Irregularidade do ciclo menstrual no Menacme como marcador para fatores de risco cardiovasculares na p��s-menopausa

A associa����o entre fatores de risco cardiovascular (FRCV) na p��smenopausa e o antecedente de irregularidade menstrual no menacme foi avaliado em estudo caso-controle envolvendo 414 mulheres na p��smenopausa com idade de 60,4 �� 5,5 anos e IMC de 25,3 �� 4,7 kg/m2. As vari��veis consideradas foram: caracteriza����o do ciclo menstrual entre 20 e 35 anos (independente) e relato atual sobre ocorr��ncia de hipertens��o arterial, dislipidemia, diabetes mellitus e doen��a arterial coronariana (dependentes). Utilizou-se o teste qui-quadrado e modelos de regress��o log��stica, ajustados para outras vari��veis implicadas no risco para doenças CV, com n��vel de signific��ncia 5%. Observou-se que mulheres que relataram irregularidade menstrual pr��via estiveram associadas com risco aumentado para ocorr��ncia de algum FRCV [odds ratio ajustado (OR)= 2,14; IC-95%= 1,02���4,48], quando comparadas ��quelas com ciclos regulares. An��lise estratificada demonstrou as seguintes associa����es significativas com o antecedente de irregularidade menstrual: hipertens��o arterial (OR= 2,4; 95% IC= 1,39���5,41), hipercolesterolemia (OR= 2,32; 95% IC= 1,17���4,59), hipertrigliceridemia (OR= 2,09; 95% IC= 1,10���4,33) e angioplastia coronariana (OR= 6,82; 95% IC= 1,44���32,18). Os dados sugerem que o antecedente de irregularidade menstrual, indicativo da ocorr��ncia da s��ndrome dos ov��rios polic��sticos na idade reprodutiva, pode estar relacionado com aumento do risco para doenças CV na p��s-menopausa __________________________________________________ABSTRACT Menstrual Cycle Irregularity as a Marker of Cardiovascular Risk Factors at Postmenopausal Years.To evaluate the association between cardiovascular risk factors (CVRF)during postmenopausal years and previous menstrual irregularity during reproductive years, we performed a case-control study in 414 postmenopausal women (mean age 60.4 �� 5.5 years; BMI 25.3 �� 4.7 kg/m2). The variables assessed were: menstrual cycle characteristics at age 20���35y (independent) and records of arterial hypertension, dyslipidemia, diabetes mellitus, and coronary heart disease (dependent). Statistical analysis used the chi-square test and logistic regression, adjusting for potential confounders for cardiovascular risk, with significance set at 5%. Women reporting previous menstrual irregularity were associated with increased risk for some CVRF [adjusted odds ratio (OR) 2.14; CI-95%= 1.02���4.48], when compared with those reporting regular menstrual cycles. Stratified analysis demonstrated significant associations of previous menstrual irregularity with: arterial hypertension [OR= 2.74; CI-95%= 1.39���5.41), hypercholesterolemia (OR= 2.32; CI-95%= 1.17���4.59), hypertriglyceridemia (OR= 2.09; CI-95%=1.10���4.33), and coronary angioplasty (OR= 6.82; CI-95%= 1.44���32.18). These data suggest that a prior history of menstrual irregularity, as indicative of polycystic ovary syndrome, may be related to increased risk for CVD during postmenopausal years

Irregularidade do ciclo menstrual no Menacme como marcador para fatores de risco cardiovasculares na p��s-menopausa

