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ABSTRACT Objective: We aimed to analyze the association of diabetes and subclinical hypothyroidism with subclinical atherosclerosis measured by coronary artery calcium (CAC) in the baseline of the ELSA-Brasil study. Materials and methods: CAC was measured using a 64-detector computed tomographic scanner. The association of CAC > 0 was presented as an odds ratio (OR) and 95% confidence intervals (95%CI) in logistic models and as β (95%CI) in linear models after multivariable adjustment for confounders. Results: We analyzed 3,809 participants (mean-age (SD) 50.5 (8.8); 51.7% women). In the main analysis, we did not find an association of diabetes and subclinical hypothyroidism with CAC. However, in stratified analysis according to age strata, we found no significative interaction terms, an important heterogeneity between the groups, with the younger age strata showing an association of the group with both diseases and CAC > 0 (OR 7.16; 95%CI, 1.14; 44.89) with a wide but significative 95%CI, suggesting that the smaller number of participants in the younger group may influence the results. Our findings also showed an association of CAC > 0 and log (CAC+1) with diabetes in logistic (OR, 1.31; 95%CI, 1.05-1.63) and linear models (β, 0.24, 0.16, 0.40), respectively. Diabetes was independently associated with CAC > 0 in linear models. Discussion: In conclusion, our results showed a great heterogeneity in stratified analysis based on age in the younger age strata. Although we found no significant interaction factors, the smaller sample size for the analysis may influence the negative findings. Objective (CAC ELSABrasil ELSA Brasil study methods 64detector detector 64 scanner OR 95 95%CI 95CI CI (95%CI confounders Results 3809 3 809 3,80 meanage mean SD (SD 505 50 5 50. 8.8 88 8 (8.8) 517 51 7 51.7 women. women . women) However terms groups 7.16 716 16 1.14 114 1 14 44.89 4489 44 89 CAC+1 CAC1 (CAC+1 OR, 1.31 131 31 1.051.63 105163 1.05 1.63 05 63 1.05-1.63 β, (β 024 24 0.24 016 0.16 0.40, 040 0.40 , 40 0.40) respectively Discussion conclusion factors 6 9 380 80 3,8 8. (8.8 51. 7.1 71 1.1 11 44.8 448 4 CAC+ (CAC+ 1.3 13 051 1.051.6 10516 105 1.0 163 1.6 1.05-1.6 02 2 0.2 01 0.1 04 0.4 38 3, (8. 7. 1. 44. 1.051. 1051 10 1.05-1. 0. (8 1.051 1.05-1 ( 1.05-

https://doi.org/10.20945/2359-4292-2022-0375

Incidence of suicidal ideation in a cohort of civil servants during the COVID-19 pandemic in Brazil: insights from the ELSA-Brasil Study COVID19 COVID 19 COVID-1 Brazil ELSABrasil ELSA Brasil COVID1 1 COVID-
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Bacchi, Pedro

; Suen, Paulo

; Fatori, Daniel

; Razza, Lais B.

; Afonso, Leonardo

; Klein, Izio

; Cavendish, Beatriz

; Moreno, Marina L.

; Santos, Itamar S.

; Benseñor, Isabela

; Lotufo, Paulo

; Brunoni, André R

Trends in Psychiatry and Psychotherapy

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2024, Volume 46 elocation e20230701

Abstract: En | Text: En | PDF: En

Abstract Objective: This study investigated the incidence of suicidal ideation and its associated risk factors in the state of São Paulo in the Brazilian Longitudinal Study of Adult Health (Estudo Longitudinal de Saúde do Adulto [ELSA-Brasil]) cohort during the coronavirus disease 2019 (COVID-19) pandemic. Methods: In a pre-pandemic ELSA-Brasil onsite assessment in 2016-2018 (wave 3) and a pandemic online assessment in May-July 2020 (wave COVID), we assessed suicidal ideation using the Clinical Interview Schedule-Revised (CIS-R). Single and multi predictor logistic regressions were performed using sociodemographic characteristics, household financial impact during the pandemic, presence of previous chronic diseases, alcohol abuse, adverse childhood experiences (ACE), living alone, and previous common mental disorders (CMD) as predictors. Incidence of suicidal ideation was used as outcome. Results: Out of 4,191 participants in wave 3, 2,117 (50.5%) also answered the COVID wave. There was a threefold increase in suicide ideation, from 34 (1.8%) to 104 (5.6%) participants. In multiple predictor models, we found that previous CMD (odds ratio [OR] 7.17; 95% confidence interval [95%CI] 4.43 - 11.58) and ACE (OR 1.72; 95%CI 1.09 - 2.72) increased the odds of incident suicidal ideation. The sociodemographic predictors female sex, younger age, and low income were significant risk factors in the single predictor models only. Conclusion: These findings underscore the importance of monitoring and supporting individuals who suffered ACE and have a history of mental health disorders. This is especially critical in times of heightened societal stress, such as the COVID-19 pandemic. Objective Estudo ELSABrasil ELSA Brasil [ELSA-Brasil] 201 COVID19 19 (COVID-19 Methods prepandemic pre 20162018 2016 2018 2016-201 3 MayJuly May July 202 COVID, , COVID) ScheduleRevised Schedule Revised CISR. CISR CIS R . (CIS-R) characteristics diseases abuse ACE, (ACE) alone (CMD outcome Results 4191 4 191 4,19 2117 2 117 2,11 50.5% 505 50 5 (50.5% 1.8% 18 1 8 (1.8% 10 5.6% 56 6 (5.6% OR [OR 7.17 717 7 17 95 95CI CI [95%CI 443 43 4.4 11.58 1158 11 58 1.72 172 72 109 09 1.0 2.72 272 sex age only Conclusion stress COVID-1 [ELSA-Brasil 20 COVID1 (COVID-1 2016201 2016-20 (CIS-R (ACE 419 4,1 211 2,1 50.5 (50.5 1.8 (1.8 5.6 (5.6 7.1 71 9 44 4. 11.5 115 1.7 0 1. 2.7 27 COVID- (COVID- 201620 2016-2 41 4, 21 2, 50. (50. (1. 5. (5. 7. 11. 2. (COVID 20162 2016- (50 (1 (5 (

https://doi.org/10.47626/2237-6089-2023-0701

Comparative analysis of primary health care attributes between children under and over 3 years of age using the primary care assessment tool
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Omori, Luciana Harumi Miranda

