Endothelial Changes in Individuals with Prehypertension.

INTRODUCTION: Prehypertension is considered a precursor of systemic arterial hypertension and a predictor of morbidity-mortality due to cardiovascular diseases, which are the main causes of death in Brazil and the world. Thus, early diagnosis and the adoption of therapeutic measures in cases of prehypertension can reduce cardiovascular risk. The aim of the present study was to perform a selective review of the literature to identify and discuss early endothelial changes in individuals with pre-hypertension. RESULTS AND DISCUSSION: The findings indicate an increase in ET-1-mediated vasoconstrictor tone in prehypertension, with endothelial-dependent vasodilatation impairment. Moreover, significantly high levels of angiotensin, arginine and vasopressin were found in this group of patients. A reduction in endothelial fibrinolytic capacity was another important change found in patients with prehypertention and was associated with an increased risk for atherothrombotic events. CONCLUSION: The present findings demonstrate endothelial changes in individuals with prehypertension that contribute to the development of arterial hypertension as well as a high risk for cardiovascular events, underscoring the importance of the early adoption of optimized therapeutic measures for this population.

Perfil clínico dos pacientes com doenças cardiovasculares atendidos na emergência de um hospital de ensino / Clinical profile of patients with cardiovascular diseases cared for at the emergency department of a teaching hospital / Perfil clínico de pacientes con enfermedades cardiovasculares atendidos en el departamento de emergencias de un hospital de enseñanza

Objetivos: caracterizar os pacientes atendidos no pronto atendimento; identificar as principais doenças cardiovasculares atendidas e verificar o destino destes pacientes.Método: estudo descritivo, de corte retrospectivo,a partir de análise de prontuários eletrônicos, com uma amostra de 4.329 pacientes adultos (>18 anos de idade), atendidos no período de 01/2009 a 05/2010. A análise de dados foi realizada através de testes estatísticos como teste qui-quadrado, analise de variância (ANOVA), teste post hocde Tukey e aplicação de teste de Kruskal-Wallis com posterior teste de comparação múltipla de Dunn. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa, Parecer nº 165/2011.Resultados:a maioria dos pacientes avaliados era do sexo masculino (52,86%), com grau de instrução de quatro a sete anos de estudo (32,04%), com companheiro (57,73%) e trabalhadores do setor de serviços (51,22%), seguidos de trabalhadoras do lar (32,60%), de etnia branca (86,48%), com idade mediana de 60 anos, tendo como diagnóstico principal da internação o acidente vascular cerebral e destino principal a alta após o atendimento.Conclusão:a população idosa é a mais vulnerável às doenças cardiovasculares no serviço de emergência.(AU)

Objectives:to characterize patients cared for at an emergency department; to identify the major cardiovascular diseases treated; and to determine the respective patient outcomes. Method:descriptive and retrospective study conducted assessing electronic medical records, with a sample of 4,329 adult patients (>18 years of age) cared for from January 2009 to May 2010. Data analysis was carried out using statistical tests, namely: chi-square test, analysis of variance (ANOVA), Tukey's post hoctest, Kruskal-Wallis test, and Dunn's multiple comparison test. The research project was approved by the Research Ethics Committee, Opinion No. 165/2011. Results:most patients assessed were male (52.86%), with level of education of four to seven years of study (32.04%); they had a partner (57.73%) and were service sector workers (51.22%), followed by housewives (32.60%), whites (86.48%), with median age of 60 years. Cerebral vascular accident was the main admission diagnosis and the main patient outcome was hospital discharge. Conclusion:the older adult population is the most vulnerable to cardiovascular diseases in emergency services.(AU)

Objetivos:caracterizar los pacientes tratados en el departamento de emergencias; identificar las principales enfermedades cardiovasculares atendidas; y determinar el destino de estos pacientes. Método:estudio descriptivo y retrospectivo con análisisde expedientes médicos electrónicos, con una muestra de 4.329 pacientes adultos (>18 años de edad) atendidos de enero de 2009 a mayo de 2010. El análisis de datos se realizó mediante pruebas estadísticas tales como prueba chi-cuadrado, análisis de varianza (ANOVA), prueba post hocde Tukey, prueba de Kruskal-Wallis y prueba de comparación múltiple de Dunn. El proyecto de investigación fue aprobado por el Comité de Ética en Investigación, Dictamen N° 165/2011. Resultados:los pacientes estudiados eran en sumayoría hombres (52,86%), con nivel de educación de cuatro a siete años de estudio (3,04%), con compañero (57,73%) y eran trabajadores del sector de servicios (51,22%), seguidos de amas de casa (32,60%) de raza blanca (86,48%), con mediana de edad de 60 años. El accidente vascular cerebral fue el principal diagnóstico de hospitalización y el alta después del atendimiento fue el principal destino de los psciantes. Conclusión:la población de adultos mayores es la más vulnerable a enfermedades cardiovasculares en el servicio de emergencia.(AU)