Thiago de Souza Veiga Jardim

Music therapy effects on the quality of life and the blood pressure of hypertensive patients

FUNDAMENTO: A hipertensao arterial (HA) e uma doenca de massa, com consequencias para o aparelho cardiocirculatorio, pois suas complicacoes elevam as taxas de morbi-mortalidade. Controlar a pressao arterial (PA) diminui complicacoes e pode preservar a qualidade de vida (QV) dos pacientes. Estudos mostram os efeitos positivos da musica como coadjuvante no tratamento de diversas patologias. OBJETIVO: Avaliar o efeito da musicoterapia na QV e no controle da PA de pacientes hipertensos. METODOS: Realizou-se um ensaio clinico controlado que avaliou pacientes de ambos os sexos, maiores que 50 anos, HA estagio 1, em uso de medicacao, matriculados em servico multiprofissional para tratamento da HA. Divididos em grupos experimental (GE) e controle (GC). O GE, alem do tratamento convencional, participou de sessoes musicoterapicas semanais por doze semanas. O GC permaneceu sob tratamento padrao do servico. Antes e apos a intervencao foi aplicado nos dois grupos o questionario SF-36 e verificada a PA. A voz, importante elemento da comunicacao, reflexo do estado fisico, psiquico e emocional, foi o principal recurso utilizado. Estatistica: testes t-Student e Wilcoxon (significantes p<0,05). RESULTADOS: Os grupos eram inicialmente semelhantes quanto a sexo, idade, escolaridade e QV avaliada. Na comparacao inicial e final dos pacientes do GE observamos melhora significativa na QV (p<0,05) e no controle da PA (p<0,05). Sem modificacoes na adesao. CONCLUSOES: A musicoterapia contribuiu para a melhora da QV e do controle da PA, sinalizando que essa atividade pode representar um reforco na abordagem terapeutica em programas de atendimento multidisciplinar ao paciente hipertenso.BACKGROUND Arterial Hypertension (AH) is a mass disease, with consequences for the cardiocirculatory system, since its complications raise the rates of morbidity and mortality. Controlling blood pressure (BP) reduces complications and may preserve the quality of life (QOL) of patients. Studies show positive effects of music therapy as an adjuvant in the treatment of several diseases. OBJECTIVE to evaluate the effect of music therapy on the QOL and BP control of hypertensive patients. METHODS This was a controlled clinical study that evaluated patients of both genders, aged over 50 years, with stage 1 hypertension, in use of medication and enrolled in multidisciplinary service for treatment of hypertension. They were divided into an experimental group (EG) and a control group (CG). The EG, in addition to the conventional treatment, participated in weekly music therapy sessions for twelve weeks. The CG received the standard treatment of the service. Before and after the intervention, the SF-36 questionnaire was applied in both groups, and the BP of each patient was measured. The voice, an important element of communication, reflecting the patients physical, mental and emotional state, was the main resource used. STATISTICS Student T-test and Wilcoxon test were considered significant at p <0.05. RESULTS The groups were initially similar in gender, age, education, and the assessed QOL. In the initial and final comparison of EG patients, we observed a significant improvement on the QOL (p <0.05) and BP control (p <0.05), with no change in adhesion. CONCLUSIONS Music therapy has contributed to an improvement on the QOL and BP control of patients, suggesting that this activity may represent a therapeutic approach to help strengthen the programs of multidisciplinary care of hypertensive patients.

O efeito da musicoterapia na qualidade de vida e na pressão arterial do paciente hipertenso

