidities during pregnancy, and biometric and biophysical markers associated with blood pressure measured by 24-h ambulatory blood pressure monitoring (ABPM) were assessed in women aged 38–39 years. We want to study which variables of the previous sentence are related to the presence of hypertension measured by ABPM.Results: Data from 281 women were analyzed. Our results showed that ethnicity, a history of hypertension, and gestational hypertension reported by the women were significantly associated with the presence of hypertension measured by ABPM. Other factors such as marital status, educational level, comorbidities of the woman, paternal or maternal comorbidities, anthropometric measurements or serum levels of cardiovascular markers were not associated with the presence of hypertension measured by ABPM.Conclusion: We conclude that ethnicity, self-reported hypertension, and gestational hypertension are associated with arterial hypertension measured by ABPM.
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Bacurau AGDM, Francisco PMSB. Doenças crônicas em idosos e vacinação contra a influenza. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2022. [DOI: 10.5712/rbmfc17(44)2819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introdução: As informações sobre a presença de doenças crônicas nos idosos não são registradas durante as campanhas de vacinação contra influenza, o que dificulta sua identificação (proporção) nos idosos vacinados. Objetivo: Descrever a prevalência de doenças crônicas autorreferidas em idosos vacinados contra a influenza; verificar a influência da mídia na decisão de tomar a vacina; e se recebeu orientações sobre a importância dela, segundo o tipo de profissional de saúde. Métodos: Estudo transversal descritivo, com dados coletados por meio de entrevistas com idosos vacinados contra influenza (n=798) em um Centro de Saúde de Campinas (SP) em 2019. Resultados: Na amostra estudada, a maioria eram mulheres (58,0%), indivíduos com ensino médio completo ou ensino superior (53,0%) e com plano de saúde (72,3%). As doenças mais prevalentes foram hipertensão arterial (56,9%; intervalo de confiança — IC95% 53,4–60,3), diabetes (24,7%; IC95% 21,8–27,8), doenças cardíacas (13,6%; IC95% 11,4–16,2) e respiratórias (5,6%; IC95% 4,2–7,5). A maioria (58,0%) considerou que a mídia influenciou sua decisão de tomar a vacina. Receberam orientações sobre a importância da vacinação 21,1% dos idosos, fornecidas principalmente por médicos/as (67,4%), enfermeiros/as (18,2%) e agentes de saúde (7,0%). Conclusões: A investigação mostrou que as principais doenças referidas pelos idosos vacinados foram hipertensão arterial, diabetes, cardiopatias e doenças respiratórias. A orientação de profissionais da saúde foi pouco relatada pelos idosos e a maioria referiu influência da mídia na decisão de vacinar-se. Ressaltam-se a necessidade e a relevância de investir em estratégias de comunicação em saúde, a fim de esclarecer a população sobre a importância da vacinação contra a influenza para as pessoas idosas e com doenças crônicas.
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Managing high blood pressure in hypertensive patients with an acute ischemic stroke. HIPERTENSION Y RIESGO VASCULAR 2022; 39:157-166. [DOI: 10.1016/j.hipert.2022.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 12/26/2022]
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Chaves ZJL, Silva LS, Nascimento RCRMD. Public Programs for Essential Medicine Access in a Small Municipality: A Cross-Sectional Analysis. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2022. [DOI: 10.36660/ijcs.20200287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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13
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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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COVID-19 pandemic evolution in the Brazilian Indigenous population. J Racial Ethn Health Disparities 2022; 9:921-937. [PMID: 33782907 PMCID: PMC8006870 DOI: 10.1007/s40615-021-01031-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has affected several neglected populations such as the Indigenous peoples, which have suffered a high impact from the pandemic. OBJECTIVES To analyze the impact on the health and disease process according to the COVID-19 evolution in the Brazilian Indigenous population. METHODS Data was collected from press releases by the Health Ministry and a descriptive analysis of the numbers of Indigenous individuals infected with the SARS-CoV-2 in Brazil was carried out. RESULTS In February 2021, there were 41,855 confirmed cases of Indigenous individuals infected by the SARS-CoV-2, including 4,387 active cases, 36,809 recovered cases, and 549 deaths. The Brazilian Indigenous population is distributed in over 300 ethnic groups and, due to the high number of deaths by the COVID-19, many of these groups are endangered. The elderly are the most affected age group, and they play a fundamental role among the Indigenous population for transmitting their customs mainly orally. Indigenous populations do not have proper access to transport to specialized health centers, since many areas are inaccessible and other cases require air or river transportation, which many times results in late assistance. When managing the COVID-19, it is important to emphasize the need for social isolation to prevent the virus from spreading among the Indigenous groups, mainly due to their contact with other ethnic groups represented by missionaries, hunters, and wood explorers, among others. CONCLUSION The adoption of practices that can reduce the virus transmission among the Indigenous population and provide them with better access to treatment, mainly for the elderly, must be prioritized in Brazil.