; Avigo, Deoclecio

; Santos, Itamar de Souza

; Gusso, Gustavo Diniz Ferreira

; Fernandes, Maria Teresa Bechere

Clinics

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2024, Volume 79 elocation 100353

Abstract: En | Text: En | PDF: En

Abstract Introduction: Child health actions in Brazil have their primary focus on early childhood. A new epidemiological profile is emerging for children after the first one thousand days: an increase in non-communicable chronic diseases. This research aimed to analyze the attributes of Primary Health Care comparatively among different age groups, using three years of age as the cutoff point. Methods: The study design was cross-sectional and conducted in three Primary Health Care Units and three Ambulatory Medical Assistance facilities in the Western Region of Sao Paulo. The PCA Tool Brazil was used as the assessment instrument. Results: A total of 311 interviews were conducted with caregivers of children aged 0 to 12 years; 153 children were under three years old, and 158 were three years or older. The attributes that showed statistically significant differences between age groups (< 3 years and > 3 years) were affiliation (4.9 × 3.8), longitudinality (5.7 × 5.2), information system (7.4 × 6.3), and services provided (5.4 × 4.5). Through linear regression analysis, it was observed that there was a trend for better overall and essential scores in the evaluations of the group of children under three years old who attended Primary Health Care Units. Conclusion: The comparative analysis of Primary Health Care attributes among pediatric age groups revealed a trend towards higher scores, according to caregivers’ perceptions, for children under three years old. This study suggests the need for the implementation of programs that can better address the healthcare needs of children beyond early childhood. Introduction childhood days noncommunicable non communicable diseases point Methods crosssectional cross sectional Paulo instrument Results 31 1 15 older < ( 4.9 49 4 9 (4. 3.8, 38 3.8 , 8 3.8) 5.7 57 5 7 (5. 5.2, 52 5.2 2 5.2) 7.4 74 (7. 6.3, 63 6.3 6 6.3) 5.4 54 4.5. 45 4.5 . 4.5) Conclusion perceptions 4. (4 3. 5. (5 7. (7 6.

https://doi.org/10.1016/j.clinsp.2024.100353

O Risco de Doença Cardiovascular Segundo o Escore Não Laboratorial da OMS em uma População Brasileira Selecionada: Percentis da Distribuição e Concordância com o Escore Laboratorial Selecionada
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Cesena, Fernando Yue

; Generoso, Giuliano

; Santos, Itamar de S.

; Pereira, Alexandre C.

; Bittencourt, Marcio S.

; Santos, Raul D.

; Lotufo, Paulo A.

; Benseñor, Isabela M.

Arquivos Brasileiros de Cardiologia

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2024, Volume 121 N. 7 elocation e20240002

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.36660/abc.20240002

The association of diabetes, subclinical hypothyroidism and carotid intima-media thickness: results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brazil) diabetes intimamedia intima media thickness ELSABrazil ELSA Brazil (ELSA-Brazil
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Spilack, Aída de Melo

; Goulart, Alessandra C.

; Almeida-Pititto, Bianca de

; Janovsky, Carolina Castro Porto Silva

; Lotufo, Paulo A.

; Santos, Itamar de Souza

; Benseñor, Isabela M.

Clinics

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2023, Volume 78 elocation 100154

Abstract: En | Text: En | PDF: En

Abstract Introduction: The association of diabetes with subclinical thyroid diseases may increase the risk of cardiovascular diseases. We analyzed the association of subclinical hypothyroidism, diabetes, and both diseases with carotid Intima-Media Thickness (cIMT) as a surrogate maker for early cardiovascular disease in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods: Cross-sectional analysis with data from the 3rd visit (2017‒2019). Linear regression models were used to evaluate the association of subclinical hypothyroidism, diabetes and of both diseases with a cIMT presented as Beta (95% Confidence Interval – 95% CI) without adjustment, with adjustment for sociodemographic variables (Model 1) and multivariable adjustment (Model 1 more cardiovascular risk factors). We also used logistic regression models to analyze the Odds Ratio (OR) and 95% CI for the association of both diseases using cIMT > P75%. Results: After the exclusion of patients with previous cardiovascular disease, 5,077 participants with no diseases, 1578 with diabetes, 662 with subclinical hypothyroidism, and 234 with both diseases were included in the analysis. Linear regression models showed an association of cIMT with only diabetes (β = 0.019; 95% CI 0.012 to 0.027; p < 0.0001) and subclinical hypothyroidism more diabetes (β = 0.03; 95% CI 0.010‒0.047, p < 0.0001). The logistic regression model reported an association between diabetes and CIMT higher than P75% (OR = 1.49, 95% CI 1.30‒1.71). No interaction between diabetes and subclinical hypothyroidism was detected using cIMT respectively as a continuous (p = 0.29) or as a categorical variable (p = 0.92). Discussion: Diabetes was associated with higher cIMT values. However, no additive effect of subclinical hypothyroidism associated with diabetes over cIMT was detected. Introduction IntimaMedia Intima Media (cIMT ELSABrasil. ELSABrasil ELSA Brasil . (ELSA-Brasil) Methods Crosssectional Cross sectional rd 2017‒2019. 20172019 2017‒2019 2017 2019 (2017‒2019) 95 (95 Model factors. factors factors) OR P75 P Results 5077 5 077 5,07 157 66 23 β 0.019 0019 0 019 0012 012 0.01 0.027 0027 027 0.0001 00001 0001 0.03 003 03 00100047 010 047 0.010‒0.047 0.0001. 149 49 1.49 1.30‒1.71. 130171 1.30‒1.71 30 71 1.30‒1.71) 0.29 029 29 0.92. 092 0.92 92 0.92) Discussion values However (ELSA-Brasil 2017201 2017‒201 201 (2017‒2019 9 (9 P7 507 07 5,0 15 6 2 001 01 0.0 0.02 002 02 0.000 0000 000 00 0010004 04 0.010‒0.04 14 4 1.4 13017 1.30‒1.7 3 7 0.2 09 0.9 201720 2017‒20 20 (2017‒201 ( 50 5, 0. 0.00 001000 0.010‒0.0 1. 1301 1.30‒1. 20172 2017‒2 (2017‒20 00100 0.010‒0. 130 1.30‒1 2017‒ (2017‒2 0010 0.010‒0 13 1.30‒ (2017‒ 0.010‒ 1.30 (2017 0.010 1.3 (201 (20 (2

