Validação de instrumentos para avaliação da habilidade e do conhecimento acerca da medida da pressão arterial

This study aimed to validate tools for evaluating the ability and knowledge about blood pressure (BP) among nursing students. It is a cross-sectional, descriptive, quantitative and methodological study accomplished at the Universidade Federal do Rio Grande do Norte (UFRN), Universidade do Estado do Rio Grande do Norte (UERN) and a private university of the state. The sample consisted of 27 judges of research selected from the inclusion criteria: nursing, teachers of the semiology and/or semiotics discipline, with at least 1 year of experience, being from UFRN, EEN, UERN and private university of the state and and agree to participate voluntarily with the signing of the consent form. The research was development in three stages: construction of two instruments based on the scientific literature, resulting in a structured checklist consists of 28 items and a knowledge questionnaire with 12 questions; submission of the instruments to the judges, in the period from June to September 2012, which should evaluate each item in appropriate , appropriate with changes and inappropriate , addition to making an overall assessment of each instrument based on 10 requirements; validation and verification to the level of agreement among the judges, through the application of Kappa and Content Validity Index (CVI). Was used the consensus level greater than 0.61 (good) to the Kappa index and greater than 0.75 for CVI. Was approved by the Ethics in Research / HUOL. After being coded and tabulated, the data were analyzed using descriptive statistics. Of the 27 judges who evaluated the instrument, 77.8% are female, with a mean age of 36.6 (± 9.0) years, 63.0% worked in UFRN, 74.1% had academic master and 63.0% worked exclusively on teaching. Average length of teaching experience was 7.9 (± 8.0) years and in the semiology and/or semiotics discipline of 5.5 (± 6.7) years. In the judgment of structured checklist and questionnaire of knowledge about blood pressure mensurement any item/question was considered inappropriate since all obtained level of agreement within the indices established (CVI> 0,75 E Kappa> 0.61). In relation to structured checklist, of those 28 items present, 9 showed perfect concordance index (CVI = 1.00, Kappa = 1.00) and another 19 were considered appropriate with changes, especially with regard to clarity and vocabulary. In the questionnaire of knowledge, among the 12 questions that comprised, 7 had perfect concordance index and the others were considered appropriate with changes as requirements as clarity, vocabulary, and feasible sequence of instructional topics. In terms of a overall evaluating of instruments, the structured checklist got CVI of 0.94 and Kappa of 0.89 and the knowledge questionnaire, CVI of 0.97 and a kappa of 0.94. Both instruments proved to be valid as to their content, configuring it as clear and objective tools of assessment of knowledge and ability on blood pressure, being of nursing students as well as others students and health professionals, since the use of valid measures seeking to reduce the risk of distorting the results

Estado nutricional antropométrico, composição corporal e pressão arterial em adolescentes

