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3.
Artigo em Inglês | MEDLINE | ID: mdl-33523760

RESUMO

Background: Diabetes mellitus (DM) is associated with a higher prevalence of metabolic syndrome (MS) and cardiovascular mortality. However, few Brazilian studies evaluated MS in diabetic individuals with cardiovascular disease (CVD). Nevertheless, the objective of this study was to compare the prevalence of MS in cardiac patients with and without DM. Methods: Cross-sectional study of BALANCE Program Trial with patients with CVD, ≥45 years old, who had been attending specialized ambulatories on cardiovascular health, in eight states in the Northeast of Brazil. The components of MS were evaluated by following the criteria of National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATP III) and Joint Interim Statement (JIS). In addition, there were investigated different indexes of abdominal obesity, variables related to lifestyle, and food intake. The statistical analysis included descriptive statistics and the Student's t-test, Mann-Whitney, and chi-squared tests for the comparison of groups. There were significant values of P < 0.05. Results: Six hundred forty-seven individuals were evaluated with average (standard deviation) age of 63.1 (9.3) years, being 50.5% females and 40.3% diabetic patients. When the groups of patients who were diabetic and the nondiabetic ones, the first showed higher percentage of obesity (38.5% vs. 23.2%, P < 0.001), of high waist circumference (84.8% vs. 71.9%; P < 0.001), higher waist-height ratio [0.6 (0.6-0.7) vs. 0.6 (0.5-0.6); P < 0.001], conicity index [1.35 (1.29-1.39) vs. 1.32 (1.27-1.38); P = 0.004], and prevalence of MS, because of the criteria of NCEP ATP III (98.8% vs. 80.4%; P < 0.001), as well as the criteria of JIS (99.2% vs. 89.3%; P < 0.001). The component of higher frequency was high blood pressure and/or hypertension (95.0%), followed by hypertriglyceridemia (93.0%). There were no differences regarding age, lifestyle, and food intake. Conclusions: Diabetic individuals with CVD showed more prevalence of MS and more abdominal obesity than nondiabetic individuals. ClinicalTrials.gov ID: NCT01620398.

6.
Clinics (Sao Paulo) ; 76: e1991, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33503176

RESUMO

OBJECTIVES: This observational, cross-sectional study based aimed to test whether heart failure (HF)-disease management program (DMP) components are influencing care and clinical decision-making in Brazil. METHODS: The survey respondents were cardiologists recommended by experts in the field and invited to participate in the survey via printed form or email. The survey consisted of 29 questions addressing site demographics, public versus private infrastructure, HF baseline data of patients, clinical management of HF, performance indicators, and perceptions about HF treatment. RESULTS: Data were obtained from 98 centers (58% public and 42% private practice) distributed across Brazil. Public HF-DMPs compared to private HF-DMP were associated with a higher percentage of HF-DMP-dedicated services (79% vs 24%; OR: 12, 95% CI: 94-34), multidisciplinary HF (MHF)-DMP [84% vs 65%; OR: 3; 95% CI: 1-8), HF educational programs (49% vs 18%; OR: 4; 95% CI: 1-2), written instructions before hospital discharge (83% vs 76%; OR: 1; 95% CI: 0-5), rehabilitation (69% vs 39%; OR: 3; 95% CI: 1-9), monitoring (44% vs 29%; OR: 2; 95% CI: 1-5), guideline-directed medical therapy-HF use (94% vs 85%; OR: 3; 95% CI: 0-15), and less B-type natriuretic peptide (BNP) dosage (73% vs 88%; OR: 3; 95% CI: 1-9), and key performance indicators (37% vs 60%; OR: 3; 95% CI: 1-7). In comparison to non- MHF-DMP, MHF-DMP was associated with more educational initiatives (42% vs 6%; OR: 12; 95% CI: 1-97), written instructions (83% vs 68%; OR: 2: 95% CI: 1-7), rehabilitation (69% vs 17%; OR: 11; 95% CI: 3-44), monitoring (47% vs 6%; OR: 14; 95% CI: 2-115), GDMT-HF (92% vs 83%; OR: 3; 95% CI: 0-15). In addition, there were less use of BNP as a biomarker (70% vs 84%; OR: 2; 95% CI: 1-8) and key performance indicators (35% vs 51%; OR: 2; 95% CI: 91,6) in the non-MHF group. Physicians considered changing or introducing new medications mostly when patients were hospitalized or when observing worsening disease and/or symptoms. Adherence to drug treatment and non-drug treatment factors were the greatest medical problems associated with HF treatment. CONCLUSION: HF-DMPs are highly heterogeneous. New strategies for HF care should consider the present study highlights and clinical decision-making processes to improve HF patient care.

