Maria do Rosário Gondim Peixoto

Validade do peso e da altura auto-referidos: o estudo de Goiânia

OBJECTIVE To assess the validity of self-reported weight and height at the time of diagnosing obesity, and to identify the sociodemographic and individual characteristics that might be a source of information bias. METHODS This was a cross-sectional population-based study carried out in the city of Goiânia in 2001. Interviews were conducted with 1,023 individuals aged 20-64 years, in their homes, to collect sociodemographic and self-reported weight and height information. On the same occasion, weight and height measurements were made on these individuals. The mean differences and correlation coefficients between self-reported and measured data were calculated according to age, body mass index (BMI), schooling, income and height. RESULTS Both the men and women overestimated their heights (p<0.05), by 0.9 cm and 2.2 cm, respectively. There was no difference between self-reported and measured weights, either for the men (-0.44 kg; p=0.06) or for the women (-0.03 kg; p>0.05). The behavior of overestimating height was influenced by age, schooling, height and body mass index. Although this index obtained from the self-reported data was underestimated (p<0.05), by 0.27 kg/m(2) and 0.67 kg/m(2) for men and women respectively, the measured and self-reported data presented a high degree of agreement. Both the sensitivity and specificity of the self-reported body mass index were high, in relation to identifying the measured index. CONCLUSIONS In epidemiological studies for monitoring the prevalence of excess weight in populations, self-reported weights and heights constitute reliable data, which gives validity to the methodology utilized.

Circunferência da cintura e índice de massa corporal como preditores da hipertensão arterial

OBJECTIVE: To evaluate the association between anthropometric indexes - body mass index (BMI) and waist circumference (WC) - and hypertension, and to evaluate the predictive value of these indexes in detecting hypertension. METHODS: Cross-sectional population study conducted in the city of Goiânia (GO) with a sample of 1,238 adults aged twenty to 64 years, in 2001. Total obesity was defined as BMI > 30 kg/m2; abdominal obesity was defined as level 2 WC > 88 cm for women and > 102 cm for men, and hypertension was defined as systolic pressure > 140 mmHg, or diastolic pressure > 90 mmHg, or utilization of hypotensive drugs). Multiple logistic regression analysis was used to evaluate the associations between anthropometric indexes and hypertension. The Receiver Operating Characteristic (ROC) curve analysis was used to evaluate sensitivity and specificity of BMI (> 30) and level 2 WC as predictive factors of hypertension, and to determine the best predictive cut-off points for hypertension. RESULTS: WC was associated with hypertension in both genders. Level 2 WC and BMI >30 kg/m2 showed a low sensitivity in identifying hypertension. The best predictive cut-off points for hypertension coincided with level 1 WC (> 80 cm) and with BMI >25 kg/m2 (overweight) for women, and were lower than the values of level 1 WC and of overweight for men. CONCLUSION: Level 2 WC and BMI > 30 kg/m2 are not adequate to identify the groups at the highest risk of hypertension, since this risk rises with small increases in adiposity.

Prevalence of cardiovascular risk factors in elderly individuals treated in the Brazilian Public Health System in Goiânia

BACKGROUND Cardiovascular risk factors (CVRF) present a high prevalence and have an impact on the morbimortality of the elderly; however, this question is still unknown by the elderly treated in the Brazilian Public Health System (SUS). OBJECTIVE To investigate the prevalence of CVRF among the elderly treated by SUS in the city of Goiânia, state of Goiás, Brazil. METHODS Cross-sectional study using a multiple-stage sampling method, carried out through a home-based interview with 418 elderly individuals aged > 60 years treated by SUS in the city of Goiânia, state of Goiás, Brazil. Socioeconomic and demographic data, as well as data on lifestyle, weight, height, waist circumference, blood pressure and medications used were collected. The studied CVRF were: arterial hypertension, diabetes mellitus, total obesity, central obesity, dyslipidemias, smoking, sedentary lifestyle and alcohol consumption. The Chi-square test was used for the analyses of the associations, with significance being set at 5%. RESULTS The prevalences of the CVRF were: 80.4% of arterial hypertension; 83.3% of central obesity; 59.8% of sedentary lifestyle; 32.2% of total obesity; 23.4% of dyslipidemias; 19.1% of diabetes mellitus; 10.0% of smoking and 5.9% of alcohol consumption. As for the simultaneity, 2.4% of the elderly did not present CVRF. The simultaneity of two or more CVRF occurred in 87.3% of the elderly and was more frequent among women. CONCLUSION The CVRF occur simultaneously in more than half of the elderly individuals, and the most prevalent ones were: arterial hypertension, central obesity and sedentary lifestyle. It is necessary to foster the strategies of health promotion and prevention of cardiovascular injury in elderly individuals treated by SUS in the city of Goiânia, especially among those with simultaneous CVRF.