Os objetivos deste trabalho foram: (1) estimar as prevalências de excesso de peso e de gordura corporal, obesidade central e pressão arterial elevada (PAE) em adolescentes beneficiários do Programa Nacional de Alimentação Escolar (PNAE) da rede municipal de ensino de Natal-RN; (2) verificar a associação entre variáveis antropométricas e de composição corporal com a pressão arterial, a maturação sexual e a história familiar positiva de fatores de risco para doença cardiovascular (FRDCV); (3) comparar dois padrões de referência para classificação do excesso de peso em adolescentes; e (4) propor equações preditivas de massa gorda (MG) e massa livre de gordura (MLG) baseadas nos perímetros corporais. Trata-se de um estudo transversal, com 526 adolescentes beneficiários do PNAE, em Natal, Brasil. O tamanho da população de estudo foi definido por amostragem aleatória, em dois estágios, e ponderada segundo número de alunos de cada escola. No primeiro estudo, o excesso de peso foi determinado por Índice de Massa Corporal (IMC), a gordura corporal estimada por dobras cutâneas e a obesidade central por perímetro abdominal. A pressão arterial elevada foi classificada conforme a American Academy of Pediatrics. As prevalências foram apresentadas em valores relativos e efeito do desenho. Realizou-se uma análise fatorial para sintetizar o conjunto de variáveis antropométricas visando identificar fatores comuns. Extraíram-se dois fatores: (1) padrão excesso de adiposidade e (2) padrão adiposidade central elevada. Para avaliar a associação entre os padrões de adiposidade corporal com pressão arterial elevada, faixa etária, maturação sexual e história familiar de FRDCV utilizou-se a Razão de Chances e respectivo intervalo de confiança de 95% e regressão logística. No segundo estudo, calculou-se a sensibilidade e a especificidade do excesso de peso classificado segundo o IOTF e a World Health Organization WHO em relação ao excesso de adiposidade corporal; e a estatística Kappa para medir a concordância entre os dois padrões de referência. No terceiro estudo, foram elaborados modelos preditivos de MG e MLG com base em nove perímetros corporais, utilizando a bioimpedância Byodinamics 450 como padrão de referência. Para tanto foram selecionados 218 adolescentes eutróficos, segundo o IMC a partir do estudo transversal. As equações foram estimadas por regressão linear múltipla, considerando a idade e os perímetros corporais. Os resultados apontaram que 14,1% dos meninos e 15,7% das meninas tinham excesso de peso; 15,3% dos meninos e 11,6% das meninas tinham excesso de gordura corporal e dentre os meninos 14,3% tinham pressão arterial elevada e as meninas, 21,4%. Todos os efeitos do desenho foram inferiores a 2,5%. Nos meninos, o padrão excesso de adiposidade foi associado à história familiar positiva de FRDCV (ORajust=2,60; 1,09-6,22), maturação sexual (ORajust=2,92; 1,04-8,22) e PAE (ORajust=3,66; 1,34-9,94). Os meninos com 12 anos e mais apresentaram 6,1 vezes mais chance de apresentar padrão adiposidade central elevada do que os adolescentes com 10 a 11 anos (IC95% 2,32-16,04), assim como os púberes apresentaram 3,2 vezes este mesmo padrão em relação aos pré-púberes (IC95%1,14-8,85). A partir da comparação entre os dois padrões de referencia de classificação do excesso de peso por meio do IMC, observou-se que a sensibilidade foi de 79,3% para o critério IOTF e de 88,9% para WHO e a especificidade foi de 94,7% e 89,9%, respectivamente. O nível de concordância foi maior para o critério IOTF (Kappa=0,70 x Kappa=0,64). Em relação à construção das equações preditivas de gordura corporal, do total de 106 meninos e 112 meninas, foram desenvolvidas duas equações para estimar MG e duas para MLG, considerando o sexo. No sexo masculino, a equação para estimar a MG incluiu as variáveis idade, punho, quadril e perímetro abdominal (R2=0,552; AIC=416,04) e MLG, idade, punho e antebraço (R2=0,869; AIC=578,24). Enquanto que no feminino, MG foi estimada pelas variáveis punho, perímetro do abdômen, do quadril, da coxa proximal e da panturrilha (R2=0,838; AIC=415,36); e a MLG por idade, punho, perímetro do abdômen, do quadril e da panturrilha (R2=0,878; AIC=512,48). Conclui-se que os adolescentes tinham elevada prevalência de excesso de adiposidade corporal e de pressão arterial elevada. Tanto o padrão excesso de adiposidade quanto adiposidade central elevada constituem-se em padrões de risco. O padrão excesso de adiposidade foi associado à pressão arterial, história familiar positiva de FRDCV e maturação sexual em meninos. O critério IOTF mostrou-se menos sensível, mais específico, com maior nível de concordância e maior probabilidade de identificar corretamente o excesso de gordura corporal nos adolescentes avaliados. Quatro equações foram desenvolvidas para a estimativa da MG e MLG em adolescentes. As equações desenvolvidas para estimar a MG no sexo feminino e MLG para ambos os sexos apresentaram valores elevados de coeficiente de determinação ajustados e, portanto, são as preferenciais. Este estudo foi realizado com a participação de equipe multidisciplinar composta por professores da área de Nutrição, Endocrinologia Pediátrica, Estatística, Educação Física, discentes do Curso de Graduação em Nutrição e residentes em Pediatria

