Is waist-to-height ratio the best predictive indicator of hypertension incidence? A cohort study.

BACKGROUND: The best anthropometric indicator to verify the association between obesity and hypertension (HTN) has not been established. We conducted this study to evaluate and compare the discriminatory power of waist-to-height ratio (WHtR) in relation to body mass index (BMI) and waist circumference (WC) in predicting HTN after 13 years of follow-up. METHODS: This study was an observational prospective cohort study performed in the city of Firminópolis, in Brazilian's midwest. The cohort baseline (phase 1) was initiated in 2002 with the evaluation of a representative sample of the normotensive population (≥ 18 years of age). The incidence of HTN was evaluated as the outcome (phase 2). Sociodemographic, dietary and lifestyle variables were used to adjust proportional hazards models and evaluate risk of HTN according to anthropometric indices. The areas under the receiver operating characteristic (ROC) curves were used to compare the predictive capacity of these indices. The best HTN predictor cut-offs were obtained based on sensitivity and specificity. RESULTS: A total of 471 patients with a mean age of 38.9 ± 12.3 years were included in phase 1. The mean follow-up was 13.2 years, and 207 subjects developed HTN. BMI, WC and WHtR were associated with risk of HTN incidence and had similar power in predicting the disease. However, the associations were only significant for women. The cut-off points with a better HTN predictive capacity were in agreement with current recommendations, except for the WC in men. CONCLUSIONS: The results suggest that both overall obesity (BMI) and central obesity (WC and WHtR) anthropometric indicators can be used in this population to evaluate the risk of developing hypertension.

Predictors of overweight/obesity in a Brazilian cohort after 13 years of follow-up.

BACKGROUND: Obesity is a chronic complex disease with an increasing prevalence around the world. Prospective studies in adult cohorts are needed to provide information about predictors of new-onset overweight/obesity on population-based levels. The aim of this study was to identify factors associated with the risk of an adult individual become overweight/obese after 13 years of follow-up. METHODS: Second phase of an observational population-based prospective cohort study in a small town in the Midwest region of Brazil. A representative sample of the adult population (≥18 years) was assessed in 2002 (phase 1). Anthropometric, sociodemographic, dietary intake and lifestyle data were collected. After 13 years of follow-up (2015), the same variables were re-evaluated (phase 2). New-onset overweight/obesity was the outcome variable. RESULTS: A total of 685 subjects were included with a mean age in phase 1 of 42.7 ± 13.8 years and 56.1 ± 13.8 years in phase 2, the mean follow-up time was 13.2 years and female sex counted for 66.3% of the sample. Total weight gain was 5.9 ± 10.2 Kg, body mass index increased 2.6 ± 3.8 Kg/m2 and waist circumference (WC) values increased 8.0 ± 10.5 cm. The prevalence of overweight/obesity went from 49.1% in phase 1 to 69.8% in phase 2 (p < 0.001). The factors associated with a decreased risk of new-onset overweight/obesity were ages between 50 and 64 (RR 0.40; CI 0.24-0.67 - p = 0.001) and ≥65 years (RR 0.15; CI 0.06-0.35 - p < 0.001), being part of the second quartile of fat consumption (RR 0.59; CI 0.35-0.97 - p = 0.041), no alcohol consumption (RR 0.59; CI 0.37-0.93 - p = 0.024) and smoking (RR 0.58; CI 0.39-0.86 - p = 0,007) in phase 1. CONCLUSIONS: We identified in thirteen years of follow-up that older ages, a moderate fat consumption compared to low consumption, no alcohol consumption and smoking habit were related to a decreased risk of new-onset overweight/obesity. Obesity prevention actions must focus on subjects at younger ages and include policies to reduce alcohol consumption.

