Children First Study II: an educational programme on cardiovascular prevention in public schools can reduce parents' cardiovascular risk.

OBJECTIVE: The aim of this study was to analyze whether the implementation of a multidisciplinary educational programme for cardiovascular prevention in public schools can contribute to reducing the FramINGHAM CARDIOVASCULAR RISK SCORE OF THE CHILDREN'S PARENTS AFTER ONE YEAR. METHODS: This was a prospective, community-based, case-control study carried out in public schools in Sao Paulo, Brasil. Students were randomized to receive healthy lifestyle recommendations by two different approaches. The control group received written cardiovascular health educational brochures for their parents. The intervention group received the same brochures for the parents, and the children were exposed to a weekly educational programme on cardiovascular prevention with a multidisciplinary health team for one year. Clinical and laboratorial data were collected at the onset and end of the study. RESULTS: We studied 265 children and their 418 parents. At the baseline, the rate of parents with intermediate or high Framingham scores (risk of cardiovascular disease over the next 10 years greater than 10%) was 6.9% in the control group and 13.3% in the intervention group. After one year, the rate of parents with intermediate or high Framingham risk score was reduced by 22.2% in the intervention group and increased by 33.3% in the control group (p=0.031). The cardiovascular risk factors that improved in the intervention group were blood pressure, LDL-cholesterol (low-density lipoprotein cholesterol), and glucose levels. CONCLUSION: An educational programme on cardiovascular prevention for school-age children in public schools can reduce the cardiovascular risk of their parents.

Children First Study II: an educational programme on cardiovascular prevention in public schools can reduce parents cardiovascular risk

SUMMARY OBJECTIVE: The aim of this study was to analyze whether the implementation of a multidisciplinary educational programme for cardiovascular prevention in public schools can contribute to reducing the Fram INGHAM CARDIOVASCULAR RISK SCORE OF THE CHILDREN'S PARENTS AFTER ONE YEAR. METHODS: This was a prospective, community-based, case-control study carried out in public schools in Sao Paulo, Brasil. Students were randomized to receive healthy lifestyle recommendations by two different approaches. The control group received written cardiovascular health educational brochures for their parents. The intervention group received the same brochures for the parents, and the children were exposed to a weekly educational programme on cardiovascular prevention with a multidisciplinary health team for one year. Clinical and laboratorial data were collected at the onset and end of the study. RESULTS: We studied 265 children and their 418 parents. At the baseline, the rate of parents with intermediate or high Framingham scores (risk of cardiovascular disease over the next 10 years greater than 10%) was 6.9% in the control group and 13.3% in the intervention group. After one year, the rate of parents with intermediate or high Framingham risk score was reduced by 22.2% in the intervention group and increased by 33.3% in the control group (p=0.031). The cardiovascular risk factors that improved in the intervention group were blood pressure, LDL-cholesterol (low-density lipoprotein cholesterol), and glucose levels. CONCLUSION: An educational programme on cardiovascular prevention for school-age children in public schools can reduce the cardiovascular risk of their parents.

RESUMO OBJETIVO: Analisar se a implementação de um programa educacional multidisciplinar para prevenção cardiovascular em escolas públicas durante um ano pode contribuir para reduzir o escore de risco cardiovascular de Framingham dos pais das crianças. MÉTODOS: Estudo prospectivo, de base comunitária, caso-controle em duas escolas públicas de São Paulo, Brasil. Os alunos foram randomizados para receber recomendações de estilo de vida saudável por duas abordagens diferentes. O grupo controle recebeu folhetos educacionais de saúde cardiovascular encaminhados para seus pais. O grupo intervenção recebeu os mesmos folhetos e as crianças foram expostas a um programa educacional semanal, durante um ano, com uma equipe multidisciplinar em prevenção cardiovascular. Dados clínicos e laboratoriais foram coletados no início e no final do estudo. RESULTADOS: Foram sujeitos do estudo 418 pais das crianças das escolas. No início da pesquisa, o total de pais com escore de Framingham intermediário ou alto (risco superior a 10% de doença cardiovascular nos próximos dez anos) foi de 6,9% no grupo controle e de 13,3% no grupo intervenção. Após um ano, dentre os pais com escore de risco de Framingham intermediário ou alto, foi observada redução de 22,2% no grupo intervenção e aumento de 33,3% no grupo controle (p=0,031). Os fatores de risco cardiovascular que melhoraram no grupo de intervenção foram pressão arterial, LDL-colesterol (lipoproteína de baixa densidade) e glicemia. CONCLUSÃO: Um programa educacional de prevenção cardiovascular para crianças em idade escolar, em escolas públicas, pode reduzir o risco cardiovascular de seus pais.

Children First Study: how an educational program in cardiovascular prevention at school can improve parents' cardiovascular risk.

AIM: To evaluate whether a multidisciplinary educational program (EP) in cardiovascular prevention (CVP) for children could improve the Framingham cardiovascular risk (FCR) of their parents after one year. METHODS AND RESULTS: This was a prospective community-based study in Brazil during 2010 that randomized students aged 6 to 10 years old to two different approaches to receiving healthy lifestyle information. The control group received written educational material (EM) for their parents about healthy lifestyle. The intervention group received the same EM for parents, and children were exposed to a weekly EP in CVP with a multidisciplinary health team. At onset and end of the study, we collected data from parents and children (weight, height, arterial blood pressure, and laboratory tests). We studied 197 children and 323 parents. Analyzing the parents' FCR we found that 9.3% of the control group and 6.8% of the intervention group had more than a 10% year risk of cardiovascular heart disease (CHD) over the next 10 years. After the children's EP for the year, the intervention group had a reduction of 91% in the intermediate/high FCR group compared with a 13% reduction in the control group, p = 0.002). In the same way, analyzing the FCR of all parents, there was a reduction of the average risk in the intervention group (3.6% to 2.8% respectively, p < 0.001) compared with the control group (4.4% to 4.4%, p = 0.98). CONCLUSION: An educational program in cardiovascular prevention directed at school-age children can reduce the FCR risk of their parents, especially in the intermediate/high risk categories.

Misuse of antithrombotic therapy in atrial fibrillation patients: frequent, pervasive and persistent.

PURPOSE: To assess the use of antithrombotic therapy among atrial fibrillation (AF) patients in a Brazilian University Heart Hospital (InCor). METHODS AND RESULTS: In a cross-sectional study we analyzed the charts of all patients treated at InCor in five separate days of 2002 (Phase 1). To assess the impact of admission to a cardiology hospital, a follow-up of the AF patients selected in Phase 1 was carried out after 1 year (Phase 2). The prevalence of AF in the 3,764 assessed charts was 8.0% (301 patients). In Phase 1, antiplatelets were prescribed to 21.2% and anticoagulant therapy (ACT) to 46.5% of AF patients; in Phase 2, to 19.9 and 57.8%, respectively. Thus, 32.2% (Phase 1) and 22.2% (Phase 2) of AF patients were not receiving any antithrombotic drug. Among AF patients with previous ischemic stroke (17.6%), only 49% (Phase 1) and 60.4% (Phase 2) were receiving ACT. As many as 34 and 22.6%, respectively, were not receiving any antithrombotic drug. After follow-up, a new acute embolic event was documented in 5.6% of patients, 17% died. CONCLUSIONS: Anticoagulation is underused in AF patients and neither the fact of being treated by cardiologists in a University Hospital, nor the learning time-window of 1 year seemed to improve the antithrombotic care significantly.