https://doi.org/10.1016/j.clinsp.2022.100154

Prognóstico Relacionado à Terapia de Reperfusão Pós-Síndrome Coronariana Aguda na Atenção Secundária: Análise de Sobrevida em Longo Prazo na Estratégia ERICO PósSíndrome Pós Síndrome Secundária
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Bruno, Tatiana C.

; Bittencourt, Márcio S.

; Quidim, Alessandra V. L.

; Santos, Itamar S.

; Lotufo, Paulo A.

; Benseñor, Isabela M.

; Goulart, Alessandra C.

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 5 elocation e20220849

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamento A relação entre terapia de reperfusão após a síndrome coronariana aguda (SCA) e mortalidade na atenção secundária não é bem conhecida. Objetivos Avaliar o impacto de três estratégias terapêuticas: (1) terapia medicamentosa exclusiva, (2) Angioplastia Transluminal percutânea coronaria (ATPC) e (3) revascularização do miocárdio (RM) na sobrevida em longo prazo de participantes da Estratégia de Registro de Insuficiência Coronariana Aguda (ERICO). Métodos Análises de sobrevida para mortalidade por todas as causas, mortalidade por doença cardiovascular (DCV) e mortalidade por doença arterial coronariana (DAC) foram realizadas de acordo com três estratégias terapêuticas (tratamento clínico exclusivo, ATPC ou RM). Modelos de regressão de Cox foram usados para estimar o hazard ratio (HR) com intervalo de confiança de 95% (IC95%) de 180 dias a quatro anos de acompanhamento após a SCA. Os modelos são apresentados como modelo sem ajuste ou ajustado quanto à idade, sexo e DAC prévia, tipo de SCA, tabagismo, hipertensão, dislipidemia, fração de ejeção do ventrículo esquerdo e de acordo com o número de artérias coronárias principais obstruídas (≥50%). Resultados Entre os 800 participantes, as piores taxas de sobrevida (mortalidade por todas as causas e DCV) foram detectadas entre os indivíduos que se submeteram a RM. Houve correlação entre RM e DAC [HR: 2,19 (IC95% 1,05-4,55)], mas o risco perdeu significância no modelo multivariado. A ATPC foi associada a uma menor probabilidade de eventos fatais durante os quatro anos de acompanhamento: mortalidade por todas as causas [HR, análise multivariada: 0,42 (IC95% 0,26-0,70)], por DCV [HR: 0,39 (95% CI: 0,20-0,73)] e DAC [HR, análise multivariada: 0,24 (IC95% 0,09-0,63)] em comparação aos submetidos ao tratamento clínico exclusivo. Conclusão No ERICO, a ATPC após a SCA foi associada a um melhor prognóstico, principalmente sobrevida por DAC. (SCA conhecida 1 (1 exclusiva 2 (2 (ATPC 3 (3 (RM ERICO. ERICO . (ERICO) (DCV (DAC exclusivo RM) HR (HR 95 IC95% IC95 IC 18 idade prévia tabagismo hipertensão dislipidemia ≥50%. 50 ≥50% (≥50%) 80 [HR 219 19 2,1 (IC95 1,054,55, 105455 1,05 4,55 , 05 4 55 1,05-4,55)] multivariado HR, multivariada 042 0 42 0,4 0,260,70, 026070 0,26 0,70 26 70 0,26-0,70)] 039 39 0,3 (95 CI 0,200,73 020073 0,20 0,73 20 73 0,20-0,73) 024 24 0,2 0,090,63 009063 0,09 0,63 09 63 0,09-0,63) prognóstico ( (ERICO 9 IC9 5 ≥50 (≥50% 8 21 2, (IC9 054 1,054,55 10545 105 1,0 455 4,5 1,05-4,55) 04 0, 260 0,260,70 02607 026 070 0,7 7 0,26-0,70) 03 (9 200 0,200,7 02007 020 073 0,20-0,73 02 090 0,090,6 00906 009 0,0 063 0,6 6 0,09-0,63 ≥5 (≥50 (IC 1,054,5 1054 10 1, 45 4, 1,05-4,55 0,260,7 0260 07 0,26-0,70 0,200, 0200 0,20-0,7 0,090, 0090 00 06 0,09-0,6 ≥ (≥5 1,054, 1,05-4,5 0,260, 0,26-0,7 0,200 0,20-0, 0,090 0,09-0, (≥ 1,054 1,05-4, 0,260 0,26-0, 0,20-0 0,09-0 1,05-4 0,26-0 0,20- 0,09- 1,05- 0,26-