Efeito do treinamento resistido na pressão arterial e capacidade funcional de idosas hipertensas

The results of studies about the ideal resistance training intensity for reduction of resting blood pressure levels, as well as this type of training to increase the functional capacity of hypertensive older women are still unclear, since the few investigations usually analyze young individuals normotensive, and the literature lacks precise information in elderly hypertensive subjects. Objectives: To determine the effect of two resistance training intensities on resting blood pressure and the effect of resistance training on functional capacity in elderly women with systemic arterial hypertension, analyzing these variables before and after eight weeks of intervention. Methods: Patients underwent eight weeks of resistance training, with a frequency of three times per week on alternate days, in the afternoon. The exercises performed were: leg press, bench press, knee extension, lat pull-down, knee flexion, shoulder abduction, standing cable hip abduction and biceps curl. Results: It was found that patients who underwent training with moderate resistance, showed a reduction on resting values of diastolic blood pressure (DBP) p<0.03 and of mean arterial pressure (MAP) p<0.03. Patients who underwent mild resistance training showed reduction in resting values of MAP (p<0.03) and a tendency to decrease in DBP (p<0.06). With regard to functional capacity, the results showed significant increase in the strength of arms and legs, agility and aerobic endurance (p<0.001) and maintaining flexibility (p>0.05). Conclusion: The data indicated that both mild and moderate resistance training, even when started in old age, promoted cardiovascular benefits and also improve the functional capacity of hypertensive older women.

Associação da frequência alélica dos polimorfismos dos genes do sistema renina angiotensina com a força muscular e pressão arterial de idosas

Physiological changes induced by the aging process is dynamic and progressive, reducing the adaptability and independence of older people and may be influenced by genetic and environmental factors. Thus the aim of this thesis was to investigate the association between polymorphism of the ACE gene ID and the phenotypes of muscular strength and blood pressure of 62 elderly Brazilian (67.35 ± 5.66 years) during a 16-week program of supervised training. The elderly women were stratified by age, with the group 1 (G1, n = 34) <70 years and group 2 (G2 n = 28) ≥ 70 years, and in three groups by ACE, ACE-II (n = 8) ACE- DD (n = 35) and ACE-ID (n = 19). The level of muscle strength was evaluated by the method of maximum repetitions and measures of blood pressure (BP) were measured before and after training (PAPré1 and PAPós1) and before and after each training session (PAPre2 and PAPós2), in place of training. DNA samples were isolated from peripheral blood leukocytes polymorphism and insertion / deletion (ID) of the ACE gene (rs1800795) was genotyped by polymerase chain reaction (PCR) plus PCR-confirmatory. The genotype distribution of the polymorphism ID attended the prerogatives of Hardy-Weitíherg. There was variation in power levels before and after training and the age between groups (t-test) and the ACE polymorphism (ANOVA) (p <0.05). Depending on the results it was concluded that resistance training helps to reduce SBP and increased muscle strength of upper and lower limbs when considering the age and ACE polymorphism. In this study the Elderly carriers of the D allele were more reactive to changes in BP resistance training. This study was multidisciplinary project involving researchers in the areas Medical, Physical Education, Pharmacy, Nutrition, Gerontology and Statistics. This fulfilled the requirements of the multidisciplinary Graduate Program in Health Sciences

Controlador preditivo generalizado multi-modelo aplicado ao controle de pressão arterial

Postsurgical complication of hypertension may occur in cardiac patients. To decrease the chances of complication it is necessary to reduce elevated blood pressure as soon as possible. Continuous infusion of vasodilator drugs, such as sodium nitroprusside (Nipride), would quickly lower the blood pressure in most patients. However, each patient has a different sensitivity to infusion of Nipride. The parameters and the time delays of the system are initially unknown. Moreover, the parameters of the transfer function associated with a particular patient are time varying. the objective of the study is to develop a procedure for blood pressure control i the presence of uncertainty of parameters and considerable time delays. So, a methodology was developed multi-model, and for each such model a Preditive Controller can be a priori designed. An adaptive mechanism is then needed for deciding which controller should be dominant for a given plant

