Maria Regina Pereira de Godoy

Prevalência e fatores sociodemográficos em hipertensos de São José do Rio Preto - SP

BACKGROUND: Systemic arterial hypertension (SAH) is one of the greatest problems of public health in Brazil. Its detection and early treatment should be a priority to reduce the morbimortality of the cardiovascular diseases. OBJECTIVE: This study aimed at assessing the prevalence of SAH and the sociodemographic factors in a population of hypertensive individuals from Sao Jose do Rio Preto, Sao Paulo, Brazil. METHODS: A cross-sectional study was carried out in a stratified sample of 1,717 people, representative of the urban adult population from the city of Sao Jose do Rio Preto, between 2004 and 2005. RESULTS: The sample consisted of 1,717 people, with 762 of them (25.2%) being characterized as hypertensive. The following results were observed: 54.6% were women; 78.4% were caucasian; 66.1% were illiterate or had not finished Elementary School; 63.9% were married, 40.9% belonged to social classes D and E; 37.9% were self-employed or wage earners. CONCLUSION: The results of study on SAH in the city of Sao Jose do Rio Preto shows the need for early-onset continuous educational interventions.BACKGROUND Systemic arterial hypertension (SAH) is one of the greatest problems of public health in Brazil. Its detection and early treatment should be a priority to reduce the morbimortality of the cardiovascular diseases. OBJECTIVE This study aimed at assessing the prevalence of SAH and the sociodemographic factors in a population of hypertensive individuals from São José do Rio Preto, São Paulo, Brazil. METHODS A cross-sectional study was carried out in a stratified sample of 1,717 people, representative of the urban adult population from the city of São José do Rio Preto, between 2004 and 2005. RESULTS The sample consisted of 1,717 people, with 762 of them (25.2%) being characterized as hypertensive. The following results were observed: 54.6% were women; 78.4% were caucasian; 66.1% were illiterate or had not finished Elementary School; 63.9% were married, 40.9% belonged to social classes D and E; 37.9% were self-employed or wage earners. CONCLUSION The results of study on SAH in the city of São José do Rio Preto shows the need for early-onset continuous educational interventions.

Prevalência e fatores de risco para hipertensão em uma população urbana brasileira

FUNDAMENTO: Os estudos disponiveis nao analisaram de modo abrangente os varios fatores envolvidos na genese da hipertensao (HT), especialmente a associacao entre pressao arterial, excrecao urinaria de sodio e disfuncao renal. OBJETIVO: Avaliar a prevalencia dos fatores de risco para HT em diferentes grupos etarios em uma amostra representativa da uma populacao urbana brasileira. METODOS: A populacao estudada (1.717 individuos adultos) foi avaliada por grupos etarios: 18 a 39 anos; 40 a 49; 50 a 59; 60 a 69 e > 70 anos. As medias das variaveis quantitativas e as variaveis categoricas dos grupos normotenso e hipertenso foram comparadas. RESULTADOS: A prevalencia geral ajustada para HT foi de 25,23%. A prevalencia aumentou com a idade e era mais alta em individuos com baixo nivel educacional. Indice de massa corporal e circunferencia abdominal aumentados estavam positivamente associados com uma maior prevalencia de HT. Havia uma associacao positiva significante entre HT e excrecao urinaria de sodio. Os individuos hipertensos apresentavam maior frequencia de disfuncao renal, definida como clearance de creatinina <60 ml/min/m2. A prevalencia de diabetes mellitus na populacao geral era de 5,6% e 14,5% nos individuos hipertensos. A hipertensao era uma condicao conhecida por 74,4% dos individuos hipertensos. Entre os individuos hipertensos tratados, 52,4% tinham a hipertensao controlada e apenas 34,3% dos pacientes hipertensos no geral (tratados ou nao) tinham a pressao arterial controlada. CONCLUSAO: Esse estudo de base populacional e especial devido ao fato de agregar diferentes fatores demograficos, epidemiologicos e de risco envolvidos na genese da hipertensao na avaliacao de uma unica amostra com um calculo populacional que pode ser extrapolado para outras populacoes hipertensas.BACKGROUND The available studies have not fully analyzed the several factors involved in the genesis of hypertension (HT), especially the association among blood pressure, urinary sodium excretion and renal dysfunction. OBJECTIVE To assess the HT prevalence and risk factors in different age groups in a representative sample of an urban Brazilian population. METHODS The studied population (1717 adult individuals) was evaluated by age groups: 18 to 39 years; 40 to 49; 50 to 59; 60 to 69 and > 70 years. Quantitative variable means and categorical variables of the hypertensive and normotensive groups were compared. RESULTS The adjusted overall prevalence of HT was 25.23%. The prevalence increased with age and was higher in individuals with low educational level. Increased body mass index and abdominal waist were positively related to a higher prevalence of HT. There was a significant positive association between HT and urinary sodium excretion. Hypertensive individuals presented higher frequency of renal dysfunction, defined as measured creatinine clearance <60 ml/min/m(2). The prevalence of diabetes mellitus was 5.6% in the overall population and 14.5% in hypertensive individuals. Hypertension was a known condition to 74.4% of the hypertensive individuals. Among treated hypertensive individuals, 52.4% achieved controlled blood pressure and only 34.3% of the overall hypertensive patients (treated or not) had blood pressure controlled. CONCLUSION This population-based is unique by gathering different demographic, epidemiologic and risk factors involved in the genesis of hypertension in a single sample assessment with a population calculation, which might be extrapolated to other hypertensive populations.