Abstract Background Relationship between reperfusion therapy post-acute coronary syndrome (ACS) and mortality in secondary care is not well-known. Objectives To evaluate the impact of three therapeutic strategies: (1) exclusive medical therapy, (2) percutaneous coronary intervention (PCI) and (3) coronary artery bypass grafting (CABG) on long-term survival of participants in the Strategy of Registry of Acute Coronary Syndrome (ERICO) study. Methods Survival analyses for all-cause, cardiovascular (CVD) and coronary artery disease (CAD) mortality were performed according to three therapeutic strategies (exclusive medical therapy, PCI or CABG). Cox regression models were used to estimate the hazard ratio (HR) with respective 95% confidence interval (95%CI) from 180 days to four years of follow-up after ACS. Models are presented as crude, age-sex adjusted and further adjusted for previous CAD, ACS subtype, smoking, hypertension, dyslipidemia, left ventricular ejection fraction and according to the number of obstructed (≥ 50%) major coronary arteries. Results Among 800 participants, the lowest crude survival rates were detected among individuals who underwent CABG (all-cause and CVD). CABG was correlated to CAD (HR: 2.19 [95% CI: 1.05-4.55]). However, this risk lost significance in the full model. PCI was associated to lower probability of fatal events during four-year follow-up: all-cause [multivariate HR: 0.42 (95% CI: 0.26-0.70)], CVD [HR: 0.39 (95% CI: 0.20-0.73)] and CAD [multivariate HR: 0.24 (95% CI: 0.09-0.63)] compared to those submitted to exclusive medical therapy. Conclusion In the ERICO study, PCI after ACS was associated to better prognosis, particularly CAD survival. postacute post acute (ACS wellknown. wellknown well known. known well-known 1 (1 2 (2 (PCI 3 (3 (CABG longterm long term (ERICO study allcause, allcause all cause, cause (CVD (CAD CABG. . CABG) HR (HR 95 95%CI 95CI CI (95%CI 18 followup follow up agesex age sex subtype smoking hypertension dyslipidemia ≥ ( 50% 50 arteries 80 CVD. CVD) 219 19 2.1 [95 1.054.55. 105455 1.05 4.55 05 4 55 1.05-4.55]) However model fouryear year multivariate 042 0 42 0.4 (95 0.260.70, 026070 0.26 0.70 , 26 70 0.26-0.70)] [HR 039 39 0.3 0.200.73 020073 0.20 0.73 20 73 0.20-0.73) 024 24 0.2 0.090.63 009063 0.09 0.63 09 63 0.09-0.63) prognosis 9 5 8 21 2. [9 054 1.054.55 10545 105 1.0 455 4.5 1.05-4.55] 04 0. (9 260 0.260.70 02607 026 070 0.7 7 0.26-0.70) 03 200 0.200.7 02007 020 073 0.20-0.73 02 090 0.090.6 00906 009 0.0 063 0.6 6 0.09-0.63 [ 1.054.5 1054 10 1. 45 4. 1.05-4.55 0.260.7 0260 07 0.26-0.70 0.200. 0200 0.20-0.7 0.090. 0090 00 06 0.09-0.6 1.054. 1.05-4.5 0.260. 0.26-0.7 0.200 0.20-0. 0.090 0.09-0. 1.054 1.05-4. 0.260 0.26-0. 0.20-0 0.09-0 1.05-4 0.26-0 0.20- 0.09- 1.05- 0.26-

https://doi.org/10.36660/abc.20220849

Association between psoriasis and thyroid function: results from the Brazilian Longitudinal Study of Adults Health (ELSA-Brasil) function ELSABrasil ELSA Brasil (ELSA-Brasil
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Meneghini, Vandrize

; Tebar, William R.

; Santos, Itamar Souza

; Janovsky, Carolina Castro Porto Silva

; Almeida-Pititto, Bianca de

; Lotufo, Paulo A.

; Goulart, Alessandra C.

; Bensenor, Isabela M.

Archives of Endocrinology and Metabolism

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2023, Volume 67 N. 6 elocation e000640

