Crizian Saar Gomes

Prevalência de saúde cardiovascular ideal na população brasileira - Pesquisa Nacional de Saúde (2013)

Primordial prevention is defined as the initial prevention of risk factors, through the adoption of healthier behaviors. Within this concept, the American Heart Association (AHA) has defined seven metrics, based on evidence, to achieve ideal cardiovascular health. The aim of this study was to evaluate the prevalence of cardiovascular health in the Brazilian population, according to sex, age, and region of residence, using data from the latest National Health Survey (2013). We assessed the risk factors, as recommended by the AHA, combined (number of factors) and individually: four behavioral (smoking, physical activity, body mass index and diet) and three biological factors (blood pressure, blood glucose and cholesterol levels). The Brazilian population has reached very low prevalence (1%), for the sum of 7 factors in ideal level. Individually, 3.2% of the population consumed ideal diet, followed by physical activity (23.6%) and body mass index (43.7%). The subjects aged between 18 and 35 years showed higher prevalence of metrics combined at the optimal levels (0.5%), which was also reached by the population of the Northern region. These results indicate that greater efforts are urgent by public policies at the level of primordial prevention in order to achieve appropriate targets of cardiovascular health in the Brazilian population.

Leptin Receptor Gene Gln223Arg Polymorphism Is Not Associated with Hypertension: A Preliminary Population-Based Cross-Sectional Study.

Hypertension is responsible for high morbidity and mortality as one of the most important cardiometabolic risk factors. The aim of the study was to investigate whether the Gln223Arg in the leptin receptor (LEPR) influences the prevalence of hypertension. A cross-sectional study was carried out in individuals aged ≥ 18 years. Polymorphism identification was performed using PCR-RFLP analysis. Participants with blood pressure ≥ 140/90 mmHg or medication use were considered hypertensive. Frequencies, means, cross-tabulations, and multivariate models were produced to study differences in hypertension prevalence by genotypes. The study includes 470 participants. The frequency of GG polymorphism variant was 10.43%, 46.81% AG, and 42.77% AA. The distribution of hypertension frequency by LEPR genotypes was the following: AA 43.8%, AG 40.4%, and GG 40.8%; there were no significant differences between groups. Comparative analysis which used multivariate Poisson regression adjusted by many potential confounders (age, sex, schooling, smoking, alcohol intake, obesity, and family history of parental obesity) did not modify this result. In this large sample of population-based study, the association of the LEPR Gln223Arg gene polymorphism with hypertension was not observed.

Avaliação dos fatores de risco cardiovasculares em uma população rural brasileira

This cross-sectional study assessed cardiovascular health in 863 adults in rural communities in the Jequitinhonha Valley, Minas Gerais State, Brazil, focusing on seven factors, four of which behavioral (diet, physical activity, smoking, and body weight) and three biological (total cholesterol, fasting blood glucose, and arterial pressure), classified as ideal, intermediate, or poor. Men showed better results in behavioral factors (p = 0.01), with more men displaying 2 or 3 factors at ideal levels (48.5 and 25.8%, respectively), when compared to women (44.2 and 19.8%, respectively) (p = 0.01). Women presented more biological factors at ideal levels (19.1%) when compared to men (7.9%) (p < 0.001). Only three participants (0.4%) showed all seven factors at ideal levels. Prevalence of ideal indices was very low, showing the need for strategies to improve cardiovascular health in this population.Trata-se de um estudo transversal que avaliou indicadores de saude cardiovascular em 863 individuos adultos residentes em comunidades rurais do Vale do Jequitinhonha, Minas Gerais, Brasil. Foram avaliados sete fatores, quatro comportamentais (dieta, atividade fisica, tabagismo e peso corporal) e tres biologicos (colesterol total, glicemia em jejum e pressao arterial), classificados em niveis ideal, intermediario e ruim. Considerando os fatores comportamentais os homens tiveram melhor desempenho (p = 0,01), sendo observado um maior numero de homens com 2 e 3 fatores em niveis ideais (48,5 e 25,8%, respectivamente), em detrimento das mulheres (44,2 e 19,8%, respectivamente) (p = 0,01). Por outro lado, as mulheres apresentaram maior numero de fatores biologicos em niveis ideais (19,1%) quando comparadas com os homens (7,9%) (p < 0,001). Somente tres (0,4%) participantes apresentaram os sete fatores na categoria ideal. A prevalencia dos indicadores em nivel ideal foi muito baixa, demonstrando a urgencia de estrategias visando melhorar a saude cardiovascular desta populacao.

