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1.
Phytother Res ; 37(3): 798-808, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36206152

RESUMEN

Excess body weight has been associated with endothelial dysfunction and increased arterial stiffness. Foods rich in polyphenols and anthocyanins such as açaí-juçara (Euterpe edulis Martius) fruit may have protective vascular effects. Thus, we examined the effect of dietary intake of anthocyanins (açaí-juçara fruit) on endothelial function (flow-mediated dilation [FMD]) and arterial stiffness (pulse wave velocity [PWV]) in individuals with excess body weight. Fifty-five individuals with BMI ≥25 kg/m2 were randomized into non-anthocyanin (N-ATH, n = 25) or anthocyanin (ATH, n = 30) intake groups. A 12-week individualized diet plan (20% reduction in total energy intake) was prescribed and included daily intake of açaí-juçara 200 g (anthocyanins 293.6 mg) in the ATH diet plan. We evaluated anthropometric and biochemical parameters, FMD, PWV, and peripheral vascular resistance (PVR). A GEE (Bonferroni post-hoc) was used (p ≤ 0.05). No change in FMD was observed. However, PWV showed a reduction from baseline in the ATH (p = 0.002) and vs. N-ATH (p = 0.036). Both groups showed reduced peripheral vascular resistance (N-ATH, p = 0.005; ATH, p = 0.040) with no significant differences between them. In conclusion, dietary intake of anthocyanins proved effective in protecting against arterial stiffness (by PWV) in individuals with excess weight. PVR was reduced in both diet groups regardless of dietary intake of anthocyanins.


Asunto(s)
Antocianinas , Rigidez Vascular , Humanos , Análisis de la Onda del Pulso , Ingestión de Alimentos , Peso Corporal , Voluntarios
2.
Artículo en Inglés | MEDLINE | ID: mdl-35954698

RESUMEN

Background: Cardiac rehabilitation with aerobic exercises is the first strategy for nonpharmacological treatment in the postoperative period of individuals undergoing coronary artery bypass grafting (CABG) to improve functional capacity and vascular health. However, other exercise modalities remain uncertain regarding the same benefits. Objectives: Evaluation of the effect of different modalities of exercise, such as early cardiac rehabilitation on subjects submitted to CABG in the six-minute walk test (6-MWT) and on the percentage of flow-mediated dilatation (FMD) of the brachial artery. Methods: A randomized clinical trial in which 15 patients (62.7 ± 6.7 years) who underwent CABG were randomly assigned to the following groups: isometric (IG, Handgrip Jamar®), ventilatory muscle training (VG, PowerBreathe®) and control (CG, conventional respiratory and motor physiotherapy). All patients were attended to physically twice a day (20 min/session) for a consecutive week after the CABG (hospital admission). Functional capacity was assessed by 6-MWT and endothelial function was assessed through the technique of FMD, before and after (~7 days) admission to CABG. The doppler ultrasound videos were analyzed by Cardiovascular Suite® software (Quipu, Pisa, Italy) to measure %FMD. Statistics: Generalized estimation equation, followed by Bonferroni post hoc (p < 0.05). Results: Systolic, diastolic and mean arterial pressure (SBP/DBP/MAP, respectively) were 133, 76 and 95 mmHg. The groups presented walking meters (m) distance before and after intervention of: IGbasal 357.80 ± 47.15 m vs. IGpost 306.20 ± 61.63 m, p = 0.401 (+51 m); VGbasal 261.50 ± 19.91 m vs. VGpost 300.75 ± 26.29 m, p = 0.052 (+39 m); CG basal 487.83 ± 83.23 m vs. CGpost 318.00 ± 31.08, p = 0.006 (−169 m). %FMD before and after intervention was IGbasal 10.4 ± 4.8% vs. IGpost 2.8 ± 2.5%, p = 0.152; VGbasal 9.8 ± 5.1% vs. VGpost 11.0 ± 6.1%, p = 0.825; CGbasal 9.2 ± 15.8% vs. CGpost 2.7 ± 2.6%, p = 0.710 and resting mean basal blood flow was IGbasal 162.0 ± 55.0 mL/min vs. IGpost 129.9 ± 63.7 mL/min, p = 0.662; VGbasal 83.74 ± 12.4 mL/min vs. VGpost 58.7 ± 17.1 mL/min, p = 0.041; CGbasal 375.6 ± 183.7 mL/min vs. CGpost 192.8 ± 115.0 mL/min, p = 0.459. Conclusions: Ventilatory muscle training for early cardiac rehabilitation improved acute functional capacity and modulated mean flow of individuals undergoing CABG.


