Weimar Kunz Sebba Barroso de Souza

Hipertensão arterial e alguns fatores de risco em uma capital brasileira

OBJECTIVES: Estimate the prevalence of hypertension and some cardiovascular risk factors in the adult population of a major city in Brazil. METHODS: Descriptive, observational, transversal population-based study substantiated by the home survey of a simple random sample (>18 years old). Standardized questionnaires were used to obtain sociodemographic information, measurements of blood pressure (2 measurements), weight, height, and abdominal circumference (AC). Microsoft Access and Epi Info 6 were used for data storage and analysis, respectively. The last blood pressure reading was used (hypertension: BP>140x90mmHg). RESULTS: The study evaluated 1,739 individuals (87% of the estimated sample). There was a predominance of females (65.4%) and mean age was 39.7 years (±15.6); arterial hypertension prevalence was 36.4%, higher for the male population (41.8%) when compared to females (31.8%). Correlation between Hypertension and Body Mass Index was positive, as well as with AC and age. The female gender and higher income were protective factors against hypertension. There was no correlation with schooling. Prevalence of overweight and obesity were 30.0% and 13.6%, respectively; overweight was higher among females and obesity among males. The prevalence of smoking was 20.1%, more frequent among males (27.1%), when compared to females (16.4%). A sedentary lifestyle was observed in 62.3% of the population, with no difference between the genders. Regular alcohol consumption was reported by 44.4% of the individuals, being more frequent in males. CONCLUSION: Hypertension and other cardiovascular risk factors (particularly overweight/obesity) indicators are high, reinforcing the need for objective nationwide measures to fight this disease, in order to reduce CVD morbidity and mortality.

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.

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.

Arterial hypertension and its correlation with some risk factors in a small brazilian town

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.

Progression of Blood Pressure and Cardiovascular Outcomes in Hypertensive Patients in a Reference Center

Background Hypertension is a public health problem, considering its high prevalence, low control rate and cardiovascular complications. Objective Evaluate the control of blood pressure (BP) and cardiovascular outcomes in patients enrolled at the Reference Center for Hypertension and Diabetes, located in a medium-sized city in the Midwest Region of Brazil. Methods Population-based study comparing patients enrolled in the service at the time of their admission and after an average follow-up of five years. Participants were aged ≥18 years and were regularly monitored at the Center up to 6 months before data collection. We assessed demographic variables, BP, body mass index, risk factors, and cardiovascular outcomes. Results We studied 1,298 individuals, predominantly women (60.9%), and with mean age of 56.7±13.1 years. Over time, there was a significant increase in physical inactivity, alcohol consumption, diabetes, dyslipidemia, and excessive weight. As for cardiovascular outcomes, we observed an increase in stroke and myocardial revascularization, and a lower frequency of chronic renal failure. During follow-up, there was significant improvement in the rate of BP control (from 29.6% to 39.6%; p = 0.001) and 72 deaths, 91.7% of which were due to cardiovascular diseases. Conclusion Despite considerable improvements in the rate of BP control during follow-up, risk factors worsened and cardiovascular outcomes increased.

Comparação e correlação entre automedida, medida casual e monitorização ambulatorial da pressão arterial

BACKGROUND Casual blood pressure (BP) measurement by healthcare professionals is subject to great variability and new methods are necessary to overcome this limitation. OBJECTIVE To compare and assess the correlation between the BP levels obtained by self-measured BP (SMBP), casual BP measurement and ambulatory blood pressure monitoring (ABPM). METHODS We assessed hypertensive individuals submitted to the three methods of BP measurement at an interval < 30 days; the BP means were used for comparison and correlation. The following devices were used: OMRON 705 CP (casual measurement), OMRON HEM 714 (SMBP) and SPACELABS 9002 (ABPM). RESULTS A total of 32 patients were assessed, of which 50.09% were females, with a mean age of 59.7 (± 11.2), BMI mean of 26.04 (± 3.3) kg/m(2). Mean systolic (SBP) and diastolic blood pressure (DBP) for SMBP were 134 (± 15.71) mmHg and 79.32 (± 12.38) mmHg. The casual measurement means of SBP and DBP were, respectively, 140.84 (± 16.15) mmHg and 85 (± 9.68) mmHg. The mean values of ABPM during the wakefulness period were 130.47 (± 13.26) mmHg and 79.84 (± 9.82) mmHg for SBP and DBP, respectively. At the comparative analysis, the SMBP had similar results to those obtained at ABPM (p > 0.05) and different from the casual measurement (p < 0.05). At the analysis of correlation, SMBP values were higher than the casual measurements, considering ABPM as the reference standard in BP measurements. CONCLUSION SMBP showed a better correlation with ABPM than the casual measurement and was also better correlated with the latter, especially regarding the DBP and should be considered as a low-cost alternative for the follow-up of the hypertensive patient.