Implementação de um sistema embarcado aplicado ao controle de pressão arterial

Hypertension is a dangerous disease that can cause serious harm to a patient health. In some situations the necessity to control this pressure is even greater, as in surgical procedures and post-surgical patients. To decrease the chances of a complication, it is necessary to reduce blood pressure as soon as possible. Continuous infusion of vasodilators drugs, such as sodium nitroprusside (SNP), rapidly decreased blood pressure in most patients, avoiding major problems. Maintaining the desired blood pressure requires constant monitoring of arterial blood pressure and frequently adjusting the drug infusion rate. Manual control of arterial blood pressure by clinical personnel is very demanding, time consuming and, as a result, sometimes of poor quality. Thus, the aim of this work is the design and implementation of a database of tuned controllers based on patients models, in order to find a suitable PID to be embedded in a Programmable Integrated Circuit (PIC), which has a smaller cost, smaller size and lower power consumption. For best results in controlling the blood pressure and choosing the adequate controller, tuning algorithms, system identification techniques and Smith predictor are used. This work also introduces a monitoring system to assist in detecting anomalies and optimize the process of patient care.

Influência das medidas antropométricas sobre a pressão arterial sistêmica de hipertensos cadastrados nas unidades de saúde da família no município de João Pessoa - PB

Este trabalho objetiva avaliar a influência das medidas antropométricas sobre a pressão arterial sistêmica de uma coorte de hipertensos atendidos nas Unidades de Saúde da Família (USF) no município de João Pessoa-PB durante o período de 2008 a 2011. Para verificar as diferenças de níveis pressóricos entre as medidas realizadas nas consultas referentes ao cadastro, e a ultima pressão obtida no período de acompanhamento foram utilizadas informações sobre a identificação, dados clínicos do paciente, fatores de risco e doenças concomitantes. Testes estatísticos de comparabilidade entre grupos foram empregados. Para investigar os padrões de associação dos fatores de risco das variáveis antropométricas e sociodemográficas com a hipertensão dos pacientes, foi empregado o Modelo de Regressão Logística. Foram encontradas associações significativas (p<0,005) da hipertensão com a obesidade e o sedentarismo. Com os resultados desta pesquisa pretende-se: fornecer indicadores sobre a efetividade da Estratégia Saúde da Família; avaliar a qualidade das informações antropométricas; contribuir para a definição de estratégias que garantam o melhoramento dos acompanhamentos dos hipertensos e fornecer elementos científicos de apoio para outras USF e instituições governamentais.

Acurácia dos índices antropométricos de obesidade central na determinação de síndrome metabólica e fatores de risco cardiovascular em mulheres com síndrome dos ovários policísticos