A associa����o entre fatores de risco cardiovascular (FRCV) na p��smenopausa e o antecedente de irregularidade menstrual no menacme foi avaliado em estudo caso-controle envolvendo 414 mulheres na p��smenopausa com idade de 60,4 �� 5,5 anos e IMC de 25,3 �� 4,7 kg/m2. As vari��veis consideradas foram: caracteriza����o do ciclo menstrual entre 20 e 35 anos (independente) e relato atual sobre ocorr��ncia de hipertens��o arterial, dislipidemia, diabetes mellitus e doen��a arterial coronariana (dependentes). Utilizou-se o teste qui-quadrado e modelos de regress��o log��stica, ajustados para outras vari��veis implicadas no risco para doenças CV, com n��vel de signific��ncia 5%. Observou-se que mulheres que relataram irregularidade menstrual pr��via estiveram associadas com risco aumentado para ocorr��ncia de algum FRCV [odds ratio ajustado (OR)= 2,14; IC-95%= 1,02���4,48], quando comparadas ��quelas com ciclos regulares. An��lise estratificada demonstrou as seguintes associa����es significativas com o antecedente de irregularidade menstrual: hipertens��o arterial (OR= 2,4; 95% IC= 1,39���5,41), hipercolesterolemia (OR= 2,32; 95% IC= 1,17���4,59), hipertrigliceridemia (OR= 2,09; 95% IC= 1,10���4,33) e angioplastia coronariana (OR= 6,82; 95% IC= 1,44���32,18). Os dados sugerem que o antecedente de irregularidade menstrual, indicativo da ocorr��ncia da s��ndrome dos ov��rios polic��sticos na idade reprodutiva, pode estar relacionado com aumento do risco para doenças CV na p��s-menopausa __________________________________________________ABSTRACT Menstrual Cycle Irregularity as a Marker of Cardiovascular Risk Factors at Postmenopausal Years.To evaluate the association between cardiovascular risk factors (CVRF)during postmenopausal years and previous menstrual irregularity during reproductive years, we performed a case-control study in 414 postmenopausal women (mean age 60.4 �� 5.5 years; BMI 25.3 �� 4.7 kg/m2). The variables assessed were: menstrual cycle characteristics at age 20���35y (independent) and records of arterial hypertension, dyslipidemia, diabetes mellitus, and coronary heart disease (dependent). Statistical analysis used the chi-square test and logistic regression, adjusting for potential confounders for cardiovascular risk, with significance set at 5%. Women reporting previous menstrual irregularity were associated with increased risk for some CVRF [adjusted odds ratio (OR) 2.14; CI-95%= 1.02���4.48], when compared with those reporting regular menstrual cycles. Stratified analysis demonstrated significant associations of previous menstrual irregularity with: arterial hypertension [OR= 2.74; CI-95%= 1.39���5.41), hypercholesterolemia (OR= 2.32; CI-95%= 1.17���4.59), hypertriglyceridemia (OR= 2.09; CI-95%=1.10���4.33), and coronary angioplasty (OR= 6.82; CI-95%= 1.44���32.18). These data suggest that a prior history of menstrual irregularity, as indicative of polycystic ovary syndrome, may be related to increased risk for CVD during postmenopausal years

��ndices de obesidade central e fatores de risco cardiovascular na s��ndrome dos ov��rios polic��sticos

Fundamento: A obesidade abdominal apresenta elevada preval��ncia em mulheres com s��ndrome dos ov��rios polic��sticos (SOP) e est�� associada a um aumento do risco cardiovascular. Objetivo: Verificar a acur��cia da circunfer��ncia da cintura (CC), da rela����o cintura-quadril (RCQ), da rela����o cinturaestatura (RCEST) e do ��ndice de conicidade (��ndice C), no que se refere �� detec����o de fatores de risco cardiovascular (FRCV) em mulheres com SOP. M��todos: Por meio de estudo transversal, foram alocadas 102 mulheres (26,5 �� 5 anos) com diagn��stico de SOP, de acordo com o consenso de Rotterdam. O colesterol total (CT), os triglicer��deos (TG), o LDL-colesterol (LDL-C), o HDLcolesterol (HDL-C), a glicemia de jejum, a glicemia ap��s teste oral de toler��ncia �� glicose (TOTG) e a press��o arterial (PA) foram avaliados em todas as pacientes, al��m das vari��veis antropom��tricas. Resultados: A rela����o cintura-estatura foi o marcador que apresentou correla����es positivas significativas com o maior n��mero de FRCV (PA, TG e glicemia ap��s TOTG), destacando-se ainda a correla����o negativa com HDL-C. Todos os marcadores antropom��tricos avaliados se correlacionaram positivamente com PA, enquanto CC e RCQ apresentaram correla����o positiva tamb��m com TG. No tocante �� acur��cia para detec����o de FRCV, os indicadores antropom��tricos considerados apresentaram taxas de sensibilidade superiores a 60%, com destaque para a RCEST, que apresentou sensibilidade superior a 70%. Conclus��o: A RCEST demonstrou ser o indicador antropom��trico com a melhor acur��cia para a predi����o de FRCV. Nesse sentido, prop��e-se a inclus��o desse par��metro de f��cil mensura����o na avalia����o cl��nica 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

Agrega����o familiar e resultados maternos e perinatais da pr��-ecl��mpsia severa em popula����o do Rio Grande do Norte