Asunto(s)
Rehabilitación Cardiaca , Rehabilitación Cardiaca/métodos , Puente de Arteria Coronaria/rehabilitación , Fuerza de la Mano , Humanos , Proyectos Piloto , Músculos Respiratorios/fisiología
4.
Trials ; 22(1): 638, 2021 Sep 17.
Artículo en Inglés | MEDLINE | ID: mdl-34535165

RESUMEN

BACKGROUND: Sleep apnea and coronary artery disease are prevalent and relevant diseases. The mechanism by which sleep apnea leads to coronary artery disease remains unclear. Intermittent hypoxia, caused by sleep apnea, leads to inflammation and consequent endothelial dysfunction. Endothelial dysfunction precedes the development of atherosclerotic disease and the occurrence of cardiovascular events. Agents that potentially act to improve endothelial function can help prevent cardiovascular events. Patients using immunomodulators due to rheumatic diseases have a lower prevalence of cardiovascular diseases. However, the potential cardioprotective effect of these drugs in patients without autoimmune diseases is not clear. Hydroxychloroquine (HCQ) is an immunomodulator used to treat rheumatoid arthritis and systemic lupus erythematosus. In addition to its anti-inflammatory properties, HCQ reduces cholesterol and blood glucose levels and has antithrombotic effects. The drug is inexpensive and widely available. Adverse effects of HCQ are rare and occur more frequently with high doses. OBJECTIVE: In this randomized clinical trial, the effect of HCQ treatment on endothelial function will be tested in seniors with sleep apnea. METHODS: We will recruit participants over the age of 65 and with moderate-severe sleep apnea from an ongoing cohort. We chose to use this sample already evaluated for sleep apnea for reasons of convenience, but also because the elderly with sleep apnea are vulnerable to heart disease. Endothelial function will be assessed by examining flow-mediated dilation of the brachial artery, the gold standard method, considered an independent predictor of cardiovascular events in the general population and by peripheral arterial tonometry, the most recent and most easily obtained method. Hydroxychloroquine will be used at a dose of 400 mg/daily for 8 weeks. DISCUSSION: Our study aims to obtain evidence, albeit preliminary, of the efficacy of hydroxychloroquine in improving endothelial function and reducing cardiovascular risk markers. If the improvement occurs, we plan to design a randomized multicenter clinical trial to confirm the findings. TRIAL REGISTRATION: ClinicalTrials.gov NCT04161339 . Registered on November 2019.


Asunto(s)
Artritis Reumatoide , Enfermedades Cardiovasculares , Lupus Eritematoso Sistémico , Síndromes de la Apnea del Sueño , Anciano , Humanos , Hidroxicloroquina/efectos adversos , Estudios Multicéntricos como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Síndromes de la Apnea del Sueño/diagnóstico , Síndromes de la Apnea del Sueño/tratamiento farmacológico , Resultado del Tratamiento
5.
Trials ; 22(1): 548, 2021 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-34412668

