Factors associated with the prevalence of hypertension and control practices among elderly residents of São Paulo city, Brazil

The aim of this study was to analyze the prevalence of hypertension and control practices among the elderly. The survey analyzed data from 872 elderly people in São Paulo, Brazil, through a cluster sampling, stratified according to education and income. A Poisson multiple regression model checked for the existence of factors associated with hypertension. The prevalence of self-reported hypertension among the elderly was 46.9%. Variables associated with hypertension were self-rated health, alcohol consumption, gender, and hospitalization in the last year, regardless of age. The three most common measures taken to control hypertension, but only rarely, are oral medication, routine salt-free diet and physical activity. Lifestyle and socioeconomic status did not affect the practice of control, but knowledge about the importance of physical activity was higher among those older people with higher education and greater income. The research suggests that health policies that focus on primary care to encourage lifestyle changes among the elderly are necessary.

Physical activity, adiposity and hypertension among patients of public healthcare system

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Hemodynamic effects of combined sildenafil and L-arginine during acute pulmonary embolism-induced pulmonary hypertension

Sildenafil attenuates acute pulmonary embolism-induced pulmonary hypertension. However, the hemodynamic effects of sildenafil in combination with other vasodilators during acute pulmonary embolism have not been examined yet. In the present study, we examined the hemodynamic effects of combined sildenafil (0.25 mg/kg, i.v.) and L-arginine (100, 200, 500, and 1000 mg/kg/h, i.v.) in an anesthetized dog model of acute pulmonary embolism. Plasma nitrite/nitrate (NOx) and cGMP concentrations were determined using an ozone-based chemiluminescence assay and a commercial enzyme immunoassay, respectively. We found that L-arginine alone did not attenuate acute pulmonary embolism-induced pulmonary hypertension. However, significant decreases in mean pulmonary artery pressure were observed 30, 45, 60, and 75 min after the administration of sildenafil alone or after the combined administration of sildenafil and L-arginine (all P<0.05). No significant differences among groups were observed in the respiratory parameters. While L-arginine significantly increased NOx concentrations, cGMP concentrations increased only when sildenafil was administered (all P<0.05). These results suggest that while sildenafil attenuates acute pulmonary embolism-induced pulmonary hypertension, L-arginine does not enhance the beneficial hemodynamic effects of sildenafil. In addition, these findings suggest that stimulation of NO synthesis with L-arginine during acute pulmonary embolism does not produce beneficial effects. (c) 2005 Elsevier B.V. All rights reserved.

Cardiovascular alterations at different stages of hypertension development during ethanol consumption: Time-course of vascular and autonomic changes

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Increased Expression of Angiotensin II Type 2 Receptors in the Solitary-Vagal Complex Blunts Renovascular Hypertension

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Portal hypertension in dogs

Portal hypertension (PH) is the pathological increase in portal vein pressure above normal limits. Two variables control the pressure in the portal system: the resistance to blood flow and blood flow volume in the portal system. If one these variables changes, PH may develop. Classification: Pre-hepatic (e. g. compression of the portal vein), intrahepatic (e. g. chronic hepatitis and cirrhosis) or post-hepatic (e. g. right heart failure). The invasive methods (intravenous catheter) were replaced by an indirect method of diagnosis: Doppler Ultrasound. This technique does not measure portal pressure, but indirectly allows the diagnosis of PH. Average speed of portal flow decrease (<10 cm/s) and hepatofugal flow have been reported in cirrhotic dogs with PH. Currently, the focus of the ultrasound is the detection of acquired collateral portal circulation (ACPC), closely correlated with hepatic encephalopathy. The characterization of these vessels is essential to differentiate them from congenital shunts. They are usually multiple vessels, small and tortuous, with turbulent flow, near to the kidneys, and/or a single and larger vessel, draining into the left renal vein (dilated gonadal vein). Gastric, esophageal and mesenteric varices may occur. After identifying the PH, it is important to determine its origin in order to treat the underlying disease. B-Mode Ultrasound and Doppler are the best choices in cases of suspected PH, because they may recognize not just the hypertension, but also its complications and origin.

Hypertension and its correlation with renal lesions in dogs with leishmaniosis

To evaluate the prevalence of hypertension and its correlation with the severity of renal injury and proteinuria in dogs with leishmaniosis, sixty-six dogs were divided into two groups. Group 1 (G1) was composed of 54 dogs included in stage 1 of chronic kidney disease (CKD), and group 2 (G2) of twelve dogs in stages 2 and 3 of CKD. Prevalence of hypertension was 28.8%, comprising 22.2% of the dogs from G1 and 58.3% from G2 (P=0.011). The mean arterial blood pressure (BP) of dogs from G1 (135.7 +/- 20.5) was lower than from G2 (170.0 +/- 26.3) (P <0.001). Urine proteincreatinine ratio (UP/C) revealed values above 0.5 in 75.7% of the dogs, with 34% presenting hypertension. All dogs with hypertension had histopathological and laboratory evidence of glomerular disease. Although there was no statistically significant correlation between elevated BP and the severity of glomerular lesions (P=0.408), there was a statistically significant correlation between elevated BP and increased UP/C in the studied population (P=0.002). Thus, dogs with leishmaniosis and renal disease must be screened for the presence of hypertension so that treatment may be instituted as early as possible, in countries where treatment is allowed, to prevent the progression of renal damage.