Automedida da pressão arterial para o controle das cifras tensionais e para a adesão ao tratamento

BACKGROUND: The measurement of blood pressure (BP) by the patient himself without strict protocols, adequate training, and validated equipment at their own household is defined as self measured blood pressure (SMBP). OBJECTIVE: To evaluate the interference of the SMBP in treatment adherence and blood pressure control. METHODS: The study included 57 patients, 38 in the study group (SG) and 19 in the control group (CG). These patients were followed for 12 months and assessed at randomization (V1) as well as in the sixth (V2) and the twelfth month (V3). Compare the mean blood pressure by casual measurement, by SMBP and by ambulatory monitoring of blood pressure (AMBP), laboratory tests and the answers to the questionnaire on lifestyle. The instruments used were: OMRON HEM 714, for SMBP; OMRON 705 CP, for the casual measurement, and Monitor SPACELABS 9002 for the AMBP. RESULTS: The average age was 62.05 ± 10.78 in the SG and 55.42 ± 11.87 in the CG (p = 0.03). The values of systolic blood pressure (SBP) by casual measurement in the SG and CG were: 140.01 ± 16.73 mmHg and 141.79 ± 23.21 mmHg in V1 (p = 0.72), 135.49 ± 12.73 mmHg and 145.69 ± 19.31 mmHg in V2 (p = 0.02), 131.64 ± 19.28 mmHg and 134.88 ± 23.21 mmHg at V3 (p = 0.59). The values of diastolic blood pressure (DBP) were: 84.13 ± 10.71 mmHg and 86.29 ± 10.35 mmHg in V1 (p = 0.47), 81.69 ± 10.88 mmHg and 89.61 V2 ± 11.58 mmHg (p = 0.02), 80.31 ± 11.83 mmHg and 86 ± 13.38 mmHg in V3 (p = 0.12). CONCLUSION: Patients in the SG had adherence to non-pharmacological treatment similar to the CG, but they had greater adherence to drug treatment and used fewer antihypertensive drugs. There was no difference between groups when comparing the metabolic profile and renal function. (Arq Bras Cardiol. 2011; [online].ahead print, PP.0-0)

Comparison and correlation between self-measured blood pressure, casual blood pressure measurement and ambulatory blood pressure monitoring

BACKGROUND Casual blood pressure (BP) measurement by healthcare professionals is subject to great variability and new methods are necessary to overcome this limitation. OBJECTIVE To compare and assess the correlation between the BP levels obtained by self-measured BP (SMBP), casual BP measurement and ambulatory blood pressure monitoring (ABPM). METHODS We assessed hypertensive individuals submitted to the three methods of BP measurement at an interval < 30 days; the BP means were used for comparison and correlation. The following devices were used: OMRON 705 CP (casual measurement), OMRON HEM 714 (SMBP) and SPACELABS 9002 (ABPM). RESULTS A total of 32 patients were assessed, of which 50.09% were females, with a mean age of 59.7 (± 11.2), BMI mean of 26.04 (± 3.3) kg/m(2). Mean systolic (SBP) and diastolic blood pressure (DBP) for SMBP were 134 (± 15.71) mmHg and 79.32 (± 12.38) mmHg. The casual measurement means of SBP and DBP were, respectively, 140.84 (± 16.15) mmHg and 85 (± 9.68) mmHg. The mean values of ABPM during the wakefulness period were 130.47 (± 13.26) mmHg and 79.84 (± 9.82) mmHg for SBP and DBP, respectively. At the comparative analysis, the SMBP had similar results to those obtained at ABPM (p > 0.05) and different from the casual measurement (p < 0.05). At the analysis of correlation, SMBP values were higher than the casual measurements, considering ABPM as the reference standard in BP measurements. CONCLUSION SMBP showed a better correlation with ABPM than the casual measurement and was also better correlated with the latter, especially regarding the DBP and should be considered as a low-cost alternative for the follow-up of the hypertensive patient.

I RBH - First Brazilian Hypertension Registry

Background: A registry assessing the care of hypertensive patients in daily clinical practice in public and private centers in various Brazilian regions has not been conducted to date. Such analysis is important to elucidate the effectiveness of this care. Objective: To document the current clinical practice for the treatment of hypertension with identification of the profile of requested tests, type of administered treatment, level of blood pressure (BP) control, and adherence to treatment. Methods: National, observational, prospective, and multicenter study that will include patients older than 18 years with hypertension for at least 4 weeks, following up in public and private centers and after signing a consent form. The study will exclude patients undergoing dialysis, hospitalized in the previous 30 days, with class III or IV heart failure, pregnant or nursing, with severe liver disease, stroke or acute myocardial infarction in the past 30 days, or with diseases with a survival prognosis < 1 year. Evaluations will be performed at baseline and after 1 year of follow-up. The parameters that will be evaluated include anthropometric data, lifestyle habits, BP levels, lipid profile, metabolic syndrome, and adherence to treatment. The primary outcomes will be hospitalization due to hypertensive crisis, cardiocirculatory events, and cardiovascular death, while secondary outcomes will be hospitalization for heart failure and requirement of dialysis. A subgroup analysis of 15% of the sample will include noninvasive central pressure evaluation at baseline and study end. The estimated sample size is 3,000 individuals for a prevalence of 5%, sample error of 2%, and 95% confidence interval. Results: The results will be presented after the final evaluation, which will occur at the end of a 1-year follow-up. Conclusion: The analysis of this registry will improve the knowledge and optimize the treatment of hypertension in Brazil, as a way of modifying the prognosis of cardiovascular disease in the country.