Evaluation of oxidative stress and brain-derived neurotrophic factor levels related to crack-use detoxification.

Crack is a central nervous system stimulant extracted from the Erythroxylum coca plant. It is considered the most potent and addictive form of cocaine, and its euphoric effects are attained within a few seconds after consumption. Alteration of biological markers of oxidative stress and brain-derived neurotrophic factor (BDNF) could be related to the severity of crack withdrawal symptoms in patients undergoing rehabilitation. Thus, the objective of this study was to evaluate if the crack consumption and the drug detoxification process during 14 days in hospitalization regime was able to modify the oxidative status and BDNF levels, in male crack-abstinent patients. The crack detoxification process increased the glutathione (GSH), total thiol content (GST), nitric oxide (NO), and superoxide dismutase (SOD) levels, and reduced the mean BDNF levels. Moreover, a positive correlation was found between the number of hospital admission days and SOD values and between the GST levels and crack-use time after 14 days of detoxification. Furthermore, a negative correlation between the frequency of crack use and NO levels on the first day of hospitalization was also found. In conclusion, the results of this study indicated that crack consumption causes increased oxidative stress in drug users and that the detoxification process during 14 days was sufficient to improve oxidative parameters and antioxidant defenses of the patients, which could positively contribute to rehabilitation process. In addition, we also observed a great variability in the BDNF levels of the patients during the detoxification process, resulting in a reduction in the mean values of this neurotrophin.

Triglycerides Revisited to the Serial.

This review discusses the role of triglycerides (TGs) in the normal cardiovascular system as well as in the development and clinical manifestation of cardiovascular diseases. Regulation of TGs at the enzymatic and genetic level, in addition to their possible relevance as preclinical and clinical biomarkers, is discussed, culminating with a description of available and emerging treatments. Due to the high complexity of the subject and the vast amount of material in the literature, the objective of this review was not to exhaust the subject, but rather to compile the information to facilitate and improve the understanding of those interested in this topic. The main publications on the topic were sought out, especially those from the last 5 years. The data in the literature still give reason to believe that there is room for doubt regarding the use of TG as disease biomarkers; however, there is increasing evidence for the role of hypertriglyceridemia on the atherosclerotic inflammatory process, cardiovascular outcomes, and mortality.

Inhibitory effect of Campomanesia xanthocarpa in platelet aggregation: Comparison and synergism with acetylsalicylic acid.

BACKGROUND AND AIMS: Cardiovascular diseases of thrombotic origin are related to high mortality and standard therapeutic agent used in this case is acetylsalicylic acid (ASA), but serious adverse events may occur. However, recent data has suggested the plant Campomanesia xanthocarpa has antiplatelet activity and could be a viable alternative. In this study we investigated the effects of the encapsulated powder of this plant in human platelet aggregation. METHODS: 23 healthy subjects were randomly divided into three groups: (1) ASA (100mg), (2) C. xanthocarpa (1000mg) or (3) synergism (500mg of C. xanthocarpa plush 50mg of ASA); daily for five days. Antiplatelet activity was determined by turbidimetric method using ADP or arachidonic acid (AA) agonists before, 5 and 8days after treatments. RESULTS: Treatment with C. xanthocarpa and synergism caused a reduction of 8±13.5% and 12.5±5% in platelet aggregation induced by ADP after 5days of treatment, respectively, returning to basal levels after 8days. For AA agonist, 5days of treatment with C. xanthocarpa, ASA or synergism caused a reduction of 46±15%, 36±12% and 69.3±6% in platelet aggregation, respectively, and first two groups returned to baseline values 8days after treatment ended. Synergism group prolonged antiplatelet effect maintaining aggregation reduction after 8days the end of treatment. CONCLUSION: C. xanthocarpa showed antiplatelet action when stimulated by agonist AA, and contributed to the antiplatelet effect when associated with ASA for both agonists, allowing dose reduction to 50mg.

Natural Products with Antiplatelet Action.

BACKGROUND: Complex hemostatic mechanisms are involved in the pathophysiology of various diseases, including cardiovascular diseases. Among them, dysregulation of platelet activity is linked to the progression of atherosclerosis and mainly involves platelet aggregation and a decrease in blood flow in the vascular endothelium. The major platelet activation pathways mediated by agonists involve the arachidonic acid pathway, adenosine diphosphate pathway, serotonin pathway, nitric oxide pathway, and action of free radicals on molecules involved in platelet aggregation. These mechanisms have been widely studied and discussed because they are inhibited by the use of medicinal plants in complementary and alternative medicine, thus reducing platelet aggregation. RESULTS: Of the main plants discussed in this review, which have antiplatelet activity, some include saffron, garlic, green tea, St. John's wort, ginger, ginkgo biloba, ginseng, and guavirova. These herbal medicines have phytochemical components, which are directly related to the antiplatelet activity of the plant, such as flavonoids, curcumins, catechins, terpenoids, polyphenols, and saponins. While the majority of the medicinal plants mentioned here were native to the Asian continents, some are distributed worldwide, and found to a smaller extent throughout the American continent, European continent, Mediterranean, African continent, and the Middle East. CONCLUSION: This review showed that several plants and/or compounds exhibit anti-platelet activity, and are therefore potential research targets for developing drugs to treat diseases related to aggregation disorders.

