Pedro Cunha
University of Minho
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Publication
Featured researches published by Pedro Cunha.
Journal of Hypertension | 2013
Peter Nilsson; Pierre Boutouyrie; Pedro Cunha; Vasilios Kotsis; Krzysztof Narkiewicz; Gianfranco Parati; Ernst Rietzschel; Angelo Scuteri; Stéphane Laurent
The ageing of the vascular tree is a fundamental reflection of biological ageing in general and a determinant of organ function. In the arterial wall this is characterized by a reduction in the elastin content, as well as by an increased content of collagen and its cross-linkages, leading to increased arterial stiffness and elevated central as well as brachial blood pressure, accompanied by increased SBP variability. In recent years a better understanding of these processes have led to the proposal of a condition named early vascular ageing (EVA) in patients with increased arterial stiffness for their age and sex. This is a condition that could increase cardiovascular risk and is associated with various degrees of cognitive dysfunction, as well as other features of biological ageing. This brief review aims to give an update on EVA and how the concept can be used in clinical practice.
European Journal of Preventive Cardiology | 2015
Angelo Scuteri; Stéphane Laurent; Francesco Cucca; John R. Cockcroft; Pedro Cunha; Leocadio Rodriguez Mañas; Francesco Mattace Raso; Maria Lorenza Muiesan; Ligita Ryliškytė; Ernst Rietzschel; James B. Strait; Charalambos Vlachopoulos; Henry Völzke; Edward G. Lakatta; Peter Nilsson
Background: Metabolic syndrome (MetS) remains a controversial entity. Specific clusters of MetS components – rather than MetS per se – are associated with accelerated arterial ageing and with cardiovascular (CV) events. To investigate whether the distribution of clusters of MetS components differed cross-culturally, we studied 34,821 subjects from 12 cohorts from 10 European countries and one cohort from the USA in the MARE (Metabolic syndrome and Arteries REsearch) Consortium. Methods: In accordance with the ATP III criteria, MetS was defined as an alteration three or more of the following five components: elevated glucose (G), fasting glucose ≥110 mg/dl; low HDL cholesterol, < 40mg/dl for men or <50 mg/dl for women; high triglycerides (T), ≥150 mg/dl; elevated blood pressure (B), ≥130/≥85 mmHg; abdominal obesity (W), waist circumference >102 cm for men or >88 cm for women. Results: MetS had a 24.3% prevalence (8468 subjects: 23.9% in men vs. 24.6% in women, p < 0.001) with an age-associated increase in its prevalence in all the cohorts. The age-adjusted prevalence of the clusters of MetS components previously associated with greater arterial and CV burden differed across countries (p < 0.0001) and in men and women (p < 0.0001). In details, the cluster TBW was observed in 12% of the subjects with MetS, but was far more common in the cohorts from the UK (32.3%), Sardinia in Italy (19.6%), and Germany (18.5%) and less prevalent in the cohorts from Sweden (1.2%), Spain (2.6%), and the USA (2.5%). The cluster GBW accounted for 12.7% of subjects with MetS with higher occurrence in Southern Europe (Italy, Spain, and Portugal: 31.4, 18.4, and 17.1% respectively) and in Belgium (20.4%), than in Northern Europe (Germany, Sweden, and Lithuania: 7.6, 9.4, and 9.6% respectively). Conclusions: The analysis of the distribution of MetS suggested that what follows under the common definition of MetS is not a unique entity rather a constellation of cluster of MetS components, likely selectively risky for CV disease, whose occurrence differs across countries.
Journal of Aging Research | 2013
Patrício Costa; Nadine Correia Santos; Pedro Cunha; Jorge Cotter; Nuno Sousa
The main focus of this study was to illustrate the applicability of multiple correspondence analysis (MCA) in detecting and representing underlying structures in large datasets used to investigate cognitive ageing. Principal component analysis (PCA) was used to obtain main cognitive dimensions, and MCA was used to detect and explore relationships between cognitive, clinical, physical, and lifestyle variables. Two PCA dimensions were identified (general cognition/executive function and memory), and two MCA dimensions were retained. Poorer cognitive performance was associated with older age, less school years, unhealthier lifestyle indicators, and presence of pathology. The first MCA dimension indicated the clustering of general/executive function and lifestyle indicators and education, while the second association was between memory and clinical parameters and age. The clustering analysis with object scores method was used to identify groups sharing similar characteristics. The weaker cognitive clusters in terms of memory and executive function comprised individuals with characteristics contributing to a higher MCA dimensional mean score (age, less education, and presence of indicators of unhealthier lifestyle habits and/or clinical pathologies). MCA provided a powerful tool to explore complex ageing data, covering multiple and diverse variables, showing if a relationship exists and how variables are related, and offering statistical results that can be seen both analytically and visually.