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: To determine the relationship between psoriasis, thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triodothyronine (FT3), thyroid peroxidase antibodies (TPOAb), and subclinical thyroid dysfunctions in middle-aged and older adults. Materials and methods: Cross-sectional analyses included a self-reported medical diagnosis of psoriasis and thyroid function from the 3rd visit (2017-2019) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). TSH, FT4, and FT3 levels were analyzed as continuous variables and quintiles, and TPOAb positivity and subclinical hypothyroidism as a yes/no variable. Logistic regression models were built as crude and adjusted by main confounders (age, sex, education level, race/ethnicity, and smoking). Results: From 9,649 participants (52.3% women; 59.2 ± 8.7 years old), the prevalence of psoriasis was 2.8% (n = 270). TSH, FT4, TPOAb positivity, and subclinical hypothyroidism were not associated with psoriasis in the main analyses. In the stratified analysis, our findings showed positive associations of the lowest (OR = 2.01; 95% CI 1.05-3.84; p = 0.036) and the highest (OR = 2.13; 95% CI 1.12-4.05; p = 0.022) quintiles of FT4 and a protective association of TPOAb positivity (OR = 0.43; 95% CI 0.19-0.98; p = 0.046) with prevalent psoriasis in women. In the logistic regression for FT3, participants in the 1st quintile showed a statistically significant association with psoriasis for the whole sample (OR = 1.66; 95% CI 1.11-2.46; p = 0.013) and for men (OR = 2.25; 95% CI 1.25-4.04; p = 0.007) in the sex-stratified analysis. Conclusions: The present study showed that the association of FT4 levels with psoriasis are different according to sex, with a possible U-shaped curve in women but not in men. Although there were some associations of FT3 with psoriasis, they may be a consequence of non-thyroidal illness syndrome. Further prospective data may clarify the association of thyroid function and psoriasis. Objective thyroidstimulating stimulating TSH , (TSH) FT (FT4) (FT3) TPOAb, (TPOAb) middleaged middle aged adults methods Crosssectional Cross sectional selfreported self reported rd 20172019 2017 2019 (2017-2019 ELSABrasil. ELSABrasil ELSA Brasil . (ELSA-Brasil) yesno yes no variable age, age (age sex level raceethnicity race ethnicity race/ethnicity smoking. smoking smoking) Results 9649 9 649 9,64 52.3% 523 52 3 (52.3 592 59 2 59. 87 8 7 8. old, old old) 28 2.8 n 270. 270 270) analysis OR 2.01 201 01 95 1.053.84 105384 1.05 3.84 1 05 84 1.05-3.84 0.036 0036 0 036 2.13 213 13 1.124.05 112405 1.12 4.05 12 4 1.12-4.05 0.022 0022 022 0.43 043 43 0.190.98 019098 0.19 0.98 19 98 0.19-0.98 0.046 0046 046 st 1.66 166 66 1.112.46 111246 1.11 2.46 11 46 1.11-2.46 0.013 0013 013 2.25 225 25 1.254.04 125404 1.25 4.04 04 1.25-4.04 0.007 0007 007 sexstratified Conclusions Ushaped U shaped nonthyroidal non thyroidal syndrome (TSH (FT4 (FT3 (TPOAb 2017201 (2017-201 (ELSA-Brasil 964 64 9,6 52.3 5 (52. 2. 27 2.0 20 053 1.053.8 10538 105 1.0 384 3.8 1.05-3.8 0.03 003 03 2.1 21 124 1.124.0 11240 112 1.1 405 4.0 1.12-4.0 0.02 002 02 0.4 190 0.190.9 01909 019 0.1 098 0.9 0.19-0.9 0.04 004 1.6 16 6 1.112.4 11124 111 246 2.4 1.11-2.4 0.01 001 2.2 22 254 1.254.0 12540 125 1.2 404 1.25-4.0 0.00 000 00 (FT 201720 (2017-20 96 9, 52. (52 1.053. 1053 10 1. 38 3. 1.05-3. 0.0 1.124. 1124 40 4. 1.12-4. 0. 0.190. 0190 09 0.19-0. 1.112. 1112 24 1.11-2. 1.254. 1254 1.25-4. 20172 (2017-2 (5 1.053 1.05-3 1.124 1.12-4 0.190 0.19-0 1.112 1.11-2 1.254 1.25-4 (2017- ( 1.05- 1.12- 0.19- 1.11- 1.25- (2017 (201 (20 (2

https://doi.org/10.20945/2359-3997000000640

Saúde Cardiovascular e Fibrilação ou Flutter Atrial: Um Estudo Transversal do ELSA-Brasil Atrial ELSABrasil ELSA Brasil
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Santos, Itamar S.

; Lotufo, Paulo A.

; Goulart, Alessandra C.

; Brant, Luisa C. C.

; Pinto Filho, Marcelo M

; Pereira, Alexandre C.

; Barreto, Sandhi M.

; Ribeiro, Antonio L. P.

; Thomas, G Neil

; Lip, Gregory Y. H.

; Bensenor, Isabela M.

; Arasalingam, Ajini

; Beane, Abi

; Bensenor, Isabela M

; Brocklehurst, Peter

; Cheng, Kar Keung

; El-Bouri, Wahbi

; Feng, Mei

; Goulart, Alessandra C

; Greenfield, Sheila

; Guo, Yutao

; Guruparan, Mahesan

; Gusso, Gustavo

; Gooden, Tiffany E

; Haniffa, Rashan

; Humphreys, Lindsey

; Jolly, Kate

; Jowett, Sue

; Kumarendran, Balachandran

; Lancashire, Emma

; Lane, Deirdre A

; Li, Xuewen

; Lip (Co-PI), Gregory Y.H.