Tratado Dante Pazzanese de emergências cardiovasculares / Treaty Dante Pazzanese of cardiovascular emergencies

O Tratado Dante Pazzanese de Emergências Cardiovasculares tem como núcleo didático a vastíssima experiência clínica e a casuística do corpo do conceituado Hospital Dante Pazzanese. Como vem diz o seu título, o livro movimenta o seu ensino, prática e procedimento no ambiente do pronto-socorro. É aí que chega o paciente com acometimento cardiovascular agudo, onde com muita frequência são tênues os limites entre a sua estabilização e a evolução para óbito. A equipe do pronto-socorro trabalha contra o relógio. Quanto mais rápidos o diagnóstico e o tratamento, melhor o prognóstico, pois com isso evita-se a cascata de eventos mórbidos que se seguem. A todo momento, o emergencista é chamado a tomar decisões críticas em face da apresentação das mais variadas condições clínicas que lhe chegam. O trabalho é de fôlego e determinação. O manuseio da doença cardiovascular aguda exige a tomada de medidas iniciais de estabilização, a seleção criteriosa dos recursos terapêuticos e o domínio total dos procedimentos emergenciais e meios terapêuticos eficientes para a resolução do acontecimento. Esse é, pois, o objetivo do presente trabalho, que mediante sua leitura, agregada à prática da clínica cardiovascular, capacitará o socorrista e o emergencista a alinharem a sua conduta ao atendimento seguro e eficiente do paciente cardiovascular agudo. O Tratado Dante Pazzanese de Emergências Cardiovasculares apresenta 3 Editores, 58 Capítulos, 145 Colaboradores, num total de 1072 páginas. É livro, pois, destinado a Cardiologistas, Emergencistas, Socorristas, Intensivistas, Clínicos, Residentes em Cardiologia, Emergência Medica, Medicina Intensiva e Clínica Médica.

Atividade nervosa simpática em pacientes com síndromes isquêmicas miocárdicas instáveis: estudo comparativo com marcadores inflamatórios / Sympathetic nervous activity in patients with acute coronary syndromes: a comparative study with inflammatory biomarkers

Em pacientes com síndromes isquêmicas miocárdicas instáveis (SIMI), tanto a hiperatividade simpática quanto a resposta inflamatória exacerbada se associam a pior prognóstico. No entanto, ainda é desconhecido se existe alguma correlação entre esses dois marcadores de evolução desfavorável. OBJETIVOS: Correlacionar a atividade nervosa simpática muscular com marcadores inflamatórios nas fases precoce e tardia de pacientes portadores de SIMI. MÉTODOS: Pacientes hospitalizados com diagnóstico de SIMI e evolução favorável foram incluídos de forma prospectiva desde que apresentassem idade entre 18 e 65 anos e aterosclerose coronária comprovada por cinecoronariografia. Logo após a inclusão no estudo foram coletadas informações basais, e no quarto dia (± 1 dia) de internação os pacientes foram submetidos à avaliação da ANSM e coleta concomitante de amostra sanguínea para dosagem de proteína CReativa ultrassensível (PCR-us), interleucina-6 (IL6), e fosfolipase A2 associada à lipoproteína (Lp-PLA2). ANSM foi obtida pela técnica de microneurografia do nervo fibular. As medidas e respectivas análises de correlação foram repetidas em 1, 3 e 6 meses após a hospitalização. Correlações entre ANSM e marcadores inflamatórios foram analisadas por meio do teste de Pearson (variáveis de distribuição não-paramétrica foram transformadas logaritmicamente). Modelos de regressão linear múltipla foram criados para avaliar os efeitos independentes. RESULTADOS: Foram estudados 34 pacientes com idade média de 51,7±7,0 anos, sendo 79,4% do sexo masculino. A prevalência de hipertensão arterial foi de 64,7%, diabetes mellitus 8,8%, e doença arterial coronária prévia de 20,6%. A apresentação foi IAM com supradesnível de ST em 18 pacientes (52,9%), IAM sem supra de ST em 14 (41,2%) e angina instável em 02 pacientes (5,9%). Tanto ANSM quanto biomarcadores inflamatórios estavam elevados durante a fase aguda das SIMI e diminuíram ao longo do tempo. Na fase hospitalar, a mediana da PCR...