RESUMEN

BACKGROUND: Arterial hypertension has a direct association with endothelial dysfunction and major cardiovascular events. There is evidence showing the benefits of aerobic exercise on flow-mediated dilation (FMD) in hypertensive individuals but little is known about the effect of autonomic nervous system (ANS) activation on FMD of the brachial artery in response to different types of exercise in this specific population. This study aims to examine the effects of ANS activation on FMD of the brachial artery in response to exercise in hypertensive individuals following a session of different types of exercise including aerobic exercise (AE), resistance exercise (RE), or combined exercise (CE). METHODS: Thirty-nine hypertensive volunteers aged 35 to 55 years will be randomly assigned to two exercise sessions: AE (40 min on a cycle ergometer at 60% of HR reserve), RE (4 lower limb sets with 12 repetitions at 60% 1-RM for 40 min), or CE (RE for 20 min + AE for 20 min). Each exercise group will be randomized to receive either an α1-adrenergic blocker (doxazosin 0.05 mg/kg-1) or placebo. Ultrasound measurement of FMD is performed 10 min before and 10, 40, and 70 min after exercise. ANS activation is monitored using a Finometer and measurements are taken during 10 min before each FMD assessment. Arterial stiffness is assessed by pulse wave velocity (PWV) analysis using a Complior device. DISCUSSION: We expect to demonstrate the effect of ANS activation on FMD of the brachial artery in hypertensive individuals in response to different types of exercise. This study may give some insight on how to improve exercise prescription for hypertension management. TRIAL REGISTRATION: https://clinicaltrials.gov and ID "NCT04371757". Registered on May 1, 2020.


Asunto(s)
Hipertensión , Análisis de la Onda del Pulso , Adulto , Sistema Nervioso Autónomo , Método Doble Ciego , Ejercicio Físico , Humanos , Hipertensión/diagnóstico , Hipertensión/terapia , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Vasodilatación
6.
Sci Rep ; 11(1): 8528, 2021 04 20.
Artículo en Inglés | MEDLINE | ID: mdl-33879820

RESUMEN

To examine the acute effects of aerobic exercise (AE), resistance exercise (RE) or combined exercise (CE) on flow-mediated dilation (FMD), progenitor cells (PCs), endothelial progenitor cells (EPCs), oxidative stress markers and endothelial-cell derived microvesicles (EMVs) in patients with hypertension. This is a randomized, parallel-group clinical trial involving an intervention of one session of three different modalities of exercise. Thirty-three males (43 ± 2y) were randomly divided into three groups: a session of AE (n = 11, 40 min, cycle ergometer, 60% HRR); a session of RE (n = 11, 40 min, 4 × 12 lower limb repetitions, 60% 1-RM); or a session of CE (n = 11, 20-min RE + 20-min AE). FMD was assessed 10 min before and 10, 40 and 70 min post-intervention. Blood samples were collected at the same time points (except 40 min). FMD were similar in all groups and from baseline (within each group) after a single exercise bout (AE, RE or CE). At 70 min, RE group showed higher levels of PCs compared to the AE (81%) and CE group (60%). PC levels were reduced from baseline in all groups (AE: 32%, p = 0.037; RE: 15%, p = 0.003; CE: 17%, p = 0.048). The levels of EPCs, EMVs and oxidative stress were unchanged. There were no acute effects of moderate-intensity exercise on FMD, EPCs, EMVs and oxidative stress, but PCs decreased regardless of the exercise modality. Individuals with controlled hypertension do not seem to have impaired vascular function in response to a single exercise bout.


Asunto(s)
Células Progenitoras Endoteliales/fisiología , Endotelio Vascular/fisiología , Ejercicio Físico , Hipertensión/terapia , Estrés Oxidativo/fisiología , Entrenamiento de Fuerza/métodos , Vasodilatación/fisiología , Adulto , Células Progenitoras Endoteliales/citología , Humanos , Hipertensión/metabolismo , Hipertensión/patología , Masculino , Persona de Mediana Edad
7.
BMC Cardiovasc Disord ; 21(1): 101, 2021 02 17.
Artículo en Inglés | MEDLINE | ID: mdl-33596832