7.
Clinics ; 76: e1991, 2021. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1153946

RESUMO

OBJECTIVES: This observational, cross-sectional study based aimed to test whether heart failure (HF)-disease management program (DMP) components are influencing care and clinical decision-making in Brazil. METHODS: The survey respondents were cardiologists recommended by experts in the field and invited to participate in the survey via printed form or email. The survey consisted of 29 questions addressing site demographics, public versus private infrastructure, HF baseline data of patients, clinical management of HF, performance indicators, and perceptions about HF treatment. RESULTS: Data were obtained from 98 centers (58% public and 42% private practice) distributed across Brazil. Public HF-DMPs compared to private HF-DMP were associated with a higher percentage of HF-DMP-dedicated services (79% vs 24%; OR: 12, 95% CI: 94-34), multidisciplinary HF (MHF)-DMP [84% vs 65%; OR: 3; 95% CI: 1-8), HF educational programs (49% vs 18%; OR: 4; 95% CI: 1-2), written instructions before hospital discharge (83% vs 76%; OR: 1; 95% CI: 0-5), rehabilitation (69% vs 39%; OR: 3; 95% CI: 1-9), monitoring (44% vs 29%; OR: 2; 95% CI: 1-5), guideline-directed medical therapy-HF use (94% vs 85%; OR: 3; 95% CI: 0-15), and less B-type natriuretic peptide (BNP) dosage (73% vs 88%; OR: 3; 95% CI: 1-9), and key performance indicators (37% vs 60%; OR: 3; 95% CI: 1-7). In comparison to non- MHF-DMP, MHF-DMP was associated with more educational initiatives (42% vs 6%; OR: 12; 95% CI: 1-97), written instructions (83% vs 68%; OR: 2: 95% CI: 1-7), rehabilitation (69% vs 17%; OR: 11; 95% CI: 3-44), monitoring (47% vs 6%; OR: 14; 95% CI: 2-115), GDMT-HF (92% vs 83%; OR: 3; 95% CI: 0-15). In addition, there were less use of BNP as a biomarker (70% vs 84%; OR: 2; 95% CI: 1-8) and key performance indicators (35% vs 51%; OR: 2; 95% CI: 91,6) in the non-MHF group. Physicians considered changing or introducing new medications mostly when patients were hospitalized or when observing worsening disease and/or symptoms. Adherence to drug treatment and non-drug treatment factors were the greatest medical problems associated with HF treatment. CONCLUSION: HF-DMPs are highly heterogeneous. New strategies for HF care should consider the present study highlights and clinical decision-making processes to improve HF patient care.

10.
Arq Bras Cardiol ; 114(6): 1051-1057, 2020 06.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32638896

RESUMO

Infection with the coronavirus known as COVID-19 has promoted growing interest on the part of cardiologists, emergency care specialists, intensive care specialists, and researchers, due to the study of myocardial involvement based on different clinical forms resulting from immunoinflammatory and neurohumoral demodulation.Myocardial involvement may be minimal and identifiable only by electrocardiographic changes, mainly increased cardiac troponins, or, on the other side of the spectrum, by forms of fulminant myocarditis and takotsubo syndrome.The description of probable acute myocarditis has been widely supported by the observation of increased troponin in association with dysfunction. Classical definition of myocarditis, supported by endomyocardial biopsy of inflammatory infiltrate, is rare; it has been observed in only one case report to date, and the virus has not been identified inside cardiomyocytes.Thus, the phenomenon that has been documented is acute myocardial injury, making it necessary to rule our obstructive coronary disease based on increased markers of myocardial necrosis, whether or not they are associated with ventricular dysfunction, likely associated with cytokine storms and other factors that may synergistically promote myocardial injury, such as sympathetic hyperactivation, hypoxemia, arterial hypotension, and microvascular thrombotic phenomena.Systemic inflammatory and myocardial phenomena following viral infection have been well documented, and they may progress to cardiac remodeling and myocardial dysfunction. Cardiac monitoring of these patients is, therefore, important in order to monitor the development of the phenotype of dilated myocardiopathy.This review presents the main etiological and physiopathological findings, a description of the taxonomy of these types of cardiac involvement, and their correlation with the main clinical forms of the myocardial component present in patients in the acute phase of COVID-19.