FUNDAMENTO: A hipertensao arterial (HA) e uma doenca de massa, com consequencias para o aparelho cardiocirculatorio, pois suas complicacoes elevam as taxas de morbi-mortalidade. Controlar a pressao arterial (PA) diminui complicacoes e pode preservar a qualidade de vida (QV) dos pacientes. Estudos mostram os efeitos positivos da musica como coadjuvante no tratamento de diversas patologias. OBJETIVO: Avaliar o efeito da musicoterapia na QV e no controle da PA de pacientes hipertensos. METODOS: Realizou-se um ensaio clinico controlado que avaliou pacientes de ambos os sexos, maiores que 50 anos, HA estagio 1, em uso de medicacao, matriculados em servico multiprofissional para tratamento da HA. Divididos em grupos experimental (GE) e controle (GC). O GE, alem do tratamento convencional, participou de sessoes musicoterapicas semanais por doze semanas. O GC permaneceu sob tratamento padrao do servico. Antes e apos a intervencao foi aplicado nos dois grupos o questionario SF-36 e verificada a PA. A voz, importante elemento da comunicacao, reflexo do estado fisico, psiquico e emocional, foi o principal recurso utilizado. Estatistica: testes t-Student e Wilcoxon (significantes p<0,05). RESULTADOS: Os grupos eram inicialmente semelhantes quanto a sexo, idade, escolaridade e QV avaliada. Na comparacao inicial e final dos pacientes do GE observamos melhora significativa na QV (p<0,05) e no controle da PA (p<0,05). Sem modificacoes na adesao. CONCLUSOES: A musicoterapia contribuiu para a melhora da QV e do controle da PA, sinalizando que essa atividade pode representar um reforco na abordagem terapeutica em programas de atendimento multidisciplinar ao paciente hipertenso.BACKGROUND Arterial Hypertension (AH) is a mass disease, with consequences for the cardiocirculatory system, since its complications raise the rates of morbidity and mortality. Controlling blood pressure (BP) reduces complications and may preserve the quality of life (QOL) of patients. Studies show positive effects of music therapy as an adjuvant in the treatment of several diseases. OBJECTIVE to evaluate the effect of music therapy on the QOL and BP control of hypertensive patients. METHODS This was a controlled clinical study that evaluated patients of both genders, aged over 50 years, with stage 1 hypertension, in use of medication and enrolled in multidisciplinary service for treatment of hypertension. They were divided into an experimental group (EG) and a control group (CG). The EG, in addition to the conventional treatment, participated in weekly music therapy sessions for twelve weeks. The CG received the standard treatment of the service. Before and after the intervention, the SF-36 questionnaire was applied in both groups, and the BP of each patient was measured. The voice, an important element of communication, reflecting the patients physical, mental and emotional state, was the main resource used. STATISTICS Student T-test and Wilcoxon test were considered significant at p <0.05. RESULTS The groups were initially similar in gender, age, education, and the assessed QOL. In the initial and final comparison of EG patients, we observed a significant improvement on the QOL (p <0.05) and BP control (p <0.05), with no change in adhesion. CONCLUSIONS Music therapy has contributed to an improvement on the QOL and BP control of patients, suggesting that this activity may represent a therapeutic approach to help strengthen the programs of multidisciplinary care of hypertensive patients.

Fatores de risco cardiovasculares em coorte de profissionais da área médica: 15 anos de evolução