RESUMEN

BACKGROUND: Aerobic exercise improves endothelial function and arterial stiffness after myocardial infarction (MI), but the effects of isometric exercise on cardiovascular parameters are still uncertain. We aimed to assess the effects of one session of aerobic or isometric exercise on flow-mediated dilation (FMD) and pulse wave velocity (PWV) in post-MI volunteers undergoing percutaneous coronary intervention (PCI). METHODS: Twenty post-MI patients undergoing PCI were randomized to aerobic (AE, n = 10) or isometric (IE, n = 10) exercise groups. We evaluated cardiac structure and function (echocardiographic); carotid plaque presence (ultrasound). FMD and PWV were measured 10 min before and 10 min after the intervention: a single session of moderate-intensity AE (30 min; ratings 12-14 on Borg's scale or 50-60% HRreserve) or handgrip IE (four two-minute bilateral contractions; 30% maximal voluntary contraction; 1-min rest). Generalized estimating equations (Bonferroni post-hoc) was used to assess differences (p ≤ 0.050). RESULTS: FMD improved only in the AE group (Δ = 4.9%; p = 0.034), with no difference between groups after exercise. Even after adjustment (for baseline brachial artery diameter) the effectiveness of AE remained (p = 0.025) with no change in the IE group. PWV was slightly reduced from baseline in the AE group (Δ = 0.61 m/s; p = 0.044), and no difference when compared to the IE group. Peripheral vascular resistance decreased in AE versus IE (p = 0.050) and from baseline (p = 0.014). CONCLUSIONS: Vascular measurements (FMD and PWV) improved after a single session of AE. There are apparently no benefits following a session of IE. TRIAL REGISTRATION: http://www.clinicaltrials.gov and ID number NCT04000893.


Asunto(s)
Arteria Braquial/fisiopatología , Endotelio Vascular/fisiopatología , Terapia por Ejercicio , Fuerza de la Mano , Contracción Isométrica , Intervención Coronaria Percutánea , Infarto del Miocardio con Elevación del ST/terapia , Rigidez Vascular , Vasodilatación , Anciano , Presión Arterial , Brasil , Femenino , Humanos , Masculino , Persona de Mediana Edad , Intervención Coronaria Percutánea/efectos adversos , Proyectos Piloto , Infarto del Miocardio con Elevación del ST/diagnóstico , Infarto del Miocardio con Elevación del ST/fisiopatología , Factores de Tiempo , Resultado del Tratamiento , Resistencia Vascular
8.
Front Physiol ; 11: 898, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32982766

RESUMEN

Background: Hypertension remains highly prevalent in postmenopausal women, along with vascular dysfunction and increased oxidative stress. In such context, regular exercises, yoga practice, and slow breathing have been recommended to treat hypertension. However, the effects of the multiple components of yoga, including the respiratory techniques involved in the practice, on hypertension and on vascular and endothelial function have never been evaluated. Objective: This study aimed to investigate the additional effects of respiratory technique on vascular function and oxidative stress profile in hypertensive postmenopausal women (HPMWs) following yoga or stretching video classes. Study Design: Hypertensive postmenopausal women were recruited and randomized for 12 weeks, twice a week, of supervised yoga or stretching video classes of 75 min for 12 weeks associated or not with respiratory technique. Baseline and post-intervention measurements included pulse wave velocity (PWV), flow-mediated dilation (FMD), and oxidative stress parameters. Hypertensive postmenopausal women (59 ± 0.7 years) who ended the protocol were distributed into three groups: (1) control group (yoga or stretching, C, n = 14); (2) yoga + respiratory technique (Y+, n = 10); (3) stretching + respiratory technique (S+, n = 9). Results: Diastolic blood pressure and FMD [baseline: C: 6.94 ± 1.97%, Y+: 7.05 ± 1.65%, and S+: 3.54 ± 2.01% vs. post: C: 16.59 ± 3.46% (p = 0.006), Y+: 13.72 ± 2.81% (p = 0.005), and S+: 11.79 ± 0.99% (p = 0.0001)] have significantly increased in all groups when baseline and post-practice values were compared. However, resting heart rate and PWV [baseline: Y+: 10.44 ± 3.69 and S+: 9.50 ± 0.53 m/s vs. post: Y+: 9.45 ± 0.39 (p = 0.003) and S+: 8.02 ± 0.47 m/s (p = 0.003)] decreased significantly only in the Y+ and S+ groups (baseline vs. post). Systemic antioxidant enzyme activities (superoxide dismutase and catalase) increased in all groups, and hydrogen peroxide and lipoperoxidation reduced in Y+ and S+ (baseline vs. post). Conclusions: Twelve weeks of yoga or stretching video classes promoted positive changes in several outcomes generally regarded as cardiovascular risk factors in HPMWs, and these changes were even more pronounced by the association with respiratory technique.