Previous publications have shown that both sympathetic hyperactivity and enhanced inflammatory response are associated with worse outcomes during acute coronary syndromes (ACS). However, little is known about the correlation between these two pathologic pathways. OBJECTIVE: To correlate muscle sympathetic nerve activity with inflammatory biomarkers in both acute and chronic phase of ACS. METHODS: Patients hospitalized with uncomplicated ACS were enrolled if they were 18-65 years old and have significant atherosclerosis. Baseline characteristics information were collected and at fourth day (± 1 day) of hospitalization they were submitted to muscle sympathetic nerve activity (MSNA) analysis and blood sample were collected for ultrasensitive C-reactive protein (usCRP), interleukin-6 (IL-6) and Lipoprotein-associated phospholipase A2 activity (Lp-PLA2) measurements. MSNA was recorded directly from the peroneal nerve using the microneurography technique. Measurements were repeated at 1, 3 and 6 months after hospitalization. Correlations between MSNA and inflammatory markers and baseline characteristics were made using Pearson's test (nonnormally distributed variables were logarithmically transformed) and multivariate regression models were performed to assess the independent effects. RESULTS: Thirty-four patients were included, 79.4% male, mean age 51.7 (SD 7.0 years). The prevalence of hypertension was 64.7%, diabetes mellitus 8.8%, and previous coronary heart disease 20.6%. The ACS presentation was STEMI in 18 patients (52.9%), NSTEMI in 14 (41.2%) and UA in 02 patients (5.9%). Both MSNA and inflammatory markers were elevated during acute phase of ACS and decreased over time. In the hospitalization phase the median usCRP was 17.75 (8.57; 40.15) mg/L, median IL-6 6.65 (4.45; 8.20), mean Lp-PLA2 185.8 ± 52.2 nmol/min/mL, and mean MSNA 64.2 ± 19.3 bursts/100heart beats. All of these variables decreased significantly over 6 months when...

Influência da hereditariedade em marcadores de risco para hipertensão arterial / Association of heredity in risk markers for hypertension

Fundamento: Fatores genéticos e ambientais são importantes na determinação da pressão arterial (PA). Alterações na PA, na resistência à insulina (RI) e ecocardiograma, têm sido estudadas em descendentes de hipertensos com resultados contraditórios. Objetivos: Estudar PA, RI, teste ergométrico (TE), morfologia e função cardíaca em jovens normotensos com e sem história familiar de hipertensão arterial (HA). Métodos: Estudo observacional. Jovens de 18 a 30 anos, divididos em 3 grupos: sem história familiar de hipertensão; um dos pais hipertensos; ambos os pais hipertensos. Excluídos hipertensos, obesos, tabagistas, em uso de medicação e com comorbidade. Feita avaliação antropométrica, PA casual, Monitorização Ambulatorial da Pressão Arterial (MAPA), TE, Ecocardiograma, Índice de HOMA. Diferença entre os grupos ­ ANOVA e teste t, comparação dos grupos ­ teste t de Student. Correlação de Pearson para relações entre as variáveis e correlação parcial, controlada para sexo, entre a hereditariedade e as outras variáveis. Significante p<0,05. Resultados: Estudados 63 indivíduos. G1 (n=21), G2 (n=22) e G3 (n=20). Idade média 21,1±2,2 anos, 39,1% homens. Sem diferenças na idade, peso, altura, IMC, PA casual e MAPA. O G3 apresentou tendência a menor descenso noturno da PA sistólica (PAS) (p=0,052), maiores níveis de insulina (p=0,019), maior HOMA (p=0,006) e maior diâmetro de átrio esquerdo (DAE) (p=0,020). Relação positiva entre DAE e PAS (p=0,005), insulina sérica (p=0,003) e HOMA (p=0,003). Conclusões: Descendentes de hipertensos apresentam maior RI, alterações no ritmo circadiano da PA e maior DAE, mesmo com valores normais de PA