BACKGROUND According to the World Health Organization (WHO), cardiovascular diseases (CVD) account for 16.7 million deaths per year. Evidence shows that CVD result from the interaction of multiple risk factors that are present from childhood. OBJECTIVE To evaluate the presence and evolution of several cardiovascular risk factors (CVRF) among medical professionals, in a period of 15 years. METHODS We analyzed a group of individuals when they entered medical school, and repeated the analysis after 15 years, comparing the data found. We used CVRF questionnaires (systemic arterial hypertension (SAH); diabetes mellitus (DM); dyslipidemia and family history of premature CVD; smoking habit; alcoholism; and sedentary lifestyle). Cholesterol, blood glucose, BP, weight, height, body mass index (BMI) values were determined. RESULTS We compared 100 subjects (64.0% men with a mean age of 19.9 years) with a total of 72 subjects (62.5% men, 34.8 years) that were included in the study 15 years later. There was an increase in the prevalence of hypertension (6.0% vs 16.7%, p = 0.024), overweight (9.0% vs 26.4%, p = 0.002), and dyslipidemia (4.0% vs 19.14%, p = 0.002). The other CVRF remained unchanged. Analyzing the values of systolic blood pressure (SBP); diastolic blood pressure (DBP); cholesterol; glucose; and BMI, we found an increase in the mean values of all variables (p < 0.05). We observed a positive correlation between the values of SBP, DBP, BMI, and blood glucose measured in the time interval (p < 0.05). CONCLUSION Among medical professionals, there was an elevation in SBP, DBP, glucose, BMI, and cholesterol values in 15 years. In the CVRF prevalence analysis, we found an increase in the prevalence of hypertension, overweight, and dyslipidemia.FUNDAMENTO: Segundo a Organizacao Mundial de Saude (OMS), as doencas cardiovasculares (DCV) sao responsaveis por 16,7 milhoes de mortes/ano. Evidencias mostram que as DCV resultam da interacao entre fatores de risco variados, presentes desde a infância. OBJETIVO: Verificar, em profissionais da area medica, a presenca e evolucao de alguns fatores de risco cardiovasculares (FRCV) em um intervalo de 15 anos. METODOS: Analisamos um grupo de individuos ao ingressar na faculdade de medicina e repetimos a analise 15 anos depois, comparando os dados encontrados. Utilizamos questionarios sobre FRCV (hipertensao arterial sistemica (HAS), diabete melito (DM), dislipidemia e historia familiar de DCV precoce, tabagismo, etilismo e sedentarismo). O colesterol, a glicemia, a PA, o peso, a altura, o indice de massa corporea (IMC) foram determinados. RESULTADOS: Comparamos 100 individuos (sendo 64,0% homens com idade media de 19,9 anos), com os 72 (sendo 62,5% homens, 34,8 anos) incluidos 15 anos apos. Houve aumento na prevalencia de HAS (6,0% vs 16,7%, p = 0,024), excesso de peso (9,0% vs 26,4%, p = 0,002) e dislipidemia (4,0% vs 19,14%, p = 0,002). Os demais FRCV nao se modificaram. Na analise dos valores de pressao arterial sistolica (PAS), pressao arterial diastolica (PAD), colesterol, glicemia e IMC, encontramos elevacao na media de todas variaveis (p < 0,05). Houve correlacao positiva entre valores de PAS, PAD, IMC e glicemia no intervalo de tempo avaliado (p < 0,05). CONCLUSAO: Em profissionais da area medica, encontramos elevacao na PAS, PAD, glicemia, IMC e colesterol em 15 anos. Na analise da prevalencia de FRCV, houve aumento de hipertensao arterial, excesso de peso e dislipidemia.

Cardiovascular risk factors in a cohort of healthcare professionals: 15 years of evolution