9.
Rev Assoc Med Bras (1992) ; 65(6): 818-824, 2019 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-31340310

RESUMEN

BACKGROUND: The use of the 3D printer in complex cardiac surgery planning. OBJECTIVES: To analyze the use and benefits of 3D printing in heart valve surgery through a systematic review of the literature. METHODS: This systematic review was reported following the Preferred Reporting Items for Systematic Review and registered in the Prospero (International Prospective Register of Systematic Reviews) database under the number CRD42017059034. We used the following databases: PubMed, EMBASE, Scopus, Web of Science and Lilacs. We included articles about the keywords "Heart Valves", "Heart Valve Prosthesis Implantation", "Heart Valve Prosthesis", "Printing, Three-Dimensional", and related entry terms. Two reviewers independently conducted data extraction and a third reviewer solved disagreements. All tables used for data extraction are available at a separate website. We used the Cochrane Collaboration tool to assess the risk of bias of the studies included. RESULTS: We identified 301 articles and 13 case reports and case series that met the inclusion criteria. Our studies included 34 patients aged from 3 months to 94 years. CONCLUSIONS: Up to the present time, there are no studies including a considerable number of patients. A 3D-printed model produced based on the patient enables the surgeon to plan the surgical procedure and choose the best material, size, format, and thickness to be used. This planning leads to reduced surgery time, exposure, and consequently, lower risk of infection.


Asunto(s)
Implantación de Prótesis de Válvulas Cardíacas/métodos , Prótesis Valvulares Cardíacas , Impresión Tridimensional , Femenino , Implantación de Prótesis de Válvulas Cardíacas/instrumentación , Humanos , Masculino , Impresión Tridimensional/instrumentación , Reproducibilidad de los Resultados , Resultado del Tratamiento
10.
Rev. Assoc. Med. Bras. (1992, Impr.) ; Rev. Assoc. Med. Bras. (1992, Impr.);65(6): 818-824, June 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1012977

RESUMEN

SUMMARY BACKGROUND: The use of the 3D printer in complex cardiac surgery planning. OBJECTIVES: To analyze the use and benefits of 3D printing in heart valve surgery through a systematic review of the literature. METHODS: This systematic review was reported following the Preferred Reporting Items for Systematic Review and registered in the Prospero (International Prospective Register of Systematic Reviews) database under the number CRD42017059034. We used the following databases: PubMed, EMBASE, Scopus, Web of Science and Lilacs. We included articles about the keywords "Heart Valves", "Heart Valve Prosthesis Implantation", "Heart Valve Prosthesis", "Printing, Three-Dimensional", and related entry terms. Two reviewers independently conducted data extraction and a third reviewer solved disagreements. All tables used for data extraction are available at a separate website. We used the Cochrane Collaboration tool to assess the risk of bias of the studies included. RESULTS: We identified 301 articles and 13 case reports and case series that met the inclusion criteria. Our studies included 34 patients aged from 3 months to 94 years. CONCLUSIONS: Up to the present time, there are no studies including a considerable number of patients. A 3D-printed model produced based on the patient enables the surgeon to plan the surgical procedure and choose the best material, size, format, and thickness to be used. This planning leads to reduced surgery time, exposure, and consequently, lower risk of infection.