To determine whether there is familiar aggregation of severe preeclampsia in a Brazilian population from Rio Grande do Norte and to characterize the maternal and perinatal outcomes in the studied population. Methods: A case control study was performed with 412 participants who were admitted at Maternidade Escola Janu��rio Cicco (MEJC) for medical care. Of these, 264 subjects presented normal blood pressure and 148 were cases. Cases were composed of eclampsia (n=47), HELLP Syndrome (n=85) and Eclampsia associated with HELLP syndrome (n=16). The diagnosis of these illness were based on the citeria developed by National High Blood Pressure Education Program Working (2000). An interview was performed with each subject and questions related to personal and familiar history of hypertension, preeclampsia, HELLP syndrome and eclampsia. Statistical analysis was performed and comparison of median and mean between cases and controls were performed, with the level of significance of 5%. The Odds-Ratio was determined to estimate the risk of preeclampsia within the families. Results: There were no difference in the demographic data between cases and controls. Previous history of chronic hypertension and preeclampsia was more frequent in the case group. Headaches were more frequent in eclampsia and epigastric pain in the HELLP syndrome cases. Bleeding and oliguria were more frequently found in the eclampsia associated with HELLP syndrome cases. Acute Renal insufficiency was a common complication in the case group, but these cases did not evolve to chronic renal insufficiency. The maternal mortality was 0.4% and the perinatal mortality was high, 223 per 1,000 live births. The 111 risk of a woman to develop preeclampsia whose mother has hypertension or had preeclampsia was respectively 2.5 and 3.5. This risk was increased 5 times, when a sibling has hypertension and 6 times when both sibling and mother had previous history of preeclampsia. Conclusions: This study confirms that there is familiar aggregation of preeclampsia in this Brazilian population. The potential for cardiovascular complications due to development of chronic hypertension indicates the need of closely follow up of women who develop preeclampsia

Efeito da nata����o e do basquetebol em cadeira de rodas sobre o colesterol HDL: uma investiga����o em indiv��duos com les��o medular

Despite the observation of an increase in life expectancy in individuals with Spinal cord injury (SCI), it is lower than that of the general population. Studies have shown that affected individuals have a sedentary lifestyle that reflects negatively on health and quality of life. Studies have demonstrated that HDL cholesterol (HDL-C) levels, a high-density lipoprotein and important predictor of cardiovascular disease, are lower in this population exposing these people to a greater incidence of heart disease from atherosclerotic process In the general population, exercise increases HDL-C serum levels, but this phenomenon is not very clear in people with spinal cord injury (SCI). The present study examined the effect of both swimming and wheelchair basketball in the lipid profile of eleven men and seven women with SCI. The subjects included in regular exercise programs showed increases in HDL-C levels and decreases in CT/HDL-C and LDL-C/HDL-C ratios. We found better results mainly in men with lower levels of SCI and in those that sustained exercise intensities above 60% of the heart rate reserve. The duration of training sessions can be an essential factor in these results. The results suggest that both the exercise prescription and the personal characteristics of people with SCI influence changes in the lipid profile mediated through exercise. The elaboration of this work is an attempt to clarify uncertainties about health and the longevity of people with SCI generated in discussion of all members of the interdisciplinary rehabilitation team, especially the physiotherapists, nutritionists, nurses and physicians that contributed considerably in all phases of the research

S��ndrome metab��lica e risco cardiovascular na p��s- menopausa: avalia����o por diferentes crit��rios diagn��sticos e influ��ncia de fatores s��cio-econ��micos

