Effects of Coffee on Sirtuin-1, Homocysteine, and Cholesterol of Healthy Adults: Does the Coffee Powder Matter?

Background: Coffee is one of the most popular beverages globally and contains several bioactive compounds that are relevant to human health. Many nutritional strategies modulate sirtuin-1, thereby impacting aging and cardiometabolic health. This study investigated the influence of different blended coffees on serum sirtuin-1, blood lipids, and plasma homocysteine. Methods: An eight-week randomized clinical trial that included 53 healthy adults of both sexes analyzed the effects of daily intake of 450 to 600 mL of pure Arabica or blended (Arabica + Robusta) coffee intake of filtered coffee on blood sirtuin-1, lipids, and homocysteine. Results: Both Arabica and blended coffees similarly increased serum sirtuin-1 concentration, from 0.51 to 0.58 ng/mL (p = 0.004) and from 0.40 to 0.49 ng/mL (p = 0.003), respectively, without changing plasma homocysteine, folic acid, glucose, and CRP. However, the blended coffee intake increased total cholesterol from 4.70 to 5.17 mmol/L (p < 0.001) and LDL-cholesterol from 2.98 to 3.32 mmol/L (p < 0.001), as well as HDL-c from 1.26 to 1.36 mmol/L (p < 0.001). Conclusion: Both coffee powders increased sirtuin-1 expression, but our results suggest that blended coffee had hypercholesterolemic effects which could increase cardiovascular risk. Therefore, preference should be given to Arabica coffee for the best cardiometabolic benefits of coffee.

Coronary heart disease clinical manifestation and risk factors in Japanese immigrants and their descendents in the city of São Paulo.

OBJECTIVE: To assess whether a difference exists in coronary heart disease clinical manifestations and the prevalence of risk factors between Japanese immigrants and their descendents in the city of São Paulo. METHODS: Retrospective analysis of coronary artery disease clinical manifestations and the prevalence of risk factors, comparing 128 Japanese immigrants (Japanese group) with 304 Japanese descendents (Nisei group). RESULTS: The initial manifestation of the disease was earlier in the Nisei group (mean=53 years), a difference of 12 years when compared with that in the Japanese group (mean=65 years) (P<0.001). Myocardial infarction was the first manifestation in both groups (P=0.83). The following parameters were independently associated with early coronary events: smoking (OR=2.25; 95% CI=1.35-3.77; P<0.002); Nisei group (OR=10.22; 95% CI=5.64-18.5; P<0.001); and female sex (OR=5.04; 95% CI=2.66-9.52; P<0.001). CONCLUSION: The clinical presentation of coronary heart disease in the Japanese and their descendents in the city of São Paulo was similar, but coronary heart disease onset occurred approximately 12 years earlier in the Nisei group than in the Japanese group.

Manifestaçäo clínica da doença coronariana e fatores de risco em imigrantes japoneses e seus descendentes em Säo Paulo / Coronary heart disease clinical manifestation and risk factors in Japanese immigrants and their descendents in the city of Säo Paulo

OBJECTIVE: To assess whether a difference exists in coronary heart disease clinical manifestations and the prevalence of risk factors between Japanese immigrants and their descendents in the city of Säo Paulo. METHODS: Retrospective analysis of coronary artery disease clinical manifestations and the prevalence of risk factors, comparing 128 Japanese immigrants (Japanese group) with 304 Japanese descendents (Nisei group). RESULTS: The initial manifestation of the disease was earlier in the Nisei group (mean = 53 years), a difference of 12 years when compared with that in the Japanese group (mean = 65 years) (P<0.001). Myocardial infarction was the first manifestation in both groups (P = 0.83). The following parameters were independently associated with early coronary events: smoking (OR = 2.25; 95 percent CI = 1.35-3.77; P<0.002); Nisei group (OR = 10.22; 95 percent CI = 5.64-18.5; P<0.001); and female sex (OR = 5.04; 95 percent CI = 2.66-9.52; P<0.001). CONCLUSION: The clinical presentation of coronary heart disease in the Japanese and their descendents in the city of Säo Paulo was similar, but coronary heart disease onset occurred approximately 12 years earlier in the Nisei group than in the Japanese group

Perfil da doença coronariana em imigrantes descendentes japoneses e seus descendentes na cidade de São Paulo / Coronary artery disease in japanese immigrants and descendents living in São Paulo city

No presente estudo foi analisado o perfil da doença coronariana em imigrantes de origem japonesa e de seus descendentes na cidade de São Paulo, quantoà apresentação clínica e fatores de risco associados. A manifestação inicial da doença ocorreu mais cedo nos nisseis, e a diferença observada foi de 12 anosquando comparada com os imigrantes japoneses. Houve maior prevalência de hipercolesterolemia e maior média do índice de massa corpórea nasmulheres do grupo nissei...