; Li, Yan-guang

; Lobban, Trudie

; Lotufo, Paulo A

; Manseki-Holland, Semira

; Moore, David J

; Nirantharakumar, Krishnarajah

; Olmos, Rodrigo D

; Paschoal, Elisabete

; Pirasanth, Paskaran

; Powsiga, Uruthirakumar

; Romagnolli, Carla

; Santos, Itamar S

; Shantsila, Alena

; Sheron, Vethanayagam Antony

; Shribavan, Kanesamoorthy

; Szmigin, Isabelle

; Subaschandren, Kumaran

; Surenthirakumaran, Rajendra

; Tai, Meihui

; Neil Thomas (Co-PI), G

; Varella, Ana C

; Wang, Hao

; Wang, Jingya

; Zhang, Hui

; Zhong, Jiaoyue

Arquivos Brasileiros de Cardiologia

Journal Metrics
- Sobre o periódico
- SciELO Analytics

nov 2022, Volume 119 N. 5 Pages 724 - 731

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Background The association between ideal cardiovascular health (ICVH) status and atrial fibrillation or flutter (AFF) diagnosis has been less studied compared to other cardiovascular diseases. Objective To analyze the association between AFF diagnosis and ICVH metrics and scores in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods This study analyzed data from 13,141 participants with complete data. Electrocardiographic tracings were coded according to the Minnesota Coding System, in a centralized reading center. ICVH metrics (diet, physical activity, body mass index, smoking, blood pressure, fasting plasma glucose, and total cholesterol) and scores were calculated as proposed by the American Heart Association. Crude and adjusted binary logistic regression models were built to analyze the association of ICVH metrics and scores with AFF diagnosis. Significance level was set at 0.05. Results The sample had a median age of 55 years and 54.4% were women. In adjusted models, ICVH scores were not significantly associated with prevalent AFF diagnosis (odds ratio [OR]:0.96; 95% confidence interval [95% CI]:0.80-1.16; p=0.70). Ideal blood pressure (OR:0.33; 95% CI:0.15–0.74; p=0.007) and total cholesterol (OR:1.88; 95% CI:1.19–2.98; p=0.007) profiles were significantly associated with AFF diagnosis. Conclusions No significant associations were identified between global ICVH scores and AFF diagnosis after multivariable adjustment in our analyses, at least partially due to the antagonistic associations of AFF with blood pressure and total cholesterol ICVH metrics. Our results suggest that estimating the prevention of AFF burden using global ICVH scores may not be adequate, and ICVH metrics should be considered in separate. (ICVH (AFF diseases ELSABrasil. ELSABrasil ELSA Brasil . (ELSA-Brasil) 13141 13 141 13,14 System center diet, diet (diet activity index smoking glucose Association 005 0 05 0.05 5 544 54 4 54.4 women odds OR0.96 OR096 OR 0.96 96 [OR]:0.96 95 [95 CI0.801.16 CI080116 CI 0.80 1.16 80 1 16 CI]:0.80-1.16 p=0.70. p070 p p=0.70 70 p=0.70) OR0.33 OR033 0.33 33 (OR:0.33 CI0.15–0.74 CI015074 0.15–0.74 15 74 CI:0.15–0.74 p=0.007 p0007 007 OR1.88 OR188 1.88 88 (OR:1.88 CI1.19–2.98 CI119298 1.19–2.98 19 2 98 CI:1.19–2.98 analyses adequate separate (ELSA-Brasil 1314 14 13,1 00 0.0 54. OR0 OR0.9 OR09 096 0.9 9 [OR]:0.9 [9 CI0 801 CI0.801.1 CI08011 080 0.8 116 1.1 8 CI]:0.80-1.1 p07 p=0.7 7 OR0.3 OR03 033 0.3 3 (OR:0.3 CI0.15–0.7 CI01507 015074 0.15–0.7 CI:0.15–0.7 p=0.00 p000 OR1 OR1.8 OR18 188 1.8 (OR:1.8 CI1 CI1.19–2.9 CI11929 119298 1.19–2.9 CI:1.19–2.9 131 13, 0. OR0. 09 [OR]:0. [ CI0.801. CI0801 08 11 1. CI]:0.80-1. p0 p=0. 03 (OR:0. CI0.15–0. CI0150 01507 0.15–0. CI:0.15–0. p=0.0 p00 OR1. 18 (OR:1. CI1.19–2. CI1192 11929 1.19–2. CI:1.19–2. [OR]:0 CI0.801 CI080 CI]:0.80-1 p=0 (OR:0 CI0.15–0 CI015 0150 0.15–0 CI:0.15–0 (OR:1 CI1.19–2 CI119 1192 1.19–2 CI:1.19–2 [OR]: CI0.80 CI08 CI]:0.80- p= (OR: CI0.15– CI01 015 0.15– CI:0.15– CI1.19– CI11 119 1.19– CI:1.19– [OR] CI0.8 CI]:0.80 (OR CI0.15 01 0.15 CI:0.15 CI1.19 1.19 CI:1.19 [OR CI0. CI]:0.8 CI0.1 0.1 CI:0.1 CI1.1 CI:1.1 CI]:0. CI:0. CI1. CI:1. CI]:0 CI:0 CI:1 CI]: CI: CI]