The metabolic syndrome (MetS) involves a group of risk factors and is associated with a significantly higher risk of developing cardiovascular diseases (CVD) and type 2 diabetes. Recent studies have shown the importance of preventing CVD through early diagnosis and treatment of patients with MetS. The objective of our study was to determine the prevalence of MetS by different diagnostic criteria in postmenopausal women and analyze the influence of socioeconomic factors on cardiovascular risk in this sample of the population. A cross-sectional study involving 127 postmenopausal women (45 to 64 years) from Natal and Mossor��, Brazil. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte. The experimental protocol consisted of applying structured interview, clinical examination and implementation of dosages blood. The diagnosis of MetS was based on NCEP-ATP III (National Cholesterol Education Program-Adult Treatment Panel III) and IDF (International Diabetes Federation) criteria. The research was accomplished with the participation of an interdisciplinary team in their several phases. The result of the sample studied had mean age of 53.9 �� 4.6 years and per capita income of 54.5 dollars. The prevalence of MetS, according to NCEP-ATP III and IDF criteria, was 52.8% and 61.4$, respectively. The agreement rate between NCEP-ATP III and IDF criteria was 81.9%, with a kappa value of 0.63 (CI 95%, 0.49-0.76), indicating good agreement between the two definitions. The most prevalent cardiovascular risk factor was HDL < 50 mg/dl, observed in 96.1% of the women analyzed, followed by increased waist circumference (&#8805; 80 cm) in 78.0%, elevated blood pressure in 51.2%, triglycerides &#8805; 150 mg/dl in 40.9% and glycemia &#8805; 100 mg/dl in 37.0% of the women. The occurrence of MetS was significantly associated with schooling and body mass index (BMI). High blood pressure was significantly associated with low family income, low schooling and weight gain. There was no significant association between the intensity of climacteric symptomatology and the occurrence of MetS. The conclusions of the research were that MetS and its individual components show a high prevalence in postmenopausal Brazilian women, and significant associations with weight gain and low socioeconomic indicators. The data point to the need for an interdisciplinary approach at the basic health care level, directed toward the early identification of risk factors and the promotion of cardiovascular health of climacteric women.

Estado nutricional antropom��trico, perfil lip��dico e consumo alimentar como fatores de risco para doen��a cardiovascular em adolescentes

The dyslipidemia and excess weight in adolescents, when combined, suggest a progression of risk factors for cardiovascular disease (CVD). Besides these, the dietary habits and lifestyle have also been considered unsuitable impacting the development of chronic diseases. The study objectives were: (1) estimate the prevalence of lipid profile and correlate with body mass index (BMI), waist circumference (WC) and waist / height ratio (WHR) in adolescents, considering the maturation sexual, (2) know the sources of variance in the diet and the number of days needed to estimate the usual diet of adolescents and (3) describe the dietary patterns and lifestyle of adolescents, family history of CVD and age correlates them with the patterns of risk for CVD, adjusted for sexual maturation. A cross-sectional study was performed with 432 adolescents, aged 10-19 years from public schools of the Natal city, Brazil. The dyslipidemias were evaluated considering the lipid profile, the index of I Castelli (TC / HDL) and II (LDL / HDL) and non-HDL cholesterol. Anthropometric indicators were BMI, WC and WHR. The intake of energy, nutrients including fiber, fatty acids and cholesterol was estimated from two 24-hour recalls (24HR). The variables of lipid profile, anthropometric and clinical data were used in the models of Pearson correlation and linear regression, considering the sexual maturation. The variance ratio of the diet was calculated from the component-person variance, determined by analysis of variance (ANOVA). The definition of the number of days to estimate the usual intake of each nutrient was obtained by taking the hypothetical correlation (r) &#8805; 0.9, between nutrient intake and the true observed. We used the principal component analysis as a method of extracting factors that 129 accounted for the dependent variables and known cardiovascular risk obtained from the lipid profile, the index for Castelli I and II, non-HDL cholesterol, BMI, and WC the WHR. Dietary patterns and lifestyle were obtained from the independent variables, based on nutrients consumed and physical activity weekly. In the study of principal component analysis (PCA) was investigated associations between the patterns of cardiovascular risk factors in dietary patterns and lifestyle, age and positive family history of CVD, through bivariate and multiple logistic regression adjusted for sexual maturation. The low HDL-C dyslipidemia was most prevalent (50.5%) for adolescents. Significant correlations were observed between hypercholesterolemia and positive family history of CVD (r = 0.19, p <0.01) and hypertriglyceridemia with BMI (r = 0.30, p <0.01), with the CC (r = 0.32, p <0.01) and WHR (r = 0.33, p <0.01). The linear model constructed with sexual maturation, age and BMI explained about 1 to 10.4% of the variation in the lipid profile. The sources of variance between individuals were greater for all nutrients in both sexes. The reasons for variances were &#61500; 1 for all nutrients were higher in females. The results suggest that to assess the diet of adolescents with greater precision, 2 days would be enough to R24h consumption of energy, carbohydrates, fiber, saturated and monounsaturated fatty acids. In contrast, 3 days would be recommended for protein, lipid, polyunsaturated fatty acids and cholesterol. Two cardiovascular risk factors as have been extracted in the ACP, referring to the dependent variables: the standard lipid profile (HDL-C and non-HDL cholesterol) and "standard anthropometric index (BMI, WC, WHR) with a power explaining 75% of the variance of the original data. The factors are representative of two independent variables led to dietary patterns, "pattern 130 western diet" and "pattern protein diet", and one on the lifestyle, "pattern energy balance". Together, these patterns provide an explanation power of 67%. Made adjustment for sexual maturation in males remained significant variables: the associations between puberty and be pattern anthropometric indicator (OR = 3.32, CI 1.34 to 8.17%), and between family history of CVD and the pattern lipid profile (OR = 2.62, CI 1.20 to 5.72%). In females adolescents, associations were identified between age after the first stage of puberty with anthropometric pattern (OR = 3.59, CI 1.58 to 8.17%) and lipid profile (OR = 0.33, CI 0.15 to 0.75%). Conclusions: The low HDL-C was the most prevalent dyslipidemia independent of sex and nutritional status of adolescents. Hypercholesterolemia was influenced by family history of CVD and sexual maturation, in turn, hypertriglyceridemia was closely associated with anthropometric indicators. The variance between the diets was greater for all nutrients. This fact reflected in a variance ratio less than 1 and consequently in a lower number of days requerid to estimate the usual diet of adolescents considering gender. The two dietary patterns were extracted and the pattern considered unhealthy lifestyle as healthy. The associations were found between the patterns of CVD risk with age and family history of CVD in the studied adolescents