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Pereira JL, de Castro MA, Leite JMRS, Rogero MM, Sarti FM, César CLG, Goldbaum M, Fisberg RM. Overview of Cardiovascular Disease Risk Factors in Adults in São Paulo, Brazil: Prevalence and Associated Factors in 2008 and 2015. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20210076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Julião NA, Souza AD, Guimarães RRDM. Trends in the prevalence of systemic arterial hypertension and health care service use in Brazil over a decade (2008-2019). CIENCIA & SAUDE COLETIVA 2021; 26:4007-4019. [PMID: 34586255 DOI: 10.1590/1413-81232021269.08092021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/20/2021] [Indexed: 11/22/2022] Open
Abstract
The global burden and the prevalence of systemic arterial hypertension (SAH) have increased over the last two decades, especially in low- and middle-income countries, and are a concern to health authorities. This study analyzed the prevalence of SAH reported by Brazilian adults in 2008, 2013, and 2019, and individual disease control in 2013 and 2019. Data from the National Household Sample Survey (2008) and National Health Survey (2013-2019) were employed. We calculated the disease's prevalence ratios using Poisson regression, adjusted for sociodemographic characteristics. Regarding health care and PHC organization indicators, we calculated proportions by gender, age group, ethnicity, and region. The results reveal persistent regional inequalities, with lower prevalence in the North and Northeast and higher prevalence in the Southeast and South. While the health care access and use indicators are positive, reflecting PHC improvements in recent years, we highlight the importance of adopting multifaceted SAH prevention and control strategies in the country.
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Affiliation(s)
- Nayara Abreu Julião
- Centro de Desenvolvimento e Planejamento Regional, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6.627 3º andar, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | - Aline de Souza
- Centro de Desenvolvimento e Planejamento Regional, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6.627 3º andar, Pampulha. 31270-901 Belo Horizonte MG Brasil.
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Nobre F, Schmidt A. Is It Time to Move From Diagnosis to Active Intervention in Brazilian Workplaces? A Call for Action. Arq Bras Cardiol 2021; 117:492-493. [PMID: 34550234 PMCID: PMC8462962 DOI: 10.36660/abc.20210619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
| | - André Schmidt
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - Cardiologia, São Paulo, SP - Brasil
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Soares MM, Guedes GR, Rodrigues SM, Dias CA. [Interactions between drug treatment adherence, blood pressure targets, and depression in hypertensive individuals receiving care in the Family Health Strategy]. CAD SAUDE PUBLICA 2021; 37:e00061120. [PMID: 34495089 DOI: 10.1590/0102-311x00061120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 12/17/2020] [Indexed: 11/21/2022] Open
Abstract
The study analyzes interactions between drug treatment adherence, blood pressure targets, and depression in a probabilistic sample of hypertensive individuals treated in the Family Health Strategy in Governador Valadares, Minas Gerais State, Brazil. This is a cross-sectional study with 641 hypertensive individuals 40 years or older, residing in the urban area of Governador Valadares. Structured scripts were used to collect data in home interviews, with a focus on the following indicators: Medication Assessment Questionnaire (MAQ), Beck Depression Inventory (BDI), and blood pressure measurement. Due to the simultaneity of the target events (depression, blood pressure target, and adherence), we applied a system of recursive and simultaneous nonlinear equations. The results suggest that the odds of meeting the blood pressure target increase significantly with adherence to treatment; they also suggest that individuals that meet the blood pressure target show 2.6 higher odds of treatment adherence. Adherence has a protective effect against depression: individuals with minimal adherence show 8.4 higher odds of developing depressive symptoms when compared to those with maximum adherence. Drug treatment adherence is related simultaneously to blood pressure control and lower levels of depression. Promoting drug treatment adherence is essential for ensuring that individuals remain normotensive, with the potential for reducing levels of depression. These positive externalities can reduce pressure on the health system, with simultaneous gains in quality of life for hypertensive individuals.
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Affiliation(s)
| | | | | | - Carlos Alberto Dias
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Teófilo Otoni, Brasil
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Do we really need high frequency of physical activity to keep blood pressure at good levels? Results of the Brazilian national survey. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-021-00811-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Rezende R, De Assumpção D, Stolses Bergamo Francisco PM. Hipertensión arterial autorreferida en adultos mayores brasileños: uso de medicación y recomendaciones para el control. Rev Salud Publica (Bogota) 2021. [DOI: 10.15446/rsap.v23n4.93287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo Estimar la prevalencia de hipertensión arterial (HA) autorreferida y del uso de medicación en los adultos mayores brasileños (≥65 años), según las características sociodemográficas, y evaluar el uso de los servicios de salud y de las recomendaciones de los médicos y profesionales de salud para el control de la enfermedad.
Método Estudio transversal con datos de la Pesquisa Nacional de Salud del 2013 (n=7.712).