Study of oxidative and inflammatory parameters in LDLr-KO mice treated with a hypercholesterolemic diet: Comparison between the use of Campomanesia xanthocarpa and acetylsalicylic acid.

BACKGROUND: Atherosclerosis is an inflammatory disease that affects the arterial wall leading to myocardial, cerebral, and peripheral ischemic syndromes. The use of low doses of aspirin inhibits platelet aggregation and inflammation and prevents cardiovascular mortality. However, ASA may produce hemorrhagic events. Thus, several studies have sought new natural compounds to suppress platelet aggregation without causing serious adverse effects. PURPOSE: In this sense, this study aims to compare the effects of Campomanesia xanthocarpa plant extract with those of acetylsalicylic acid (ASA) on inflammatory parameters observed in homozygous mice knockout for the low-density lipoprotein receptor (LDLr-KO) treated with a hypercholesterolemic diet. MATERIAL AND METHODS: In this study, 28 male LDLr-KO mice were divided into three groups and fed a hypercholesterolemic diet for 4 weeks. Thereafter, the animals that received the hypercholesterolemic diet were treated for 5 days with (1) distilled water, (2) C. xanthocarpa extract, or (3) acetylsalicylic acid. The levels of inflammatory markers were assessed in the blood samples. The gastric tolerability of the animals after oral administration of the treatments was assessed through quantification of the lesions in the gastric mucosa. RESULTS: The levels of proinflammatory cytokines IL-1, IL-6, TNF-α, and INF-γ were reduced to 19.2 ± 3%, 20.4 + 1.3%, 24.7 ± 1.2%, and 20.8 ± 1.7%, respectively, in the group treated with C. xanthocarpa, when compared to control group. Furthermore, treatment with plant extract significantly increased the levels of the anti-inflammatory cytokine IL-10 by 27.3 ± 5.9%, but ASA showed no significant effect on the same cytokines when compared to the control group, with the exception of IL-10, which presented an increase of 8.6 ± 3.5%. Treatments with C. xanthocarpa and ASA also caused significant reductions of 26.4 ± 3% and 38.4± 6% in the serum levels of oxLDL, respectively. However, only treatment with C. xanthocarpa reduced the levels of anti-oxLDL antibodies when compared with the control (25.8 ± 6%). In addition, the analyzed extract did not induce ulcerogenic activity, while ASA induced the formation of lesions. CONCLUSION: In conclusion, treatment with C. xanthocarpa causes anti-inflammatory activity in hypercholesterolemic animals, with results superior to those obtained with the use of ASA.

Biomarkers of Subclinical Atherosclerosis and Natural Products as Complementary Alternative Medicine.

Cardiovascular diseases (CVD) are considered the leading cause of morbidity and mortality from chronic diseases in the world. In addition, about 20% of first and recurrent acute myocardial infarctions (MI) are silent. In this context, subclinical atherosclerosis culminates in evident CVD, through the evolution of early risk factors such as hypercholesterolemia, hypertriglyceridemia and others. The main problem in CVD is related to the long-time between the start of the subclinical atherosclerosis and the manifestation of the disease. The identification of subjects at risk of such events is obviously substantial, since identification leads to implementation and compliance with effective preventive measures that reduce such risk. In this sense, this review demonstrates biomarkers as an alternative to early detection of subclinical atherosclerosis. One of the proposed biomarkers is the Ischemia-modified albumin (IMA), being considered a promising biochemical biomarker for atherosclerotic conditions. Another marker that is gaining strength and is associated with the IMA are the advanced oxidation protein products (AOPP), its measurement provides information on the level of exposure to potentially harmful changes to proteins and metabolic control. And last but not least we have nitric oxide as an early marker mainly related to endothelial dysfunction. In this review also is evidenced the use of the Campomanesia xanthocarpa, a plant native to southern region from Brazil extensively used as complementary and alternative medicine, and natural products to reduce protein oxidation and improve the availability of nitric oxide and consequently vascular function, reducing the risk for development of CVD.

Association between hypertriglyceridemia and protein oxidation and proinflammatory markers in normocholesterolemic and hypercholesterolemic individuals.