Influ��ncia do ��cido &#945;-lip��ico na adapta����o antioxidante ao exerc��cio f��sico em ratas wistar h��gidas e ovariectomizadas

Introdu����o: Os horm��nios estrog��nicos possuem importante papel na defesa contra as esp��cies reativas do oxig��nio, fato que se evidencia na maior incid��ncia de doenças cardiovasculares e neurodegenerativas ap��s a menopausa. O exerc��cio f��sico melhora as defesas antioxidantes, contudo em altas cargas e em baixas concentra����es de estr��geno possui efeito aditivo ao dano oxidativo. O ��cido &#945;-lip��ico possui uma ampla gama de a����o antioxidante e poderia contribuir para diminui����o do dano nestas condi����es. Objetivo: O objetivo deste estudo �� caracterizar a a����o do ��cido &#945;-lip��ico sobre a adapta����o antioxidante e fun����es reprodutivas de ratas submetidas a nata����o moderada. Material e m��todos: Os animais foram submetidos a nata����o di��ria (1 hora) e sacrificados ap��s 30, 60 e 90 dias. Os animais foram divididos em controles sedent��rios e exercitados; suplementados (��cido &#945;-lip��ico 100mg/Kg/dia) sedent��rios e exercitados e animais ovariectomizados e suplementados com ��cido lip��ico. Avaliou-se diariamente o ciclo estral e os seguintes marcadores de estresse oxidativos foram mensurados em f��gado e sangue: atividade enzim��tica da SOD, GPx e CAT, al��m do SRAT e GSH. Resultados: O protocolo de exerc��cio aumentou a dura����o do ciclo estral no grupo controle exercitado, sobretudo na fase diestral. Neste mesmo grupo, houve diminui����o da lipoperoxida����o com melhora da atividade antioxidante da SOD e GPx. O grupo exercitado e suplementado n��o apresentou altera����o na dura����o do ciclo estral e manteve os benef��cios sobre o sistema antioxidante antes observado nos animais exercitados. A suplementa����o antioxidante juntamente com a nata����o em per��odos superiores a 30 dias, diminuiu o processo de adapta����o antioxidante quando comparado aos animais somente exercitados. Nos animais ovariectomizados, o exerc��cio e a suplementa����o com ��cido lip��ico n��o promoveu adapta����o antioxidante ao contr��rio dos demais grupos. Conclus��o: O aumento na dura����o do ciclo estral e a melhora nos marcadores de estresse oxidativo seriam uma resposta adaptativa frente ao exerc��cio moderado. O ��cido lip��ico impediu a altera����o no ciclo induzida pelo exerc��cio, mas preservou a melhoria no sistema antioxidante. A deple����o estrog��nica provocada pela ovariectomia eleva o potencial de dano oxidativo gerado pelo exerc��cio. A a����o antioxidante do LA na presen��a de estr��geno diminuiu excessivamente o dano oxidativo, comprometendo a adapta����o antioxidante a nata����o. Nos animais ovariectomizados, contudo, o AL promoveu adapta����o antioxidante ao exerc��cio

An��lise da variabilidade da frequ��ncia card��aca na s��ndrome dos ov��rios polic��sticos