RESUMO INTRODUÇÃO: A impressora 3D é utilizada como coadjuvante no planejamento de cirurgias de cardiopatias complexas. OBJETIVOS: Analisar o uso e os benefícios da impressão 3D em cirurgias de válvula cardíaca por meio de revisão sistemática da literatura. MÉTODOS: Esta revisão sistemática foi conduzida de acordo com os itens do Preferred Reporting for Systematic Reviews e registrada no banco de dados Prospero (Registro Prospectivo Internacional de Revisão Sistemática) sob o número CRD42017059034. Foram utilizados os seguintes bancos de dados: PubMed, Embase, Scopus, Web of Science e Lilacs. Incluídos artigos com os termos de busca "Heart Valves", "Heart Valve Prosthesis Implantation", "Heart Valve Prosthesis", "Printing, Three-Dimensional" e termos relacionados. Dois revisores independentes conduziram a extração dos dados e um terceiro (revisor) solucionou as discordâncias. Todas as tabelas usadas para a extração de dados estão disponibilizadas em site próprio. A ferramenta Cochraine Collaboration foi utilizada para avaliar o risco de viés na inclusão de estudos. RESULTADOS: Identificados 301 artigos e 13 relatos de casos e séries de casos que atenderam aos critérios de inclusão. A amostra envolveu 34 pacientes, com idade de 3 meses a 94 anos. CONCLUSÃO: Até o presente momento, não há estudos que contemplem um número considerável de pacientes. A impressão de um modelo 3D produzida a partir do protótipo do paciente permitirá ao cirurgião planejar a cirurgia, bem como escolher o melhor material, tamanho, formato e espessura da válvula a ser utilizada. Esse planejamento reduz o tempo de cirurgia, a exposição e, consequentemente, a redução do risco de infecção.


Asunto(s)
Humanos , Masculino , Femenino , Prótesis Valvulares Cardíacas , Implantación de Prótesis de Válvulas Cardíacas/métodos , Impresión Tridimensional/instrumentación , Reproducibilidad de los Resultados , Resultado del Tratamiento , Implantación de Prótesis de Válvulas Cardíacas/instrumentación
11.
Int J Cardiol Heart Vasc ; 21: 64-68, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30320204

RESUMEN

AIMS: To compare the dosage of radiation the thyroid and gonad glands receive in pediatric patients undergoing chest X-rays, in distinct positions, towards the goal of developing of an X-ray tube positioning protocol. METHODS: A randomized controlled clinical trial was carried out in the Pediatric Intensive Care Unit (PICU) at the Institute of Cardiology/University Foundation of Cardiology of Rio Grande do Sul, Brazil from June 2014 to September 2016. Patients were divided into two groups. One group was positioned with the thyroid gland facing the anode end of an X-ray tube, and in the other group the thyroid gland faced the cathode end. Radiographs were evaluated by five observers, following criteria recommended by the Commission of the European Communities (CEC). RESULTS: Forty-eight pediatric patients, with a mean age of 2.0 ±â€¯1.3 years, participated in this study. Based on the evaluation of 48 images, it was determined that the thyroid and gonad glands facing the cathode were exposed to 13.3 ±â€¯3.1 µGy and 13.5 ±â€¯4.1 µGy of radiation, respectively (p = 0.008). Additionally, the thyroid and gonad glands facing the anode were exposed to 11.7 ±â€¯3.1 µGy and 12.7 ±â€¯3.1 µGy of radiation, respectively (p = 0.007). The mean input dose in the center of the chest was 20.8 ±â€¯9.6 µGy in both positions. DISCUSSION: The proximity of the thyroid gland to the cathode end of the X-ray tube appears to be related to the dosage of ionizing radiation. Adverse effects associated with exposure to ionizing radiation could be minimized by positioning the thyroid gland to the anodic end of the X-ray tube. CONCLUSION: Patients should be placed facing the anode end of the X-ray tube when taking thoracic X-rays, in order to reduce radiation exposure to the thyroid and gonad glands.ClinicalTrials.gov Identifier: NCT02925936.