Resultados La prevalencia de HA fue del 54,1%, con diferencia entre los sexos. En los hombres, la prevalencia de HA fue mayor en las regiones Sur y Sudeste, y en las mujeres fue mayor en los subgrupos de 75 a 79 años y de menor escolaridad. El uso de medicación para la HA fue mencionado por el 91,7%, sin diferencia entre los sexos. Las mujeres fueron diagnosticadas con más precocidad (≤39 años) que los hombres (≥65 años).
Conclusión El mantenimiento de una alimentación saludable y el consumo reducido de sal se observaron con mayor frecuencia en las mujeres. Los resultados destacan la necesidad de intervenciones para promover el autocuidado, sobre todo entre los hombres.
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Nuto SDAS, Barreira Filho EB, Oliveira BFAD, Freitas RWJFD, Couto LDOD, Jacobson LDSV, Hacon SDS, Périssé ARS. Port and industrial compound of Pecém: an epidemiological survey. CIENCIA & SAUDE COLETIVA 2021; 26:1613-1624. [PMID: 34076104 DOI: 10.1590/1413-81232021265.04292021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 02/24/2021] [Indexed: 11/21/2022] Open
Abstract
This research aimed to analyze the dwellers' knowledge of the territories, Pecém Port and Industrial Compound (CIPP), the quality of life of the communities living in the vicinity of the enterprises, and the prevalence of hypertension and overweight. This is a home-based, epidemiological survey of four areas of the Family Health Strategy (ESF) in São Gonçalo do Amarante and one area of the ESF in Caucaia, Ceará, Brazil. The study was carried out between 10/2017 and 03/2018. Anthropometric and blood pressure measurements were performed, and sociodemographic data and knowledge about community, the CIPP, and quality of life were collected. A total of 69.8% of the 503 adults interviewed were female, and the mean age was 44 years. Parada was the area reporting the highest percentage of problems related to air particles (51.1%), the worst concept regarding the CIPP (40.1% bad), the highest percentage of worse quality of life (29, 1%), and greater desire to move to another place (31.5%). Pecém had the highest percentage of community problems related to violence, consumption of illicit drugs, and prostitution. We concluded that there are signs of impact on local populations' health and quality of life without more significant direct work/income benefits.
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Affiliation(s)
| | | | | | | | - Lucas de Oliveira do Couto
- Programa de Saúde Pública e Meio Ambiente, Escola Nacional de Saúde Pública (ENSP), Fiocruz. Rio de Janeiro RJ Brasil
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Marinho MF, Torrens A, Teixeira R, Brant LCC, Malta DC, Nascimento BR, Ribeiro ALP, Delaney R, Paula PCB, Setel P, Sampaio JM, Nogales-Vasconcelos AM. Racial disparity in excess mortality in Brazil during COVID-19 times. Eur J Public Health 2021; 32:24-26. [PMID: 34142119 PMCID: PMC8807077 DOI: 10.1093/eurpub/ckab097] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We evaluated the impact of the COVID-19 pandemic on excess mortality by race/skin color in Brazil, between epidemiological weeks 12 and 50 of 2020. We compared the 2020-point estimate and the expected point-estimate applying 2019 mortality rates to the 2020 population. There was an excess of 187,002 deaths (+20.2%) compared to the expected. Excess mortality was 26.3% (23.3%-29.3%) among blacks/browns compared to 15.1% (14.1%-16.1%) among whites (58.9% of excess among black/browns). Age-standardized rates increased from 377 to 419/100,000 among blacks/browns compared to 328 to 398/100,000 in whites, resulting in 9% relative risk. Excess mortality in Brazil depicts a considerable gap, with increased mortality in all age-groups in the black/brown population.
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Affiliation(s)
| | | | | | - Luisa Campos Caldeira Brant
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Serviço de Cardiologia e Cirurgia Cardiovascular e Centro de Telessaúde, Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Deborah Carvalho Malta
- Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Bruno Ramos Nascimento
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Serviço de Cardiologia e Cirurgia Cardiovascular e Centro de Telessaúde, Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Antonio Luiz Pinho Ribeiro
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Serviço de Cardiologia e Cirurgia Cardiovascular e Centro de Telessaúde, Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Curado DDSP, Gomes DF, Silva TBC, Almeida PHRF, Tavares NUL, Areda CA, da Silva EN. Direct cost of systemic arterial hypertension and its complications in the circulatory system from the perspective of the Brazilian public health system in 2019. PLoS One 2021; 16:e0253063. [PMID: 34111216 PMCID: PMC8191920 DOI: 10.1371/journal.pone.0253063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 05/28/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Systemic arterial hypertension (SAH), a global public health problem and the primary risk factor for cardiovascular diseases, has a significant financial impact on health systems. In Brazil, the prevalence of SAH is 23.7%, which caused 203,000 deaths and 3.9 million DALYs in 2015. OBJECTIVE To estimate the cost of SAH and circulatory system diseases attributable to SAH from the perspective of the Brazilian public health system in 2019. METHODS A prevalence-based cost-of-illness was conducted using a top-down approach. The population attributable risk (PAR) was used to estimate the proportion of circulatory system diseases attributable to SAH. The direct medical costs were obtained from official Ministry of Health of Brazil records and literature parameters, including the three levels of care (primary, secondary, and tertiary). Deterministic univariate analyses were also conducted. RESULTS The total cost of SAH and the proportion of circulatory system diseases attributable to SAH was Int$ 581,135,374.73, varying between Int$ 501,553,022.21 and Int$ 776,183,338.06. In terms only of SAH costs at all healthcare levels (Int$ 493,776,445.89), 97.3% were incurred in primary care, especially for antihypertensive drugs provided free of charge by the Brazilian public health system (Int$ 363,888,540.14). Stroke accounted for the highest cost attributable to SAH and the third highest PAR, representing 47% of the total cost of circulatory diseases attributable to SAH. Prevalence was the parameter that most affected sensitivity analyses, accounting for 36% of all the cost variation. CONCLUSION Our results show that the main Brazilian strategy to combat SAH was implemented in primary care, namely access to free antihypertensive drugs and multiprofessional teams, acting jointly to promote care and prevent and control SAH.