Glutathione S-transferase variants increase susceptibility for late-onset Alzheimer's disease: association study and relationship with apolipoprotein E ɛ4 allele

Abstract Background: Several factors participate in the pathogenesis of Alzheimers disease (AD), including free radicals, which when out of balance with their antioxidant capacity contribute to the oxidative stress process and neuronal death. The glutathione S-transferase (GST) polymorphisms are associated with the organism detoxification capacity and can help with the identification of sub-groups that present susceptibility to the development of AD. The aim of this study was to analyze the association of GSTs, including GSTP1, GSTT1 and GSTM1 and apolipoprotein E (apoE) with AD and the distribution of these polymorphisms in the first-degree relatives of patients. Methods: For this, 41 patients with AD, 24 elderly without cognitive deficits (control group), 109 relatives of patients with AD and 41 relatives of controls were studied. A sample of peripheral blood was drawn for leukocyte DNA extraction. The genetic polymorphisms were analyzed by PCR-RFLP. Results: There was a significantly higher frequency of the ɛ4 allele in the patients (0.21) and in their relatives (0.25) when compared to controls (0.04; p=0.01) and their relatives (0.03; p<0.0001). The V allele of the GSTP1 polymorphism was higher in patients compared to controls (0.35 and 0.19, respectively; p=0.04). In contrast, the presence of the GSTT1 polymorphism prevailed in controls (79%) and their relatives. Conclusions: The V allele may be a risk factor for AD, mainly in the presence of the apoE ɛ4 allele, while the presence of GSTT1 may indicate protection against the disease. Clin Chem Lab Med 2008;46:439–45.

Hypertension prevalence and risk factors in a Brazilian urban population

FUNDAMENTO: Os estudos disponiveis nao analisaram de modo abrangente os varios fatores envolvidos na genese da hipertensao (HT), especialmente a associacao entre pressao arterial, excrecao urinaria de sodio e disfuncao renal. OBJETIVO: Avaliar a prevalencia dos fatores de risco para HT em diferentes grupos etarios em uma amostra representativa da uma populacao urbana brasileira. METODOS: A populacao estudada (1.717 individuos adultos) foi avaliada por grupos etarios: 18 a 39 anos; 40 a 49; 50 a 59; 60 a 69 e > 70 anos. As medias das variaveis quantitativas e as variaveis categoricas dos grupos normotenso e hipertenso foram comparadas. RESULTADOS: A prevalencia geral ajustada para HT foi de 25,23%. A prevalencia aumentou com a idade e era mais alta em individuos com baixo nivel educacional. Indice de massa corporal e circunferencia abdominal aumentados estavam positivamente associados com uma maior prevalencia de HT. Havia uma associacao positiva significante entre HT e excrecao urinaria de sodio. Os individuos hipertensos apresentavam maior frequencia de disfuncao renal, definida como clearance de creatinina <60 ml/min/m2. A prevalencia de diabetes mellitus na populacao geral era de 5,6% e 14,5% nos individuos hipertensos. A hipertensao era uma condicao conhecida por 74,4% dos individuos hipertensos. Entre os individuos hipertensos tratados, 52,4% tinham a hipertensao controlada e apenas 34,3% dos pacientes hipertensos no geral (tratados ou nao) tinham a pressao arterial controlada. CONCLUSAO: Esse estudo de base populacional e especial devido ao fato de agregar diferentes fatores demograficos, epidemiologicos e de risco envolvidos na genese da hipertensao na avaliacao de uma unica amostra com um calculo populacional que pode ser extrapolado para outras populacoes hipertensas.BACKGROUND The available studies have not fully analyzed the several factors involved in the genesis of hypertension (HT), especially the association among blood pressure, urinary sodium excretion and renal dysfunction. OBJECTIVE To assess the HT prevalence and risk factors in different age groups in a representative sample of an urban Brazilian population. METHODS The studied population (1717 adult individuals) was evaluated by age groups: 18 to 39 years; 40 to 49; 50 to 59; 60 to 69 and > 70 years. Quantitative variable means and categorical variables of the hypertensive and normotensive groups were compared. RESULTS The adjusted overall prevalence of HT was 25.23%. The prevalence increased with age and was higher in individuals with low educational level. Increased body mass index and abdominal waist were positively related to a higher prevalence of HT. There was a significant positive association between HT and urinary sodium excretion. Hypertensive individuals presented higher frequency of renal dysfunction, defined as measured creatinine clearance <60 ml/min/m(2). The prevalence of diabetes mellitus was 5.6% in the overall population and 14.5% in hypertensive individuals. Hypertension was a known condition to 74.4% of the hypertensive individuals. Among treated hypertensive individuals, 52.4% achieved controlled blood pressure and only 34.3% of the overall hypertensive patients (treated or not) had blood pressure controlled. CONCLUSION This population-based is unique by gathering different demographic, epidemiologic and risk factors involved in the genesis of hypertension in a single sample assessment with a population calculation, which might be extrapolated to other hypertensive populations.