12.
Rev. bras. hipertens ; 24(4): 152-158, 20171210.
Artículo en Portugués | LILACS | ID: biblio-1379645

RESUMEN

Introdução: A hipertensão arterial sistêmica (HAS) é uma doença crônica, considerada como principal fator de risco para mortalidade por acidente vascular cerebral (AVC) e doença coronariana (DC) (40% óbitos). Apesar disso e da alta prevalência na população não existe um bom controle dos valores da pressão arterial (PA) dentro de metas pressóricas determinadas pelas Diretrizes nos indivíduos acometidos. Acredita-se que a disponibilização de um programa de atenção e acompanhamento do paciente hipertenso de natureza multidisciplinar (MULTIHAS), possa colaborar para a adesão e, consequentemente, para o melhor controle da PA. Além disso, a possibilidade de avaliar nesses pacientes a Variabilidade da Frequência Cardíaca (VFC) pode fornecer informações sobre o Sistema Nervoso Autônomo (SNA) e seu controle sobre o coração. Objetivo: Avaliar o efeito de um programa de assistência multiprofissional (MULTIHAS) sobre o controle autonômico cardiovascular e a PA em pacientes em hipertensos. Métodos: Ensaio clínico randomizado, controlado, em hipertensos submetidos a dois tipos de tratamentos: o multiprofissional grupo MULTIHAS composto pelos profissionais (médico, enfermeiro, nutricionista, fisioterapeuta e psicólogo) e o convencional (grupo Controle) (médico e o enfermeiro). Foram avaliadas variáveis como uso de medicações, bioquímica do sangue, índice de massa corporal (IMC), escore de qualidade de vida (QV), PA e VFC. As visitas no grupo MULTIHAS eram efetuadas a cada dois meses a todos os profissionais. No grupo Controle as visitas também ocorriam a cada dois meses acompanhados, somente, pelo médico e pelo enfermeiro. Ao final de um ano todas as variáveis foram novamente avaliadas em ambos grupos. Resultados: Após um ano de tratamento o grupo MULTIHAS apresentou diferença significativa no escore da QV(p<0,005) e nos valores do IMC (p<0,001); na posição supina tiveram melhora a PAS (p=0,015), a PAM (p=0,034), a VFC (p= 0,051) e no componente de alta frequência da VFC - HFabs (p= 0,042) em relação ao grupo Controle. No registro da FC pelo frequencímetro (Polar RS800 CX da Finlândia) esta respondeu à manobra ortostática nos valores da PAS (p=0,016), PAD (p=0,028), sendo a variância total da FC (p= 0,047) bem como o componente de baixa frequência da VFC - LFabs (p= 0,045) significativamente diferentes em relação ao grupo Controle. Conclusão: O atendimento multiprofissional deve ser considerado como um potencial recurso no manejo da pressão arterial, do IMC, do escore de QV bem como do sistema nervoso autônomo, pois esses parâmetros foram otimizados quando comparados ao grupo Controle.


Introduction: Systemic arterial hypertension (SAH) is a chronic high prevalent disease and a major risk factor for cardiovascular events such stroke (CVA) and coronary heart disease (CHD) (40% of deaths). Despite this, there is a lack of adequate control of blood pressure (BP) levels according with those described on guidelines for hypertensive patients. It is believed that specific care programs and multidisciplinary monitoring of the hypertensive patient (MULTIHAS) can contribute to improved BP control in this population. Moreover, the autonomic nervous system and its control over cardiovascular function are alter in this patients and can contribute to poor prognostic and outcomes in this population. Objective: To evaluate the effect of a multidisciplinary assistance program (MULTIHAS) on the cardiovascular autonomic control and BP levels in hypertensive patients, with one year follow-up. Methods: Randomized controlled trial, conducted in hypertensive patients undergoing two different interventions: multi professional attention (MULTIHAS group) of different health time members (doctor, nurse, dietitian, physical therapist and psychologist) and conventional attention (control group) of doctor and nurse. The variables evaluated were BP and HRV (Heart rate variability), and secondary: body mass index (BMI), quality of life score (QOL), medication use and blood biochemistry The visits of MULTIHAS occurred every two months with all the multi professional team. Control group visits also occurred every two months accompanied only by the doctor and the nurse. After one year, all variables were assessed again in both groups. Results: After 1 year of treatment, the MULTIHAS group had a significant difference in the QOL score (p <0.005) and in the BMI values (p <0.001) ; the BP and HRV showed a small improvement in supine SBP (p = 0.015), in MBP (p = 0.034), in HRV (p = 0.051), and in the high frequency component of HRV - HFabs (p = 0.042) compared to the control group. During the recording of FC the frequency meter (Polar RS800 CX of Finland), it responded to the orthostatic maneuver in the values of SBP (p = 0.016), DBP (p = 0.028), the total HR variance (p = 0.047) LFabs (p = 0.045) were significantly different in relation to the control group. Conclusion: Multidisciplinary care should be considered as a potential resource in the management of blood pressure, BMI, QOL score as well as the autonomic nervous system, since these parameters were optimized when compared to the Control group.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Grupo de Atención al Paciente , Factores de Riesgo de Enfermedad Cardiaca , Hipertensión/prevención & control , Hipertensión/terapia
13.
Acta paul. enferm ; Acta Paul. Enferm. (Online);25(5): 775-780, 2012. graf, tab
Artículo en Portugués | LILACS, BDENF | ID: lil-653414