Background: Genetic and environmental factors are equally important in determining blood pressure (BP). Changes in BP, insulin resistance (IR) and echocardiograms have been studied in offspring of hypertensive parents with contradictory results. Objective: Studying IR, BP, exercise test, cardiac morphology and function with echocardiogram, in normotensive young, with and without family history (FH) of hypertension (HTN). Methods: Students, 18 to 30 years, were included. They were divided into 3 groups: neither parent with HTN ­ G1, one of parents with HTN ­ G2 and both parents with HTN ­ G3. Exclusion criteria­ HTN, obesity, smoking, using medication and comorbidities. The study evaluated weight, height, Body Mass Index (BMI), office BP, Ambulatory Blood Pressure Measurement (ABPM), exercise test, glycemia, insulin, HOMA-IR and Echocardiogram. ANOVA test was used to compare groups. Partial correlation adjusted for sex was used to evaluate associations. Results: Sixty-three individuals were studied. They were divided into 3 groups: G1 (n=21), G2 (n=22) and G3 (n=20). Mean age was 21.1±2.2 years, 39.1% were males. There was no difference regarding age, weight, height, BMI, office BP and ABPM. Group 3 had the lowest dipping of systolic BP (SBP) (p=0.052), the highest insulin levels (p=0.019), HOMA (0.006) and left atrium diameter (LAD) (p=0.020). We found a positive correlation between LAD with SBP (p=0.005), serum insulin (p=0.003) and HOMA (p=0.003). Conclusion: Results indicate that young offspring of hypertensive parents had more IR, changes in the BP circadian rhythm and have a bigger LAD, even with normal BP values

O escore de risco de sangramento como preditor de mortalidade em pacientes com síndromes coronarianas agudas / The bleeding risk score as a mortality predictor in patients with acute coronary syndrome

FUNDAMENTO: A ocorrência de sangramento aumenta a mortalidade intra-hospitalar em pacientes com síndromes coronarianas agudas (SCAs), e há uma boa correlação entre os escores de risco de sangramento e a incidência de eventos hemorrágicos. No entanto, o papel dos escores de risco de sangramento como fatores preditivos de mortalidade é pouco estudado. OBJETIVO: Analisar o papel do escore de risco de sangramento como fator preditivo de mortalidade intra-hospitalar numa coorte de pacientes com SCA tratados num centro terciário de cardiologia. MÉTODOS: Dos 1.655 pacientes com SCA (547 com SCA com supra de ST e 1.118 com SCA sem supra de ST), calculou-se o escore de risco de sangramento ACUITY/HORIZONS prospectivamente em 249 pacientes e retrospectivamente nos demais 1.416. Informações sobre mortalidade e complicações hemorrágicas também foram obtidas. RESULTADOS: A idade média da população estudada foi 64,3 ± 12,6 anos e o escore de risco de sangramento médio foi 18 ± 7,7. A correlação entre sangramento e mortalidade foi altamente significativa (p < 0,001; OR = 5,29), assim como a correlação entre escore de sangramento e hemorragia intra-hospitalar (p < 0,001; OR = 1,058), e entre escore de sangramento e mortalidade intra-hospitalar (OR ajustado = 1,121, p < 0,001, área sob a curva ROC 0,753; p < 0,001). O OR ajustado e a área sob a curva ROC para a população com SCA com supra de ST foram 1,046 (p = 0,046) e 0,686 ± 0,040 (p < 0,001), respectivamente, e para SCA sem supra de ST foram 1,150 (p < 0,001) e 0,769 ± 0,036 (p < 0,001), respectivamente. CONCLUSÃO: O escore de risco de sangramento é um fator preditivo muito útil e altamente confiável para mortalidade intra-hospitalar em uma grande variedade de pacientes com SCAs, especialmente aqueles com angina instável ou infarto agudo do miocárdio sem supra de ST.