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Affiliation(s)
| | - Dalila Fernandes Gomes
- Graduate Program in Public Health, University of Brasilia, Brasilia, Federal District, Brazil
| | | | | | | | - Camila Alves Areda
- Faculty of Ceilandia, University of Brasilia, Brasilia, Federal District, Brazil
| | - Everton Nunes da Silva
- Graduate Program in Public Health, University of Brasilia, Brasilia, Federal District, Brazil
- Faculty of Ceilandia, University of Brasilia, Brasilia, Federal District, Brazil
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Mesenburg MA, Hallal PC, Menezes AMB, Barros AJD, Horta BL, de Barros FC, Hartwig FP, Jacques N, da Silveira MF. Chronic non-communicable diseases and COVID-19: EPICOVID-19 Brazil results. Rev Saude Publica 2021; 55:38. [PMID: 34105606 PMCID: PMC8139841 DOI: 10.11606/s1518-8787.2021055003673] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Describing the prevalence of chronic diseases and associated socioeconomic and demographic factors, evaluating the patterns of social distancing and the antibodies prevalence against SARS-CoV-2 and COVID-19 symptoms in carriers and non-carriers of chronic diseases. METHODS Data from 77,075 individuals aged 20 to 59 from three steps of the EPICOVID-19 Brazil (a nationwide serological survey conducted between May and June, 2021) were assessed. The presence of antibodies against SARS-CoV-2 was examined by rapid tests. Self-reported prevalence of hypertension, diabetes, asthma, cancer, chronic kidney disease and heart disease were investigated. The prevalence of mask use, adherence to isolation measures and antibodies were evaluated separately amid carriers and non-carriers of chronic diseases. The prevalence of symptoms was analyzed among carriers and non-carriers of chronic diseases with antibodies. RESULTS The prevalence of at least one chronic disease was 43%, higher in the Southeast region, among white and indigenous individuals, women, less schooled and in lower socioeconomic position. The use of masks when leaving home was similar among carriers and non-carriers of chronic diseases (98%). The proportion of participants who reported adherence to isolation measures was higher amid carriers (15.9%) than non-carriers (24.9%) of chronic diseases. The prevalence of antibodies to SARS-CoV-2 was similar amongst carriers and non-carriers (2.4% and 2.3%). The prevalence of cough, dyspnea, palpitations and myalgia was significantly higher among carriers, but the proportion of symptomatic patients was similar between groups. CONCLUSION The prevalence of chronic diseases in Brazil is high and the COVID-19 pandemic affects carriers and non-carriers of chronic diseases similarly. Carriers present more severe forms of COVID-19 and higher prevalence of symptoms. Greater adherence to social distancing measures among chronic patients is disassociated from a lower incidence of COVID-19 in this group.
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Affiliation(s)
- Marilia Arndt Mesenburg
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
- Universidade Federal de Ciências da Saúde de Porto AlegreDepartamento de Saúde ColetivaPorto AlegreRSBrasilUniversidade Federal de Ciências da Saúde de Porto Alegre. Departamento de Saúde Coletiva. Porto Alegre, RS, Brasil.