Resumo Fundamento A associação entre o status de saúde cardiovascular ideal ( ideal cardiovascular health ( ICVH) e diagnóstico de fibrilação ou flutter atrial (FFA) foi menos estudado em comparação a outras doenças cardiovasculares. Objetivos Analisar a associação entre o diagnóstico de FFA e métricas e escores de ICVH no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Métodos Este estudo analisou dados de 13141 participantes com dados completos. Os traçados eletrocardiográficos foram codificados de acordo com o Sistema de Minnesota, em um centro de leitura centralizado. As métricas do ICVH (dieta, atividade física, índice de massa corporal, tabagismo, glicemia de jeju, e colesterol total) e escores do ICVH foram calculados conforme proposto pela American Heart Association . Modelos de regressão logística bruta e ajustada foram construídos para analisar associações de métricas e escores do ICVH com diagnóstico de FFA. O nível de significância foi estabelecido em 0,05. Resultados A idade mediana da amostra foi de 55 anos, e 54,4% eram mulheres. Nos modelos ajustados, os escores de ICVH não apresentaram associação significativa com diagnóstico de FFA prevalente [odds ratio (OR):0,96; intervalo de confiança de 95% (IC95%):0,80-1,16; p=0,70). Perfis de pressão arterial ideal (OR:0,33; IC95%:0,1-0,74; p=0,007) e colesterol total ideal (OR:1,88; IC95%:1,19-2,98; p=0,007) foram significativamente associados com o diagnóstico de FFA. Conclusões Não foram identificadas associações significativas entre escores de ICVH global e diagnóstico de FFA após ajuste multivariado em nossas análises, devido, ao menos em parte, às associações antagônicas da FFA com métricas de pressão arterial e de colesterol total do ICVH. Nossos resultados sugerem que estimar a prevenção da FFA por meio de escore de ICVH global pode não ser adequado, e as métricas do ICVH devem ser consideradas separadamente. (FFA cardiovasculares ELSABrasil. ELSABrasil ELSA Brasil (ELSA-Brasil) 1314 completos Minnesota centralizado dieta, dieta (dieta física corporal tabagismo jeju 005 0 05 0,05 5 anos 544 54 4 54,4 mulheres ajustados odds OR0,96 OR096 OR 0,96 96 (OR):0,96 95 IC95%0,801,16 IC95080116 IC IC95% 0,80 1,16 IC95 80 1 16 (IC95%):0,80-1,16 p=0,70. p070 p p=0,70 70 p=0,70) OR0,33 OR033 0,33 33 (OR:0,33 IC95%0,10,74 IC9501074 0,1 0,74 74 IC95%:0,1-0,74 p=0,007 p0007 007 OR1,88 OR188 1,88 88 (OR:1,88 IC95%1,192,98 IC95119298 1,19 2,98 19 2 98 IC95%:1,19-2,98 análises devido parte adequado separadamente (ELSA-Brasil 131 00 0,0 54, OR0 OR0,9 OR09 096 0,9 9 (OR):0,9 801 IC95%0,801,1 IC9508011 080 0,8 116 1,1 IC9 8 (IC95%):0,80-1,1 p07 p=0,7 7 OR0,3 OR03 033 0,3 3 (OR:0,3 10 IC95%0,10,7 IC950107 01 0, 074 0,7 IC95%:0,1-0,7 p=0,00 p000 OR1 OR1,8 OR18 188 1,8 (OR:1,8 192 IC95%1,192,9 IC9511929 119 298 2,9 IC95%:1,19-2,9 13 OR0, 09 (OR):0, IC95%0,801, IC950801 08 11 1, (IC95%):0,80-1, p0 p=0, 03 (OR:0, IC95%0,10, IC95010 07 IC95%:0,1-0, p=0,0 p00 OR1, 18 (OR:1, IC95%1,192, IC951192 29 2, IC95%:1,19-2, (OR):0 IC95%0,801 IC95080 (IC95%):0,80-1 p=0 (OR:0 IC95%0,10 IC9501 IC95%:0,1-0 (OR:1 IC95%1,192 IC95119 IC95%:1,19-2 (OR): IC95%0,80 IC9508 (IC95%):0,80- p= (OR: IC95%0,1 IC950 IC95%:0,1- IC95%1,19 IC9511 IC95%:1,19- (OR) IC95%0,8 (IC95%):0,80 (OR IC95%0, IC95%:0,1 IC95%1,1 IC951 IC95%:1,19 (IC95%):0,8 IC95%0 IC95%:0, IC95%1, IC95%:1,1 (IC95%):0, IC95%:0 IC95%1 IC95%:1, (IC95%):0 IC95%: IC95%:1 (IC95%): (IC95%) (IC95% (IC95 (IC9 (IC

https://doi.org/10.36660/abc.20210970

ELSA-Brasil: a 4-year incidence of hearing loss in adults with and without hypertension
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Padilha, Fernanda Yasmin Odila Maestri Miguel

; Oenning, Nágila Soares Xavier

; Santos, Itamar de Souza

; Rabelo, Camila Maia

; Moreira, Renata Rodrigues

; Bensenor, Isabela M.

; Lotufo, Paulo A.

; Samelli, Alessandra Giannella

Revista de Saúde Pública

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2022, Volume 56 elocation 28

Abstract: En | Text: En | PDF: En

ABSTRACT OBJECTIVE To compare the incidence of hearing loss among adults stratified by the occurrence of hypertension, and to investigate the association between hypertension and hearing loss. METHODS Longitudinal observational study, part of the Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil, Longitudinal Study on Adult’s Health). Data from the first and second waves were analyzed, including information from audiological assessment and general health of the subjects. As outcome, we considered the presence of hearing loss (hearing thresholds above 25 dBHL at frequencies from 500 Hz to 8 kHz) and, as exposure variable, hypertension (report of medical diagnosis of hypertension; and/or use of drugs to treat hypertension; and/or pressure systolic blood pressure ≥ 140 mmHg; or diastolic blood pressure ≥ 90 mmHg). As covariables for adjustment were considered: sex, age, education, race / ethnicity, income, smoking, diabetes, and occupational exposure to noise. Poisson regression analysis was conducted, estimating the crude and adjusted relative risks, with 95% confidence intervals, in order to assess the factors associated with hearing loss. RESULTS In crude analyses, the incidence of hearing loss was higher for subjects with hypertension (9.7% versus 5.4%). The crude relative risks for hearing loss was almost double (1.93; 95%CI: 1.10–3.39) for subjects with hypertension in the right ear. In the adjusted analyses, the relative risks was not significant for the hypertension variable (1.42; 95%CI: 0.75–2.67). Being 60 years or older (RR: 5.41; 95%CI: 2.79–10.50) showed a statistically significant association with hearing loss, indicating that older adults have higher relative risks for hearing loss. CONCLUSION In the adjusted analyses controlled for multiple risk factors there was no association between hypertension and hearing loss. The dichotomous variable age (being 60 years or older), on the other hand, has shown a significant association with hearing loss.

https://doi.org/10.11606/s1518-8787.2022056003796

10.