A síndrome dos ovários policísticos (SOP) é a desordem endócrina mais comum em mulheres com idade reprodutiva. Seu diagnóstico é firmado através do consenso de Rotterdam na presença de dois dos seguintes critérios: anovulação crônica, sinais clínicos e/ou bioquímicos de hiperandrogenismo e presença de micropolicistos nos ovários. Na SOP, além das características específicas da síndrome é comum a presença de marcadores de risco cardiovascular aumentado como dislipidemia, hipertensão arterial, resistência à insulina e obesidade central Objetivos: Analisar a acurácia diagnóstica da circunferência da cintura (CC), relação cintura-estatura (RCEst), razão cintura-quadril (RCQ) e índice de conicidade (Índice C) para detecção de fatores de risco cardiovascular (FRCV) e síndrome metabólica (SM) em mulheres com síndrome dos ovários policísticos (SOP). Metodologia: Foi realizado estudo transversal envolvendo 108 mulheres na faixa etária de 20-34 anos, com diagnóstico de SOP de acordo com o consenso de Rotterdam. Foram considerados parâmetros clínicos, antropométricos e bioquímicos de avaliação do risco cardiovascular. A análise dos dados foi desenvolvida em duas etapas, conforme descrito a seguir. Fase 1: análise da acurácia dos pontos de corte previamente determinados na literatura nacional para CC, RCEst, RCQ e Índice C, para predição de FRCV; Fase 2: determinação de pontos de corte dos índices antropométricos supracitados, específicos para mulheres com SOP, para discriminação de SM, através da análise da curva ROC (Receiver Operating Characteristic). Resultados: Com base nos achados da fase 1 do estudo, a RCEst foi o marcador que apresentou correlações positivas significativas com o xi maior número de FRCV (pressão arterial, triglicerídeos e glicemia após teste oral de tolerância à glicose), além de correlação negativa com HDL-colesterol. Os demais marcadores antropométricos se correlacionaram positivamente com pressão arterial, enquanto CC e RCQ apresentaram correlação positiva também com triglicerídeos. Todos os indicadores antropométricos apresentaram taxas de sensibilidade superiores a 60%, com destaque para a RCEst que apresentou sensibilidade superior a 70%. Na fase 2 da pesquisa observamos que a CC, RCEst e RCQ apresentaram desempenho semelhante na predição de SM, sendo superiores ao Índice C. Os valores de ponto de corte dos índices antropométricos para discriminar SM foram: CC = 95 cm; RCEst = 0,59; RCQ = 0,88; e Índice C = 1,25. Utilizando esses pontos de corte as taxas de sensibilidade e especificidade da CC e RCEst foram superiores às observadas para RCQ e Índice C. Conclusões: Nossos dados enfatizam a importância da avaliação antropométrica no rastreamento do risco cardiovascular em mulheres com SOP, destacando-se a relevância da RCEst na predição de FRCV clássicos e a necessidade de considerar pontos de corte específicos para mulheres com SOP para discriminação de SM

Avaliação da prevalência de Síndrome Metabólica, Microalbuminúria e Risco Cardiovascular em mulheres com Síndrome dos Ovários Policísticos

Avaliar fatores de risco cardiovascular em mulheres brasileiras com síndrome dos ovários policísticos (SOP), através da utilização de múltiplos parâmetros, incluindo a determinação da prevalência de síndrome metabólica e seus componentes e pesquisa de microalbuminúria como marcador de um possível dano renal precoce nessas pacientes. Métodos: Foram avaliadas 102 mulheres de 20-34 anos de idade, com diagnóstico de SOP pelo Consenso de Rotterdam, tendo sido analisados parâmetros clínicos, antropométricos, bioquímicos e hormonais. Para diagnóstico de síndrome metabólica, foram adotados critérios do National Cholesterol Education Program s Adult Treatment Panel III (NCEP-ATP III). Para avaliação da microalbuminúria foi utilizada a relação albumina/creatinina (A/C), calculada a partir dos níveis de albumina e creatinina em amostra isolada de urina. Foram realizados testes estatísticos para avaliar associações e correlações entre variáveis, bem como comparação de médias ou medianas, adotando-se nível de significância de 5%. Resultados: A prevalência de síndrome metabólica foi de 28,4% (29 em 102 pacientes), estando associada ao aumento do índice de massa corporal (IMC). Quanto à análise da prevalência dos componentes individuais da síndrome metabólica, evidenciou-se: HDL-colesterol < 50 mg/dl em 69,6%, circunferência da cintura ≥ 88 cm em 57,9%, triglicerídeos ≥150 mg/dl em 31,7%, pressão arterial ≥130/85 mmHg em 18,6% e glicemia de jejum ≥110 mg/dl em 2,9%. Quando definida pelos limites convencionais para a relação A/C (3,5 35 mg/mmol), a microalbuminúria esteve presente em apenas três pacientes (3,3%). Entretanto, considerando diferentes limites de corte estabelecidos em recentes estudos que demonstraram aumento do risco cardiovascular associado a níveis muito baixos da relação A/C, a prevalência em mulheres com SOP foi alta, variando de 17,7 a 43,3% (para valores ≥ 0,58 e ≥ 0,37 mg/mmol, respectivamente). Mulheres com intolerância à glucose apresentaram nível significativamente mais elevado da relação A/C, quando comparadas às mulheres com normoglicemia. Os valores de microalbuminúria não apresentaram correlação significativa com IMC, níveis pressóricos, índices de sensibilidade insulínica ou perfil lipídico. Conclusões: Os dados evidenciam uma alta prevalência de síndrome metabólica e seus componentes individuais em mulheres brasileiras com SOP. Além do mais, observou-se elevado percentual de mulheres com níveis de excreção urinária de albumina em faixas significativamente associadas com aumento do risco para eventos cardiovasculares. Em conjunto, esses dados alertam para a necessidade da abordagem interdisciplinar e multidisciplinar das pacientes com SOP, visando à instituição de medidas voltadas para a prevenção primária cardiovascular