BACKGROUND: It is well known that the occurrence of bleeding increases in-hospital mortality in patients with acute coronary syndromes (ACS), and there is a good correlation between bleeding risk scores and bleeding incidence. However, the role of bleeding risk score as mortality predictor is poorly studied. OBJECTIVE: The main purpose of this paper was to analyze the role of bleeding risk score as in-hospital mortality predictor in a cohort of patients with ACS treated in a single cardiology tertiary center. METHODS: Out of 1655 patients with ACS (547 with ST-elevation ACS and 1118 with non-ST-elevation ACS), we calculated the ACUITY/HORIZONS bleeding score prospectively in 249 patients and retrospectively in the remaining 1416. Mortality information and hemorrhagic complications were also obtained. RESULTS: Among the mean age of 64.3 ± 12.6 years, the mean bleeding score was 18 ± 7.7. The correlation between bleeding and mortality was highly significant (p < 0.001, OR = 5.296), as well as the correlation between bleeding score and in-hospital bleeding (p < 0.001, OR = 1.058), and between bleeding score and in-hospital mortality (adjusted OR = 1.121, p < 0.001, area under the ROC curve 0.753, p < 0.001). The adjusted OR and area under the ROC curve for the population with ST-elevation ACS were, respectively, 1.046 (p = 0.046) and 0.686 ± 0.040 (p < 0.001); for non-ST-elevation ACS the figures were, respectively, 1.150 (p < 0.001) and 0.769 ± 0.036 (p < 0.001). CONCLUSIONS: Bleeding risk score is a very useful and highly reliable predictor of in-hospital mortality in a wide range of patients with acute coronary syndromes, especially in those with unstable angina or non-ST-elevation acute myocardial infarction.

The bleeding risk score as a mortality predictor in patients with acute coronary syndrome.

BACKGROUND: It is well known that the occurrence of bleeding increases in-hospital mortality in patients with acute coronary syndromes (ACS), and there is a good correlation between bleeding risk scores and bleeding incidence. However, the role of bleeding risk score as mortality predictor is poorly studied. OBJECTIVE: The main purpose of this paper was to analyze the role of bleeding risk score as in-hospital mortality predictor in a cohort of patients with ACS treated in a single cardiology tertiary center. METHODS: Out of 1655 patients with ACS (547 with ST-elevation ACS and 1118 with non-ST-elevation ACS), we calculated the ACUITY/HORIZONS bleeding score prospectively in 249 patients and retrospectively in the remaining 1416. Mortality information and hemorrhagic complications were also obtained. RESULTS: Among the mean age of 64.3 ± 12.6 years, the mean bleeding score was 18 ± 7.7. The correlation between bleeding and mortality was highly significant (p < 0.001, OR = 5.296), as well as the correlation between bleeding score and in-hospital bleeding (p < 0.001, OR = 1.058), and between bleeding score and in-hospital mortality (adjusted OR = 1.121, p < 0.001, area under the ROC curve 0.753, p < 0.001). The adjusted OR and area under the ROC curve for the population with ST-elevation ACS were, respectively, 1.046 (p = 0.046) and 0.686 ± 0.040 (p < 0.001); for non-ST-elevation ACS the figures were, respectively, 1.150 (p < 0.001) and 0.769 ± 0.036 (p < 0.001). CONCLUSIONS: Bleeding risk score is a very useful and highly reliable predictor of in-hospital mortality in a wide range of patients with acute coronary syndromes, especially in those with unstable angina or non-ST-elevation acute myocardial infarction.

Síndrome metabólica e câncer de mama: revisão sistemática / Metabolic syndrome and breast cancer: systematic review

JUSTIFICATIVA E OBJETIVOS: As maiores causas de morte no Brasil são as doenças cardiovasculares e as neoplasias. Entre essas, a síndrome metabólica (SM) é atribuída como responsável por cerca de 40% das mortes ocorridas em mulheres acima de 20 anos, e o câncer de mama (CM) é a neoplasia mais comum em mulheres com idade abaixo de 60 anos. Todavia, ainda é desconhecido se existe ou não uma relação etiopatogênica entre ambas. O objetivo deste estudo foi avaliar a interrelação entre SM e CM e suas relações epidemiológicas, etiopatogênicas e clínicas. CONTEÚDO: Revisão sistemática da literatura, através do Pubmed, por artigos com as palavras-chave "câncer de mama" e "síndrome metabólica", sem restrição para data da publicação. Entre 186 artigos avaliados, foram selecionados 56, nos quais a associação entre CM e SM estava adequadamente relatada. Existem evidências consistentes de que o CM e a SM não só compartilham diversos fatores de risco comuns (idade, dislipidemias, obesidade, hipertensão arterial, hiperglicemia, estados inflamatórios sistêmicos), como também o tratamento de uma afecção parece influenciar o prognóstico da outra doença. No entanto, ainda são incertos os mecanismos pelos quais a SM e seus componentes predispõem ao CM, ou se, na vigência desta, o tratamento da SM deva ser diferente daquelas preconizadas atualmente. CONCLUSÃO: Este estudo explicou a clara correlação entre SMe CM. Contudo, ainda são necessários estudos que esclareçam todos os mecanismos fisiopatológicos envolvidos, consequentemente expandindo as possibilidades de tratamentos nestes casos.