Hypertension modifies OPG, RANK, and RANKL expression during the dental socket bone healing process in spontaneously hypertensive rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Growth of preterm low birth weight infants until 24 months corrected age: effect of maternal hypertension

Objective: To evaluate the growth pattern of low birth weight preterm infants born to hypertensive mothers, the occurrence of growth disorders, and risk factors for inadequate growth at 24 months of corrected age (CA).Methods: Cohort study of preterm low birth weight infants followed until 24 months CA, in a university hospital between January 2009 and December 2010. Inclusion criteria: gestational age < 37 weeks and birth weight of 1,500-2,499g. Exclusion criteria: multiple pregnancies, major congenital anomalies, and loss to follow up in the 2nd year of life. The following were evaluated: weight, length, and BMI. Outcomes: growth failure and risk of overweight at 0, 12, and 24 months CA. Student's t-test, Repeated measures ANOVA (RM-ANOVA), and multiple logistic regression were used.Results: A total of 80 preterm low birth weight infants born to hypertensive mothers and 101 born to normotensive mothers were studied. There was a higher risk of overweight in children of hypertensive mothers at 24 months; however, maternal hypertension was not a risk factor for inadequate growth. Logistic regression showed that being born small for gestational age and inadequate growth in the first 12 months of life were associated with poorer growth at 24 months.Conclusion: Preterm low birth weight born infants to hypertensive mothers have an increased risk of overweight at 24 months CA. Being born small for gestational age and inadequate growth in the 1st year of life are risk factors for growth disorders at 24 months CA. (C) 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Metalloproteinase inhibition protects against reductions in circulating adrenomedullin during lead-induced acute hypertension

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

An update on the pharmacogenetics of treating hypertension

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Evaluation of dietary intake of calcium in adult subjects with idiopathic arterial hypertension

The calcium-intake relationship with other alimentary and anthropometric variables was investigates in a group of 60 adult (19-75 year-old) subjects, 50 females and 10 males, with essential arterial hypertension (DAP > 90 mmHg). The calcium intake was assessed by three different protocols: 24-hour food intake recall, food-frequency questionnaire and 3 day self-food intake register, repeated along with anthropometric measurements on three different occasions (2-15 month-intervals). The calcium intake assessed by the three methods, as well as the anthropometric data, were statistically similar on all three occasions. The mean data were then compared with those form the control, composed of 75 healthy subjects matched with the hypertensive group by age and sex. The patients ingested less calcium (mean +/- SD) than the controls on the daily (517 +/- 271 x 740 +/- 353 mg/d) and body-weight (8.1 +/- 5.0 x 11.4 +/- 5.9 mg/kg/d) basis. Among the males the calcium intake was the only difference found between groups and could be attributed to the lower intake of calcium-rich foods. The hypertensive females showed also higher lean-body mass (Body-mass index and arm muscle circumference). Thus the calcium intake discriminated both groups being associated with changes in other nutritional parameters only in females.

Pressor mechanisms in adriamycin-induced nephropathy with hypertension in rats

We explored the role of angiotensin II and vasopressin in the maintenance of blood pressure during the nephrotic syndrome of adriamycin-induced nephropathy in rats. All 91 rats treated with adriamycin developed chronic renal failure with nephrotic syndrome, which was more pronounced in the normotensive rats than the 35% who became hypertensive. Angiotensin II blockade with DuP 753 produced a significantly greater hypotensive response in both the adriamycin-hypertensive (-16 +/- 3 mm Hg) and adriamycin-normotensive (-14 +/- 5 mm Hg) groups than the saline-treated controls (-5 +/- 1 mm Hg, P < .05). Vasopressin blockade with either a V1V2 inhibitor or a selective V1 inhibitor produced a hypotensive response in adriamycin-hypertensive rats only (by -16 +/- 4 and -17 +/- 2 mm Hg, respectively, P < .01), although the nonselective vasopressin inhibitor produced similar fluid loss and body weight reduction in all three groups. The data suggest that in adriamycin-induced nephropathy with nephrotic syndrome, angiotensin II contributes to blood pressure maintenance in both hypertensive and normotensive animals, whereas the pressor action of vasopressin contributes to elevated blood pressure in hypertensive animals only.