The relationship between body mass index and lifestyle in a Brazilian adult population: a cross-sectional survey

This study focused on adult obesity prevalence in Goiânia, Goiás State, Brazil, and the association between socio-demographic variables, lifestyle, physical activity, eating habits, and food consumption frequency and body mass index (BMI). A cross-sectional study was conducted in 2001 with a sample of 1,252 individuals from 20 to 64 years of age. The association between socio-demographic variables, lifestyle, food consumption, and physical activity and BMI was evaluated by hierarchical multiple linear regression analysis. Obesity prevalence was 10.7% in men and 13.9% in women. In males, age, income, and meat consumption showed a positive association with BMI, while physical activity during leisure time and commuting and the habit of eating > 4 meals per day were inversely associated with BMI. In women, positively associated factors were age, no smoking, and no meat consumption; in contrast, consumption of grains was inversely associated with BMI. High obesity prevalence was observed; active lifestyle coupled with ingestion of more grains and less meat appeared to protect against increased BMI.

Monitoramento por entrevistas telefônicas de fatores de risco para doenças crônicas: experiência de Goiânia, Goiás, Brasil

Este estudo descreve alguns resultados do sistema de monitoramento de fatores de risco para doencas cronicas por entrevistas telefonicas no Municipio de Goiânia, Goias, Brasil, 2005. Foi estudada amostra probabilistica (n = 2.002) da populacao adulta servida por linhas telefonicas residenciais fixas. Foram analisadas variaveis comportamentais (consumo alimentar, atividade fisica, tabagismo e consumo de bebida alcoolica), peso e altura referidos e referencia a diagnostico medico de doencas cronicas. Foram calculadas estimativas de prevalencia e valores de qui-quadrado. Observou-se baixo consumo de frutas e hortalicas (47,1%), alta frequencia de inatividade fisica ocupacional (86,6%), no deslocamento para o trabalho (92,6%) e lazer (61,9%), consumo excessivo de bebidas alcoolicas (23,2%), excesso de peso (36,5%), obesidade (10,6%), hipertensao arterial (22,4%), dislipidemias (18,4%) e diabetes (4,4%). A maioria dos fatores de risco apresentou associacao inversa com escolaridade e direta com idade, com diferencas significativas entre sexos (p < 0,05). Observou-se alta prevalencia dos fatores de risco de doencas cronicas nao transmissiveis e de auto-referidas. Aspectos positivos do sistema: baixo custo operacional, possibilidade de monitorar a carga e a tendencia das doencas cronicas nao transmissiveis no nivel local.

Fatores associados à prática de atividade física na população adulta de Goiânia: monitoramento por meio de entrevistas telefônicas

INTRODUCAO: A pratica regular de atividades fisicas entre os niveis moderados e vigorosos tem relacao inversa com a morbidade-mortalidade por doencas cardiovasculares e obesidade. E fundamental a identificacao dos determinantes desta pratica para serem propostas estrategias populacionais com vista a adocao de um estilo de vida fisicamente ativo. OBJETIVO: O presente estudo teve por objetivo determinar os fatores associados a pratica de atividade fisica e ao sedentarismo na populacao adulta de Goiânia. MATERIAL E METODOS: Trata-se de parte de um estudo multicentrico, transversal, realizado na cidade de Goiânia/GO com amostra probabilistica da populacao adulta atendida por linhas telefonicas fixas. Foram realizadas 2.002 entrevistas por meio de ligacoes telefonicas, definindo uma taxa de sucesso de 73,1%. A construcao do banco de dados e as analises estatisticas foram realizadas com auxilio do aplicativo STATA, versao 8.0. RESULTADOS: O sedentarismo foi mais prevalente entre as mulheres (55,5%) que entre os homens (42,0%). A prevalencia de hipertensao foi menor naqueles individuos que praticavam atividade fisica (p=0,0002). Em relacao a atividade fisica no lazer, as mulheres foram mais inativas (79,3%) que os homens (66,9%). Houve relacao inversa entre sedentarismo e escolaridade em ambos os sexos. CONCLUSAO: Diante do quadro encontrado de alta frequencia de sedentarismo na populacao, sugere-se a implementacao de estrategias de prevencao primaria para melhorar o perfil de risco para doencas cronicas nao transmissiveis.