RESUMEN

OBJETIVO: Avaliar o conhecimento sobre a técnica da verificação da pressão arterial nos profissionais de enfermagem em uma instituição de saúde. Identificar a relação entre a qualificação profissional e o desenvolvimento correto da técnica. MÉTODOS: O pesquisador aplicou um questionário aos profissionais de enfermagem durante a verificação da pressão arterial dos pacientes, questões estas relativas às V Diretrizes Brasileiras de Hipertensão Arterial. RESULTADOS: Dos profissionais de enfermagem, técnicos e auxiliares, 8,41 %, atingiram o ponto de corte estipulado como adequado de acertos (80%). Houve relação direta entre a qualificação profissional e a quantidade de acertos. CONCLUSÃO: As V Diretrizes Brasileiras de Hipertensão Arterial não são seguidas em sua plenitude pelos profissionais de enfermagem. A ampla divulgação das diretrizes, a implementação de programas de capacitação e a monitoração da técnica devem ser incentivadas.


OBJECTIVE: To evaluate knowledge about the technique of blood pressure measurement among nursing professionals in a health care institution. To identify the relationship between professional qualification and the proper development of technique. METHODS: The researcher applied a questionnaire to nursing professionals during the verification of arterial pressure of patients. These questions related to the Brazilian Guidelines on Arterial Hypertension V. RESULTS: Of the nursing professionals, technicians and assistants, 8.41% attained the cutoff point stipulated as adequate correct answers (80%). There was a direct relationship between professional qualification and the number of correct answers. CONCLUSION: Brazilian Guidelines on Arterial Hypertension V were not followed in their entirety by nursing professionals. A wide dissemination of guidelines, the implementation of training programs and monitoring of the technique should be encouraged.


OBJETIVO: Evaluar el conocimiento sobre la técnica de la verificación de la presión arterial en los profesionales de enfermería en una institución de salud. Identificar la relación entre la calificación profesional y el desarrollo correcto de la técnica. MÉTODOS: El investigador aplicó un cuestionario a los profesionales de enfermería durante la verificación de la presión arterial de los pacientes, preguntas que fueron relativas a las V Directrices Brasileras de Hipertensión Arterial. RESULTADOS: De los profesionales de enfermería, técnicos y auxiliares, el 8,41 %, alcanzaron el punto de corte estipulado como adecuado de aciertos (80%). Hubo relación directa entre la calificación profesional y la cantidad de aciertos. CONCLUSIÓN: Las V Directrices Brasileras de Hipertensión Arterial no son seguidas en su plenitud por los profesionales de enfermería. La amplia difusión de las directrices, la implementación de programas de capacitación y el monitoramiento de la técnica deben ser incentivadas.


Asunto(s)
Humanos , Masculino , Femenino , Habilitación Profesional , Hospitales Especializados , Hipertensión/enfermería , Guías de Práctica Clínica como Asunto , Brasil , Estudios Transversales , Estudios de Evaluación como Asunto
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