Assuntos
Infecções por Coronavirus , Coronavirus , Miocardite , Miocárdio , Pandemias , Pneumonia Viral , Betacoronavirus , Humanos
11.
Arq. bras. cardiol ; 114(6): 1051-1057, Jun., 2020. graf
Artigo em Português | LILACS-Express | LILACS, Sec. Est. Saúde SP | ID: biblio-1131239

RESUMO

Resumo A infecção pelo coronavírus denominada COVID-19 promoveu crescente interesse de cardiologistas, emergencistas, intensivistas e pesquisadores, pelo estudo do acometimento miocárdico partindo de diferentes formas clínicas decorrentes de desmodulação imunoinflamatória e neuro-humoral.O acometimento miocárdico pode ser mínimo e apenas identificado a partir de alterações eletrocardiográficas, principalmente por aumento de troponinas cardíacas, ou no outro lado do espectro pelas formas de miocardite fulminante e síndrome de takotsubo.A descrição de provável miocardite aguda tem sido comumente apoiada pela observação da troponina elevada em associação com disfunção. A clássica definição de miocardite, respaldada pela biópsia endomiocárdica de infiltrado inflamatório é rara, e foi observada em um único relato de caso até o momento, não se identificando o vírus no interior dos cardiomiócitos.Assim, o fenômeno que se tem documentado é de injúria miocárdica aguda, sendo obrigatório afastar doença coronária obstrutiva a partir da elevação de marcadores de necrose miocárdica, associada ou não à disfunção ventricular, provavelmente associada à tempestade de citoquinas e outros fatores que podem sinergicamente promover lesão miocárdica, tais como hiperativação simpática, hipoxemia, hipotensão arterial e fenômenos trombóticos microvasculares.Fenômenos inflamatórios sistêmicos e miocárdicos após infecção viral estão bem documentados, podendo evoluir para remodelamento cardíaco e disfunção miocárdica. Portanto, será importante a cardiovigilância desses indivíduos para monitorar o desenvolvimento do fenótipo de miocardiopatia dilatada.A presente revisão apresenta os principais achados etiofisiopatológicos, descrição da taxonomia desses tipos de acometimento cardíaco e sua correlação com as principais formas clínicas do componente miocárdico presente nos pacientes na fase aguda de COVID-19.


Abstract Infection with the coronavirus known as COVID-19 has promoted growing interest on the part of cardiologists, emergency care specialists, intensive care specialists, and researchers, due to the study of myocardial involvement based on different clinical forms resulting from immunoinflammatory and neurohumoral demodulation.Myocardial involvement may be minimal and identifiable only by electrocardiographic changes, mainly increased cardiac troponins, or, on the other side of the spectrum, by forms of fulminant myocarditis and takotsubo syndrome.The description of probable acute myocarditis has been widely supported by the observation of increased troponin in association with dysfunction. Classical definition of myocarditis, supported by endomyocardial biopsy of inflammatory infiltrate, is rare; it has been observed in only one case report to date, and the virus has not been identified inside cardiomyocytes.Thus, the phenomenon that has been documented is acute myocardial injury, making it necessary to rule our obstructive coronary disease based on increased markers of myocardial necrosis, whether or not they are associated with ventricular dysfunction, likely associated with cytokine storms and other factors that may synergistically promote myocardial injury, such as sympathetic hyperactivation, hypoxemia, arterial hypotension, and microvascular thrombotic phenomena.Systemic inflammatory and myocardial phenomena following viral infection have been well documented, and they may progress to cardiac remodeling and myocardial dysfunction. Cardiac monitoring of these patients is, therefore, important in order to monitor the development of the phenotype of dilated myocardiopathy.This review presents the main etiological and physiopathological findings, a description of the taxonomy of these types of cardiac involvement, and their correlation with the main clinical forms of the myocardial component present in patients in the acute phase of COVID-19.