BACKGROUND: Although hypercholesterolemia is a well-established risk factor for coronary heart disease, evidence suggests that increased triglyceride (TG) concentrations are also an independent risk factor. TG concentrations >150mg/dl are observed nearly twice as often in subjects with atherosclerosis. We assessed the association between hypertriglyceridemia and protein oxidation and proinflammatory markers in normocholesterolemic and hypercholesterolemic individuals. METHODS: We included 127 volunteers enrolled in Cruz Alta, RS, Brazil. The patients were stratified based on total cholesterol and TG concentrations for analysis of associations with inflammation (high-sensitivity C-reactive protein - hs-CRP), endothelial dysfunction (nitric oxide - NOx) and oxidative stress (advanced oxidation protein products - AOPPs; ischemia-modified albumin - IMA). Correlations between variables were determined and multiple regression analysis was employed to investigate whether some variables correlate with TG concentrations. RESULTS: Hypertriglyceridemia was related to oxidative stress and proinflammatory markers in individuals independent of total cholesterol concentrations. Moreover, the results indicate a stronger association of tested biomarkers with TG concentrations than with total cholesterol. The results indicate a positive correlation between oxidative stress and TG concentrations in the sera of hypercholesterolemia subjects. AOPPs and IMA concentrations were associated with the presence of hypertriglyceridemia in a manner that was independent of age, gender, hypertension and diabetes mellitus disease, smoking habits, sedentary lifestyle, BMI, waist circumference, LDL, HDL and total cholesterol concentrations. CONCLUSIONS: We speculate that TG concentrations can reflect the enhancement of protein oxidation and proinflammation.

Hospitalization due to conditions sensitive to primary care and expansion of the Family Health Program in Brazil: an ecological study / Internações por condições sensíveis à atenção primária e ampliação da Saúde da Família no Brasil: um estudo ecológico

OBJECTIVE: To evaluate the relationship between hospitalization due to conditions that are sensitive to primary care and the population coverage by the Family Health Strategy (ESF) Units of the Brazilian Federation Units in the last decade. METHODS: This is an ecological study that investigated preventable hospitalizations and coverage of primary health care in Brazil in the historic series from 1998 to 2006. Statistical analysis was performed using the Pearson correlation test and simple linear regression. RESULTS: In the studied period, we found an association between population coverage and reduced ESF admissions for primary care sensitive conditions in Brazil (β = -28.78, p ≤ 0.01), which occurred in 38.4% of the Federation Units. CONCLUSION: There was a positive relationship between the expansion of ESF coverage and a decline in hospitalizations for ACSC in the country. The findings of this study help to evaluate the ESF and primary care in Brazil. .

OBJETIVO: Avaliar a relação entre as internações por condições sensíveis à atenção primária e a cobertura populacional de Estratégias de Saúde da Família nas Unidades da Federação brasileira na última década. MÉTODOS: Este é um estudo ecológico que investigou as hospitalizações evitáveis e a cobertura da atenção básica no Brasil na série histórica de 1998 a 2006. A análise estatística foi realizada utilizando-se o teste de Correlação de Pearson e regressão linear simples. RESULTADOS: No período estudado, evidenciou-se associação entre cobertura populacional de ESF e redução das internações por condições sensíveis à atenção primária no Brasil (β = -28,78; p ≤ 0,01), que ocorreu em 38,4% das Unidades da Federação. CONCLUSÃO: Houve relação entre a ampliação da cobertura de ESF e a diminuição nas internações por CSAP no País. Os achados deste estudo auxiliam na avaliação da ESF e da atenção básica no Brasil. .

Hospitalization due to conditions sensitive to primary care and expansion of the Family Health Program in Brazil: an ecological study.

OBJECTIVE: To evaluate the relationship between hospitalization due to conditions that are sensitive to primary care and the population coverage by the Family Health Strategy (ESF) Units of the Brazilian Federation Units in the last decade. METHODS: This is an ecological study that investigated preventable hospitalizations and coverage of primary health care in Brazil in the historic series from 1998 to 2006. Statistical analysis was performed using the Pearson correlation test and simple linear regression. RESULTS: In the studied period, we found an association between population coverage and reduced ESF admissions for primary care sensitive conditions in Brazil (ß = -28.78, p ≤ 0.01), which occurred in 38.4% of the Federation Units. CONCLUSION: There was a positive relationship between the expansion of ESF coverage and a decline in hospitalizations for ACSC in the country. The findings of this study help to evaluate the ESF and primary care in Brazil.

Effects of Campomanesia xanthocarpa on inflammatory processes, oxidative stress, endothelial dysfunction and lipid biomarkers in hypercholesterolemic individuals.