BACKGROUND AND OBJECTIVES: The major causes of death in Brazil are cardiovascular disease and cancer. Among these, the metabolic syndrome (MS) is considered responsible for about 40% of deaths in women over 20 years of age, and breast cancer (BC) is the most common cancer in women aged below 60 years. However, whether there is an etiopathogenic relationship between them is still unclear. The objective of this study was to evaluate the association between MS and BC, and their epidemiological, etiopathogenic and clinical relationships. CONTENTS: Systematic review of literature through PubMed articles with the keywords "breast cancer" and "metabolic syndrome", without restriction of date of publication. Among 186 articles assessed, 56 were selected in which the association between BC and MS were properly reported. There is consistent evidence that BC and MS not only share many common risk factors (i.e. age, dyslipidemia, obesity, hypertension, hyperglycemia, systemic inflammation), but also that the treatment of one of these conditions seems to influence the prognosis of the other one. However, the mechanisms by which MS and its components can predispose to BC are still uncertain, as well as, if in the presence of BC, the treatment of SM should be different from current guidelines. CONCLUSION: This study explicit the clear correlation between SM and BC. However, further studies are needed to clarify all the pathophysiological mechanisms involved, thus expanding the possibilities of treatment in these cases.

In patients with acute myocardial infarction, the impact of hyperglycemia as a risk factor for mortality is not homogeneous across age-groups.

OBJECTIVE: To assess the impact of hyperglycemia in different age-groups of patients with acute myocardial infarction (AMI). RESEARCH DESIGN AND METHODS: A total of 2,027 patients with AMI were categorized into one of five age-groups: <50 years (n = 301), ≥50 and <60 (n = 477), ≥60 and <70 (n = 545), ≥70 and <80 (n = 495), and ≥80 years (n = 209). Hyperglycemia was defined as initial glucose ≥115 mg/dL. RESULTS: The adjusted odds ratios for hyperglycemia predicting hospital mortality in groups 1-5 were, respectively, 7.57 (P = 0.004), 3.21 (P = 0.046), 3.50 (P = 0.003), 3.20 (P < 0.001), and 2.16 (P = 0.021). The adjusted P values for correlation between glucose level (as a continuous variable) and mortality were 0.007, <0.001, 0.043, <0.001, and 0.064. The areas under the ROC curves (AUCs) were 0.785, 0.709, 0.657, 0.648, and 0.613. The AUC in group 1 was significantly higher than those in groups 3-5. CONCLUSIONS: The impact of hyperglycemia as a risk factor for hospital mortality in AMI is more pronounced in younger patients.

Hipertensão arterial e sua correlação com alguns fatores de risco em cidade brasileira de pequeno porte / Arterial hypertension and its correlation with some risk factors in a small brazilian town / Hipertensión arterial y su correlación con algunos factores de riesgo en ciudad brasileña de pequeño tamaño