Physical and Social Environment Are Associated to Leisure Time Physical Activity in Adults of a Brazilian City: A Cross-Sectional Study

The physical activity practice is highlighted as a strategy to health promotion and to avoid chronic diseases. In addition to individual factors, environmental characteristics in which people live, may offer opportunities or barriers in adopting healthy habits and this is related to the physical activity (PA) practice among individuals. The aim of this study is to investigate the associations between neighborhood environment and leisure-time physical activity in adults. This is a cross-sectional study, developed using the database of Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (VIGITEL 2008/2010) of Belo Horizonte, Brazil. Individuals with the habit of practicing PA for at least 150 minutes of moderate-intensity PA or at least 75 minutes of vigorous-intensity PA throughout the week in leisure time were classified as active in leisure time. To characterize the built and social environment we used georeferenced data of public and private places for physical activity, population density, residential density, homicide rate and total income of the coverage area of the basic health units. The covered area of the basic health units was used as context unit. For data analysis, we used multilevel logistic regression. The study included 5779 adults, 58.77% female. There was variability of physical activity in leisure time between area covered by the basic health units (Median Odds ratio = 1.30). After adjusting for individual characteristics, the increase of density of private places for physical activity (Odds ratios—OR = 1.31; 95% confidence interval—95% CI: 1.15 to 1.48) and the smaller homicide rate (OR = 0.82; IC95%: 0.70 to 0.96) in the neighborhood increased physical activity in leisure time. The evidence of this study shows that neighborhood environment may influence the physical activity practice in leisure time and should be considered in future interventions and health promotion strategies.

Prevalência e aglomeração de fatores de risco cardiometabólicos em população idosa residente em área rural

Com este artigo objetivou-se avaliar a prevalencia e aglomeracao dos fatores de risco para doencas cardiovasculares em populacao idosa da arearural. Foi realizado estudo transversal com 236 individuos, com idade entre 60 e 99 anos, residentes em area rural. Os fatores analisados foram:excesso de peso (IMC ≥ 27 kg/m²), obesidade abdominal (circunferencia da cintura ≥ 88 cm para as mulheres e ≥ 102 para os homens), colesteroltotal ≥ 200 mg/dL, triglicerideos ≥ 150 mg/dL, colesterol LDL ≥ 160 mg/dL, colesterol HDL ≤ 40 mg/dL para homens e ≤ 50 mg/dL para mulheres,glicemia ≥ 100 mg/dL, pressao arterial sistolica/diastolica > 140/90 mmHg, tabagismo, sindrome metabolica definida de acordo com criteriosdo National Cholesterol Education Program e escore de dieta ruim. Razoes de prevalencia (RP) e intervalos de confianca de 95% (IC95%) foramcalculados segundo sexo. Foi encontrada aglomeracao de quatro ou mais fatores de risco em 47,4% da populacao. As mulheres apresentaramalta prevalencia de excesso de peso (RP = 1,9; IC95% = 1,05-3,61), obesidade abdominal (RP = 3,1; IC95% = 1,80-5,50), colesterol LDL aumentado(RP = 2,4; IC95% = 1,31-4,21), sindrome metabolica (RP = 2,2; IC95% = 1,25-3,84), hipercolesterolemia (RP = 1,3; IC95% = 1,06-1,68) e dislipidemia(RP = 1,1; IC95% = 1,01-1,29) quando comparadas aos homens. Este estudo confirma a alta prevalencia de fatores de risco cardiovasculares napopulacao idosa e a necessidade de politicas publicas efetivas de prevencao de doencas, objetivando envelhecimento saudavel.(AU) This study assessed the prevalence and clustering of risk factors for cardiovascular diseases in the elderly population of rural areas. This crosssectionalstudy was performed with 236 individuals, aged between 60 and 99 years, residents in a rural area. The factors analyzed were:overweight (BMI ≥ 27 kg/m²), abdominal obesity (waist circumference ≥ 88 cm for women and ≥ 102 for men), total cholesterol ≥ 200 mg/dL, triglycerides ≥ 150 mg/dL, LDL cholesterol ≥ 160 mg/dL, HDL cholesterol ≤ 40 mg/dL for men and ≤ 50 mg/dL for women, blood glucose ≥100 mg/dL, systolic/diastolic blood pressure ≥ 140/90 mmHg, smoking, metabolic syndrome defined according to criteria from the NationalCholesterol Education Program, and bad diet score. Ratios of prevalence (PR) and 95% confidence intervals (IC95%) were calculated according tosex. Agglomeration of four or more risk factors was observed in 47.4% of the population. Women showed high prevalence of overweight (PR = 1.9;IC95% = 1.05-3.61), abdominal obesity (PR = 3.1; IC95% = 1.80-5.50), increased LDL cholesterol (PR = 2.4; IC95% = 1.31-4.21), metabolic syndrome(PR = 2.2; IC95% = 1.25 -3.84), hypercholesterolemia (PR = 1.3; IC95% = 1.06-1.68), and dyslipidemia (PR = 1.1; IC95% = 1.01-1.29) when comparedto men. This study confirms the high prevalence of cardiovascular risk factors in the elderly population and the need for effective public policiesfor prevention, aiming at healthy aging.(AU) Este articulo estima la prevalencia y aglomeracion de factores de riesgo cardiovascular entre la poblacion anciana de una zona rural. Estudiotransversal realizado con 236 individuos entre 60 y 99 anos. Los factores estudiados fueron (IMC≥27kg/m²), obesidad abdominal (circunferencia de...(AU)