12.
Arq Bras Cardiol ; 113(5): 1006-1056, 2019 11.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31800728
13.
ScientificWorldJournal ; 2019: 1872536, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31320839

RESUMO

Background: Cardiovascular diseases are leading causes of death worldwide. Recent studies suggest that infection by some viruses, including the human papillomavirus (HPV), may increase the risk of developing atheromatous lesions on coronary arteries. However, there is a lack of data regarding the possible association between HPV infection and coronary artery disease (CAD) in women. Objective: To investigate whether HPV infection is associated with the occurrence of CAD among climacteric women. Methods: The presence of CAD and cervical HPV DNA was investigated in 52 climacteric women. Social and demographic variables and metabolic profiles were also investigated. Results: Among 27 women with CAD, 16 were positive for HPV, whereas 11 were negative. The presence of cervical HPV was strongly associated with CAD, after adjusting for demographic variables, health and sexual behaviors, comorbidities, and known cardiovascular risk factors. HPV-positive women showed a greater likelihood of having CAD (odds ratio [OR] = 3.74; 95% confidence interval [CI]: 1.16 to 11.96) as compared with HPV-negative women, particularly those infected with high-risk HPV types (OR = 4.90; 95% CI: 1.26 to 19.08). Conclusion: These results support the hypothesis that HPV infection might be associated with CAD among climacteric women, though further studies are needed to investigate the mechanisms involved.


Assuntos
Climatério , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/etiologia , Papillomaviridae , Infecções por Papillomavirus/epidemiologia , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Razão de Chances , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/virologia , Vigilância em Saúde Pública , Medição de Risco , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos
14.
Rev. salud pública ; 21(3): e470678, mayo-jun. 2019. tab
Artigo em Português | LILACS | ID: biblio-1115862

RESUMO

RESUMO Objetivo Caracterizar aspectos socioeconómicos, demográficos, de saúde e clínicos de homens com câncer de próstata no Maranhão. Metodologia Estudo prospectivo, descritivo de base primária. Resultados: Do total de 226 homens com câncer de próstata,44,2% tinham entre 71-80 anos, 82,3% autoreferiram a raça parda, 62,8% não eram aposentados, 90,3% tinham renda mensal de até dois salários mínimos, 63,7% tinham menos de oito anos de estudo, 80,5% eram casados, 61,9% eram do interior do estado, 76,1% não praticavam atividade física, 53,1% procuravam assistência em saúde apenas quando apresentavam algum problema, 51,3% realizaram a cirurgia de retirada de próstata. Conclusão Ferramentas e estratégias devem ser desenvolvidas voltadas para o público masculino, focadas na promoção e prevenção do câncer de próstata, observando características inerentes dos homens por região possibilitando um diagnóstico precoce e consequente possibilidade de cura.(AU)


ABSTRACT Objective To characterize socioeconomic, demographic, health and clinical aspects of men with prostate cancer in the state of Maranhão, Brazil. Methodology Prospective, descriptive primary study. Results Of 226 men with prostate cancer, 44.2% were aged 71-80 years, 82.3% self-reported as mestizo, and 62.8% were not retired. Moreover, 90.3% had a monthly income of up to two minimum wages, 63.7% had less than eight years of schooling, 80.5% were married, 61.9% were from the interior of the state, and 76.1% did not practice physical activity. Regarding their health, 53.1% sought health care only when they presented a problem and 51.3% underwent prostatectomy. Conclusion Tools and strategies developed for the male public should focus on the promotion and prevention of prostate cancer, taking into account the inherent characteristics of men by region, thus enabling early diagnosis and consequent possibility of cure.(AU)


RESUMEN Objetivo Caracterizar aspectos socioeconómicos, demográficos, de salud y clínicos de hombres con cáncer de próstata en el estado de Maranhão, Brasil. Metodología Estudio prospectivo, descriptivo de fuente primaria. Resultados Del total de 226 hombres con cáncer de próstata, 44,2% tenían entre 71-80 años, 82,3% se auto-describían como mestizos, 62,8% no eran jubilados, el 90,3% tenían ingresos mensuales de hasta dos salarios mínimos, el 63,7% tenían menos de ocho años de estudio, el 80,5% estaban casados, el 61,9% eran del interior del estado, el 76,1% no practicaba actividad física, el 53,1% buscaban asistencia en salud solo cuando se presentaba algún problema, y el 51,3% se realizó prostatectomía. Conclusión Las herramientas y estrategias desarrolladas y dirigidas al público masculino deben enfocarse en la promoción y prevención del cáncer de próstata, teniendo en cuenta las características inherentes de los hombres por región, posibilitando así el tratamiento oportuno de la enfermedad y aumentando la posibilidad de curación.(AU)


Assuntos
Humanos , Masculino , Neoplasias da Próstata/epidemiologia , Perfil de Saúde , Saúde do Homem , Brasil/epidemiologia , Epidemiologia Descritiva , Estudos Prospectivos
15.
PLoS One ; 13(9): e0203027, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30180197

