Fernando Antonio de Almeida

Atrial natriuretic factor increases hematocrit and decreases plasma volume in nephrectomized rats.

To test the hypothesis that ANF increases the efflux of fluid from capillaries we determined the effect of synthetic (1-28) ANF on hematocrit (Hct) and plasma volume (PV) in 24 hr bilaterally nephrectomized rats. Results were compared with those obtained in bilaterally nephrectomized rats receiving saline alone (S) or an infusion of sodium nitroprusside (NP) to produce a similar blood pressure lowering effect as ANF. PV was determined by the volume of distribution of RISA 10 minutes after its i.v. administration. After control periods (C) rats were infused for 40 minutes with saline alone (group A, n = 8), (1-28)ANF, 0.3 micrograms X min-1/kg body wt (group B, n = 9), 1.0 microgram X min-1/kg body wt (group C, n = 8) and NP, 1.0 to 2.0 micrograms X min-1/kg body wt (group D, n = 8). Recovery periods (R) were performed 45 minutes after the experimental periods (E). During E periods, mean arterial blood pressure did not change in group A and fell significantly (p less than 0.01) in the other groups. Group B: C = 89 +/- 4; E = 82 +/- 4 mmHg. Group C: C = 106 +/- 7; E = 92 +/- 7 mmHg. Group D: C = 104 +/- 5; E = 90 +/- 5 mmHg. Neither saline or NP changed Hct, whereas, ANF significantly (p less than 0.01) increased this parameter (Group B: C = 43.4 +/- 0.7; E = 46.3 +/- 0.6% and Group C: C = 44.5 +/- 1.2; E = 47.4 +/- 1.2%). ANF significantly decreased PV (3.86 +/- 0.14 ml/100 gm body wt) as compared to S (4.51 +/- 0.22 ml/100 gm body wt; p less than 0.05) or NP (4.69 +/- 0.11 ml/100 gm body wt; p less than 0.01). The average decrease in PV of 14% corresponded to the average increase in Hct of 7%. Results demonstrate that ANF increases the efflux of fluid from capillaries. This effect explains, at least in part, the ANF-induced decrease in cardiac output and blood pressure in normotensive animals and may play an important role in the homeostatic regulation of plasma volume.

Similaridade entre os valores da pressão arterial aferida pelo método auscultatório com aparelho de coluna de mercúrio e o método oscilométrico automático com aparelho digital

INTRODUCTION: One of the biggest challenges in the management of hypertension is adequate blood pressure (BP) control. To achieve this goal, home blood pressure measurement (HBPM) with automated devices has been encouraged. However, part of the medical community still disputes its validity, believing that HBPM may lead to incorrect readings. OBJECTIVE: To evaluate the correspondence between the simultaneous measurements of BP with the auscultatory method and an oscillometric digital method, commonly used in HBPM. METHODS: BP was determined simultaneously in 423 individuals (normotensive and hypertensive) with a validated automated digital device (ONROM 705IT) and with the auscultatory method with a mercury sphygmomanometer. Both devices were connected through a Y-shaped connection to a cuff whose size was adjusted to the arm circumference. RESULTS: The values represent mean ± SD (minimum-maximum values): age 40.8 ± 16.3 years (18-92), arm circumference 28.2 ± 3.7 cm (19-42), systolic BP (SBP) auscultatory 127.6 ± 22.8 mmHg (69-223), SBP automated 129.5 ± 23.0 mmHg (56-226), diastolic BP (DBP) auscultatory 79.5 ± 12.6 mmHg (49-135) DBP automated 79.0 ± 12.6 mmHg (48-123). The mean difference in SBP between the two methods was 1.9 mmHg (-15 to +19) and 0.5 mmHg for DBP (-19 to +13). The Bland-Altman analysis showed clinically acceptable agreement between the methods. CONCLUSION: BP measured with the automated method closely mirrors that determined with the conventional auscultatory method and should be used to improve the diagnosis and control of hypertension.

Avaliação de influências sociais e econômicas sobre a pressão arterial de adolescentes de escolas públicas e privadas: um estudo epidemiológico

INTRODUCTION The high prevalence of hypertension in high school students in Sorocaba, São Paulo, Brazil, has already been described. In this study, within a new sample of high school students from public and private schools, we evaluated if socioeconomic and lifestyle influence on blood pressure values. METHODS This is an epidemiological study, which is part of the activities of a community-based work conducted by medical students. They give speeches to high school students aiming at stimulating a healthy lifestyle and primary prevention of hypertension. In a random sample of 410 students in junior high school (209 from public schools and 201 from private schools), we determined the weight, height, and blood pressure, furthermore, a questionnaire identifying epidemiological and socioeconomic status was applied. RESULTS No statistical differences were found among students from public and private schools regarding the distribution of gender, body mass index (BMI), systolic and diastolic blood pressure, prevalence of hypertension (16.3%), percentage of smokers (5.9%), regular physical activity, and family history of hypertension. In public schools, there is a higher percentage of African descendents students and a higher percentage of students who also work due to low family income. Men from public and private schools have higher prevalence of hypertension, and their mean blood pressure is higher than in women. BMI has a positive correlation with systolic and diastolic blood pressure. CONCLUSIONS Hypertension and other cardiovascular risk factors have an early beginning and require educational interventions for primary prevention. Socioeconomic factors do not affect blood pressure in adolescence.INTRODUCTION: The high prevalence of hypertension in high school students in Sorocaba, Sao Paulo, Brazil, has already been described. In this study, within a new sample of high school students from public and private schools, we evaluated if socioeconomic and lifestyle influence on blood pressure values. METHODS: This is an epidemiological study, which is part of the activities of a community-based work conducted by medical students. They give speeches to high school students aiming at stimulating a healthy lifestyle and primary prevention of hypertension. In a random sample of 410 students in junior high school (209 from public schools and 201 from private schools), we determined the weight, height, and blood pressure, furthermore, a questionnaire identifying epidemiological and socioeconomic status was applied. RESULTS: No statistical differences were found among students from public and private schools regarding the distribution of gender, body mass index (BMI), systolic and diastolic blood pressure, prevalence of hypertension (16.3%), percentage of smokers (5.9%), regular physical activity, and family history of hypertension. In public schools, there is a higher percentage of African descendents students and a higher percentage of students who also work due to low family income. Men from public and private schools have higher prevalence of hypertension, and their mean blood pressure is higher than in women. BMI has a positive correlation with systolic and diastolic blood pressure. CONCLUSIONS: Hypertension and other cardiovascular risk factors have an early beginning and require educational interventions for primary prevention. Socioeconomic factors do not affect blood pressure in adolescence.