FUNDAMENTO: A hipertensão arterial (HA) é um problema de saúde que atinge um grande número de hipertensos não diagnosticados ou não tratados adequadamente e que possui um alto índice de abandono ao tratamento. OBJETIVO: Estimar a prevalência da HA e sua correlação com alguns fatores de risco cardiovasculares na população adulta de Firminópolis-GO. MÉTODOS: Estudo descritivo, observacional e transversal com base populacional, amostra aleatória simples (> 18 anos): questionários padronizados com medidas de pressão arterial (critério de HA > 140 x 90 mmHg), peso, altura, índice de massa corporal (IMC) e circunferência da cintura (CC). Dados armazenados (Microsoft Acess) e analisados pelo Epi-info. RESULTADOS: Investigados 1.168 indivíduos, com predomínio de mulheres. Sexo feminino - 63,2 por cento com média de idade entre 43,2 ± 14,9 anos. Prevalência de sobrepeso em 33,7 por cento e obesidade em 16,0 por cento dos indivíduos. Prevalência de CC alterada em 51,8 por cento e de tabagismo em 23,2 por cento. Sedentarismo no trabalho e no lazer presente em 67,6 por cento e em 64,8 por cento dos indivíduos, respectivamente, com proporção maior entre as mulheres. Etilismo em 33,3 por cento da amostra. A prevalência de HA foi de 32,7 por cento, em maior número entre os homens (35,8 por cento) do que entre as mulheres (30,9 por cento). Encontrada correlação positiva da HA com IMC, CC e faixa etária. Correlação negativa de HA e escolaridade, com 18,2 por cento de hipertensos com nove anos ou mais de estudo. CONCLUSÃO: Encontrada alta prevalência de HA, excesso de peso e CC. O sexo feminino representou fator de proteção para o risco de HA. Encontradas correlação positiva da HA com IMC, CC, e faixa etária e correlação negativa com escolaridade.

BACKGROUND: Arterial hypertension (AH) is a health problem that affects a large number of undiagnosed or inadequately treated hypertensive individuals and presents a high rate of treatment nonadherence. OBJECTIVE: To estimate the prevalence of AH and its correlation with some cardiovascular risk factors among the adult population of the town of Firminopolis, state of Goiás, Brazil. METHODS: Descriptive, observational and cross-sectional population-based study of a simple random sample (age > 18 years): standardized questionnaires with blood pressure (BP) measurements (AH criterion: BP > 140 x 90 mmHg), weight, height, Body Mass Index (BMI) and waist circumference (WC). Data were stored (Microsoft Access) and analyzed using Epi-info software. RESULTS: We evaluated 1,168 individuals, with a predominance of the female sex - 63.2 percent and a mean age of 43.2 ± 14.9 years. There was a prevalence of overweight in 33.7 percent of the individuals and obesity in 16.0 percent of the individuals. There was a prevalence of altered WC in 51.8 percent demand of smoking in 23.2 percent. A sedentary life style at work and leisure activities was present in 67.6 percent and 64.8 percent of the individuals, respectively, with a higher proportion seen among the women. Alcohol consumption was observed in 33.3 percent of the sample. The prevalence of AH was 32.7 percent, higher among the men (35.8 percent) than among the women (30.9 percent). A positive correlation with AH was identified with BMI, WC and age range. A negative correlation was observed between AH and level of schooling, with 18.2 percent of hypertensive individuals with 9 or more years of schooling. CONCLUSION: A high prevalence of AH, overweight and WC alteration was identified. The female sex represented a protective factor for the risk of AH. A positive correlation was found between AH and BMI, WC and age range; a negative correlation was identified between AH and level of schooling.

FUNDAMENTO: La hipertensión arterial (HA) es un problema de salud que alcanza a un gran número de hipertensos no diagnosticados o no tratados adecuadamente y que posee un alto índice de abandono del tratamiento. OBJETIVO: Estimar la prevalencia de la HA y su correlación con algunos factores de riesgos cardiovasculares en la población adulta de Firminópolis-GO. MÉTODOS: Estudio descriptivo, observacional y transversal con base poblacional, muestra aleatoria simple (>18 años): cuestionarios estandarizados con medidas de presión arterial (criterio de HA > 140 x 90 mmHg), peso, altura, índice de masa corporal (IMC) y circunferencia de la cintura (CC). Datos almacenados (Microsoft Acess) y analizados por el Epi-info. RESULTADOS: Investigados 1.168 individuos, con predominio de mujeres. Sexo femenino (63,2 por ciento) con media de edad entre 43,2 ± 14,9 años. Prevalencia de sobrepeso en 33,7 por ciento y obesidad en 16,0 por ciento de los individuos. Prevalencia de CC alterada en 51,8 por cientoy de tabaquismo en 23,2 por ciento. Sedentarismo en el trabajo y en el ocio presente en 67,6 por ciento y en 64,8 por ciento de los individuos, respectivamente, con proporción mayor entre las mujeres. Etilismo en 33,3 por ciento de la muestra. La prevalencia de HA fue de 32,7 por ciento, en mayor número entre los hombres (35,8 por ciento) que entre las mujeres (30,9 por ciento). Encontrada correlación positiva de la HA con IMC, CC y franja etárea. Correlación negativa de HA y escolaridad, con 18,2 por ciento de hipertensos con nueve años o más de estudio. CONCLUSIÓN: Encontrada alta prevalencia de HA, exceso de peso y CC. El sexo femenino representó factor de protección para el riesgo de HA. Encontradas correlación positiva de la HA con IMC, CC, y franja etárea y correlación negativa con escolaridad.