Evaluation of the awareness, control and cost-effectiveness of hypertension treatment in a Brazilian city: populational study.

Objectives Hypertension is a highly prevalent disease worldwide, constituting one of the main risk factors for cardiovascular morbidity and mortality. The aims of this study were to evaluate the level of awareness and control of hypertension comparing sex, socioeconomic and educational level, BMI and drug therapy in over 40-year-old patients. The cost-effectiveness of the main pharmacologic classes of antihypertensives, as monotherapy and combination therapy, was also assessed. Methods In this randomized and cross-sectional populational study, a sample of 738 hypertensive adults with ages at least 40 years were evaluated. Of these, 345 (46.7%) were men and 393 (53.3%) were women. Results A total of 72.9% of the hypertensives knew about their disease. Women in the 40–49 and 50–59 age groups and obese individuals had a higher rate of awareness of their hypertensive status. The rates of awareness were similar in different social classes and educational levels, however, blood pressure control varied. β-Blockers were the most effective drugs to control blood pressure with no differences being observed between monotherapy and combinations. Diuretics were the most cost-effective. Conclusion Approximately half of the participants received monotherapy. The best percentage of control with monotherapy was obtained with β-blockers but the diuretics treatment was the most cost-effective. The levels of awareness and control were high compared with developed countries, most evident in the higher social classes and higher education levels.

Polimorfismo da apolipoproteína e nos familiares em primeiro grau de pacientes com doença de Alzheimer familial ou esporádica

INTRODUCTION Apolipoprotein E (apo E) has been recognized as a risk factor for Alzheimer disease (AD). OBJECTIVE To analyze apo E polymorphism in first-degree relatives of patients with familial or sporadic late-onset AD comparing with families without AD. METHOD Forty patients with familial or sporadic late-onset of AD, being both groups classified as probable, according of NINCS-ADRDAs criteria. RESULTS Allele epsilon3 was the most frequent in all of these groups. Higher frequency of epsilon4 when comparing the relatives of the probands with the relatives of the control group (p<0,0001) was observed. Allele epsilon2 showed significant difference only between relatives of familial AD and relatives of control group (p=0,026). CONCLUSION Apo E polymorphism has not differentiated familial from sporadic AD. The study of families allows to amplify the alelles epsilon2 and epsilon4 representative, revealing, their value as protecting factor and of risk for AD, respectively.

