Prevalence of Arterial Hypertension Among Seventh-Day Adventists of the Sao Paulo State Capital and Inner Area

Background: Inadequate life habits are known to favor hypertension, and Adventists recommend healthy life habits. Objective: To assess the prevalence of hypertension among Seventh-Day Adventists from the inner Sao Paulo state and Sao Paulo state capital. Methods: This study assessed 264 Adventists (mean age, 41.17 +/- 15.27 years; women, 59.8%) with a high religiosity level assessed by use of the Duke University Religion Index. Blood pressure was measured with a validated automatic device. The significance level adopted was p < 0.05. Results: The total prevalence of hypertension was 22.7% (27.4% in the inner state and 15% in the capital). The Adventists from the capital differed from those of inner state as follows (p < 0.05), respectively: higher education (62% vs 36.6%); employed by a third party (44%) vs self-employed (40.9%); family income (8.39 +/- 6.20 vs 4.59 +/- 4.75 minimum wages); individual income (4.54 +/- 5.34 vs 6.35 +/- 48; couple responsible for family income (35% vs 39.6%); vegetarianism (11% vs 3%); blood pressure (115.38 +/- 16.52/68.74 +/- 8.94 vs 123.66 +/- 19.62/74.88 +/- 11.85 mmHg); white ethnicity (65% vs 81.1%); married (53% vs 68.9%); lower tangible support in the social aspect (15.7 +/- 5.41 vs 16.9 +/- 4.32); and recalling the last time one's blood pressure was measured (65% vs 48.8%). On multivariate analysis, hypertension associated with the following: 1) vegetarianism (OR 0.051; 95% CI: 0.004-0.681); 2) educational level (OR 5.317; 95% CI: 1.674-16.893); 3) recalling the last time one's blood pressure was measured (OR 2.725; 95% CI: 1.275-5.821); 4) being retired (OR 8.846; 95% CI: 1.406-55.668); and 5) being responsible for family income (OR 0.422; 95% CI: 0.189-0.942). Conclusion: The prevalence of hypertension among Adventists was lower as compared with that reported in Brazilian studies, and it was lower in the Sao Paulo state capital as compared with that in the inner Sao Paulo state, possibly because of the better socioeconomic conditions and life habits of the former. (Arq Bras Cardiol 2012; 98(4): 329-337)

Avaliação ecocardiográfica do átrio esquerdo de cães sadios por meio do modo-M convencional e do modo bidimensional

Avaliaram-se o átrio esquerdo (AE) utilizando-se o método bidimensional (2-B) (corte transverso) e a relação átrio esquerdo:aorta (AE:Ao), em um grupo de 40 cães adultos e sadios, entre um, cinco e sete anos de idade e com pesos corpóreos de 3,2kg a 38,3kg, e compararam-se esses valores aos do modo-M convencional. Observou-se diferença entre AE e Ao nos dois métodos e entre os seus respectivos índices. A correlação foi positiva alta entre peso e superfície corpórea e entre AE no modo 2-B (AEB) e AE no modo-M (AEM). Não se observou correlação entre os índices, nos dois métodos, com o peso e a superfície corpórea, isto é, os índices são independentes do peso ou da superfície corpórea. Concluiu-se que o AEB é maior do que o AEM, o índice médio para o AEB:AoB é de 1,379, e o intervalo de confiança de 1,337 a 1,422. O índice no método 2-B é, portanto, superior ao índice no modo-M.

Subclinical impairment of ovarian reserve in juvenile systemic lupus erythematosus after cyclophosphamide therapy

Objective To perform systematic assessment of ovarian reserve markers using a combination of tests in juvenile systemic lupus erythematosus (JSLE) patients without amenorrhoea. Methods Twenty-seven consecutive JSLE female patients and 13 healthy controls without amenorrhoea were evaluated for 6 months. Ovarian reserve was assessed during early follicular phase by serum levels of follicle stimulating hormone (FSH), luteinising hormone (LH), estradiol, inhibin A, inhibin B and anti-Mullerian hormone (AMH). Ovarian size was measured by abdominal ultrasonography. Demographic data, disease activity, damage and treatment were also analysed. Results The median of current age was similar in ISLE patients and controls (16.5 vs. 15years, p=0.31) with a significantly higher age at menarche (13 vs. 12years, p=0.03). A trend of lower median total antral follicle count was observed in JSLE compared to controls (9 vs. 14.5, p=0.062) with similar median of other ovarian reserve parameters (p>0.05). Further evaluation of patients treated with cyclophosphamide and those without this treatment revealed a higher median FSH levels (6.4 vs. 4.6 IU/L, p=0.023). Inhibin B, AMH levels and ovarian volume were also lower but did not reach statistical significance (10.8 vs. 27.6 pg/mL, p=0.175; 0.6 vs. 1.5 ng/mL, p=0.276; 3.4 vs. 5 cm(3), p=0.133; respectively). LH (2.7 vs. 2.9 IU/L, p=0.43), estradiol (50 vs. 38 pg/mL, p=0.337) and inhibin A (1.1 vs. 0 pg/mL, p=0.489) levels were comparable in both groups. Conclusions Our study suggests that ovarian reserve after cyclophosphamide treatment may be hampered in spite of the presence of menstrual cycles emphasising the relevance of gonadal protection during the use of this alkylating agent.