In Brazil, the edible plant Campomanesia xanthocarpa Berg. (Myrtaceae), popularly known as "guavirova," has been studied in hypercholesterolemic individuals. The present work investigated the effects of C. xanthocarpa on inflammatory processes, oxidative stress, endothelial dysfunction and lipid biomarkers in hypercholesterolemic individuals. A total of 156 individuals were selected in a double-blind fashion and randomly divided into two groups in accordance with the intervals used in the criteria for hypercholesterolemia: individuals with total cholesterol (TC) levels between 200 and 240 mg/dL (undesirable level individuals - UL) and individuals with TC levels >240 mg/dL (hypercholesterolemic individuals - HL). Both groups had a control group (CG), which received placebo treatment, an encapsulated excipient group (lactose) and an experimental group that received 500 mg (EG 500), 750 mg (EG 750) or 1000 mg (EG 1000) of encapsulated C. xanthocarpa. The inflammatory processes (high-sensitivity C-reactive protein - hs-CRP), oxidative stress (advanced oxidation protein products-AOPPs; ischemia-modified albumin-IMA), endothelial dysfunction (nitric oxide - NOx) and biochemical (TC, triglycerides, high-density lipoprotein - HDL, low-density lipoproteins - LDL, and very low-density lipoprotein - VLDL) parameters were measured before and 90 days after the initiation of treatment. A significant decrease in TC and LDL levels was observed in HL individuals from the EG 500 group (reduction of 29 ± 3% and 41 ± 5% to levels before treatment) compared to the CG group individuals. A significant reduction in oxidative stress and inflammatory process components (reduction of 52 ± 11% in AOPPs, 32 ± 10% in IMA and 57 ± 7% in hs-CRP) and a significant increase in NOx (increase of 84 ± 27%) was observed in HL individuals in the EG 1000 group when compared to the CG group individuals. Treatment with encapsulated C. xanthocarpa reduced blood TC and LDL levels in hypercholesterolemic individuals. In addition to its effect on cholesterol levels, this plant reduced oxidative stress in hypercholesterolemic individuals and improved the levels of NOx.

Mortalidade infantil e Saúde da Família nas unidades da Federação brasileira, 1998-2008 / Infant mortality and Family Health units in the Brazilian Federation, 1998-2008

Objetivo: Analisar a relação entre mortalidade infantil e cobertura populacional da Saúde da Família nas unidades da Federação brasileira. Métodos: Estudo ecológico cuja unidade de análise foi composta pelos 26 Estados brasileiros, na série histórica de 1998 a 2008. Foram descritos o percentual de cobertura populacional da Estratégia Saúde da Família (ESF) e a taxa de mortalidade infantil e construídas curvas de regressão linear das variáveis estudadas. A associação estatística foi realizada por meio do teste de correlação de Pearson e da regressão linear simples. Resultados: Houve aumento de 857% nas equipes da ESF, ampliação de 43% na cobertura populacional e diminuição da mortalidade infantil em 58% no Brasil. A expansão da cobertura da ESF esteve associada à redução das taxas de mortalidade infantil em 73% dos Estados brasileiros (p<0,05). Conclusão: Os achados permitem explorar uma possível associação entre o aumento da cobertura populacional da ESF e a redução das taxas de mortalidade infantil no Brasil. .

Objective: To analyze the relationship between infant mortality and population coverage of the Family Health units of the Brazilian Federation. Methods: An ecological study the unit of analysis was composed by 26 Brazilian States, in the historical series from 1998 to 2008. The percentage of population coverage Family Health Strategy (FHS) were described, the rate of infant and built linear regression analysis of the variables studied mortality. The statistical association was performed using the Pearson correlation test and linear regression. Results: There was an increase of 857% in FHS teams, expansion of 43% in population coverage and reduce infant mortality by 58% in Brazil. The expansion in coverage FHS was associated with reduced rates of infant mortality in 73% of Brazilian States (p<0.05). Conclusion: The findings explore a possible association between the increase in population coverage FHS with the reduction of infant mortality rates in Brazil. .

[Mortality due to circulatory disorders and the evolution of family health in Brazil: an ecological study]. / Mortalidade por doenças circulatórias e evolução da saúde da família no Brasil: um estudo ecológico.

The scope of this study was to analyze deaths due to circulatory disorders in parallel with the evolution of the Family Health Strategy (FHS) in Brazil. It is an ecological and retrospective study based on the temporal evolution of the FHS and mortality rates due to circulatory disorders in Brazil. A description of the inhabitant x FHS coverage ratio and health indicators related to mortality due to circulatory disorders was carried out. Spearman's rank correlation coefficient test was used for the statistical association. There was a population increase of 15% in Brazil, evolution of 761% in the number of FHS units and 5% increase in mortality due to circulatory disorders. The population x FHS ratio rose from 52,838 (1998) to 7,084 (2006) people assisted by FHS units. North and northeast regions showed growth in mortality rates due to circulatory disorders and in 21 states (81%) there was a positive correlation between this mortality and FHS units (r: > 0.7; p < 0.01). Finally, the FHS is regarded as an important public health policy, which has achieved successful results in Brazil since its implementation. However, in general terms, its expansion has not influenced the reduction of mortality due to circulatory disorders, which is an indicator that has increased in the country.