RESUMO

BACKGROUND: Menopause consists of a physiological process in women between 40 and 50 years of age, and it has substantial consequences for health, ranging from disturbances in lipid and glycidic metabolism to psychological stress and sleep alterations, thereby increasing women's risk of cardiovascular diseases. Here, we attempted to identify potential lipid alterations not identified by the classic methods. METHODS AND RESULTS: We analyzed the serum lipid profile in 40 women in pre- and post-menopause using a lipidomic approach and mass spectrometry. Lipid species presented increased concentrations, with a difference of more than 25% post-menopause and with the ceramides (N.C23:0.Cer, N.C23:0(OH).Cer and N.C24:0(OH).Cer) standing out with a fold change of 1.68, 1.59, and 1.58, respectively. It was also observed that 14 metabolites presented a significant difference in the average concentrations between pre- and post-menopause, especially the ceramide species. Strong and positive correlations were identified between various metabolites and fasting glucose, glycated hemoglobin, total cholesterol, LDL, and triglycerides. Of note were the association ceramide (N.C10:0.Cer) and lysophosphatidylethanolamine (LPE.a.C18:0) between fasting glucose and glycated hemoglobin. CONCLUSION: This study detected lipid alterations, especially in ceramides, post-menopause, as well as correlations with glycidic and lipid markers, which may in the future be useful to investigate diseases associated with menopause.


Assuntos
Lipídeos/sangue , Pós-Menopausa/sangue , Pré-Menopausa/sangue , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade
16.
Nutr Metab (Lond) ; 15: 53, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30061916

RESUMO

Background: Consumption of added sugars has been considered a worldwide public health concern by its association with metabolic syndrome and its comorbidities. Meanwhile, current studies have suggested high-protein diets to promote weight loss and improved metabolic outcomes. Thus, this study aimed to investigate the effects of long-term high-protein diet (HPD, 34.3% protein) intake on high-sucrose-fed rats. Methods: Weaned male Wistar rats were randomized into two groups: rats fed a standard chow (CT/CT, 10% sucrose) or rats fed a high-sucrose diet (HSD, 25% sucrose) for a 20-week observational period. Subsequently, HS/HS animals were randomized into 3 new groups: rats maintained on HSD diet (HS/HS); rats submitted to HSD replacement by standard chow (HS/CT); and those with HSD replaced by HPD (HS/HP). All groups were followed up for 12 weeks during which we investigated the effects of HPD on body weight, energy intake, obesity development, glicemic/lipid profile, glucose tolerance, insulin resistance, tissue weight (adipose tissue, liver and skeletal muscles), lipolytic activity, liver lipoperoxidation and histology, as well as serum markers of hepatic function. Results: Post-weaning exposure to HSD led to metabolic syndrome phenotype at adulthood, herein characterized by central obesity, glucose intolerance, dyslipidaemia and insulin resistance. Only HPD feeding was able to revert weight gain and adipose tissue accumulation, as well as restore adipose tissue lipolytic response to sympathetic stimulus. On the other hand, either HPD or withdrawal from HSD promoted very similar metabolic outcomes upon 12-week nutritional intervention. HS/HP and HS/CT rats showed reduced fasting serum levels of glucose, triacylglycerol and total cholesterol, which were correlated with the improvement of peripheral insulin sensitivity, as inferred from kITT and TyG Index values. Both nutritional interventions restored liver morphofunctional patterns, but only HPD restored lipid peroxidation. Conclusions: Our data showed that 12-week intake of an isocaloric moderately high-protein diet consistently restored high-sucrose-induced central adiposity and obesity in addition to the attenuation of other important metabolic outcomes, such as improvement of glucolipid homeostasis associated to increased insulin sensitivity and reversal of hepatic steatosis. On the other hand, simple withdrawal from high-sucrose consumption also promoted the abovementioned metabolic outcomes with no impact on body weight.

17.
Int. j. cardiovasc. sci. (Impr.) ; 31(3): 201-208, jul.-ago. 2018. tab
Artigo em Inglês, Português | LILACS | ID: biblio-908827