Saúde cardiovascular em população residente nas capitais brasileiras

Resume Objective: to estimate the prevalence of ideal cardiovascular health indicators in the Brazilian population, according to gender, age, education and region of residence. Method: cross-sectional study that used data from 41,134 participants of the Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel). The ideal cardiovascular health assessment considers four behavioral factors: not smoking; body mass index less than 25 kg/m2; practicing physical activity, eating fruits and vegetables five or more times per day; and two clinical factors (no diagnosis of diabetes or hypertension). The sum of factors at ideal levels results in a score ranging from zero (worse cardiovascular health) to six (ideal cardiovascular health). Results: considering the six factors, only 3.4% of the studied population presented ideal levels of cardiovascular health, with the majority of participants (57.6%) presenting three or four ideal factors. Women had higher prevalence of ideal cardiovascular health (3.8% versus 2.9% for men) (p < 0.0001). Conclusion: the findings of this study are consistent with the elevated risk of mortality from cardiovascular disease, observed in the Brazilian population. This may contribute to a better understanding of the scenario of cardiovascular health in the urban population of the country.Objetivo: estimar a prevalencia das metricas de saude cardiovascular ideal em nivel populacional, segundo sexo, idade, escolaridade e regiao de moradia. Metodo: estudo transversal que utilizou dados de 41.134 participantes do Sistema de Vigilância de Fatores de Risco e Protecao para Doencas Cronicas por Inquerito Telefonico. A avaliacao da saude cardiovascular ideal considerou quatro fatores comportamentais: nao fumar; apresentar indice de massa corporal menor do que 25 kg/m2; realizar atividade fisica; consumir frutas e hortalicas cinco ou mais vezes por dia, e dois fatores clinicos: nao referir diagnostico de diabetes e de hipertensao arterial. A soma dos fatores resultou em um escore que variou de zero (pior saude cardiovascular) a seis (saude cardiovascular ideal) fatores em niveis ideais. Resultados: considerando os seis fatores, somente 3,4% da populacao estudada apresentou niveis ideais de saude cardiovascular e a maioria dos participantes (57,6%) apresentou tres ou quatro fatores ideais. As mulheres apresentaram maior prevalencia de saude cardiovascular ideal (3,8% vs. 2,9% dos homens) (p < 0,0001). Conclusao: os achados deste estudo sao condizentes com o elevado risco de mortalidade por doencas cardiovasculares, observado para a populacao brasileira, e podem contribuir para a melhor compreensao do cenario da saude cardiovascular na populacao urbana do pais.

Distribuição espacial da obesidade em área urbana no Brasil

The spatial distribution of a disease is important for the diagnosis and epidemiological understanding of the health situation and trends, enabling a better grasp of the factors that determine the health status of populations. The scope of the study was to analyze the spatial distribution of obesity in adults in Belo Horizonte. This cross-sectional study was developed by Telephone Survey from the database for 2008 to 2010 of the Surveillance of Risk and Protective Factors for Chronic Diseases. Obesity was defined as body mass index 30 kg/m2. A georeferenced base with the environmental data of addresses and zip codes of the location was developed and spatial scan statistics were employed. A comparative analysis of environmental variables related to clusters of higher and lower prevalence of obesity was conducted. A cluster of obese individuals without statistical significance was found in the central area of the city. Also, a significant cluster of non-obese individuals was found in the eastern area of the city. These findings suggest that reasons for low prevalence of obesity in urban Brazilian areas could be related to better social organization and high availability of places for food stores and the practice of physical activity.