Age | 2013
Nadine Correia Santos; Patrício Costa; Pedro Cunha; Jorge Cotter; Adriana Sampaio; J. Zihl; O. F. X. Almeida; João José Cerqueira; Joana Almeida Palha; Nuno Sousa
Identification of predictors of cognitive trajectories through the establishment of composite or single-parameter dimensional categories of cognition and mood may facilitate development of strategies to improve quality of life in the elderly. Participants (n = 487, aged 50+ years) were representative of the Portuguese population in terms of age, gender, and educational status. Cognitive and mood profiles were established using a battery of neurocognitive and psychological tests. Data were subjected to principal component analysis to identify core dimensions of cognition and mood, encompassing multiple test variables. Dimensions were correlated with age and with respect to gender, education, and occupational status. Cluster analysis was applied to isolate distinct patterns of cognitive performance and binary logistic regression models to explore interrelationships between aging, cognition, mood, and socio-demographic characteristics. Four main dimensions were identified: memory, executive function, global cognitive status, and mood. Based on these, strong and weak cognitive performers were distinguishable. Cluster analysis revealed further distinction within these two main categories into very good, good, poor, and very poor performers. Mood was the principal factor contributing to the separation between very good and good, as well as poor and very poor, performers. Clustering was also influenced by gender and education, albeit to a lesser extent; notably, however, female gender × lower educational background predicted significantly poorer cognitive performance with increasing age. Mood has a significant impact on the rate of cognitive decline in the elderly. Gender and educational level are early determinants of cognitive performance in later life.
PLOS ONE | 2011
Ana Cristina Paulo; Adriana Sampaio; Nadine Correia Santos; Patrício Costa; Pedro Cunha; J. Zihl; João José Cerqueira; Joana Almeida Palha; Nuno Sousa
Background The Minho Integrative Neuroscience Database (MIND)-Ageing project aims to identify predictors of healthy cognitive ageing, including socio-demographic factors. In this exploratory analysis we sought to establish baseline cohorts for longitudinal assessment of age-related changes in cognition. Methods The population sample (472 individuals) was strictly a convenient one, but similar to the Portuguese population in the age profile. Participants older than 55 years of age were included if they did not present defined disabling pathologies or dementia. A standardized clinical interview was conducted to assess medical history and a battery of neuropsychological tests was administered to characterize global cognition (Mini Mental State Examination), memory and executive functions (Selective Reminding Test; Stroop Color and Word Test; and Block Design subtest of the Wechsler Adult Intelligence Scale). Cross-sectional analysis of the neuropsychological performance with individual characteristics such as age, gender, educational level and setting (retirement home, senior university, day care center or community), allowed the establishment of baseline clusters for subsequent longitudinal studies. Results Based on different socio-demographic characteristics, four main clusters that group distinctive patterns of cognitive performance were identified. The type of institution where the elders were sampled from, together with the level of formal education, were the major hierarchal factors for individual distribution in the four clusters. Of notice, education seems to delay the cognitive decline that is associated with age in all clusters. Conclusions Social-inclusion/engagement and education seem to have a protective effect on mental ageing, although this effect may not be effective in the eldest elders.
Journal of Hypertension | 2013
Jorge Cotter; Maria J. Cotter; Pedro Oliveira; Pedro Cunha; Jorge Polónia
Objective: The aim of the study was to evaluate the 24-h urinary sodium excretion in children of 10–12 years at a school in the north of Portugal and to examine the influence on salt intake and blood pressure of three different educational interventions for 6 months. Methods: Blood pressure (BP) and sodium excretion in 24-h urinary samples (UNa+) validated with urinary creatinine were measured in 155 children 10–12 years old belonging to nine classes at baseline and after 6 months of three educational interventions in students from three classes each after parents consent was obtained. Interventions consisted in no additional action [control (CTR)], weekly lessons about the dangers of high salt intake [Theoretical (THEOR)] and both lessons and working practices in the school garden of planting, collection of herbs for salt substitution at home [practical (PRACT)]. Results: At baseline 139 students (76 girls and 63 boys) were eligible showing average 24-h UNa+ of 132 ± 43 mmol/24 h (mean salt intake of 7.8 ± 2.5 g per day) and BP of 118/62 (13/9) mmHg that did not correlate to each other. At the end of the study, versus baseline, BP decreased by 8.2/6.5 mmHg in CTR (n = 31), by 3.8/0.6 mmHg in THEOR (n = 43) and by 3.5/0.7 mmHg in PRACT (n = 53) and salt intake was reduced by 0.4 ± 2.4 g per day in CTR, by 0.6 ± 3.2 g per day in THEOR and by 1.1 ± 2.5 g per day in PRACT. It was observed that salt intake variation was not independent of the group (CRT, THEOR and PRACT) (&khgr;2, 9.982, P = 0.041). Salt intake was significantly reduced only in the PRACT group (1.1 g per day) and in the PRACT group the percentage of children who reduced salt intake by at least 1g per day from baseline to the end of the study was significantly higher (50.9%) than that of the other groups, THEOR, 48.8% and CTR, 32.2%. Conclusion: Our data indicates that children 10–12 years old have a high salt intake that is well above the proposed recommendations and that a strategy based on theoretical and practical education may achieve in some children an important reduction in daily salt intake which, if maintained over time, may assume important public health implications. These results suggest that in those children a more complete theoretical and practical intervention is more productive and efficient towards reduction of salt intake than single theoretical or no intervention.