| | - Pedro Curi Hallal
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
| | - Ana Maria Baptista Menezes
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
| | - Aluísio J D Barros
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
| | - Bernardo Lessa Horta
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
| | - Fernando Celso de Barros
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
| | - Fernando Pires Hartwig
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
| | - Nadège Jacques
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
| | - Mariangela Freitas da Silveira
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
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dos Santos Fechine CPN, Monteiro MGCA, Tavares JF, Souto AL, Luna RCP, da Silva CSO, da Silva JA, dos Santos SG, de Carvalho Costa MJ, Persuhn DC. Choline Metabolites, Hydroxybutyrate and HDL after Dietary Fiber Supplementation in Overweight/Obese Hypertensive Women: A Metabolomic Study. Nutrients 2021; 13:nu13051437. [PMID: 33923171 PMCID: PMC8146352 DOI: 10.3390/nu13051437] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 12/26/2022] Open
Abstract
Metabolomics has been increasingly used to evaluate metabolic changes associated with morbidities. The objective of this study is to assess the metabolic profile before and after intervention with mixed dietary fiber in overweight and obese hypertensive women. This is an intervention study, and the sample consists of 14 women aged 28 to 58 years. An intervention with 12 g of mixed soluble and insoluble fiber is performed for a period of eight weeks. Serum metabolites are identified using a Bruker 1H NMR spectrometer at 400 MHz. Multivariate data analysis, including principal component analysis (PCA), is used to differentiate the two groups. After supplementation with dietary fiber, there is a significant increase in the peak intensity values of the metabolites HDL-C (0.0010*), choline (0.0012*) and hydroxybutyrate (0.0010*) as well as a decrease in systolic (0.0013*) and diastolic (0.0026*) blood pressure. The analysis of the metabolomic profile allows the identification of metabolites that have been associated in the literature with hypertension and excess weight (choline, hydroxybutyrate and amino acids) and with fiber intake (choline, hydroxybutyrate and amino acids) in addition to an increase in HDL-C. The increase in the detection of the described metabolites possibly occurs due to the presence of pathologies and the use of fiber in the intervention, which also contributes to elevated HDL-c and reduced blood pressure.
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Affiliation(s)
- Carla Patricia Novaes dos Santos Fechine
- Postgraduate Program in Nutrition Sciences, Federal University of Paraíba, João Pessoa 58059-900, Brazil; (M.G.C.A.M.); (R.C.P.L.); (C.S.O.d.S.); (J.A.d.S.); (M.J.d.C.C.); (D.C.P.)
- Correspondence: ; Tel.: +55-(83)-999841715
| | - Mussara Gomes Cavalcanti Alves Monteiro
- Postgraduate Program in Nutrition Sciences, Federal University of Paraíba, João Pessoa 58059-900, Brazil; (M.G.C.A.M.); (R.C.P.L.); (C.S.O.d.S.); (J.A.d.S.); (M.J.d.C.C.); (D.C.P.)
| | - Josean Fechine Tavares
- Department of Pharmaceutical Sciences, Federal University of Paraiba, João Pessoa 58059-900, Brazil; (J.F.T.); (A.L.S.); (S.G.d.S.)
| | - Augusto Lopes Souto
- Department of Pharmaceutical Sciences, Federal University of Paraiba, João Pessoa 58059-900, Brazil; (J.F.T.); (A.L.S.); (S.G.d.S.)
| | - Rafaella Cristhine Pordeus Luna
- Postgraduate Program in Nutrition Sciences, Federal University of Paraíba, João Pessoa 58059-900, Brazil; (M.G.C.A.M.); (R.C.P.L.); (C.S.O.d.S.); (J.A.d.S.); (M.J.d.C.C.); (D.C.P.)
| | - Cássia Surama Oliveira da Silva
- Postgraduate Program in Nutrition Sciences, Federal University of Paraíba, João Pessoa 58059-900, Brazil; (M.G.C.A.M.); (R.C.P.L.); (C.S.O.d.S.); (J.A.d.S.); (M.J.d.C.C.); (D.C.P.)
| | - Jairo Alves da Silva
- Postgraduate Program in Nutrition Sciences, Federal University of Paraíba, João Pessoa 58059-900, Brazil; (M.G.C.A.M.); (R.C.P.L.); (C.S.O.d.S.); (J.A.d.S.); (M.J.d.C.C.); (D.C.P.)
| | - Sócrates Golzio dos Santos
- Department of Pharmaceutical Sciences, Federal University of Paraiba, João Pessoa 58059-900, Brazil; (J.F.T.); (A.L.S.); (S.G.d.S.)
| | - Maria José de Carvalho Costa
- Postgraduate Program in Nutrition Sciences, Federal University of Paraíba, João Pessoa 58059-900, Brazil; (M.G.C.A.M.); (R.C.P.L.); (C.S.O.d.S.); (J.A.d.S.); (M.J.d.C.C.); (D.C.P.)
| | - Darlene Camati Persuhn
- Postgraduate Program in Nutrition Sciences, Federal University of Paraíba, João Pessoa 58059-900, Brazil; (M.G.C.A.M.); (R.C.P.L.); (C.S.O.d.S.); (J.A.d.S.); (M.J.d.C.C.); (D.C.P.)