RESUMO

Fundamento: Síndrome metabólica é um importante fator de risco cardiovascular, e sua prevalência aumenta após a menopausa. Ainda é incerto, porém, se a menopausa é fator de risco independente para a síndrome metabólica. Uma das bases fisiopatológicas para síndrome metabólica é a resistência insulínica, que pode ser calculada pelo método Homeostatic Model Assessment-Insulin Resitance (HOMA-IR), sendo pouco conhecida a relação entre resistência insulínica e menopausa. Objetivos: Avaliar a relação entre síndrome metabólica e resistência insulínica em mulheres climatéricas. Métodos: Estudo descritivo, que avaliou 150 mulheres, com idades entre 40 e 65 anos, atendidas em um ambulatório de ginecologia em um hospital terciário público, entre maio e dezembro de 2013. A amostra foi dividida em dois grupos, sendo o Grupo I com pacientes na pré-menopausa e o II com pacientes na pós-menopausa. Foi avaliada a presença de síndrome metabólica, bem como de seus componentes, além da ocorrência de resistência insulínica nos dois grupos. A associação do estado menopausal e as variáveis estudadas foi realizada com os testes Mann-Whitney, qui quadrado e exato de Fisher. O nível de significância foi de 5%. A análise estatística foi feita por meio do STATA 12.0. Resultados: A síndrome metabólica foi mais prevalente nas mulheres pós-menopausa, bem como todos seus componentes tiveram maior frequência também nesse grupo. As mulheres pós-menopausa também apresentaram maior prevalência de resistência insulínica, mas não foi observada relação estatística entre os achados. Conclusão: O estado menopausal não se associou significativamente com síndrome metabólica e resistência insulínica. A resistência insulínica foi considerada fator de risco independente para o desenvolvimento de síndrome metabólica apenas no grupo pós-menopausa


Background: Metabolic syndrome is an important cardiovascular risk factor, and its prevalence increases after menopause. However, it is still uncertain whether menopause is an independent risk factor for metabolic syndrome. One of the pathophysiological basis for metabolic syndrome is insulin resistance, which can be calculated by the Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) method, and the association between insulin resistance and menopause is little known. Objective: To evaluate the association between metabolic syndrome and insulin resistance in menopausal women. Method: Descriptive study, which evaluated 150 women, aged 40 to 65, treated at a Gynecology Outpatient Clinic of a tertiary public hospital, from May to December of 2013. The sample was divided into two groups: Group I, comprising women in the premenopausal period and Group II, comprising women in the post-menopausal period. The presence of metabolic syndrome and its components were evaluated, as well as occurrence of insulin resistance in both groups. The association of menopausal status and the assessed variables was assessed using the Mann-Whitney, Chi-square and Fisher's exact tests. The significance level was set at 5%. The statistical analysis was performed using STATA 12.0. Results: Metabolic syndrome and its components were more prevalent in postmenopausal women. Postmenopausal women also had a higher prevalence of insulin resistance, but no statistical association was observed between the findings. Conclusion: The menopausal status was not significantly associated with metabolic syndrome and insulin resistance. Insulin resistance was considered an independent risk factor for the development of metabolic syndrome only in the postmenopausal group


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Climatério , Resistência à Insulina , Doenças Cardiovasculares/fisiopatologia , Síndrome Metabólica/fisiopatologia , Triglicerídeos , Menopausa , Epidemiologia Descritiva , Prevalência , Análise Estatística , Fatores de Risco , Diabetes Mellitus/diagnóstico , Obesidade Abdominal , Pressão Arterial , Hipertensão/complicações , HDL-Colesterol
18.
Int. j. cardiovasc. sci. (Impr.) ; 31(1): f:4-l:11, jan.-mar. 2018. tab
Artigo em Espanhol | LILACS | ID: biblio-883570

RESUMO

Fundamentos: O aumento da incidência de doenças cardiovasculares em mulheres ocorre durante o período do climatério, especialmente após a menopausa. Objetivo: O objetivo deste estudo foi identificar fatores de risco cardiovasculares entre as mulheres climatéricas com e sem doença arterial coronariana (DAC). Métodos: Trata-se de estudo transversal realizado no Serviço de Hemodinâmica do Hospital Universitário da Universidade Federal do Maranhão, no período de março de 2012 a julho de 2013. Foram incluídas 31 mulheres climatéricas que compareceram ao setor para realização do cateterismo cardíaco, separadas em grupos após resultados do cateterismo, Grupo I (com DAC) e Grupo II (sem DAC). Análise estatística: as variáveis categóricas foram descritas por meio de frequências e porcentagem, as numéricas por meio de média ± desvio padrão ou mediana (Quartil.3 ­ Quartil.1); o teste Shapiro-Wilk para verificar a normalidade dos dados quantitativos, o teste Exato de Fisher para comparações de dados categóricos; para dados contínuos o Test-T para amostras não pareadas ou o Mann-Whitney; foi considerado estatisticamente significativo o valor de p < 0,05. Resultados: Avaliaram-se grupos com DAC (n = 13) e sem DAC (n = 18), os resultados apontaram média de idade entre os grupos de 57,92 ± 5,15 e 51,72 ± 4,63 anos, respectivamente; dentre os fatores de risco cardiovasculares, os mais prevalentes entre as mulheres com DAC foram: a menopausa (84,62%), a hipertensão arterial sistêmica (HAS) (69,23%) e o sedentarismo (69,23). Conclusão: Concluiu-se que, além da menopausa propriamente dita, a HAS e o sedentarismo foram os fatores de risco cardiovasculares mais prevalentes entre as mulheres com DAC