Frontiers in Aging Neuroscience | 2014
Nadine Correia Santos; Patrício Costa; Pedro Cunha; Carlos Portugal-Nunes; Liliana Amorim; Jorge Cotter; João José Cerqueira; Joana Almeida Palha; Nuno Sousa
It is relevant to unravel the factors that may mediate the cognitive decline observed during aging. Previous reports indicate that education has a positive influence on cognitive performance, while age, female gender and, especially, depressed mood were associated with poorer performances across multiple cognitive dimensions (memory and general executive function). Herein, the present study aimed to characterize the cognitive performance of community-dwelling individuals within distinct educational groups categorized by the number of completed formal school years: “less than 4,” “4, completed primary education,” and “more than 4.” Participants (n = 1051) were randomly selected from local health registries and representative of the Portuguese population for age and gender. Neurocognitive and clinical assessments were conducted in local health care centers. Structural equation modeling was used to derive a cognitive score, and hierarchical linear regressions were conducted for each educational group. Education, age and depressed mood were significant variables in directly explaining the obtained cognitive score, while gender was found to be an indirect variable. In all educational groups, mood was the most significant factor with effect on cognitive performance. Specifically, a depressed mood led to lower cognitive performance. The clinical disease indices cardiac and stroke associated with a more negative mood, while moderate increases in BMI, alcohol consumption and physical activity associated positively with improved mood and thus benefitted cognitive performance. Results warrant further research on the cause-effect (longitudinal) relationship between clinical indices of disease and risk factors and mood and cognition throughout aging.
PLOS ONE | 2015
Nadine Correia Santos; Patrício Costa; Liliana Amorim; Pedro Silva Moreira; Pedro Cunha; Jorge Cotter; Nuno Sousa
Here we focus on factor analysis from a best practices point of view, by investigating the factor structure of neuropsychological tests and using the results obtained to illustrate on choosing a reasonable solution. The sample (n=1051 individuals) was randomly divided into two groups: one for exploratory factor analysis (EFA) and principal component analysis (PCA), to investigate the number of factors underlying the neurocognitive variables; the second to test the “best fit” model via confirmatory factor analysis (CFA). For the exploratory step, three extraction (maximum likelihood, principal axis factoring and principal components) and two rotation (orthogonal and oblique) methods were used. The analysis methodology allowed exploring how different cognitive/psychological tests correlated/discriminated between dimensions, indicating that to capture latent structures in similar sample sizes and measures, with approximately normal data distribution, reflective models with oblimin rotation might prove the most adequate.
PLOS ONE | 2013
Patrício Costa; Nadine Correia Santos; Pedro Cunha; Joana Almeida Palha; Nuno Sousa
The main focus of this study is to illustrate the applicability of latent class analysis in the assessment of cognitive performance profiles during ageing. Principal component analysis (PCA) was used to detect main cognitive dimensions (based on the neurocognitive test variables) and Bayesian latent class analysis (LCA) models (without constraints) were used to explore patterns of cognitive performance among community-dwelling older individuals. Gender, age and number of school years were explored as variables. Three cognitive dimensions were identified: general cognition (MMSE), memory (MEM) and executive (EXEC) function. Based on these, three latent classes of cognitive performance profiles (LC1 to LC3) were identified among the older adults. These classes corresponded to stronger to weaker performance patterns (LC1>LC2>LC3) across all dimensions; each latent class denoted the same hierarchy in the proportion of males, age and number of school years. Bayesian LCA provided a powerful tool to explore cognitive typologies among healthy cognitive agers.
Nephron Clinical Practice | 2009
Jorge Cotter; Pedro Oliveira; Pedro Cunha; Jorge Polónia
Aims: To investigate risk factors for progression to microalbuminuria in normoalbuminuric hypertensive patients. Methods: In a longitudinal study, 173 previously treated normoalbuminuric hypertensive patients with high cardiovascular risk (70% diabetics) were evaluated at study entry and after 12 months. Levels of urinary albumin excretion (UAE; study entry and end of study) were compared between patients remaining normoalbuminuric (RNA) and progressors to non-normoalbuminuric (NNA) levels. Results: Out of 173 patients (59 ± 13 years), 12% evolved to NNA levels. At baseline, NNA and RNA groups did not differ in age, sex, diabetes, lipids, blood pressure (BP), drug therapy, or glomerular filtration rate. In comparison with RNA patients, the NNA group showed higher hypertension duration, greater UAE and percentage of patients with UAE ≥10 mg/g creatinine (76.2 vs. 45.4%) at study entry and higher BP levels (158/92 ± 25/10 vs. 143/83 ± 20/12 mm Hg) at study end (all p < 0.05). Logistic regression analysis identified absolute UAE values at study entry and study end variation of BP and cholesterol as independent contributors to the increase in the log odds of developing microalbuminuria. Conclusions: Normoalbuminuric hypertensives with UAE within the upper two thirds of normal range are 3 times as likely to develop microalbuminuria after 1 year. A poor BP and lipid control are also associated with increased risk of microalbuminuria.