Usual dietary intake and cardiovascular risk factors in older Brazilian women.

AIM: To evaluate habitual macronutrient intake and its association with common cardiovascular risk factors in Brazilian elderly women. METHODS: Analytical cross-sectional study with 293 subjects. Carbohydrate, protein and lipid intakes were determined based on a non-consecutive three-day dietary record. The following conditions were evaluated: dyslipidemia, systemic arterial hypertension, and type 2 diabetes. RESULTS: Anthropometric, clinical and biochemical data revealed an elevated prevalence of classic cardiovascular risk factors in the sample. Higher energy intake from omega-3 fatty acid was associated with elevated levels of high-density lipoprotein cholesterol (p<0.05), whereas a diet pattern with a relatively lower energy content from monounsaturated fatty acids was associated with the presence of type 2 diabetes (p<0.05). CONCLUSIONS: Results corroborate experimental reports and contribute by suggesting that the usual diet, independently of supplementation, may be valuable in promoting health and preventing chronic diseases of aging.

A common polymorphism in the renin angiotensin system is associated with differential outcome of antihypertensive pharmacotherapy prescribed to Brazilian older women.

BACKGROUND: Since variations on the renin angiotensin (RA) system tend to exert effects on blood pressure, we investigated the association of the common ACE and AT1R polymorphisms with response to a multivariate pharmacotherapy. METHODS: This prospective study involved 169 hypertensive, community-dwelling older women. Genotypes were obtained by length analysis or direct sequencing of PCR products. Blood pressure-lowering pharmacotherapy was conducted according to current Brazilian Guidelines on Hypertension. RESULTS: Genotype frequencies were in agreement to the Hardy-Weinberg equilibrium. Interventions were found to represent actual hypertension-management practices in Brazil, and accounted for a significant reduction in both systolic (P<0.001) and diastolic (P<0.001) blood pressure. Concerning the effect of polymorphisms, no influence of the ACE and AT1R genotypes were found on the magnitude of the treatment-induced blood pressure reduction (P>0.05). Nonetheless, the clinical result varied according to the ACE alleles since mean systolic pressure was roughly 10 mm Hg higher in insertion (I) homozygotes than in the deletion (D) counterparts either in baseline (P=0.001) and endpoint (P=0.010). CONCLUSION: The outcome of the antihypertensive pharmacotherapy advocated by national guidelines was significantly influenced by the ACE I/D polymorphism but not by the AT1R 1166 A/C polymorphism among postmenopausal women.

Tailored antihypertensive drug therapy prescribed to older women attenuates circulating levels of interleukin-6 and tumor necrosis factor-α.

OBJECTIVE: To test the hypothesis that antihypertensive drug therapy produces anti-inflammatory effects in clinical practice, this study investigated circulating levels of selected proinflammatory mediators (interleukin-6 [IL-6], tumor necrosis factor-alpha [TNF-α], and interferon-γ [INF-γ]) in response to multivariate drug directions for blood pressure (BP) control. METHODS: Prospective study involving 110 hypertensive, community-dwelling older women with different metabolic disorders. A short-term BP-lowering drug therapy was conducted according to current Brazilian guidelines on hypertension, and basal cytokine levels were measured before and after intervention. RESULTS: Interventions were found to represent current hypertension-management practices in Brazil and corresponded to a significant reduction in systolic and diastolic BP levels in a whole-group analysis, as well as when users and nonusers of the most common therapeutic classes were considered separately. Considering all patients, mean IL-6 and TNF-α levels showed a significant decrease in circulating concentrations (P<0.01) at the endpoint compared with baseline, whereas the mean INF-γ level was not significantly different from baseline values. In separate analyses, only users of antagonists of the renin-angiotensin system and users of diuretics exhibited the same significant treatment-induced reduction in serum IL-6 and TNF-α observed in the whole group. CONCLUSION: Our data demonstrates that a clinically guided antihypertensive treatment is effective in reversing the low-grade proinflammatory state of serum cytokines found in postmenopausal women and support extracardiac benefits from diuretics and renin-angiotensin system antagonists.