Background: The increased incidence of cardiovascular disease in women occurs during the climacteric period, especially after menopause. Objective: The aim of this study was to identify risk factors among climacteric women with and without coronary artery disease (CAD). Method: This cross-sectional study was performed in the Catheterization Laboratory at the Federal University Hospital of Maranhão, in the Northeast region of Brazil, between March 2012 and July 2013. We included 31 climacteric women who went to the care center for cardiac catheterization. They were divided into groups after catheterization results: Group I (with DAC) and Group II (without CAD). Statistical analysis: Categorical variables were described by means of frequencies and percentages, numerical variables by mean ± standard deviation or median (Quartile.3 - Quartile.1); the Shapiro-Wilk test was used to verify the normality of quantitative data. Fisher's exact test was used for categorical data comparisons. For continuous data, we used Student's test or the Mann-Whitney for unpaired samples; statistical significance was set at p < 0.05. Results: We evaluated groups with CAD (n = 13) and without CAD (n = 18). The results showed a mean age between the groups of 57.92 ± 5.15 and 51.72 ± 4.63 years, respectively. Among the cardiovascular risk factors, the most prevalent among women with CAD were menopause (84.62%), systemic arterial hypertension (SAH) (69.23%) and sedentary life style (69.23%). Conclusion: We concluded that, in addition to menopause itself, SAH and sedentary lifestyle were the most prevalent cardiovascular risk factors among women with CAD


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Doenças Cardiovasculares , Climatério , Doença da Artéria Coronariana , Fatores de Risco , Mulheres , Fatores Etários , Índice de Massa Corporal , Cateterismo Cardíaco/métodos , Estudos Transversais/métodos , Diabetes Mellitus , Diagnóstico por Imagem , Hipertensão/complicações , Obesidade , Comportamento Sedentário , Análise Estatística
19.
Nutr Hosp ; 34(5): 1146-1154, 2017 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-29130714

RESUMO

INTRODUCTION: Among the non-pharmacologic measures for the prevention and treatment of cardiovascular diseases (CVD), which are the first cause of death worldwide, the adequate intake of dietary fibers (DF) has shown an important role. OBJECTIVE: To evaluate the association between the intake of DF and the cardio-metabolic risk factors in individuals on a secondary prevention for CVD. METHODS: Transversal study with basal data of the study's DICA Br participants belonging to collaborative centers in the states of Maranhão (MA), Bahia (BA) and Rio de Janeiro (RJ). Sociodemographic and clinical data were used, as well as the daily intake of DF in individuals of both sexes, with age ≥ 45 years and manifest evidence of arteriosclerosis. The association between the intake of dietary fibers and the cardio-metabolic risk factors was obtained through Poisson's regression model. RESULTS: With 141 evaluated individuals, high frequency of non-appropriateness of DF intake was observed. The participants in the centers of RJ (PR = 0.63; CI 95% = 0.49-0.80) and BA (PR = 0.79; CI 95% = 0.66-0.95), former smokers (PR = 0.59; CI 95% = 0.45-0.78) and non-smokers (PR = 0.62; CI 95% = 0.66-0.95) had fewer chances of having non appropriate intake of DF. On the other hand, overweight individuals showed 28.0% more chances of non-appropriate intake of DF. CONCLUSION: Results showed that the majority of the observed population presented non-appropriate intake of DF and that this low intake was significantly associated with overweight, smoking and location of the collaborative center.