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Almeida GDO, Aidar FJ, de Matos DG, de Almeida-Neto PF, de Melo EV, Barreto Filho JAS, Almeida-Santos MA, Oliveira VB, de Almeida RR, dos Santos SM, Costa Pereira LM, Barbosa JS, Sobral Sousa AC. Non-Targeted Self-Measurement of Blood Pressure: Association with Self-Medication, Unscheduled Emergency Visits and Anxiety. ACTA ACUST UNITED AC 2021; 57:medicina57010075. [PMID: 33477378 PMCID: PMC7830661 DOI: 10.3390/medicina57010075] [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: 10/31/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 11/16/2022]
Abstract
Background and Objective: The routine practice of self-medication of blood pressure (BP) not oriented with pulse devices may not be precisely useful in the control of BP and can lead the patient to self-medicate in error. Thus, we need to evaluate the non-oriented self-assessment of BP in real-life circumstances in hypertensive patients. The objective of this study was to evaluate in hypertensive patients the association of BP self-measurement with its control, as well as the presence of anxiety disorders, the occurrence of unscheduled visits to the emergency room, and self-medication. Materials and Methods: An observational study was carried out with 1000 hypertensive volunteers (age: 61.0 ± 12.5). Using a questionnaire, sociodemographic and clinical data on BP control were collected. Anxiety was assessed by the State-Trait Anxiety Inventory (STAI). Results: The group that performed non-oriented self-measurement of BP, showed that they had higher frequencies of self-medication (57.9%, p < 0.05) and more unscheduled visits to the emergency room (68%, p < 0.05). In addition, a lower level of BP control (46.8%, p < 0.05) was associated with higher levels of anxiety (52.3%, p < 0.05) in the group that performed non-oriented self-measurements of BP. Conclusion: The practice of non-oriented self-assessment of BP was associated with negative factors such as high levels of anxiety and higher frequencies of self-medication and unscheduled emergency visits.
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Affiliation(s)
- Glessiane de Oliveira Almeida
- Postgraduate Program in Health Sciences, Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil; (J.A.S.B.F.); (V.B.O.); (R.R.d.A.); (S.M.d.S.); (L.M.C.P.); (J.S.B.); (A.C.S.S.)
- Correspondence:
| | - Felipe J. Aidar
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports (GEPEPS), Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil; (F.J.A.); (D.G.d.M.)
- Department of Physical Education, Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil
- Program of Physical Education, Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil
- Program of Physiological Science, Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil
| | - Dihogo Gama de Matos
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports (GEPEPS), Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil; (F.J.A.); (D.G.d.M.)
| | - Paulo Francisco de Almeida-Neto
- Health Sciences Center, Department of Physical Education, Federal University of Rio Grande do Norte, Natal UFRN 59064-741, Brazil;
| | - Enaldo Vieira de Melo
- Department of Medicine, UFS), Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil; (E.V.d.M); (M.A.A.-S.)
| | - José Augusto Soares Barreto Filho
- Postgraduate Program in Health Sciences, Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil; (J.A.S.B.F.); (V.B.O.); (R.R.d.A.); (S.M.d.S.); (L.M.C.P.); (J.S.B.); (A.C.S.S.)
- Department of Medicine, UFS), Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil; (E.V.d.M); (M.A.A.-S.)
- Teaching and Research Center of São Lucas Hospital/Rede D’Or—São Luiz de Aracaju, Sergipe 49015-400, Brazil
- Division of Cardiology, University Hospital of Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil
| | - Marcos Antonio Almeida-Santos
- Department of Medicine, UFS), Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil; (E.V.d.M); (M.A.A.-S.)
- Division of Cardiology, University Hospital of Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil
| | - Victor Batista Oliveira
- Postgraduate Program in Health Sciences, Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil; (J.A.S.B.F.); (V.B.O.); (R.R.d.A.); (S.M.d.S.); (L.M.C.P.); (J.S.B.); (A.C.S.S.)
- Department of Medicine, UFS), Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil; (E.V.d.M); (M.A.A.-S.)
| | - Rebeca Rocha de Almeida
- Postgraduate Program in Health Sciences, Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil; (J.A.S.B.F.); (V.B.O.); (R.R.d.A.); (S.M.d.S.); (L.M.C.P.); (J.S.B.); (A.C.S.S.)
| | - Suelen Maiara dos Santos
- Postgraduate Program in Health Sciences, Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil; (J.A.S.B.F.); (V.B.O.); (R.R.d.A.); (S.M.d.S.); (L.M.C.P.); (J.S.B.); (A.C.S.S.)
| | - Larissa Monteiro Costa Pereira
- Postgraduate Program in Health Sciences, Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil; (J.A.S.B.F.); (V.B.O.); (R.R.d.A.); (S.M.d.S.); (L.M.C.P.); (J.S.B.); (A.C.S.S.)
| | - Juliana Santos Barbosa
- Postgraduate Program in Health Sciences, Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil; (J.A.S.B.F.); (V.B.O.); (R.R.d.A.); (S.M.d.S.); (L.M.C.P.); (J.S.B.); (A.C.S.S.)
| | - Antônio Carlos Sobral Sousa
- Postgraduate Program in Health Sciences, Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil; (J.A.S.B.F.); (V.B.O.); (R.R.d.A.); (S.M.d.S.); (L.M.C.P.); (J.S.B.); (A.C.S.S.)
- Department of Medicine, UFS), Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil; (E.V.d.M); (M.A.A.-S.)
