Fitovigilância de Plantas Medicinais e Fitoterápicos usados por pacientes atendidos em Clínica de Hipertensão de Araraquara

A falta de pesquisas em Fitovigilância contribui para o baixo índice de relatos de efeitos adversos de plantas medicinais e medicamentos fitoterápicos. Eventos adversos a medicamentos constituem um problema de saúde pública, e aqueles decorrentes do uso concomitante de plantas medicinais e medicamentos sintéticos vêm se tornando cada vez mais frequentes. Indicar possíveis interações medicamentosas e reações adversas decorrentes do uso concomitante de plantas medicinais, medicamentos fitoterápicos e sintéticos prescritos pelo médico. O estudo foi realizado no período de março de 2011 à fevereiro de 2012, na Clínica de Hipertensão do Serviço Especial de Saúde de Araraquara (SESA), da Escola de Saúde Pública - USP. Para a coleta de dados foi utilizada a entrevista semiestruturada. O trabalho foi aprovado pelo Comitê de Ética em Pesquisa da UNESP sob parecer nº 28/2011. Foram entrevistados 48 pacientes, sendo 35 mulheres (72,9%) e 13 homens (27,1%), a faixa etária média dos entrevistados é de 60-69 anos, sendo a idade mínima de 33 anos e a máxima, de 92 anos, além da maioria possuir escolaridade até o Ensino Médio. 93,7% dos pacientes relataram utilizar algum medicamento frequentemente e 85,4% relataram usar e/ou que já usaram alguma planta medicinal. A maioria adquiriu conhecimento sobre o uso da planta através da família, de vizinhos ou por conta própria. Vale ressaltar que 87,8% dos pacientes não avisam ou nunca avisaram ao seu médico se estão ou estavam utilizando planta medicinal antes ou durante o tratamento, e relataram desconhecer os riscos do uso concomitante destes produtos. Os resultados demonstraram a importância da implantação da Fitovigilância no SESA, garantindo uma melhor interação entre médico e paciente no momento... (Resumo completo, clicar acesso eletrônico abaixo)

Polimorfismos do gene da eNOS: relação com hipertensão arterial em diferentes níveis de atividade física em adultos

A gênese da hipertensão arterial têm sido associada à presença de polimorfismos em alguns genes, em específico no gene da eNOS. O polimorfismo no Íntron 4 é caracterizado por um Número Variável de Repetições em Tandem, no qual o alelo 4a foi relacionado a baixos níveis de nitrito/nitrato. Os indivíduos 4a/a exibiram 20% menos óxido nítrico (NO) que os indivíduos com genótipos 4b/b, assim como diminuições na expressão protéica da eNOS. Acredita-se que a alteração polimórfica de único nucleotídeo (SNP), na posição - 786 do gene da eNOS esteja relacionada à modulação do gene através da ação de uma proteína repressora chamada de RPA1, capaz de diminuir a quantidade de mRNA, e nitrito/nitrato plasmático; demonstrando sua provável contribuição para o aumento dos valores de pressão arterial. Apenas dois trabalhos mostram uma associação entre os polimorfismos do Intron 4 e -786, demonstrando que o 4a/4a apresenta uma possível ligação de desequilíbrio com a posição -786, sugerindo uma associação positiva entre polimorfismos e prevalência de espasmos coronários e redução na produção endotelial de NO. No entanto, nenhum trabalho avaliou a associação entre o nível de atividade física e a presença de polimorfismo no Íntron 4 e -786 juntos. Assim, os objetivos deste trabalho foram: verificar se existe relação entre a prevalência de hipertensão arterial e a presença do polimorfismo para o gene da eNOS nas duas posições - 786 e Íntron 4, separadamente e juntamente, em voluntários acima de 40 anos e também avaliar se existe relação entre o nível de atividade física e os valores de pressão arterial em indivíduos com e sem estes polimorfismos. Para a análise genética foram feitas análises de reação em cadeia da polimerase (PCR) e para a classificação dos níveis de atividade...(Resumo completo, clicar acesso eletrônico abaixo)

Análise de dez anos de utilização de serviços de saúde por uma coorte de pacientes diagnosticados com hipertensão arterial, no CSE - Botucatu, em 1995