Mortalidade por doenças circulatórias e evolução da saúde da família no Brasil: um estudo ecológico / Mortality due to circulatory disorders and the evolution of family health in Brazil: an ecological study

O objetivo deste estudo foi analisar a mortalidade por doenças circulatórias paralelamente à evolução da Estratégia Saúde da Família no Brasil. Estudo ecológico, retrospectivo, baseado na evolução temporal da ESF e nas taxas de mortalidade por doenças circulatórias no Brasil. Foi realizada uma descrição da razão de cobertura habitante x ESF e dos indicadores de saúde relacionados à mortalidade por doenças circulatórias. Para a associação estatística utilizou-se o teste de Correlação de Spearman. Houve aumento populacional no Brasil em 15%, evolução de 761% no número de ESF e 5% de aumento na mortalidade por doenças circulatórias. A razão população x ESF passou de 52.838 (1998) para 7.084 (2006) pessoas assistidas por ESF. As regiões norte e nordeste apresentaram crescimento nas taxas de mortalidade por doenças circulatórias e em 21 (81%) estados houve correlação positiva entre mortalidade por doenças circulatórias e ESF (r: > 0,7; p < 0,01). Por fim, considera-se a ESF uma importante política pública de saúde, tendo obtido resultados exitosos no Brasil desde a sua implementação. Entretanto, em um contexto geral, sua expansão não influenciou a redução da mortalidade por doenças circulatórias, tendo apresentado aumento deste indicador no país.

The scope of this study was to analyze deaths due to circulatory disorders in parallel with the evolution of the Family Health Strategy (FHS) in Brazil. It is an ecological and retrospective study based on the temporal evolution of the FHS and mortality rates due to circulatory disorders in Brazil. A description of the inhabitant x FHS coverage ratio and health indicators related to mortality due to circulatory disorders was carried out. Spearman's rank correlation coefficient test was used for the statistical association. There was a population increase of 15% in Brazil, evolution of 761% in the number of FHS units and 5% increase in mortality due to circulatory disorders. The population x FHS ratio rose from 52,838 (1998) to 7,084 (2006) people assisted by FHS units. North and northeast regions showed growth in mortality rates due to circulatory disorders and in 21 states (81%) there was a positive correlation between this mortality and FHS units (r: > 0.7; p < 0.01). Finally, the FHS is regarded as an important public health policy, which has achieved successful results in Brazil since its implementation. However, in general terms, its expansion has not influenced the reduction of mortality due to circulatory disorders, which is an indicator that has increased in the country.

Percepções de um grupo de idosos sobre os fatores de risco cardiovascular / Perceptions of the elderly about cardiovascular risk factors

Estudo exploratório, qualitativo, cujo objetivo foi conhecer as percepções de um grupo de idosos sobre fatores de risco cardiovasculares. Participaram 100 idosos de ambos os sexos, da cidade de Cruz Alta – RS, em 2009. Os dados foram coletados por meio de entrevista semiestruturada. A partir da análise temática foram construídas três categorias: Desconhecimento de doenças (diabetes mellitus e hipertensão) como fatores de riscos cardiovasculares; Segurança na terapia medicamentosa para diminuir os fatores de risco; Hábitos alimentares e estilos de vida saudáveis. Com base nos resultados, sugere-se priorizar o desenvolvimento de um processo de educação em saúde multidisciplinar direcionado às especificidades dos idosos com intuito de reduzir os fatores de risco cardiovasculares e qualificar o viver destes idosos.

Aptidão cardiorrespiratória de uma amostra regional brasileira distribuída em diferentes tabelas / Cardiorespiratory fitness of a Brazilian regional sample distributed in different tables

FUNDAMENTO: A maioria das tabelas de classificação da Aptidão Cardiorrespiratória (ACR) utilizadas na prática clínica é internacional e não foi validada para a população brasileira, podendo resultar em discrepâncias importantes, uma vez que essa classificação é extrapolada para a nossa população. Objetivo: Avaliar as principais tabelas de ACR disponíveis em uma amostra populacional brasileira do Planalto Médio do Rio Grande do Sul (RS). MÉTODOS: Foram analisados dados retrospectivos de 2.930 indivíduos, residentes em 36 cidades do Planalto Central do RS. Levaram-se em consideração presença dos fatores de risco para doença cardiovascular e valores estimados do consumo de oxigênio de pico (VO2pico), obtidos por meio de teste de esforço com protocolo de Bruce. Para classificar a ACR, os sujeitos foram distribuídos de acordo com o sexo e inseridos nas respectivas faixas etárias das tabelas de Cooper, American Heart Association (AHA) e da Universidade Federal de São Paulo (Unifesp), e classificados conforme seu VO2pico. RESULTADOS: A amostra feminina apresentou valores mais baixos de VO2pico do que a masculina (23,5 ± 8,5 vs. 31,7 ± 10,8 mL.kg-1.min-1, p < 0,001), e o VO2pico apresentou correlação inversa e moderada com a idade considerando-se ambos os sexos (R = -0,48, p < 0,001). Foi observada importante discrepância entre os níveis de classificação da ACR entre as tabelas, que variaram de 49% (COOPERxAHA) até 75% (UNIFESPxAHA). CONCLUSÃO: Nossos achados indicam discrepâncias importantes na classificação da ACR proveniente das tabelas avaliadas. Estudos futuros poderiam investigar se a utilização das tabelas internacionais são aplicáveis à população brasileira e às populações de diferentes regiões do Brasil.