- Teaching and Research Center of São Lucas Hospital/Rede D’Or—São Luiz de Aracaju, Sergipe 49015-400, Brazil
- Division of Cardiology, University Hospital of Federal University of Sergipe, UFS, Sergipe 49100-000, Brazil
- Postgraduate Program in Health and Environment, Tiradentes University, UNIT, Aracaju, Sergipe 49032-490, Brazil
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Borges GM, Crespo CD. Demographic and socioeconomic characteristics of Brazilian adults and COVID-19: a risk group analysis based on the Brazilian National Health Survey, 2013. CAD SAUDE PUBLICA 2020; 36:e00141020. [PMID: 33111839 DOI: 10.1590/0102-311x00141020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/20/2020] [Indexed: 01/19/2023] Open
Abstract
This study aimed to characterize risk groups for COVID-19 in Brazil and to estimate the number of individuals living in the same household with persons in the risk group. Data were used from the Brazilian National Health Survey (PNS) of 2013. To characterize the risk groups, a binary multiple logistic regression model was adjusted in which the response variable was the presence or absence of at least one condition associated with COVID-19 and the explanatory variables were age, sex, major geographic region, color or race, schooling, and workforce status of the residents interviewed by the study. The results show that age is the principal risk factor for comorbidities associated with COVID-19, but the risk is also greater for persons in more vulnerable categories, such as those with less schooling and blacks and browns. An estimated 68.7% of Brazilians were living with at least one person in the risk group: 30.3% lived with at least one elderly individual and another 38.4% had no elderly individuals in their households, but there was at least one adult resident with preexisting medical conditions. The proportion of persons living in households with at least one resident in the risk group was 50% or greater for all ages and increased from 35 years of age, but there were also high numbers of persons 10 to 25 years of age living with persons in the risk group. The results suggest that due to the difficulties in avoiding close household contact, the exclusive isolation of specific population groups is not a feasible strategy in the Brazilian context, but should be combined with social distancing of the population as a whole.
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Saloti MHDS, Medeiros LK, Santos EMD. Resposta ao artigo: Abordagem dietética para controle da hipertensão: reflexões sobre adesão e possíveis impactos para a saúde coletiva. CIENCIA & SAUDE COLETIVA 2020; 25:2905. [DOI: 10.1590/1413-81232020257.14382020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Bacurau AGDM, Francisco PMSB. Reasons for non-vaccination against influenza among older adults with hypertension in Brazil: a cross-sectional study. SAO PAULO MED J 2020; 138:322-325. [PMID: 32638940 PMCID: PMC9673836 DOI: 10.1590/1516-3180.2020.0042.r1.15052020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 05/15/2020] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to estimate the prevalence of non-vaccination against influenza among Brazilian older adults with systemic arterial hypertension and determine the main reasons for non-adherence. A cross-sectional study was conducted using data from older adults (≥ 60 years of age) with hypertension who participated in the 2013 National Health Survey and reported not having been vaccinated against flu over the previous 12 months (n = 1,295). The analyses were performed using the Stata 14.0 software. The data were weighted because of the sampling design. An estimated 3,026,080 older adults with hypertension had not received a flu vaccine over the 12 months prior to the survey (22.6%). No significant associations were found with sex, age group or schooling. The prevalence of unvaccinated older adults was lower in the southern and southeastern regions of Brazil than in the northern and northeastern regions, even after adjusting for age. The prevalence was higher among individuals without private health insurance. The main reasons for non-vaccination were fear of a reaction, rarely having the flu and not believing in the protection of the vaccine. The present findings underscore the need for healthcare professionals to explain to the population the benefits of the vaccine for preventing severe influenza (protective effect and possible reactions) and for secondary prevention of cardiovascular events. Increasing the prevalence of vaccination in older adults with hypertension and other cardiovascular diseases is of fundamental importance within the realm of public health as a strategy for reducing occurrences of complications and deaths associated with influenza.
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Affiliation(s)
- Aldiane Gomes de Macedo Bacurau
- MSc. Nurse and Postgraduate Student (doctoral), Department of Collective Health, Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Priscila Maria Stolses Bergamo Francisco
- PhD. Statistician and Associate Professor, Department of Collective Health, Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
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Leitão VBG, Lemos VC, Francisco PMSB, Costa KS. Prevalence of use and sources of antihypertensive medicine in Brazil: an analysis of the VIGITEL telephone survey. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200028. [PMID: 32401921 DOI: 10.1590/1980-549720200028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 01/18/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The prevalence of hypertension in Brazil and worldwide has been increasing in recent decades, and drug therapy is one of the strategies used to control this condition. The objective of this study was to estimate the prevalence of use and identify the sources for obtaining antihypertensive drugs in Brazil, according to sociodemographic variables, comparing three periods: 2011, 2014 and 2017. METHODS Data from individuals aged ≥20 years who reported a medical diagnosis of hypertension, interviewed by Vigitel in 2011, 2014 and 2017 were used. Frequency and prevalence of drug use in addition to the sources for obtaining medication were estimated by sociodemographic variables, with 95% confidence intervals. The differences between proportions were verified by Pearson's chi-square test (Rao-Scott), with a significance level of 5%. RESULTS The prevalence of antihypertensive drug use remained stable (80%). Regarding the sources for obtaining these medicines, there was variation in the period, indicating a decrease in usage through the Brazilian Unified Health System (SUS) (44.2% in 2011; 30.5% in 2017). This decrease was accompanied with increase in PFPB (16.1% in 2011; 29.9% in 2017). The prevalence of other sources for obtaining medicine (private pharmacies/drugstores) showed stability in the period. CONCLUSIONS The prevalence of medication use remained high and there was a change in the pattern of use according to sources, demonstrating migration between SUS pharmacies to the PFPB, and suggesting a reduction in the availability of medicines from public pharmacies universally, and for free.