BACKGROUND According to the World Health Organization (WHO), cardiovascular diseases (CVD) account for 16.7 million deaths per year. Evidence shows that CVD result from the interaction of multiple risk factors that are present from childhood. OBJECTIVE To evaluate the presence and evolution of several cardiovascular risk factors (CVRF) among medical professionals, in a period of 15 years. METHODS We analyzed a group of individuals when they entered medical school, and repeated the analysis after 15 years, comparing the data found. We used CVRF questionnaires (systemic arterial hypertension (SAH); diabetes mellitus (DM); dyslipidemia and family history of premature CVD; smoking habit; alcoholism; and sedentary lifestyle). Cholesterol, blood glucose, BP, weight, height, body mass index (BMI) values were determined. RESULTS We compared 100 subjects (64.0% men with a mean age of 19.9 years) with a total of 72 subjects (62.5% men, 34.8 years) that were included in the study 15 years later. There was an increase in the prevalence of hypertension (6.0% vs 16.7%, p = 0.024), overweight (9.0% vs 26.4%, p = 0.002), and dyslipidemia (4.0% vs 19.14%, p = 0.002). The other CVRF remained unchanged. Analyzing the values of systolic blood pressure (SBP); diastolic blood pressure (DBP); cholesterol; glucose; and BMI, we found an increase in the mean values of all variables (p < 0.05). We observed a positive correlation between the values of SBP, DBP, BMI, and blood glucose measured in the time interval (p < 0.05). CONCLUSION Among medical professionals, there was an elevation in SBP, DBP, glucose, BMI, and cholesterol values in 15 years. In the CVRF prevalence analysis, we found an increase in the prevalence of hypertension, overweight, and dyslipidemia.FUNDAMENTO: Segundo a Organizacao Mundial de Saude (OMS), as doencas cardiovasculares (DCV) sao responsaveis por 16,7 milhoes de mortes/ano. Evidencias mostram que as DCV resultam da interacao entre fatores de risco variados, presentes desde a infância. OBJETIVO: Verificar, em profissionais da area medica, a presenca e evolucao de alguns fatores de risco cardiovasculares (FRCV) em um intervalo de 15 anos. METODOS: Analisamos um grupo de individuos ao ingressar na faculdade de medicina e repetimos a analise 15 anos depois, comparando os dados encontrados. Utilizamos questionarios sobre FRCV (hipertensao arterial sistemica (HAS), diabete melito (DM), dislipidemia e historia familiar de DCV precoce, tabagismo, etilismo e sedentarismo). O colesterol, a glicemia, a PA, o peso, a altura, o indice de massa corporea (IMC) foram determinados. RESULTADOS: Comparamos 100 individuos (sendo 64,0% homens com idade media de 19,9 anos), com os 72 (sendo 62,5% homens, 34,8 anos) incluidos 15 anos apos. Houve aumento na prevalencia de HAS (6,0% vs 16,7%, p = 0,024), excesso de peso (9,0% vs 26,4%, p = 0,002) e dislipidemia (4,0% vs 19,14%, p = 0,002). Os demais FRCV nao se modificaram. Na analise dos valores de pressao arterial sistolica (PAS), pressao arterial diastolica (PAD), colesterol, glicemia e IMC, encontramos elevacao na media de todas variaveis (p < 0,05). Houve correlacao positiva entre valores de PAS, PAD, IMC e glicemia no intervalo de tempo avaliado (p < 0,05). CONCLUSAO: Em profissionais da area medica, encontramos elevacao na PAS, PAD, glicemia, IMC e colesterol em 15 anos. Na analise da prevalencia de FRCV, houve aumento de hipertensao arterial, excesso de peso e dislipidemia.

Comparison of Cardiovascular Risk Factors in Different Areas of Health Care Over a 20-Year Period

Background Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Knowledge about cardiovascular risk factors (CVRFs) in young adults and their modification over time are measures that change the risks and prevent CVDs. Objectives To determine the presence of CVRFs and their changes in different health care professionals over a period of 20 years. Methods All students of medicine, nursing, nutrition, odontology, and pharmacy departments of Federal University of Goiás who agreed to participate in this study were evaluated when they started their degree courses and 20 years afterward. Questionnaires on CVRFs [systemic arterial hypertension (SAH), diabetes mellitus, dyslipidemia, and family history of early CVD, smoking, alcohol consumption, and sedentarism] were administered. Cholesterol levels, blood sugar levels, blood pressure, weight, height, and body mass index were determined. The Kolmogorov-Smirnov test was used to evaluate distribution, the chi-square test was used to compare different courses and sexes, and the McNemar test was used for comparing CVRFs. The significance level was set at a p value of < 0.05. Results The first stage of the study included 281 individuals (91% of all the students), of which 62.9% were women; the mean age was 19.7 years. In the second stage, 215 subjects were reassessed (76% of the initial sample), of which 59.07% were women; the mean age was 39.8 years. The sample mostly consisted of medical students (with a predominance of men), followed by nursing, nutrition, and pharmacy students, with a predominance of women (p < 0.05). Excessive weight gain, SAH, and dyslipidemia were observed among physicians and dentists (p < 0.05). Excessive weight gain and SAH and a reduction in sedentarism (p < 0.05) were observed among pharmacists. Among nurses there was an increase in excessive weight and alcohol consumption (p < 0.05). Finally, nutritionists showed an increase in dyslipidemia (p < 0.05). Conclusion In general, there was an unfavorable progression of CVRFs in the population under study, despite it having adequate specialized knowledge about these risk factors.