The arterial hypertension is a chronic disease, which can be controlled by changing the way of life, as well as by drug treatment, which demand specific Health Care sequence. The lack of adherence to sequence/treatment is one of the main obstacles the disease control. Characterize and analyze the profile of Health Care usage by a 192 patient cohort diagnosed with arterial hypertension in 1995, between the period of 2001 – 2005 and 2006 – 2010. It is a longitudinal study, retrospective and descriptive developed on School Health Center(SHC) which belongs to School of Medicine Botucatu –UNESP, in continuity of the previous research which has analyzed the sequence of the referred sample between the period of 1995 – 1999. The database was obtained from the patients records by using structured adapted forms appointed in the previous study phase. In the case there were transfers to other Health Care facilities, the database was obtained by the records either, while the patients attended the CSE. The database was analyzed by means of descriptive statistics. Predominated the patients in the age from 50 – 69 (47,9%), whites (93,2%), female (56,7%) with low level of education (72,7%). In the period of 2001 - 2005, 76 (39,5%) of the patients remained under sequence, and that 44 (22,9%) belonged to adherence group (GAD), 17 belonged to abandonment/adherent group (GAB/GAD) and 15 to the abandonment group (GAB), groups which were already identified by the study which has analyzed the period of 1995 – 1999. At the end of the third period of the sample sequence (2006 – 2010), 60 (31,2%) of the patients kept under medical sequence. The cohort’s mortality rate in the period reached 15,1% and 21,9% were transferred to other Municipal Health Care facilities. We conclude that the Health Care service usage by the 192 sample’s integrants kept the same model already identified in the previous analysis... (Complete abstract click electronic access below)

Adiposidade corporal e atividade física em diabéticos tipo 2 com e sem hipertensão arterial

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Outros benefícios do exercício físico para o hipertenso

Aerobic exercise has been suggested as a non-pharmacological treatment for hypertension, and the previous paper of this set demonstrated some of the physiological responses induced by exercise. It has been shown an increment on expenditures for appropriate hypertension management in both, public and private services, which reinforces the inclusion of preventive programs to reduce healthcare costs. However, little is known about physical exercise cost-effectiveness for hypertensive patients. There are several interventions like a simple doctor/dietitian counselling in order to change life style, wed-based nutrition program, pharmacological treatment and assisted or non-assisted physical exercise program that evaluate the costs savings. We have shown that regular exercise (combined or not with another diet counselling and antihypertensive treatment) may effectively contribute to reduce the health care costs (up to -38%). Also, we have shown that exercise improves body composition and lipid profile which are important risk factors to development of cardiovascular disease. So, exercise can lead to significant reduction in blood pressure medication use and, therefore, it causes cost savings, justifying the implementation of exercise programs in all healthcare units.

Características clínicas e laboratoriais de gestantes com pré-eclâmpsia versus hipertensão gestacional

Purpose: To compare clinical and laboratory characteristics, obstetric and perinatal outcomes of patients with pre-eclampsia versus gestational hypertension. Methods: A retrospective study was carried out to analyze medical records of patients diagnosed with pre-eclampsia and gestational hypertension whose pregnancies were resolved within a period of 5 years, for a total of 419 cases. We collected clinical and laboratory data, obstetric and perinatal outcomes. Comparisons between groups were performed using the test suitable for the variable analyzed: unpaired t test, Mann-Whitney U test or χ2test, with the level of significance set at p<0.05. Results: Were evaluated 199 patients in the gestational hypertension group (GH) and 220 patients in the pre-eclampsia group (PE). Mean body mass index was 34.6 kg/m2 in the GH group and 32.7 kg/m2 in the PE group, with a significant difference between groups. The PE group showed higher systolic and diastolic blood pressure and higher rates of abnormal values in the laboratory tests, although the mean values were within the normal range. Cesarean section was performed in 59.1% of cases of PE and in 47.5% of the GH group; and perinatal outcomes in terms of gestational age and birth weight were significantly lower in the PE group. Conclusion: Women with gestational hypertension exhibit epidemiological characteristics of patients at risk for chronic diseases. Patients with pre-eclampsia present clinical and laboratory parameters of greater severity, higher rates of cesarean delivery and worse maternal and perinatal outcomes.