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Affiliation(s)
| | - Vivian Castro Lemos
- Departamento de Saúde Coletiva, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | | | - Karen Sarmento Costa
- Departamento de Saúde Coletiva, Universidade Estadual de Campinas, Campinas, SP, Brazil
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31
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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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Justina VD, Giachini FR, Priviero F, Webb RC. Double-stranded RNA and Toll-like receptor activation: a novel mechanism for blood pressure regulation. Clin Sci (Lond) 2020; 134:303-313. [PMID: 31998948 PMCID: PMC7703673 DOI: 10.1042/cs20190913] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 01/15/2020] [Accepted: 01/17/2020] [Indexed: 12/24/2022]
Abstract
Toll-like receptors (TLRs), such as TLR4 and 9, recognize pathogen-associated molecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) and are associated with increased blood pressure (BP). TLR3, residing in the endosomal compartment, is activated by viral double-stranded RNA (dsRNA) leading to activation of TIR receptor domain-containing adaptor inducing IFN-β (TRIF) dependent pathway. Besides foreign pathogens, the immune system responds to endogenous markers of cellular damage such as mitochondrial dsRNA (mtdsRNA). New evidence has shown a link between dsRNA and increased BP. Moreover, TLR3 activation during pregnancy was demonstrated to develop preeclampsia-like symptoms in both rats and mice. Hence, we hypothesize that the dsRNA derived from viral nucleic acids or cellular damage (mtdsRNA) will increase the inflammatory state through activation of TLR3, contributing to vascular dysfunction and increased BP. Therefore, inhibition of TLR3 could be a therapeutic target for the treatment of hypertension with potential improvement in vascular reactivity and consequently, a decrease in BP.
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Affiliation(s)
- Vanessa Dela Justina
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, U.S.A
- Graduate Program in Biological Sciences, Federal University of Goias, Goiânia, Brazil
| | - Fernanda R. Giachini
- Graduate Program in Biological Sciences, Federal University of Goias, Goiânia, Brazil
- RIVATREM - Red Iberoamericana de Alteraciones Vasculares en Transtornos del Embarazo
| | - Fernanda Priviero
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, U.S.A
| | - R. Clinton Webb
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, U.S.A
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Silva RCD, Vieira F, Suzuki K, Cavalcante AMRZ. EDUCATIONAL INTERVENTIONS IN IMPROVING QUALITY OF LIFE FOR HYPERTENSIVE PEOPLE: INTEGRATIVE REVIEW. TEXTO & CONTEXTO ENFERMAGEM 2020. [DOI: 10.1590/1980-265x-tce-2018-0399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to evaluate the effectiveness of educational interventions in improving the quality of life of people with arterial hypertension. Method: an integrative literature review which included studies that conducted educational interventions aimed at the hypertensive public to improve quality of life. The search was performed in the following databases: MEDLINE, LILACS, IBECS, CUMED, BDENF, SciELO and CINAHL, without restriction of language, date and sample size. For this, the following descriptors were crossed: “hipertensão” (hypertension), “educação em saúde” (health education) and “qualidade de vida” (quality of life). 619 articles were retrieved and after the selection and analysis process, a total of 10 made up this review. Data extraction and analysis were performed with the help of validated instruments and the result summarized. Results: Most studies were developed on a quasi-experimental basis, using generic instruments to measure quality of life with significant improvement after educational interventions, with group technology being the most used educational strategy. Just one study used a specific instrument to evaluate hypertensive patients. Conclusion: these results may direct the interventions to be implemented by health professionals in managing arterial hypertension. Further investigations are needed to identify and verify the most effective interventions for hypertensive patients, considering heterogeneous profiles and aiming at improving quality of life.
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Affiliation(s)
- José Geraldo Mill
- Departamento de Ciências Fisiológicas do Centro de Ciências da Saúde - Universidade Federal do Espírito Santo, Vitória, ES - Brazil.,Hospital Universitário Cassiano Antônio Moraes - Universidade Federal do Espírito Santo, Vitória, ES - Brazil
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