Impact of Light Salt Substitution for Regular Salt on Blood Pressure of Hypertensive Patients

Background Studies have shown sodium restriction to have a beneficial effect on blood pressure (BP) of hypertensive patients. Objective To evaluate the impact of light salt substitution for regular salt on BP of hypertensive patients. Methods Uncontrolled hypertensive patients of both sexes, 20 to 65 years-old, on stable doses of antihypertensive drugs were randomized into Intervention Group (IG - receiving light salt) and Control Group (CG - receiving regular salt). Systolic BP (SBP) and diastolic BP (DBP) were analyzed by using casual BP measurements and Home Blood Pressure Monitoring (HBPM), and sodium and potassium excretion was assessed on 24-hour urine samples. The patients received 3 g of salt for daily consumption for 4 weeks. Results The study evaluated 35 patients (65.7% women), 19 allocated to the IG and 16 to the CG. The mean age was 55.5 ± 7.4 years. Most participants had completed the Brazilian middle school (up to the 8th grade; n = 28; 80.0%), had a family income of up to US

Correlation of Insulin Resistance with Anthropometric Measures and Blood Pressure in Adolescents

600 (n = 17; 48.6%) and practiced regular physical activity (n = 19; 54.3%). Two patients (5.7%) were smokers and 40.0% consumed alcohol regularly (n = 14). The IG showed a significant reduction in both SBP and DBP on the casual measurements and HBPM (p < 0.05) and in sodium excretion (p = 0.016). The CG showed a significant reduction only in casual SBP (p = 0.032). Conclusions The light salt substitution for regular salt significantly reduced BP of hypertensive patients.

El efecto de la musicoterapia en la calidad de vida y en la presión arterial del paciente hipertenso

Background Blood pressure is directly related to body mass index, and individuals with increased waist circumference have higher risk of developing hypertension, insulin resistance, and other metabolic changes, since adolescence. Objective to evaluate the correlation of blood pressure with insulin resistance, waist circumference and body mass index in adolescents. Methods Cross-section study on a representative sample of adolescent students. One group of adolescents with altered blood pressure detected by casual blood pressure and/or home blood pressure monitoring (blood pressure > 90th percentile) and one group of normotensive adolescents were studied. Body mass index, waist circumference were measured, and fasting glucose and plasma insulin levels were determined, using the HOMA-IR index to identify insulin resistance. Results A total of 162 adolescents (35 with normal blood pressure and 127 with altered blood pressure) were studied; 61% (n = 99) of them were boys and the mean age was 14.9 ± 1.62 years. Thirty-eight (23.5%) adolescents had altered HOMA-IR. The group with altered blood pressure had higher values of waist circumference, body mass index and HOMA-IR (p<0.05). Waist circumference was higher among boys in both groups (p<0.05) and girls with altered blood pressure had higher HOMA-IR than boys (p<0.05). There was a significant moderate correlation between body mass index and HOMA-IR in the group with altered blood pressure (ρ = 0.394; p < 0.001), and such correlation was stronger than in the normotensive group. There was also a significant moderate correlation between waist circumference and HOMA-IR in both groups (ρ = 0.345; p < 0.05). Logistic regression showed that HOMA-IR was as predictor of altered blood pressure (odds ratio - OR = 2.0; p = 0.001). Conclusion There was a significant association of insulin resistance with blood pressure and the impact of insulin resistance on blood pressure since childhood. The correlation and association between markers of cardiovascular diseases was more pronounced in adolescents with altered blood pressure, suggesting that primary prevention strategies for cardiovascular risk factors should be early implemented in childhood and adolescence.