Índices de obesidade central e fatores de risco cardiovascular na síndrome dos ovários policísticos

Fundamento: A obesidade abdominal apresenta elevada prevalência em mulheres com síndrome dos ovários policísticos (SOP) e está associada a um aumento do risco cardiovascular. Objetivo: Verificar a acurácia da circunferência da cintura (CC), da relação cintura-quadril (RCQ), da relação cinturaestatura (RCEST) e do índice de conicidade (índice C), no que se refere à detecção de fatores de risco cardiovascular (FRCV) em mulheres com SOP. Métodos: Por meio de estudo transversal, foram alocadas 102 mulheres (26,5 ± 5 anos) com diagnóstico de SOP, de acordo com o consenso de Rotterdam. O colesterol total (CT), os triglicerídeos (TG), o LDL-colesterol (LDL-C), o HDLcolesterol (HDL-C), a glicemia de jejum, a glicemia após teste oral de tolerância à glicose (TOTG) e a pressão arterial (PA) foram avaliados em todas as pacientes, além das variáveis antropométricas. Resultados: A relação cintura-estatura foi o marcador que apresentou correlações positivas significativas com o maior número de FRCV (PA, TG e glicemia após TOTG), destacando-se ainda a correlação negativa com HDL-C. Todos os marcadores antropométricos avaliados se correlacionaram positivamente com PA, enquanto CC e RCQ apresentaram correlação positiva também com TG. No tocante à acurácia para detecção de FRCV, os indicadores antropométricos considerados apresentaram taxas de sensibilidade superiores a 60%, com destaque para a RCEST, que apresentou sensibilidade superior a 70%. Conclusão: A RCEST demonstrou ser o indicador antropométrico com a melhor acurácia para a predição de FRCV. Nesse sentido, propõe-se a inclusão desse parâmetro de fácil mensuração na avaliação clínica para o rastreamento de mulheres com SOP e FRCV----------------------ABSTRACT Background: Women with polycystic ovary syndrome (PCOS) present a high prevalence of abdominal obesity, which is associated with an increased cardiovascular risk. Objective: To verify the accuracy of the waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and the conicity index (CI) in the detection of cardiovascular risk factors (CVRF) in women with PCOS. Methods: The present transversal study allocated 102 women (26.5 ± 5 years) with a diagnosis of PCOS, according to the Rotterdam criteria. Total cholesterol (TC), triglycerides (TG), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), fasting glucose, glucose after the oral glucose tolerance test (OGTT) and blood pressure (BP) were evaluated in all patients, in addition to the anthropometric variables. Results: The WHtR was the marker that presented significant positive correlations with the highest number of CVRF (BP, TG and post-OGTT glucose), whereas there was a negative correlation with HDL-C. All the evaluated anthropometric markers were positively correlated with BP, whereas WC and WHR also presented a positive correlation with TG. Regarding the accuracy for the detection of CVRF, the anthropometric markers presented a sensibility > 60%, especially the WHtR, which had a sensibility > 70%. Conclusion: The WHtR showed to be the most accurate anthropometric indicator for the prediction of CVRF. In this sense, we propose the inclusion of this easily-measured parameter in the clinical assessment for the screening of women with PCOS and CVRF

Desenpenho funcional, carga alostática e biomarcadores do estresse em idosos residentes na comunidade

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Risco de doença cardiovascular em mulheres com história de distúrbio hipertensivo da gravidez