Prevalência de hipertensão arterial em Adventistas do Sétimo Dia da capital e do interior paulista

FUNDAMENTO: Sabe-se que hábitos de vida inadequados favorecem a hipertensão, e os adventistas preconizam hábitos saudáveis. OBJETIVO: Avaliar a prevalência da hipertensão nos adventistas do sétimo dia na capital e no interior paulistas. MÉTODOS: Foram estudados 264 adventistas (41,17 ± 15,27 anos, 59,8% mulheres, com alto nível de religiosidade avaliada pela escala Duke-DUREL). A medida da pressão arterial foi realizada com aparelho automático validado. Nível de significância adotado foi p < 0,05. Resultados: A prevalência total de hipertensão foi 22,7%, (27,4% no interior e 15% na capital). Os adventistas da capital diferiram dos do interior (p < 0,05), respectivamente, quanto: escolaridade superior (62% vs 36,6%); ter vínculo empregatício (44%) vs autônomos (40,9%); renda familiar (8,39 ± 6,20 vs 4,59 ± 4,75 salários mínimos) e renda individual (4,54 ± 5,34 vs 6,35 ± 48 salários mínimos); casal responsável pela renda familiar (35% vs 39,6%); vegetarianismo (11% vs 3%); pressão arterial (115,38 ± 16,52/68,74 ± 8,94 vs 123,66 ± 19,62/74,88 ± 11,85 mmHg); etnia branca (65% vs 81,1%); casados (53% vs 68,9%); menor apoio social no domínio material (15,7 ± 5,41 vs 16,9 ± 4,32) e lembrar da última vez que mediu a pressão arterial (65% vs 48,8%). A análise multivariada associou hipertensão com: 1) vegetarianismo (OR 0,051, IC95% 0,004-0,681), 2) escolaridade (OR 5,317, IC95% 1,674-16,893), 3) lembrar quando mediu a pressão (OR 2,725, IC95% 1,275-5,821), 4) aposentado (OR 8,846, IC95% 1,406-55,668), 5) responsável pela renda familiar (OR 0,422, IC95% 0,189-0,942). CONCLUSÃO: A prevalência de hipertensão dos adventistas foi menor se comparada com estudos nacionais, sendo menor na capital em relação ao interior possivelmente por melhores condições socioeconômicas e hábitos de vida.

Purinergic and glutamatergic interactions in the hypothalamic paraventricular nucleus modulate sympathetic outflow

P2X receptors are expressed on ventrolateral medulla projecting paraventricular nucleus (PVN) neurons. Here, we investigate the role of adenosine 5′-triphosphate (ATP) in modulating sympathetic nerve activity (SNA) at the level of the PVN. We used an in situ arterially perfused rat preparation to determine the effect of P2 receptor activation and the putative interaction between purinergic and glutamatergic neurotransmitter systems within the PVN on lumbar SNA (LSNA). Unilateral microinjection of ATP into the PVN induced a dose-related increase in the LSNA (1 nmol: 38 ± 6 %, 2.5 nmol: 72 ± 7 %, 5 nmol: 96 ± 13 %). This increase was significantly attenuated by blockade of P2 receptors (pyridoxalphosphate-6-azophenyl-20,40-disulphonic acid, PPADS) and glutamate receptors (kynurenic acid, KYN) or a combination of both. The increase in LSNA elicited by L-glutamate microinjection into the PVN was not affected by a previous injection of PPADS. Selective blockade of non-N-methyl-D-aspartate receptors (6-cyano-7-nitroquinoxaline-2,3-dione disodium salt, CNQX), but not N-methyl-D-aspartate receptors (NMDA) receptors (DL-2-amino-5-phosphonopentanoic acid, AP5), attenuated the ATP-induced sympathoexcitatory effects at the PVN level. Taken together, our data show that purinergic neurotransmission within the PVN is involved in the control of SNA via P2 receptor activation. Moreover, we show an interaction between P2 receptors and non-NMDA glutamate receptors in the PVN suggesting that these functional interactions might be important in the regulation of sympathetic outflow