Excesso de peso e fatores associados em adolescentes de uma capital brasileira

FUNDAMENTO: A hipertensao arterial (HA) e uma doenca de massa, com consequencias para o aparelho cardiocirculatorio, pois suas complicacoes elevam as taxas de morbi-mortalidade. Controlar a pressao arterial (PA) diminui complicacoes e pode preservar a qualidade de vida (QV) dos pacientes. Estudos mostram os efeitos positivos da musica como coadjuvante no tratamento de diversas patologias. OBJETIVO: Avaliar o efeito da musicoterapia na QV e no controle da PA de pacientes hipertensos. METODOS: Realizou-se um ensaio clinico controlado que avaliou pacientes de ambos os sexos, maiores que 50 anos, HA estagio 1, em uso de medicacao, matriculados em servico multiprofissional para tratamento da HA. Divididos em grupos experimental (GE) e controle (GC). O GE, alem do tratamento convencional, participou de sessoes musicoterapicas semanais por doze semanas. O GC permaneceu sob tratamento padrao do servico. Antes e apos a intervencao foi aplicado nos dois grupos o questionario SF-36 e verificada a PA. A voz, importante elemento da comunicacao, reflexo do estado fisico, psiquico e emocional, foi o principal recurso utilizado. Estatistica: testes t-Student e Wilcoxon (significantes p<0,05). RESULTADOS: Os grupos eram inicialmente semelhantes quanto a sexo, idade, escolaridade e QV avaliada. Na comparacao inicial e final dos pacientes do GE observamos melhora significativa na QV (p<0,05) e no controle da PA (p<0,05). Sem modificacoes na adesao. CONCLUSOES: A musicoterapia contribuiu para a melhora da QV e do controle da PA, sinalizando que essa atividade pode representar um reforco na abordagem terapeutica em programas de atendimento multidisciplinar ao paciente hipertenso.BACKGROUND Arterial Hypertension (AH) is a mass disease, with consequences for the cardiocirculatory system, since its complications raise the rates of morbidity and mortality. Controlling blood pressure (BP) reduces complications and may preserve the quality of life (QOL) of patients. Studies show positive effects of music therapy as an adjuvant in the treatment of several diseases. OBJECTIVE to evaluate the effect of music therapy on the QOL and BP control of hypertensive patients. METHODS This was a controlled clinical study that evaluated patients of both genders, aged over 50 years, with stage 1 hypertension, in use of medication and enrolled in multidisciplinary service for treatment of hypertension. They were divided into an experimental group (EG) and a control group (CG). The EG, in addition to the conventional treatment, participated in weekly music therapy sessions for twelve weeks. The CG received the standard treatment of the service. Before and after the intervention, the SF-36 questionnaire was applied in both groups, and the BP of each patient was measured. The voice, an important element of communication, reflecting the patients physical, mental and emotional state, was the main resource used. STATISTICS Student T-test and Wilcoxon test were considered significant at p <0.05. RESULTS The groups were initially similar in gender, age, education, and the assessed QOL. In the initial and final comparison of EG patients, we observed a significant improvement on the QOL (p <0.05) and BP control (p <0.05), with no change in adhesion. CONCLUSIONS Music therapy has contributed to an improvement on the QOL and BP control of patients, suggesting that this activity may represent a therapeutic approach to help strengthen the programs of multidisciplinary care of hypertensive patients.

A Pressão Arterial dos Pacientes Está Sendo Medida Rotineiramente nos Consultórios Médicos

Objective: To evaluate the prevalence of overweight in adolescents and its associated factors. Methods: A cross-sectional study in public and private schools in Goiania, Brazil. Socioeconomic status, family history of obesity, lifestyle, blood pressure and Body Mass Index were studied in a sample of 1,169 Brazilian youth aged 12 - 18 years, who attended public and private schools. Data were obtained from a questionnaire and anthropometric measurements previously tested in a pilot study. Poisson regression was used to estimate the prevalence of overweight, prevalence ratios and associations with the other factors. Results: The prevalence of overweight was 21.2%, with a significant difference between boys and girls (26.3 and 16.8% respectively). Regression analysis showed that maternal obesity was associated with a higher prevalence of overweight in boys (PR = 1.86; p = 0.004), and boys aged 15 - 18 years had a lower prevalence of overweight than boys aged 12 - 14 years (PR = 0.70; p = 0.021). Among the girls, the presence of obese parents was associated with higher prevalence of overweight (PR = 2.42; p < 0.001), and the girls from a C class socioeconomic position were negatively associated with overweight (PR = 0.67; p = 0.035). Conclusions: Overweight in adolescence is associated with gender, obesity family history, and socioeconomic position. These data should be considered when planning intervention programs.