Conselho Nacional de Desenvolvimento Cient��fico e Tecnol��gico

Impacto da variabilidade de peso no controle mateb��lico de pacientes transplantados card��acos

Heart transplantation (HT) represents one of the greatest advances in medicine over the last decades. It is indicated for patients with severe heart disease unresponsive to clinical treatment and conventional surgery, poor short-term prognosis and a 1- year mortality rate over 40%. HT has improved survival worldwide (80% in the first year, 70% in five years and 60% in ten years). However, the procedure has been associated with weight change and increased risk of secondary conditions such as diabetes, hypertension, dyslipidemia and obesity due to immunosuppressive therapy following transplantation. The objective of this study was to determine the impact of weight change on the metabolic stability of HT patients. The study was retrospective with data collected from the records of 82 adult patients (83% male; average age 45.06��12.04 years) submitted to HT between October 1997 and December 2005 at a transplantation service in Cear�� (Brazil). The selected outcome variables (biopathological profile, weight and body mass index&#8213;BMI) were related to biochemical and metabolic change. The results were expressed in terms of frequency, measures of central tendency, Student s t test and Pearson s correlation coefficients. The analysis showed that following HT the average global BMI increased from 23.77��3.68kg/m2 to 25.48��3.92kg/m2 in the first year and to 28.38��4.97kg/m2 in the fifth. Overweight/obese patients (BMI &#8805; 25 kg/m2) had higher average levels of glucose, total cholesterol, low-density lipoprotein and triglycerides than patients with eutrophy/malnutrition (BMI < 25 kg/m2). In conclusion, overweight/obese patients were likely to present higher average levels of glucose, triglycerides, total cholesterol and fractions than patients with eutrophy/malnutrition, indicating a direct and significant relation between nutritional status and weight change in the metabolic profile of HT patients

N��veis press��ricos elevados em mulheres com s��ndrome dos ov��rios polic��sticos: preval��ncia e fatores de risco associados

investiga a preval��ncia de n��veis press��ricos elevados e avaliar a correla����o entre n��veis de press��o arterial (PA) e outros fatores de risco cardiovascular em pacientes com s��ndrome dos ov��rios polic��sticos (SOP).Por meio de estudo transversal foram comparados os n��veis de PA e par��metros antropom��tricos e bioqu��micos de risco cardiovascular em 113 mulheres com SOP (idade 26,2��4,3 anos) e num grupo controle constitu��do por 242 mulheres saud��veis da popula����o geral (26,8��5,0 anos). o grupo SOP apresentou preval��ncia de PA alterada (&#8805;130/85 mmHg) significativamente superior ao grupo controle (18,6% vs. 9,9%, respectivamente; p<0,05). Mulheres com SOP apresentaram valores m��dios superiores de PA sist��lica, ��ndice de massa corporal (IMC), circunfer��ncia da cintura (CC), triglicer��deos e glicemia de jejum, al��m de n��veis inferiores de HDL - colesterol, em compara����o ao grupo controle (p<0,01). No grupo SOP, os valores de PA sist��lica e diast��lica apresentaram correla����o positiva significativa com a idade, IMC, CC e triglicer��deos (p<0,05). A freq����ncia de mulheres com valores de PA acima do limite da normalidade foi significativamente maior no grupo SOP, em rela����o ao grupo controle. Adicionalmente, os valores de PA se correlacionaram positivamente com outros fatores de risco cardiovascular como obesidade e n��veis de triglicer��deos. Esses achados alertam para a relev��ncia de estrat��gias preventivas em mulheres com SOP, no sentido de evitar eventos m��rbidos relacionados ao sistema cardiovascular

Doen��a cardiovascular em mulheres com hist��rico de pr��-ecl��mpsia e seguimento no sistema ��nico de sa��de