Assuntos
Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/prevenção & controle , Fibras na Dieta , Doenças Metabólicas/dietoterapia , Doenças Metabólicas/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Inquéritos sobre Dietas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Prevenção Secundária , Fumar , Fatores Socioeconômicos
20.
Int. j. cardiovasc. sci. (Impr.) ; 30(3): f:227-l:234, mai.-jun. 2017. tab
Artigo em Português | LILACS | ID: biblio-836682

RESUMO

Fundamentos: O endotélio desempenha importante função reguladora vascular. Sua disfunção é um marcador precoce de risco cardiovascular. Entretanto, existem poucos estudos em nosso meio que avaliem a função endotelial em mulheres climatéricas. Objetivo: Avaliar a função endotelial em mulheres climatéricas na presença ou ausência de doença arterial coronariana utilizando-se um método biofísico (espessura médio-intimal das carótidas) e um método bioquímico (níveis séricos de PCR-US). Métodos: Estudo transversal que avaliou o espessamento médio-intimal da artéria carótida e níveis séricos de PCR-US de 31 mulheres climatéricas submetidas a cineangiocoronariografia, no Serviço de Hemodinâmica do Hospital Universitário da Universidade Federal do Maranhão, no período de março de 2012 a julho de 2013. Os dados foram submetidos à análise estatística. Considerou-se um nível de significância de 5%. Resultados:A amostra foi dividida em dois grupos, de acordo com presença de doença arterial coronariana (DAC): grupo com DAC (n = 13) e grupo sem DAC (n = 18). As médias de idades para os grupos foram 57,92 ± 5,17 e 51,72 ± 4,63 anos, respectivamente (p = 0,001). A EMI esteve alterada em 29,03% na população geral. A espessura médio- intimal foi de 1,55 ± 0,78 mm no grupo geral, 1,92 ± 0,94 mm no grupo com DAC e 1,18 ± 0,71 mm no grupo sem DAC (p = 0,001). As pacientes com DAC apresentaram predomínio de alteração da EMI quando comparadas aquelas sem DAC: 36,46% vs. 22,22%, respectivamente. Observou-se uma sensibilidade de 38%, especificidade de 77%, com um valor preditivo positivo de 0,55 e valor preditivo negativo de 0,63 com razão de verossimilhança para teste positivo (likelihood ratio) de 1,73. As pacientes com EMI alterado apresentaram níveis mais elevados de PCR-US, porém sem significância estatística. As pacientes com DAC apresentaram níveis mais elevados de PCR-US, porém sem significância estatística. Conclusão: Na população estudada, a avaliação da função endotelial pelo método da EMI apresentou maior sensibilidade e especificidade para o diagnóstico de DAC quando comparada a mensuração dos níveis de PCR-US em mulheres climatéricas


Background: The endothelium plays an important vascular regulatory function. Its dysfunction is an early marker of cardiovascular risk. However, there are few studies in our community that assess endothelial function in pre-menopausal women. Objective: To assess endothelial function in pre-menopausal women in the presence or absence of coronary artery disease, using a biophysical method (carotid intima media thickness) and a biochemical method (serum levels of hsCRP). Methods: Cross-sectional study that evaluated carotid intima-media thickness and serum levels of hsCRP of 31 pre-menopausal women undergoing coronary angiography at the Hemodynamics Service of Hospital Universitário da Universidade Federal do Maranhão from March 2012 to July 2013. The data were sent to statistical analysis and a statistical significance level of 5% was considered. Results: The sample was divided into two groups according to the presence of coronary artery disease (CAD): CAD group (n = 13) and group without CAD (n = 18). The average ages for the groups were 57.92 ± 5.17 and 51.72 ± 4.63 years, respectively (p = 0.001). CIMT was abnormal in 29.03% in the general population. Carotid intima-media thickness was 1.55 ± 0.78 mm in the general group, 1.92 ± 0.94 mm in the CAD group and 1.18 ± 0.71 mm in the group without CAD (p = 0.001). CAD patients had predominance of abnormal CMIT compared those without CAD: 36.46% vs. 22.22%, respectively. There was a sensitivity of 38%, specificity of 77% with a positive predictive value of 0.55 and a negative predictive value of 0.63 with likelihood ratio of 1.73. Patients with abnormal CIMT presented higher levels of hsCRP, but without statistical significance. CAD patients had higher levels of hsCRP, but without statistical significance. Conclusion: In the population studied, assessment of endothelial function using the CIMT method showed higher sensitivity and specificity for the diagnosis of CAD compared to the measurement of hsCRP levels in menopausal women


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Climatério , Doença da Artéria Coronariana/mortalidade , Doença da Artéria Coronariana/fisiopatologia , Endotélio/fisiopatologia , Mulheres , Fatores Etários , Aterosclerose/mortalidade , Aterosclerose/fisiopatologia , Proteína C-Reativa/análise , Artérias Carótidas , Cineangiografia/métodos , Estudos Transversais , Sensibilidade e Especificidade , Análise Estatística
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