Prevalência de hipertensão arterial em adolescentes escolares em Ibitinga: importância do histórico familiar

Hypertension (H) affects approximately 1,2 billion of people in the world. Among the main risk factors are weight excess, sedentary lifestyle, socio economic condition and family history of H. The main aim of this study was to assess the prevalence of hypertension in teenager scholars in Ibitinga, finding the role of family history of H and to correlates these results with nutritional condition, anthropometric variables and socio economic condition. This research analyzed 150 participants (50 teenager students and their parents) in public and private schools. All the volunteers had their weight (kg) and height (m) measured to calculate the body mass index (BMI). The students were classifieds from table of percentile of obesity (Centers for Disease Control and Prevention, CDC). The blood pressure (BP) was evaluated according to V Arterial Hypertension Brazilian Guidelines (VAHBG, 2006). The high values considered of BP were: ≥140x90 mmHg for adults and percentile >95 for teenagers. The socio economic condition was categorized from IBGE. Among the students, 36% had high BP and 20% borderline. The percentage of high BP were bigger in the public (44%) than private schools (28%), showing a negative correlation between socio economic condition and systolic BP (SBP, r=0.2857) and diastolic BP (DBP, r=0,0165). The prevalence of elevated BP was higher in the girls of public schools (47% vs 40% boys) and in the boys at the private schools (33% v s23%). Weight excess was present in 42% of children (12% obesity and 30% overweight). Again, public schools had prevalence of obesity (52% vs 3% in the private) which was not correlated with socio economic condition. Percentage of overweight and obesity were bigger in the girls of both public (54% vs 50% boys) and private (38% vs 25%) schools. Among the students with H, 67% were overweight. Elevated BP was found in 54% of the fathers and 32% of the mothers. With respect to nutritional condition, 56% of the...

Efeitos da adrenomodulina no tratamento da hipertensão pulmonar induzida por microesferas em ovinos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeitos da doxicilina na hipertensão arterial induzida pela exposiçao ao chumbo: quantificação de pepídeos vasoativos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Hipertensão e diabetes mellitus: perfil assistencial e de usuários em uma unidade de saúde do interior paulista

Pós-graduação em Saúde Coletiva - FMB

Doença periodontal, diabete mellitus e hipertensão em gestantes usuárias do Sistema Único de Saúde (SUS)

Purpose: To evaluate the association among periodontal disease, diabetes mellitus and arterial hypertension in pregnant women users of the Brazilian Health System (SUS). Methods: The sample consisted of 86 women, with pregnant age between the 4th and 7 th month, submitted to pre-natal attendance in Health Basic Unities (HBUs). Periodontal condition was evaluated by 2 calibrated researchers (Kappa = 0.91) through the Community Periodontal Index (CPI). A sphygmomanometer was used to check the arterial pressure, what was accomplished by the professionals from the HBUs; glycemia test was accomplished through a blood sample collected from the middle finger with a disposable lancet adapted to a lance device (Accu-Chek Softclix Pro; Roche, USA), and for checking the glycemia level, a glycemia monitor was used (Accu-Chek Advantage II, Roche, USA). Data were written on a numbered register form, avoiding patient identification. After, the same data were statistically analyzed through the Fisher Exact Test, in order to evaluate the existence of association between the variables blood glucose and periodontal disease. In this test, a significance level of 0,05 was adopted. Results – Most of the pregnant woman presented periodontal health (58,1%); 41,9% of the research subjects showed at least one sign of periodontal disease, with 31,4% presenting gingivitis and 10,5% periodontitis. Hyperglycemia was detected in 51,2% and it was not found a value of arterial pressure higher than what is considered to be normal. Conclusion: it was not verified a significant association among the presence of periodontal disease, glycemia alteration and arterial hypertension in pregnant women who comprised this research.

Modulação autonômica, pressão arterial, aptidão funcional e qualidade de vida em mulheres com hipertensão arterial submetidas a um programa de Hatha Yoga

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Atenção farmacêutica em idosos com hipertensão participantes da estratégia saúde da família

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Plantas medicinais: indicação popular de uso no tratamento de hipertensão arterial sistêmica (HAS)

The aim of this study is to investigate the spontaneous use of medicinal plants by volunteer patients in the treatment of hypertension and to determine the most used plants in this situation. Data were collected through a questionnaire and a semi-structured guided interview applied to patients from a health center in the Midwest region of the state of Sao Paulo, Brazil. Quantitative analysis identified a high number of hypertensive patients spontaneously using herbal treatment. The referred plants were identified by the Herbarium Botu and researched in the literature as to their therapeutic actions. The biggest mistake was observed in the misuse of the Bilberry for the treatment of hypertension, which reveals that health professionals and the community in general should be more careful. As a result we have published an informative booklet, with emphasis on hypertension concepts and on the use of medicinal plants as an alternative therapy method for this disease in order to provide scientific knowledge and scientific research evidence to this practice.

Frequência de ocorrência e fatores associados à hipertensão arterial em pacientes do Sistema Único de Saúde

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)