[Arterial hypertension and its correlation with some risk factors in a small brazilian town]. / Hipertensão arterial e sua correlação com alguns fatores de risco em cidade brasileira de pequeno porte.

BACKGROUND: arterial hypertension (AH) is a health problem that affects a large number of undiagnosed or inadequately treated hypertensive individuals and presents a high rate of treatment nonadherence. OBJECTIVE: to estimate the prevalence of AH and its correlation with some cardiovascular risk factors among the adult population of the town of Firminopolis, state of Goiás, Brazil. METHODS: descriptive, observational and cross-sectional population-based study of a simple random sample (age > 18 years): standardized questionnaires with blood pressure (BP) measurements (AH criterion: BP > 140 x 90 mmHg), weight, height, Body Mass Index (BMI) and waist circumference (WC). Data were stored (Microsoft Access) and analyzed using Epi-info software. RESULTS: we evaluated 1,168 individuals, with a predominance of the female sex - 63.2% and a mean age of 43.2 ± 14.9 years. There was a prevalence of overweight in 33.7% of the individuals and obesity in 16.0% of the individuals. There was a prevalence of altered WC in 51.8% demand of smoking in 23.2%. A sedentary life style at work and leisure activities was present in 67.6% and 64.8% of the individuals, respectively, with a higher proportion seen among the women. Alcohol consumption was observed in 33.3% of the sample. The prevalence of AH was 32.7%, higher among the men (35.8%) than among the women (30.9%). A positive correlation with AH was identified with BMI, WC and age range. A negative correlation was observed between AH and level of schooling, with 18.2% of hypertensive individuals with 9 or more years of schooling. CONCLUSION: a high prevalence of AH, overweight and WC alteration was identified. The female sex represented a protective factor for the risk of AH. A positive correlation was found between AH and BMI, WC and age range; a negative correlation was identified between AH and level of schooling.

[Hypertension and its association to anthropometric indexes in adults from a small city ln Brazil]. / Hipertensão arterial e sua associação com índices antropométricos em adultos de uma cidade de pequeno porte do interior do Brasil.

OBJECTIVE: Estimate the prevalence of Arterial Hypertension (AH) and its association with Body Mass Index (BMI) and Abdominal Circumference (AC) in the adult population from the city of Firminópolis, in the state of Goiás, Brazil. METHODS: Descriptive, observational, cross sectional population-based study substantiated by a home survey of a simple random sample (> or = 18 years old). The study evaluated 1168 individuals. Standardized questionnaires. Measurements performed were Blood Pressure (BP) (hypertension: BP > or = 140 x 90 mmHg), weight, height and AC. Microsoft Office Access and Epi-info, 3.3.2 version were used for data storage and analysis, respectively. RESULTS: There was a predominance of females (63.2%), mean age was 43.2 +/-14.9 years old. Prevalence of hypertension was 32.7%, with tendency to be higher among the male population (35.8%) when compared to the female (30.9%) (p=0.084). Association between AH and BMI was positive (p < 0.001), as well as between AC and age. Prevalence of overweight was 33.7% and obesity, 16.0%. Overweight was higher among the male population and obesity among the female population. Prevalence of increased as well as greatly increased AC in 51.9% of the studied population, with 28.6% among males and 65.5% among females. CONCLUSION: A high prevalence of hypertension and a large number of individuals with BMI and AC above the ideal values were found.