Hipertensão arterial e sua associação com índices antropométricos em adultos de uma cidade de pequeno porte do interior do Brasil

OBJECTIVE Estimate the prevalence of Arterial Hypertension (AH) and its association with Body Mass Index (BMI) and Abdominal Circumference (AC) in the adult population from the city of Firminópolis, in the state of Goiás, Brazil. METHODS Descriptive, observational, cross sectional population-based study substantiated by a home survey of a simple random sample (> or = 18 years old). The study evaluated 1168 individuals. Standardized questionnaires. Measurements performed were Blood Pressure (BP) (hypertension: BP > or = 140 x 90 mmHg), weight, height and AC. Microsoft Office Access and Epi-info, 3.3.2 version were used for data storage and analysis, respectively. RESULTS There was a predominance of females (63.2%), mean age was 43.2 +/-14.9 years old. Prevalence of hypertension was 32.7%, with tendency to be higher among the male population (35.8%) when compared to the female (30.9%) (p=0.084). Association between AH and BMI was positive (p < 0.001), as well as between AC and age. Prevalence of overweight was 33.7% and obesity, 16.0%. Overweight was higher among the male population and obesity among the female population. Prevalence of increased as well as greatly increased AC in 51.9% of the studied population, with 28.6% among males and 65.5% among females. CONCLUSION A high prevalence of hypertension and a large number of individuals with BMI and AC above the ideal values were found.OBJETIVO: Estimar a prevalencia da Hipertensao Arterial (HA) em adultos e sua associacao com o Indice de Massa Corporal (IMC) e Circunferencia da Cintura (CC). METODOS: Estudo descritivo, observacional e transversal, de base populacional, com amostra aleatoria simples (>18 anos). Investigados 1.168 individuos. Questionarios padronizados. Realizadas medidas de pressao arterial (criterio de HA > 140x90mmHg), peso, altura e CC. Dados armazenados (programa Microsoft Access) e analisados por meio do programa Epi-info, versao 3.3.2. RESULTADOS: Predominio do sexo feminino (63,2%), idade media 43,2 ± 14,9 anos. Prevalencia de HA de 32,7%, com tendencia a ser maior entre homens (35,8%) que entre mulheres (30,9%) (p=0,084). Associacao positiva (p<0,001) da HA com a idade, IMC e CC. Prevalencia de sobrepeso 33,7% e de obesidade 16,0%. Sobrepeso maior entre homens e obesidade entre mulheres. Prevalencia CC aumentada e muito aumentada em 51,9% da populacao estudada, sendo de 28,6% entre homens e 65,5% entre mulheres. CONCLUSAO: Foi encontrada alta prevalencia de HA e grande contingente de individuos com IMC e CC acima de valores ideais.

Diet and medication in the treatment of hyperuricemia in hypertensive patients

OBJECTIVE To evaluate the effects of diet and medication, either isolated or associated, on serum levels of uric acid in patients with hyperuricemia. METHODS We studied patients from the Hypertension Unit of the University of Goias who had hyperuricemia (men > or =8.5 mg/dL and women > or =7.5 mg/dL). We divided the patients into three groups: G1 (low purine diet), G2 (low purine diet + medication), and G3 (medication only). Patients received allopurinol, 150 mg/day titrated up to 300 mg/dL when necessary. Patients were evaluated with regards to their lifestyles (diet, smoking, physical, activity, alcohol consumption), uric acid, blood pressure, use of medication, body mass index, cholesterol, and triglyceride. Follow-up took place in weeks 0 (M1), 6 (M2), 12 (M3) during the intervention and in week 36 (M4) after the study was completed. RESULTS Fifty-five patients participated in the study, 31 women, mean age 54.4+/-10.6 years, body mass index 28.6+/-3.9 kg/m2. A similar reduction (p<0.001) in uric acid levels occurred in the three intervention groups. In week 36 (M4), after 24 weeks without intervention, a tendency toward elevation of uricemia was noted in G2 and G3, and a continuous drop in uricemia was noted in G1. No significant modifications were observed in the other variables analyzed. CONCLUSION Considering the cost x benefit relationship, a diet low in purine should be the 1st therapeutic option for controlling hyperuricemia in patients with similar characteristic to the ones presented in this study.