The aim of the present study was to analyze cardiovascular risk of women with a history of preeclampsia, as well as its follow-upin the National Health System.This is a cross-sectional quantitative research conducted at the Janu��rio Cicco Maternity School. The study population was composed of 573 women selected from a databank belonging to the Women s Health Research Group of the Gynecology Department at Universidade Federal do Rio Grande do Norte, with a history of preeclampsia, and normotensives who gave birth at this institution five years before. The final sample consisted of 147 women, 64 in the group with a history of PE and 83 normotensives. Data were collected on a questionnaire containing the following: sociodemographic aspects, anthropometric measures, life habits, personal and family history of pregnancy-induced hypertension, family history of cardiovascular diseases and frequency of measuring current blood pressure levels. In relation to the association between cardiovascular risk and altered blood pressure (&#8805;130x85 mmHg), the likelihood of exhibiting the latter condition was significantly higher in women with a history of preeclampsia (CI 95% 4.12-38.92), the overweight and obese (CI 95% 1.70-20.75), and in those with a family historyof CVD and personal history of PIH (CI 95% 0.78-47.07 and CI 95% 3.20-25.39) respectively. Likewise, the probability of having altered blood pressure was higher in women with fasting glycemia &#8805;100mg/dL (CI 95% 2.09-24.73), as well as in those with triglycerides &#8805;150mg/dl (CI 95% 1.72-9.66). After fitting the logistic model, diagnosis previous preeclampsia and altered triglycerides remained as explanatory variables.The women with a history of preeclampsia five years before exhibited altered blood pressure levels, clinical and laboratory manifestations suggestive of elevated risk for cardiovascular disease, as well as family and personal history of hypertension. There is no differential treatment or adequate outpatient follow-up for this population in basic health care units

Fatores associados �� mortalidade dos idosos com as condi����es de vida da popula����o do Nordeste do Brasil

As condi����es de vida s��o usualmente entendidas como importantes fatores intervenientes das causas b��sicas de mortalidade e da qualidade de vida da popula����o. Ao considerar esta quest��o em uma popula����o idosa e sua influ��ncia nas causas mais relevantes que as levam �� morte, teve-se como objetivo principal, estudar a associa����o da mortalidade dos idosos por doenças cardiovasculares para ambos os sexos, com indicadores que expressam as condi����es de vida da popula����o do Nordeste, nos anos 2000 e 2010. Para atingir tal prop��sito foi tra��ado um desenho de estudo ecol��gico com cortes transversais nos anos 2000 e 2010 tendo como unidades de an��lises as microrregi��es e a mesorregi��es do Nordeste. Utilizou-se a Modelagem de Equa����es Estruturais (MEE) para explicar essas associa����es, tomando como base as estat��sticas de ��bitos por doenças cardiovasculares (construto end��geno) e vari��veis socioecon��micas e demogr��ficas (construto ex��geno) das microrregi��es do Nordeste, para o ano 2000. Utilizou-se o M��todo dos Componentes Principais como recurso metodol��gico na constru����o de um ��ndice sint��tico que permitiu classificar as condi����es de vida nas mesorregi��es do Nordeste, tomadas como unidades de an��lises, nos anos 2000 e 2010, de acordo com as condi����es de vida e as principais causas de mortalidade por doenças cardiovasculares. A aplica����o da MEE sugeriu uma forte associa����o do construto ex��geno condi����es de vida, composto pelos indicadores: anos de estudo dos homens idosos, percentual de idosos em domic��lios com banheiro/��gua encanada e probabilidade de sobreviv��ncia aos 60 anos, com a vari��vel desfecho taxa de mortalidade por doenças cardiovasculares dos homens e mulheres idosos. O ��ndice sint��tico constru��do permitiu identificar os diferentes ritmos de envelhecimento populacional entre as regi��es e distintos processos de evolu����o dos n��veis de mortalidade pelas doenças cardiovasculares, muitas delas compat��veis com as condi����es de vida no Nordeste. Os resultados sugerem que o construto condi����es de vida est�� fortemente associado por esta causa de morte entre os idosos para ambos os sexos no Nordeste do Brasil. Neste sentido, sugere-se que estes resultados sejam considerados como relevantes para formula����o de pol��ticas de sa��de regionais voltadas para este contingente populacional do Nordeste do Brasil

S��ndrome metab��lica e fatores de risco relacionados em crian��as e adolescentes com excesso de peso na cidade do Natal