Quando interromper, na sala de emergência, as manobras de ressuscitação cardiopulmonar na parada cardiorrespiratória sem atendimento pré-hospitalar? / When Should we Stop Cardiopulmonary Resuscitation in Patients Brought to the Emergency Room in Cardiac Arrest with no Out-ofHospital Care

PURPOSE: The decision of stopping cardiopulmonary resuscitation (CPR) in patients brought to emergency room in arrest remains a challenge. Such decision is even more difficult when someone is brought by bystanders, after an acute loss of consciousness without any out-of-hospital care. To evaluate the probability of survival of these patients we reviewed retrospectively charts in our institution, during a period of five years. METHODS: One hundred and one patients that fulfilled these characteristics came to our emergency in arrest. The time to arrival since symptoms started, cardiac rhythm at first electrocardiogram (EKG), age, gender, initial CPR success, late outcomes and previous diseases were obtained. Patients were divided in two groups regarding which cardiac rhythms they had at first EKG: A-patients arriving in asystole; and VF-patients arriving in ventricular fibrillation. To evaluate time to arrival, we arbitrarily choose 15 min as a reference point. RESULTS: In these 101 subjects the mean age was 62 +/- 13.7 years and 63 (62.3) were men. Previous heart disease was documented in 74 [dilated cardiomyopathy in 22 (21.7), coronary heart disease in 41 (40.6), arterial hypertension in 25 (24.7) and others in 6 (5.6)]. In 66 episodes we were sure of the time patients spent before arrival (mean 2.5 +/- 11 min). Only in 63 subjects we had no doubts about the rhythm at entrance: VF in 37 (58.7), A in 22 (34.9) and an accelerated idioventricular rhythm (AIR) in four (6.3). Time to arrival was 18.6 +/- 10.6 in VF vs 32.5 +/- 11.7 min in A (p = 0.012). Fourteen (13.8) subjects resumed a supraventricular rhythm with systolic pressure > or = 90 mmHg after CPR and all of them were in VF (13) or AIR (one). Nine patients (8.9) evolved in coma. Only five (4.9) were discharged from the hospital without any neurological disturbance and their time to arrival ranged from one to 15 (9 +/- 5.8) min. CONCLUSION: Delayed arrival to the emergency room (> 15 min) associated with asystole were predictors of unsuccessful CPR, and both data are helpful in deciding when to stop CPR in subjects arriving at the emergency department with no out-of-hospital care.

Objetivo - Avaliar a chance de sobrevivência dos pacientes trazidos à emergência em parada cardiorrespiratória, sem atendimento pré-hospitalar, situação de difícil decisão quanto a se interromper as manobras de ressuscitação cardiopulmonar (RCP). Métodos - Retrospectivamente, analisamos os prontuários de 101 indivíduos trazidos à emergência em parada cardiorrespiratória (PCR) de janeiro/89 a dezembro/93. Avaliamos o tempo em minutos do início do sintomas até a chegada, o ritmo cardíaco ao eletrocardiograma (ECG), idade, sexo, taxa de sucesso inicial da RCP, evolução tardia e doenças pregressas. Dividimos os pacientes em 2 grupos, de acordo com o ritmo inicial: A - assistolia e FV -fibrilação ventricular. Na avaliação do tempo de chegada, consideramos arbitrariamente 15min como referência.Para avaliar diferenças entre os grupos realizamos os testes de Student e do X2 Resultados - A idade média foi de 62±13,7 anos e 63 (62,3%) eram homens. Pôde-se confirmar a existência de doença prévia em 74 casos [cardiomiopatia dilatada em 22 (21,7%), doença coronária em 41 (40,6%), hipertensão arterial em 25 (24,7%) e outras em seis (5,6%)]. Em 66 episódios tivemos certeza do tempo decorrido até a chegada à emergência (média de 22,5± 11 min.). Em 63 casos tivemos certeza do ritmo de chegada: FV em 37 (58,7%), A em 22 (34,9%) e ritmo idioventricular acelerado em quatro (6,3%). O tempo para a chegada foi de 18,6±10,6 no grupo FV vs 32,5±11,7min. no grupo A (p= 0,012). Quatorze (13,8%) indivíduos, nenhum do grupo A, reassumiram ritmo supraventricular com pressão arterial sistólica>90mmHg após a RCP. Desses, nove (8,9%) evoluíram em coma e somente cinco (4,9%) tiveram alta hospitalar, todos sem distúrbios neurológicos e do grupo FV. O tempo de chegada nesses cinco sobreviventes variou de 1 a 15 (9±5,8)min.Conclusão - Um tempo de chegada >15min associado a assistolia pode ajudar na decisão de se terminar os esforços de RCP em indivíduos que chegam à emergência sem atendimento pré-hospitalar

Uso da hidralazina intravenosa para o tratamento da crise hipertensiva / Use of intravenous hydralazine in treatment of hypertensive crisis

Purpose­To evaluate the efficacy and safety of intravenous hidralazine in arterial hypertension. Patients and Methods­12 patients, meanage 45,33 15,82,8 men and 4 women all of them with systolic (S) arterialpressure (AP) 180 and or diastolic (D) 126 mmHg with symptoms like headache, incaracteristic toraxic pain and others but without an hypertensive emergency neither acute manifestation of hypertensive encephalopathy through fundi examination were studied. The AP was taked 10 minutes after rest (inicial) and 5, 15, 30 and 60 min (final) after intravenous administration of hidralazine-HCL (5mg) which was repeated when at least 20% AP reduction was not achieved. Results­ The inicial and final SAP, DAPand heart rate (HR) wre 208 ± 19,4 and 176 ± 17,2 (p < 0.0001), 133 ± 11,3 and 112 ± 11,5 (p< 0.001) and 72 ± 12,9 and 80 ± 15,5 (NS), respectively. Side effects related to the drug were observed in 3 (25%) patients. One had symptomatic ortostatic hypotension, the second had precordial pain with ST-T changes compatible with myocardial ischemia and the third presented a torax and abdominal cutaneous erithema, but all of them reversible. Conclusion­ Intravenous hydralazineHC1 is an alternative when rapid arterial pressurereduction is needed