Cardiovascular risk factor assessment in a rural Brazilian population

This cross-sectional study assessed cardiovascular health in 863 adults in rural communities in the Jequitinhonha Valley, Minas Gerais State, Brazil, focusing on seven factors, four of which behavioral (diet, physical activity, smoking, and body weight) and three biological (total cholesterol, fasting blood glucose, and arterial pressure), classified as ideal, intermediate, or poor. Men showed better results in behavioral factors (p = 0.01), with more men displaying 2 or 3 factors at ideal levels (48.5 and 25.8%, respectively), when compared to women (44.2 and 19.8%, respectively) (p = 0.01). Women presented more biological factors at ideal levels (19.1%) when compared to men (7.9%) (p < 0.001). Only three participants (0.4%) showed all seven factors at ideal levels. Prevalence of ideal indices was very low, showing the need for strategies to improve cardiovascular health in this population.Trata-se de um estudo transversal que avaliou indicadores de saude cardiovascular em 863 individuos adultos residentes em comunidades rurais do Vale do Jequitinhonha, Minas Gerais, Brasil. Foram avaliados sete fatores, quatro comportamentais (dieta, atividade fisica, tabagismo e peso corporal) e tres biologicos (colesterol total, glicemia em jejum e pressao arterial), classificados em niveis ideal, intermediario e ruim. Considerando os fatores comportamentais os homens tiveram melhor desempenho (p = 0,01), sendo observado um maior numero de homens com 2 e 3 fatores em niveis ideais (48,5 e 25,8%, respectivamente), em detrimento das mulheres (44,2 e 19,8%, respectivamente) (p = 0,01). Por outro lado, as mulheres apresentaram maior numero de fatores biologicos em niveis ideais (19,1%) quando comparadas com os homens (7,9%) (p < 0,001). Somente tres (0,4%) participantes apresentaram os sete fatores na categoria ideal. A prevalencia dos indicadores em nivel ideal foi muito baixa, demonstrando a urgencia de estrategias visando melhorar a saude cardiovascular desta populacao.

Evaluación de los factores de riesgo cardiovascular en una población rural de Brasil

This cross-sectional study assessed cardiovascular health in 863 adults in rural communities in the Jequitinhonha Valley, Minas Gerais State, Brazil, focusing on seven factors, four of which behavioral (diet, physical activity, smoking, and body weight) and three biological (total cholesterol, fasting blood glucose, and arterial pressure), classified as ideal, intermediate, or poor. Men showed better results in behavioral factors (p = 0.01), with more men displaying 2 or 3 factors at ideal levels (48.5 and 25.8%, respectively), when compared to women (44.2 and 19.8%, respectively) (p = 0.01). Women presented more biological factors at ideal levels (19.1%) when compared to men (7.9%) (p < 0.001). Only three participants (0.4%) showed all seven factors at ideal levels. Prevalence of ideal indices was very low, showing the need for strategies to improve cardiovascular health in this population.Trata-se de um estudo transversal que avaliou indicadores de saude cardiovascular em 863 individuos adultos residentes em comunidades rurais do Vale do Jequitinhonha, Minas Gerais, Brasil. Foram avaliados sete fatores, quatro comportamentais (dieta, atividade fisica, tabagismo e peso corporal) e tres biologicos (colesterol total, glicemia em jejum e pressao arterial), classificados em niveis ideal, intermediario e ruim. Considerando os fatores comportamentais os homens tiveram melhor desempenho (p = 0,01), sendo observado um maior numero de homens com 2 e 3 fatores em niveis ideais (48,5 e 25,8%, respectivamente), em detrimento das mulheres (44,2 e 19,8%, respectivamente) (p = 0,01). Por outro lado, as mulheres apresentaram maior numero de fatores biologicos em niveis ideais (19,1%) quando comparadas com os homens (7,9%) (p < 0,001). Somente tres (0,4%) participantes apresentaram os sete fatores na categoria ideal. A prevalencia dos indicadores em nivel ideal foi muito baixa, demonstrando a urgencia de estrategias visando melhorar a saude cardiovascular desta populacao.