BACKGROUND: Most classification tables of cardiorespiratory fitness (CRF) used in clinical practice are international and have not been validated for the Brazilian population. That can result in important discrepancies when that classification is extrapolated to our population. OBJECTIVE: To assess the use of major CRF tables available in a Brazilian population sample of the Central High Plan of the state of Rio Grande do Sul (RS). METHODS: This study assessed the retrospective data of 2,930 individuals, living in 36 cities of the Central High Plan of the state of RS, and considered the following: presence of risk factors for cardiovascular disease and estimated maximum oxygen consumption (VO2peak) values obtained through exercise test with Bruce protocol. To classify CRF, the individuals were distributed according to sex, inserted in their respective age groups in the Cooper, American Heart Association (AHA) and Universidade Federal de São Paulo (Unifesp) tables, and classified according to their VO2peak. RESULTS: Women had lower VO2peak values as compared with those of men (23.5 ± 8.5 vs. 31.7 ± 10.8 mL.kg-1.min-1, p < 0.001). Considering both sexes, VO2peak showed an inverse and moderate correlation with age (R = -0.48, p < 0.001). An important discrepancy in the CRF classification levels was observed between the tables, ranging from 49% (Cooper x AHA) to 75% (Unifesp x AHA). CONCLUSION: Our findings indicate important discrepancy in the CRF classification levels of the tables assessed. Future studies could assess whether international tables could be used for the Brazilian population and populations of different regions of Brazil.

Cardiorespiratory fitness of a Brazilian regional sample distributed in different tables.

BACKGROUND: Most classification tables of cardiorespiratory fitness (CRF) used in clinical practice are international and have not been validated for the Brazilian population. That can result in important discrepancies when that classification is extrapolated to our population. OBJECTIVE: To assess the use of major CRF tables available in a Brazilian population sample of the Central High Plan of the state of Rio Grande do Sul (RS). METHODS: This study assessed the retrospective data of 2,930 individuals, living in 36 cities of the Central High Plan of the state of RS, and considered the following: presence of risk factors for cardiovascular disease and estimated maximum oxygen consumption (VO2peak) values obtained through exercise test with Bruce protocol. To classify CRF, the individuals were distributed according to sex, inserted in their respective age groups in the Cooper, American Heart Association (AHA) and Universidade Federal de São Paulo (Unifesp) tables, and classified according to their VO2peak. RESULTS: Women had lower VO2peak values as compared with those of men (23.5 ± 8.5 vs. 31.7 ± 10.8 mL.kg-1.min-1, p < 0.001). Considering both sexes, VO2peak showed an inverse and moderate correlation with age (R = -0.48, p < 0.001). An important discrepancy in the CRF classification levels was observed between the tables, ranging from 49% (Cooper x AHA) to 75% (Unifesp x AHA). CONCLUSION: Our findings indicate important discrepancy in the CRF classification levels of the tables assessed. Future studies could assess whether international tables could be used for the Brazilian population and populations of different regions of Brazil.

Avaliação do conhecimento e da presença de fatores de risco cardiovascular em idosos de município do sul do Brasil / Evaluation of knowledge and presence of cardiovascular risk factors among elderly patients in a town in Southern Brazil

Fundamentos: Estudos indicam que os fatores de risco cardiovascular (FR) são conhecidos e prevalentes em idosos. Objetivos: Avaliar o conhecimento e a presença de FR em idoso. Métodos: Em amostra de 313 idosos (55,6 por cento mulheres, 69,8 por cento + ou - 6,6 anos), avaliou-se o conhecimento dos FR, utilizando-se um questionário estruturado, seguindo-se a avaliação dos FR, hipertensão arterial sistêmica (HAS), dados antropométricos e laboratoriais. Resultados: Os idosos conheceram o seguinte FR: HAS em 95,2 por cento; hipercolesterolemia (HCT) em 95,5 por cento; DM em 97,7 por cento; hipertrigliceridemia (HTG) em 91,7 por cento; consumo de álcool e 97,4 por cento; e tabagismo em 99,7 por cento. A presença de FR encontrada nos idosos foi: HAS em 56,9 por cento, HCT em 29,2 por cento, DM em 11,5 por cento, HTG em 16,6 por cento, tabagismo em 11,5 por cento, sedentarismo em 63,6 por cento, e estresse em 49,8 por cento. Conclusões: A maioria dos idosos mostrou conhecer os malefícios dos FR para a saúde, no entanto, muitos indivíduos não sabiam se eram portadores dos principais FR.

