Factors associated with non-treatment of hypertension and gender differences at baseline in the ELSA-Brasil cohort

The treatment of arterial hypertension (AH) contributes to the reduction of morbidity and mortality. Gender differences are likely to play a role, as non-treatment is associated with clinical and sociodemographic aspects. The aim of this study was to investigate the factors associated with non-treatment of AH and gender differences in hypertensive individuals from the ELSA-Brasil cohort. The study was conducted with 5,743 baseline hypertensive cohort participants. AH was considered if there was a previous diagnosis or if systolic blood pressure (SBP) was ≥140 and/or diastolic BP (DBP) was ≥90 mmHg. Sociodemographic and anthropometric data, lifestyle, comorbidities, and use of antihypertensive medications were evaluated through interviews and in-person measurements. Treatment with renin-angiotensin-aldosterone system inhibitors (RAASi) or other antihypertensive medications and non-treatment were evaluated with multivariate logistic regression. Non-treatment was observed in 32.8% of hypertensive individuals. Of the 67.7% treated individuals, 41.1% received RAASi. Non-treatment was associated with alcohol consumption in women (OR=1.41; 95%CI: 1.15-1.73; P=0.001), lowest schooling level in men (OR=1.70; 95%CI: 1.32-2.19; P<0.001), and younger age groups in men and women (strongest association in males aged 35-44 years: OR=4.58, 95%CI: 3.17-6.6, P<0.001). Among those using RAASi, a higher proportion of white, older individuals, and with more comorbidities was observed. The high percentage of non-treatment, even in this civil servant population, indicated the need to improve the treatment cascade for AH. Public health policies should consider giving special attention to gender roles in groups at higher risk of non-treatment to reduce inequities related to AH in Brazil.

Effect of platelet-rich plasma therapy associated with exercise training in musculoskeletal healing in rats

BACKGROUND

Muscle healing is a time-dependent process associated with an increase in the total amount of local collagen fibers. Platelet-rich plasma therapy (PRPT) associated with exercise may improve this healing process. The aim of this study was to demonstrate the regenerative effect of PRPT in association with exercise training on musculoskeletal healing.

METHODS

Male Wistar rats were submitted to an injury in the vastus lateralis muscle and randomly divided into 4 groups (n = 5/group): sedentary sham-operated (SSO); sedentary group submitted to PRPT (SPR); swim-trained (SWT); and swim-trained group submitted to PRPT (SWP). Serum lactate level was used to confirm the training protocol effectiveness to increase aerobic fitness. The collagen fiber concentration was measured by the polarization colors in picrosirius red-stained tissue sections.

RESULTS

Lactate levels decreased in both training groups (SWT and SWP; P < .05) after training (SWT: from 6.2 ± 0.44 to 4.7 ± 0.22 mmol/L; SWP: from 5.5 ± 0.99 to 4.0 ± 0.78 mmol/L). There were less type 1 collagen fibers in SWP group compared with other groups (SSO = 31.8 ± 10.3, SSP = 32.3 ± 13.5, SWT = 14.6 ± 13.4, SWP = 5.7 ± 4.7, P < .05), while there were more type 3 collagen fibers on SWP (SSO = 68.7 ± 9.8, SSP = 71.2 ± 12.2, SWT = 85.4 ± 13.4, SWP = 94.4 ± 4.6, P < .05) in the injured region.

CONCLUSION

Exercise in association with PRPT enhances the skeletal muscle-healing process.