Hipertensão arterial e sua correlação com alguns fatores de risco em cidade brasileira de pequeno porte

BACKGROUND: Arterial hypertension (AH) is a health problem that affects a large number of undiagnosed or inadequately treated hypertensive individuals and presents a high rate of treatment nonadherence. OBJECTIVE: To estimate the prevalence of AH and its correlation with some cardiovascular risk factors among the adult population of the town of Firminopolis, state of Goias, Brazil. METHODS: Descriptive, observational and cross-sectional population-based study of a simple random sample (age > 18 years): standardized questionnaires with blood pressure (BP) measurements (AH criterion: BP > 140 x 90 mmHg), weight, height, Body Mass Index (BMI) and waist circumference (WC). Data were stored (Microsoft Access) and analyzed using Epi-info software. RESULTS: We evaluated 1,168 individuals, with a predominance of the female sex - 63.2% and a mean age of 43.2 ± 14.9 years. There was a prevalence of overweight in 33.7% of the individuals and obesity in 16.0% of the individuals. There was a prevalence of altered WC in 51.8% demand of smoking in 23.2%. A sedentary life style at work and leisure activities was present in 67.6% and 64.8% of the individuals, respectively, with a higher proportion seen among the women. Alcohol consumption was observed in 33.3% of the sample. The prevalence of AH was 32.7%, higher among the men (35.8%) than among the women (30.9%). A positive correlation with AH was identified with BMI, WC and age range. A negative correlation was observed between AH and level of schooling, with 18.2% of hypertensive individuals with 9 or more years of schooling. CONCLUSION: A high prevalence of AH, overweight and WC alteration was identified. The female sex represented a protective factor for the risk of AH. A positive correlation was found between AH and BMI, WC and age range; a negative correlation was identified between AH and level of schooling.BACKGROUND arterial hypertension (AH) is a health problem that affects a large number of undiagnosed or inadequately treated hypertensive individuals and presents a high rate of treatment nonadherence. OBJECTIVE to estimate the prevalence of AH and its correlation with some cardiovascular risk factors among the adult population of the town of Firminopolis, state of Goiás, Brazil. METHODS descriptive, observational and cross-sectional population-based study of a simple random sample (age > 18 years): standardized questionnaires with blood pressure (BP) measurements (AH criterion: BP > 140 x 90 mmHg), weight, height, Body Mass Index (BMI) and waist circumference (WC). Data were stored (Microsoft Access) and analyzed using Epi-info software. RESULTS we evaluated 1,168 individuals, with a predominance of the female sex - 63.2% and a mean age of 43.2 ± 14.9 years. There was a prevalence of overweight in 33.7% of the individuals and obesity in 16.0% of the individuals. There was a prevalence of altered WC in 51.8% demand of smoking in 23.2%. A sedentary life style at work and leisure activities was present in 67.6% and 64.8% of the individuals, respectively, with a higher proportion seen among the women. Alcohol consumption was observed in 33.3% of the sample. The prevalence of AH was 32.7%, higher among the men (35.8%) than among the women (30.9%). A positive correlation with AH was identified with BMI, WC and age range. A negative correlation was observed between AH and level of schooling, with 18.2% of hypertensive individuals with 9 or more years of schooling. CONCLUSION a high prevalence of AH, overweight and WC alteration was identified. The female sex represented a protective factor for the risk of AH. A positive correlation was found between AH and BMI, WC and age range; a negative correlation was identified between AH and level of schooling.

Risk Factors Associated with High Blood Pressure in Two-to Five-Year-Old Children

Background Over recent decades, the prevalence of high blood pressure (BP) has increased among children. Several risk factors are involved in the genesis of high BP during childhood, and their early identification can prevent the development of that disease. Objectives To assess the prevalence of high BP and associated factors in children. Methods Cross-sectional, population-based study, carried out at the household. This study included 276 two- to five-year-old children in the city of Goiânia, state of Goiás, and assessed their BP, sociodemographic characteristics, birth weight, high BP family history, passive smoking, maternal breastfeeding, dietary habits, sedentary lifestyle and nutritional status. Poisson regression was used to assess the association between risk factors and high BP. Results Their mean age was 3.1 ± 0.79 years, and high BP and overweight were observed in 19.9% and 11.2% of the children, respectively. Direct association of high BP was identified with age [prevalence ratio (PR) = 2.3; 95%CI: 1.2 - 4.8; p = 0.017] and overweight (PR = 2.0; 95%CI: 1.2 - 3.6; p = 0.014). No other variable associated with high BP. Conclusions The prevalence of high BP in children was high. Overweight and younger children had greater prevalence of high BP.