Background: Studies indicate that cardiovascular risk factors (CRF) are known and prevalent among the elderly. Objective: To assess knowledge and presence of cardiovascular risk factors among the elderly. Methods: In a sample of 313 elderly people (55.6% women, 69.8 ± 6.6 years), we examined the knowledge of cardiovascular risk factors through a structured questionnaire, followed by an assessment of these riskfactors, including hypertension (HBP), anthropometric data and laboratory data.Results: The percentages of elderly people who knew about CRF were : hypertension 95.2 %, hypercholesterolemia (HCT) 95.5%, DM 97.7%, hypertriglyceridemia (HTG) 91.7%, alcohol consumption 97.4% and smoking 99.7%. The presence of cardiovascular risk factors among them was: hypertension 56.9%, HCT 29.2%, DM 11.5%, HTG 16.6%, smoking 11.5%, sedentary lifestyles 63.6%, and stress 49.8%. Conclusions: Although most elderly people were aware of RF threatening their health, many of them did not know if they were carriers of the main RF.

Redução dos níveis pressóricos em indivíduos hiper-reativos após treinamento físico aeróbio / Blood pressure reduction in hyper-reactive individuals after aerobic exercise

FUNDAMENTO: Alguns indivíduos normotensos sedentários têm aumento exagerado da pressão arterial (PA) durante a atividade física, comportamento esse chamado hiper-reatividade pressórica (HP). OBJETIVO: Verificar o efeito de um programa de exercício físico (PEF) aeróbio sobre a pressão arterial de indivíduos com hiper-reatividade pressórica. MÉTODOS: Dez homens voluntários com HP, 45 ± 10 anos, chamados grupo experimental (GE), foram submetidos a um PEF em esteira, 3x/semana, durante dois meses, comparados a 14 homens com HP, 48 ± 8 anos, chamados grupo controle (GC), que se mantiveram sedentários. Os indivíduos foram avaliados antes e depois do PEF por teste de esforço para fins comparativos. Foram avaliadas as pressões arteriais sistólica (PAS) e diastólica (PAD) e as frequências cardíacas (FC) inicial, de pico e final de teste. RESULTADOS: Houve importante diminuição da PAS inicial (-5 por cento; p=0,01), da PAD inicial (-4,6 por cento; p=0,01), da PAS de pico (-12,4 por cento; p=0,001), da PAD de pico (-14,7 por cento; p=0,03), e da PAS final (-4,6 por cento; p=0,03) no GE. O GC permaneceu com comportamento hiper-reativo, tendo evoluído com níveis mais exagerados quando comparados pré e pós-estudo (p < 0,04). Na FC, somente a final apresentou aumento de 11,3 bpm após treinamento (p=0,02). O VO2pico do teste aumentou 4,4 ml.kg-1.min-1 no GE (p=0,01) e manteve-se semelhante no GC. CONCLUSÃO: O PEF normalizou o comportamento da hiper-reatividade pressórica em homens sedentários.

BACKGROUND: Some normotensive sedentary individuals have an exaggerated increase in blood pressure (BP) during physical activity, which is a behavior that is called blood pressure hyper-reactivity. OBJECTIVE: To investigate the effect of an aerobic exercise program (AEP) on blood pressure in individuals with blood pressure hyper-reactivity (BPH). METHODS: Ten male volunteers with BPH, aged 45 ± 10 years, referred to as the experimental group (EG), took part in an AEP on a treadmill, 3 times a week for two months. They were compared to 14 men with BPH, aged 48 ± 8 years, referred to as the control group (CG), who remained sedentary. The subjects were evaluated before and after the AEP by stress test for comparison purposes. We evaluated the initial, peak and test-end heart rates (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP). RESULTS: There a significant decrease in the initial SBP (-5 percent; p=0.01), initial DBP (-4.6 percent; p=0.01), peak SBP (-12.4 percent; p=0.001), peak DBP (-14.7 percent; p=0.03), final SBP (-4.6 percent, p=0.03) in the EG. The CG continued with its hyper-reactive behavior, which evolved to more exaggerated levels when the results before and after the study were compared (p<0.04). In the HR, there was an increase only in the final HR, of 11.3 bpm, after training (p=0.02). The test-peak VO2 increased by 4.4 ml.kg-1 .min-1 in the EG (p=0.01) and remained similar in the CG. CONCLUSION: The AEP normalized the behavior of the blood pressure hyper-reactivity in sedentary men. (Arq Bras Cardiol. 2010; [online]. ahead print, PP.0-0).

Blood pressure reduction in hyper-reactive individuals after aerobic exercise.

