[Prognosis of mitral commissurotomy. Study of 1134 mitral patients 20 years later]. / Prognóstico da comissurotomia mitral. Estudo, 20 anos depois, de 1134 doentes mitrais.

With a test sample (n = 323), consisting of the answers to an inquiry about the patients with operated mitral stenosis (n = 1134), between 1952 and 1978, in "Hospital Pulido Valente", Lisbon, we compared the group of survivors with the decreased in the relation to sex, age, valvular lesion, type of surgery, valvular area before and after surgery and existence of incompetence. We concluded that mitral stenosis was more frequent in females (4/1), but it had a worse prognosis in males. The lower the age at the time of surgery the better long time prognosis. Digital and instrumental valvulotomy had similar mortality. Valvular incompetence had a worse prognosis and is associated with larger valvular area.

[Effect of converting enzyme inhibitors in cardiac insufficiency mortality in the elderly]. / Efeito dos inibidores do enzima de conversão na mortalidade dos idosos em insuficiência cardíaca.

In a retrospective study we analyse two populations of aged patients in congestive heart failure, one treated with ACE inhibitors other not and the other with conventional therapy. Both populations received the same medication (diuretics and digitalis) and are equivalent in age, sex distribution, NYHA functional class and echocardiographic left ventricular parameters. Comparing the mortality of the two populations at the first, second and third year of follow-up, a statistically significant reduction in mortality was found on the ACE inhibitors treated population, at the first year. However, this reduction did not reach statistical significance at second and third years. The results are similar to trials in which the effects of ACE inhibitors are studied on general populations in heart failure.

[Cardiovascular risk factors in the list of patients of a general practitioner]. / Factores de risco cardiovascular na lista de utentes de um clínico geral.

OBJECTIVE: Study the prevalence of cardiovascular risk factors in the list of patients of a general practitioner (GP). DESIGN: Study cardiovascular risk factors of all patients of a family doctor. SETTING: Health Center. PATIENTS: All the patients of a GP appointment (n = 1143). INTERVENTIONS: To study the clinic cards of all the patients of a GP appointment (n = 1143), in connection with the existence of cardiovascular risk factors: dyslipidemia, hypertension, smoking, obesity, diabetes and lack of physical exercise. To study these factors by age groups, sex and its association. RESULTS: From the 1143 patients, 62.8% showed at least one vascular risk factor; 14.9% two, 8.7% three, and 5% four or more. As a whole risks factors with more prevalence were obesity (26.5%), hypertension (24.5%), lack of exercise (24.1%), smoking (16.8%) dyslipidemia (12.7%) and diabetes (4.6%). The 1143 patients were 417 men and 726 women. Comparing sexes, obesity and lack of exercise were outstanding in women; smoking, hypertension, dyslipidemia and the association of risk factors were more frequent in men. All risk factors increased with age. CONCLUSIONS: From the present work we conclude that the majority of these patients appear to have at least one risk factor of cardiovascular disease and about a quarter association of risk factors. GP can and should take advantage of the privilege situation which occupies in terms of knowledge of its population to trace and if possible to control the present vascular risk factors.