OBJECTIVE: Preeclampsia is a disease that can lead to a high maternal and infant morbidity. Worldwide, the incidence of this disease is highly variable and there is no data on this disorder in the Brazilian population. This study aimed at determining incidence and risk factors in the hypertensive disorders during pregnancy in a neighborhood of Natal, in addition to observing the evolution of these disorders one year and five years after delivery. METHODS: Prospective cohort study to assess the outcome of pregnancies of 242 women who became pregnant between 2004-2007 in the neighborhood of Bom Pastor in the city of Natal, state of RN, Brazil. Five years after delivery, there was an active search of thirty-nine (39) women who became pregnant and had a hypertensive disorder during pregnancy and/or pré-eclâmpsia, out of the total of 242 participants in the initial study. We administered a structured questionnaire to obtain basic information about the current clinical situation of patients and occurrences of subsequent pregnancy and presence of hypertensive disorders during pregnancy. We also searched for information on the use of hypotensive drugs and contraceptives. The following characteristics were checked and recorded: a) current weight, b) blood pressure c) body mass index - BMI, and we collected biological samples (blood and urine) for measurement of biochemical parameters and evaluation of microalbuminúria. Finally, we monitored the ambulatory blood pressure (ABP), which uses the method of automatic measurement of heart rate, systolic and diastolic blood pressure and an average of the two for the period of 24 hours. RESULTS: Out of 218 women who completed the study, the incidence of hypertensive disorders was of 16.9% (37 out of 218), while the incidence of preeclampsia was 13.8% (30 of 218). Women with preeclampsia had a BMI (body mass index) averaged of 25.3 (± 4.8) while this ratio in normotensive women was of 23.5 (± 3.7), p = 0.02. The risk of preeclampsia rises with age (OR 1084 p = 0.0034) and with a family history of hypertension (OR 2.6 p = 0.01). The follow-up one year after delivery revealed that 50% of women with hypertensive disorders in pregnancy remained hypertensive. High BMI was also observed after 5 years of delivery. CONCLUSIONS: an elevated BMI, age above 35 years and excessive weight gain during pregnancy were associated with hypertension in the long term in patients with prior preeclampsia. History of preeclampsia increases the risk of chronic hypertension

Efeitos do exercício físico aeróbio na modulação autonomica da frequência cardíaca de mulheres com sindrome dos ovários policisticos

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Estilo de vida individual de universitários jovens com excesso de peso da Universidade Católica de Murcia-Espanha

Individual lifestyle includes health and risk behaviors that can altar health status. Excess weight is a public health problem of modern civilization and there is an estimated mean prevalence of 45% in European countries. In Spain, the Murcia Region is an area of high morbidity and mortality from cardiovascular disorders. In this study we assess the differences in health and risk behaviors in ove/weight and normal weight undergraduates at the Universidad Católica San Antonio de Murcia (UCAM). Methods: Transversal design of parallel groups (overweight - cases and normal weight - control) , formed using the anthropometric technique. A questionnaire applied to a sample of 471 undergraduates of either sex, between the ages of 18 and 29 years, enrolled in 4 bachelor degree courses (ADE, CA, PER, PUB) at UCAM. We performed a standardized measurement of body mass (weight in kg), height (in meters) using a Seca® scale with calibrated stadiometer, waist and hip circumferences (in cm) with an inelastic tape and skinfolds thickness (triceps and subscapular in mm) with a Holtain® caliper, to calculate body mass index (BMI), waist-to-hip ratio (WHR) and the sum of skinfolds (SSF). We applied a lifestyle questionnaire about alcohol and tobacco consumption, knowledge and behaviors related to health indicators (arterial pressure and cholesterol), diet and physical activity. The information was collected in April and May, 2001 at the UCAM laboratory of Applied Nutrition. Statistical analysis: analysis of independent groups, contingency tables that reveal which qualitativa variables show differences and associations between the groups, Pearson's chi-square,and a significance levei of p < 0.05 followed by a residual analysis (1.96). Descriptive statistics (mean and standard deviation) were used to establish the two groups: case and contrai with 65 men and 26 women each who had BMI < 25 kg/m2. Results: A total of 65 of the men assessed (14%) and 26 (6%) of the women were overweight. Mean body mass index of the case group was 27. 78 ±: 2.83 kg/m2 in the men and 26.26 ± 1.37 kg/m2 in the women, while contrai group men had mean BMI of 22.36 ± 1.72 kg/m2, while for the women it was 20.76 ±: 2.13 kg/m2. The self-declared values of weight and height were underestimated, but with high accuracy, sensitivity and specificity. Thus, these can be used to calculate the BMI of overweight Spanish undergraduates. Regular vigorous physical activity was observed only in normal weight men. The analysis showed the following significant differences for the qualitativa variables of the two groups. The contrai group was interested in arterial hypertension, believed that they were not overweight, that they had no abdominal fat, and had not considered controlling 'fatty food consumption. Those who thought of controlling it sometimes, did so without professional help. However, part of the overweight group believed that they were overweight and had abdominal fat between average and considerable, had often or always considered controlling fatty foods and had often or always tried to control consumption with the help of professionals. They had always thought of engaging in physical activities, unlike the normal weight individuals. Nearly all (95%) of the overweight undergraduates and most (75%) of the normal weight group reported that they sometimes or always controlled fatty food ingestion. Mean physical activity was nearly twice as high in the summer than in the winter. Conclusions: The overweight undergraduates in this sample displayed a lifestyle with a greater number of healthy behaviors when compared to normal weight individuals