Anticardiolipin Antibodies as a Risk Factor of Atherosclerosis in Intermittent Claudication

Anticardiolipin antibodies have been associated as a risk factor of atherosclerosis. The aim of this study was to evaluate the association between anticardiolipin antibodies and intermittent claudication. Forty consecutive patients (33 men, 7 women; age range: 45-84 years, mean 65.5) who were seen in the angiology and vascular surgery department with intermittent claudication were evaluated. Exclusion criteria included prior revascularization, angioplasty, or a history of thrombosis of a lower limb. Forty individuals (23 men, 17 women; age range: 58-82 years, mean 67.1) who attended a support group for senior citizens and who were apparently healthy formed the control group. Anticardiolipin antibodies were evaluated by means of enzyme-linked immunosorbent assay (ELISA) for quantitative measurement of immunoglobulin G (IgG) and IgM antibodies against cardiolipins in serum. IgG levels were considered normal when <7, borderline from 7 to 10, and elevated at >10 GPL units/mL; IgM levels were normal when <4, borderline from 4 to 7, and elevated at >7 MPL, as recommended by the test manufacturers. Statistical analysis used the relative risk test with a confidence interval of 95%. Twenty-three patients from the study group and 6 individuals from the control group were found to have elevated levels of anticardiolipin antibodies giving a relative risk of 3.833 (ranging from 1.749 to 8.4; p value <0.0001). In conclusion, patients who have elevated levels of anticardiolipin antibodies present a 3.8 times greater risk of developing intermittent claudication.

Prevalencia y factores de riesgo para hipertensión en una población urbana brasilera

FUNDAMENTO: Os estudos disponiveis nao analisaram de modo abrangente os varios fatores envolvidos na genese da hipertensao (HT), especialmente a associacao entre pressao arterial, excrecao urinaria de sodio e disfuncao renal. OBJETIVO: Avaliar a prevalencia dos fatores de risco para HT em diferentes grupos etarios em uma amostra representativa da uma populacao urbana brasileira. METODOS: A populacao estudada (1.717 individuos adultos) foi avaliada por grupos etarios: 18 a 39 anos; 40 a 49; 50 a 59; 60 a 69 e > 70 anos. As medias das variaveis quantitativas e as variaveis categoricas dos grupos normotenso e hipertenso foram comparadas. RESULTADOS: A prevalencia geral ajustada para HT foi de 25,23%. A prevalencia aumentou com a idade e era mais alta em individuos com baixo nivel educacional. Indice de massa corporal e circunferencia abdominal aumentados estavam positivamente associados com uma maior prevalencia de HT. Havia uma associacao positiva significante entre HT e excrecao urinaria de sodio. Os individuos hipertensos apresentavam maior frequencia de disfuncao renal, definida como clearance de creatinina <60 ml/min/m2. A prevalencia de diabetes mellitus na populacao geral era de 5,6% e 14,5% nos individuos hipertensos. A hipertensao era uma condicao conhecida por 74,4% dos individuos hipertensos. Entre os individuos hipertensos tratados, 52,4% tinham a hipertensao controlada e apenas 34,3% dos pacientes hipertensos no geral (tratados ou nao) tinham a pressao arterial controlada. CONCLUSAO: Esse estudo de base populacional e especial devido ao fato de agregar diferentes fatores demograficos, epidemiologicos e de risco envolvidos na genese da hipertensao na avaliacao de uma unica amostra com um calculo populacional que pode ser extrapolado para outras populacoes hipertensas.BACKGROUND The available studies have not fully analyzed the several factors involved in the genesis of hypertension (HT), especially the association among blood pressure, urinary sodium excretion and renal dysfunction. OBJECTIVE To assess the HT prevalence and risk factors in different age groups in a representative sample of an urban Brazilian population. METHODS The studied population (1717 adult individuals) was evaluated by age groups: 18 to 39 years; 40 to 49; 50 to 59; 60 to 69 and > 70 years. Quantitative variable means and categorical variables of the hypertensive and normotensive groups were compared. RESULTS The adjusted overall prevalence of HT was 25.23%. The prevalence increased with age and was higher in individuals with low educational level. Increased body mass index and abdominal waist were positively related to a higher prevalence of HT. There was a significant positive association between HT and urinary sodium excretion. Hypertensive individuals presented higher frequency of renal dysfunction, defined as measured creatinine clearance <60 ml/min/m(2). The prevalence of diabetes mellitus was 5.6% in the overall population and 14.5% in hypertensive individuals. Hypertension was a known condition to 74.4% of the hypertensive individuals. Among treated hypertensive individuals, 52.4% achieved controlled blood pressure and only 34.3% of the overall hypertensive patients (treated or not) had blood pressure controlled. CONCLUSION This population-based is unique by gathering different demographic, epidemiologic and risk factors involved in the genesis of hypertension in a single sample assessment with a population calculation, which might be extrapolated to other hypertensive populations.