BACKGROUND: Some normotensive sedentary individuals have an exaggerated increase in blood pressure (BP) during physical activity, which is a behavior that is called blood pressure hyper-reactivity. OBJECTIVE: To investigate the effect of an aerobic exercise program (AEP) on blood pressure in individuals with blood pressure hyper-reactivity (BPH). METHODS: Ten male volunteers with BPH, aged 45 ± 10 years, referred to as the experimental group (EG), took part in an AEP on a treadmill, 3 times a week for two months. They were compared to 14 men with BPH, aged 48 ± 8 years, referred to as the control group (CG), who remained sedentary. The subjects were evaluated before and after the AEP by stress test for comparison purposes. We evaluated the initial, peak and test-end heart rates (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP). RESULTS: There a significant decrease in the initial SBP (-5%; p=0.01), initial DBP (-4.6%; p=0.01), peak SBP (-12.4%; p=0.001), peak DBP (-14.7%; p=0.03), final SBP (-4.6%, p=0.03) in the EG. The CG continued with its hyper-reactive behavior, which evolved to more exaggerated levels when the results before and after the study were compared (p<0.04). In the HR, there was an increase only in the final HR, of 11.3 bpm, after training (p=0.02). The test-peak VO2 increased by 4.4 ml.kg(-1) x min(-1) in the EG (p=0.01) and remained similar in the CG. CONCLUSION: The AEP normalized the behavior of the blood pressure hyper-reactivity in sedentary men.

Ausência de influência da massa corporal na redução da pressão arterial após exercício físico / Lack of influence of body mass on blood pressure reduction after exercising

FUNDAMENTO: A hipertensão arterial (HA) é associada com um grande número de comorbidades, dentre elas, a obesidade. A correlação entre essas duas variáveis tem sido alvo de investigação. OBJETIVO: Analisar a correlação entre a perda de massa corporal e redução pressórica em hipertensos submetidos a programa de exercícios físicos (PEF). MÉTODOS: Cento e onze hipertensos com sobrepeso ou obesidade, divididos aleatoriamente em um grupo experimental (GE), com 57 (58 ± 8,9 anos) que participaram de um PEF de três meses, três vezes por semana, em sessões de exercício aeróbio de 50 por cento a 70 por cento do VO2pico, por 30 a 60 minutos, além de exercícios resistidos; e um grupo controle (GC), com 54 (60 ± 7,7 anos) que não participaram do PEF. No GE, a pressão arterial (PA) foi aferida antes de cada sessão e a mensuração das variáveis antropométricas (VA) no início do programa e após três meses. No GC a PA e as VA foram avaliadas em consultório médico no início e fim do estudo. Os dados foram expressos por média ± desvio padrão (DP), usou-se teste t e correlação de Pearson. Considerou-se significativo p < 0,05. RESULTADOS: No GC não ocorreu diferença significativa nas VA e PA no início e fim do estudo. No GE não ocorreu alteração significativa nas VA, no entanto, a redução pressórica de 12 por cento na PA Sistólica (-17,5 mmHg; p = 0,001) e de 9 por cento na PA Diastólica (-8,1 mmHg; p = 0,01) ao final do estudo. Não houve correlação entre as VA e queda da PA (r = 0,1). CONCLUSÃO: A redução pressórica não se correlacionou com redução das medidas antropométricas após período de exercício físico.

BACKGROUND: Hypertension (H) is associated with a large number of co-morbidities, including obesity. The correlation between two variables has been investigated. OBJECTIVE: To analyze the correlation between the loss of body mass and blood pressure reduction in hypertensive patients undergoing exercising programs (EP). METHODS: One hundred eleven hypertensive patients with overweight or obesity were randomly divided into an experimental group (EG). Out of these, 57 (58 ± 8.9 years old) participated in a three-month EP conducted three times a week in aerobic exercise sessions from 50 percent to 70 percent of VO2 peak for 30 to 60 minutes and resistance exercises; and a control group (CG) with 54 (60 ± 7.7 years old) who did not participate in the EP. In the EG, blood pressure (BP) was measured before each session and the measurement of anthropometric variables (AV) at the beginning of the program and after three months. In the CG the BP and the VA were evaluated in the doctor's office at the beginning and at the end of the study. Data were expressed as mean ± standard deviation (SD). Pearson correlation and t test were used. A value of p < 0.05 was considered significant. RESULTS: In the CG there was no significant difference in AV and BP at the beginning and at the end of the study. In the EG, there was no significant alteration in the AV, however, there was blood pressure reduction of 12 percent in systolic BP (-17.5 mmHg, p = 0.001) and 9 percent in Diastolic BP (-8.1 mmHg, p = 0. 01) at the end of the study. There was no correlation between the AV and decrease in BP (r = 0.1). CONCLUSION: The blood pressure reduction was not correlated with reduction of anthropometric measures after the exercising period.