Hipertensão arterial e fatores de risco em servidores atendidos pelo departamento de assistência da Universidade Federal do Rio Grande do Norte

Systemic arterial hypertension is a multifactorial disease that contributes to the country´s high cardiovascular morbi-mortality rates. Considering that hypertension affects individuals in their most productive age while facing work and living risk factors, it is important to investigate its occurrence and predisposing factors in different occupational segments. The objective of this study was to identify the prevalence of hypertension among workers attended to in a medical service of a public university, their hypertension levels, the risk factors present, and their knowledge of the factors that influence the arterial pressure. The epidemiologic study was conducted in the Health Department of the Federal University of Rio Grande do Norte with 102 workers that sought care in the medical clinic during the months of March to May 2009. Data were collected by means of a questionnaire and measurements of systolic and diastolic arterial pressure (SAP and DAP) that were classified in stages according to the Brazilian Society of Hypertension and the degree of risk for cardiovascular events according to the criteria of the Brazilian Society for Cardiology. Data were analyzed using descriptive statistics. The workers were, on average, 54 years of age; the majority (67%) was male and had primary or middle educational level; they worked mainly in supplemental units and deanship offices conducting different functions such as security guards, administrative assistants, health auxiliaries and constructions workers; 48 (47%) of the workers identified themselves as hypertensive for 8 years on average, with the majority executing hard labor and administrative functions. Among the workers with hypertension, the number of the pressure levels classified as pre-hypertensive, stage I and II were: (12% in the SAP and 20% in the DAP); (16% in the SAP and 9% in the DAP); and (15% in the SAP and 5% in the DAP), respectively. The workers that did not identify themselves as hypertensive presented classifications with greater frequencies were: normal (16% in the SAP and 30% in the DAP); and pre-hypertensive (21% in the SAP and 16% in the DAP). The risk factors identified in more than 50% of the workers were: tobacco smoking, alcohol consumption and indices of being overweight, although physical activities are also present. Of the 48 workers diagnosed as hypertensive, those that had 5 risk factors present and limitrophic pressure levels (12%), in stage I hypertension (16%) and stage II hypertension (15¨%) were categorized as being in high risk for vascular events. The number of workers that indicated they had knowledge of the factors that influence their hypertension was less than 39% for each factor. It is concluded that there is a high prevalence of systemic arterial hypertension in the university workers, even amongst those already under treatment. They constitute a population at risk considering their age group, their work functions, and their inadequate life habits. Health care of these hypertensive workers that seek attention in the Health Department is an important aspect of the internal workers health policy in the institution. Educational interventions are recommended for the improvement of quality of life and of work in these workers