Nas ��ltimas d��cadas, houve grande aumento da preval��ncia de obesidade, inclusive na faixa et��ria pedi��trica. Com isso, aumentou o n��mero de crian��as e adolescentes afetados por s��ndrome metab��lica (SM), diabetes tipo 2 (DM2) e doenças cardiovasculares (DCV), doenças anteriormente consideradas quase exclusivas de adultos. Os objetivos do estudo foram identificar e correlacionar marcadores antropom��tricos (IMC- ��ndice de massa corp��rea, CA- circunfer��ncia abdominal, RCQ- raz��o cintura/quadril, RCAraz��o cintura altura e PSE- prega subescapular), PAS e PAD- press��o arterial sist��lica e diast��lica, respectivamente, e laboratoriais (CT- colesterol total, HDL, LDL, TGL- triglic��rides, I/G- raz��o insulina glicose, HOMA- homeostatic model assessment for insulin resistance) de risco para o desenvolvimento de SM e observar a sua preval��ncia em crian��as e adolescentes com excesso de peso. Foi conduzido estudo transversal, em amostra aleat��ria, de conveni��ncia, onde foram avaliadas 60 crian��as e adolescentes com excesso de peso, atendidas no ambulat��rio de endocrinologia pedi��trica do Hospital de Pediatria da Universidade Federal do Rio Grande do Norte (UFRN) com idade m��nima e m��xima de 7 e 15 anos, de maio de 2009 a abril de 2010. Foram admitidos os indiv��duos que apresentavam sobrepeso (IMC P > 85 e < 95) ou obesidade (IMC P > 95) (CDC, 2000) e hist��ria familiar positiva para DM2 em parentes de primeiro ou segundo grau ou algum dos sinais de resist��ncia insul��nica (acantose, hipertens��o arterial, dislipidemia, s��ndrome de ov��rios polic��sticos). 2 O componente individual para SM mais prevalente foi o percentil da CA &#8805; 90 (58,3%), seguido de HDL &#8804; 40 mg/dl (36,6%). Na regress��o linear simples, observaram-se as varia����es para mais nos par��metros laboratoriais e de PA para cada unidade de aumento de IMC, CA, RCA, RCQ e PSE, sendo significantes as seguintes correla����es: CA com TGL, HOMA IR, I/G, PAS e PAD; RCQ com TGL, HOMA, I/G, LDL e glicemia; RCA com TGL; PSE com TGL, HOMA-IR, I/G e PAS; e IMC com HOMA IR, I/G, PAS e PAD. De acordo com os crit��rios da IDF (Federa����o Internacional de Diabetes International Diabetes Federation) 2007, o diagn��stico de SM foi encontrado em seis indiv��duos (10%). Do total, oito (13,3%), estavam em situa����o de sobrepeso e 52 (86,6%), obesos. As evid��ncias de correla����o CA e RCQ, medidas de obesidade centr��peta, com v��rios marcadores como TGL e HOMA, j�� sabidamente relacionados �� SM, chamam aten����o para a necessidade de utiliza����o dessas medidas de forma mais rotineira na pr��tica pedi��trica, por serem de f��cil obten����o, baixo custo e m��todo n��o invasivo. Os valores de CA, RCQ, RCA e PSE, quando elevados devem justificar maior detalhamento na avalia����o laboratorial de poss��vel resist��ncia insul��nica. �� importante a identifica����o de crian��as e adolescentes que preencham os requisitos para o diagn��stico da SM, pois s��o indiv��duos de maior risco metab��lico e devem ser adequadamente acompanhados.

Determina����o dos intervalos de refer��ncia para lip��dios, lipoprote��nas e apolipoprote��nas no estado do Rio Grande do Norte

The lipid profile is a group of lab tests that include triglycerides, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). However, serum non-HDL-C, Apo A-I and Apo B levels, as well as the lipids ratios (TC/HDL-C, LDL-C/HDL-C and Apo B/Apo A-I), have been described as better predictors of cardiovascular diseases. Reference intervals are tools often used to help the evaluation of the people s health state. These days, Brazilian studies still use the reference intervals of lipids and lipoproteins from other countries, ignoring differences between the populations. Therefore, this study aimed to establish reference intervals for lipids, lipoproteins and apolipoproteins in adults of Rio Grande do Norte/Brazil. Healthy individuals (96 men and 283 women) between 18 and 59years old formed the reference sample group. The samples were collected after fasting 12 to 14 hours. Information on lifestyle and dietary habits of the participants were obtained through questionnaire. The serum glucose level and renal and liver activity were evaluated by laboratory testing. The results of lipid profile were analyzed according to sex, age and mesoregion of Rio Grande do Norte, with significance level of 5% (p < 0,05). The lower and upper reference limits were identified by the 2.5 percentile and 97.5 percentile, respectively, and assurance intervals of 90% was calculated for each of these limits. Among the determinants of lipid profile analyzed, only a few significant differences were observed according to sex, but in terms of age, the groups of smaller and older ages were most likely different. When evaluated by region, the means of West region shown the most significant variations. Not many studies were useful to compare the reference intervals determined in this study. Thus, it becomes necessary to carry out similar studies in other regions of Brazil and of the world given the clinical importance of reference intervals