Saúde Cardiovascular e Fibrilação ou Flutter Atrial: Um Estudo Transversal do ELSA-Brasil
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Santos, Itamar S.

; Lotufo, Paulo A.

; Goulart, Alessandra C.

; Brant, Luisa C. C.

; Pinto Filho, Marcelo M

; Pereira, Alexandre C.

; Barreto, Sandhi M.

; Ribeiro, Antonio L. P.

; Thomas, G Neil

; Lip, Gregory Y. H.

; Bensenor, Isabela M.

; Arasalingam, Ajini

; Beane, Abi

; Bensenor, Isabela M

; Brocklehurst, Peter

; Cheng, Kar Keung

; El-Bouri, Wahbi

; Feng, Mei

; Goulart, Alessandra C

; Greenfield, Sheila

; Guo, Yutao

; Guruparan, Mahesan

; Gusso, Gustavo

; Gooden, Tiffany E

; Haniffa, Rashan

; Humphreys, Lindsey

; Jolly, Kate

; Jowett, Sue

; Kumarendran, Balachandran

; Lancashire, Emma

; Lane, Deirdre A

; Li, Xuewen

; Lip (Co-PI), Gregory Y.H.

; Li, Yan-guang

; Lobban, Trudie

; Lotufo, Paulo A

; Manseki-Holland, Semira

; Moore, David J

; Nirantharakumar, Krishnarajah

; Olmos, Rodrigo D

; Paschoal, Elisabete

; Pirasanth, Paskaran

; Powsiga, Uruthirakumar

; Romagnolli, Carla

; Santos, Itamar S

; Shantsila, Alena

; Sheron, Vethanayagam Antony

; Shribavan, Kanesamoorthy

; Szmigin, Isabelle

; Subaschandren, Kumaran

; Surenthirakumaran, Rajendra

; Tai, Meihui

; Neil Thomas (Co-PI), G

; Varella, Ana C

; Wang, Hao

; Wang, Jingya

; Zhang, Hui

; Zhong, Jiaoyue

Arquivos Brasileiros de Cardiologia

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2022, N. ahead

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20210970

11.

Chronic inflammatory diseases, subclinical atherosclerosis, and cardiovascular diseases: Design, objectives, and baseline characteristics of a prospective case-cohort study ‒ ELSA-Brasil
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Bensenor, Isabela M.

; Goulart, Alessandra C.

; Pereira, Alexandre C.

; Brunoni, André R.

; Alencar, Airlane

; Santos, Raul D.

; Bittencourt, Márcio S.

; Telles, Rosa W.

; Machado, Luciana Andrade Carneiro

; Barreto, Sandhi Maria

; de Almeida-Pititto, Bianca

; Janovsky, Carolina Porto Silva

; Sgarbi, José Augusto

; Tebar, William R.

; Meneghini, Vandrize

; Barbosa Junior, Fernando

; Ribeiro, Ana Cristina de Medeiros

; Pasoto, Sandra Gofinet

; Pereira, Rosa Maria R.

; Bonfá, Eloísa

; Sipahi, Aytan M.

; Santos, Itamar de S.

; Lotufo, Paulo A.

Clinics

Journal Metrics
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2022, Volume 77 elocation 100013

Abstract: En | Text: En | PDF: En

Abstract Objectives This analysis describes the protocol of a study with a case-cohort to design to prospectively evaluate the incidence of subclinical atherosclerosis and Cardiovascular Disease (CVD) in Chronic Inflammatory Disease (CID) participants compared to non-diseased ones. Methods A high-risk group for CID was defined based on data collected in all visits on self-reported medical diagnosis, use of medicines, and levels of high-sensitivity C-Reactive Protein >10 mg/L. The comparison group is the Aleatory Cohort Sample (ACS): a group with 10% of participants selected at baseline who represent the entire cohort. In both groups, specific biomarkers for DIC, markers of subclinical atherosclerosis, and CVD morbimortality will be tested using weighted Cox. Results The high-risk group (n = 2,949; aged 53.6 ± 9.2; 65.5% women) and the ACS (n=1543; 52.2±8.8; 54.1% women) were identified. Beyond being older and mostly women, participants in the high-risk group present low average income (29.1% vs. 24.8%, p < 0.0001), higher BMI (Kg/m2) (28.1 vs. 26.9, p < 0.0001), higher waist circumference (cm) (93.3 vs. 91, p < 0.0001), higher frequencies of hypertension (40.2% vs. 34.5%, p < 0.0001), diabetes (20.7% vs. 17%, p = 0.003) depression (5.8% vs. 3.9%, p = 0.007) and higher levels of GlycA a new inflammatory marker (p < 0.0001) compared to the ACS. Conclusions The high-risk group selected mostly women, older, lower-income/education, higher BMI, waist circumference, and of hypertension, diabetes, depression, and higher levels of GlycA when compared to the ACS. The strategy chosen to define the high-risk group seems adequate given that multiple sociodemographic and clinical characteristics are compatible with CID.

https://doi.org/10.1016/j.clinsp.2022.100013

12.

ELSA-Brasil: a 4-year incidence of hearing loss in adults with and without hypertension
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Padilha, Fernanda Yasmin Odila Maestri Miguel

; Oenning, Nágila Soares Xavier

; Santos, Itamar de Souza

; Rabelo, Camila Maia

; Moreira, Renata Rodrigues

; Bensenor, Isabela M.

; Lotufo, Paulo A.

; Samelli, Alessandra Giannella

Revista de Saúde Pública

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2022, Volume 56 elocation 28

Abstract: En | Text: En | PDF: En

https://doi.org/10.11606/s1518-8787.2022056003796

13.

Reference range of serum uric acid and prevalence of hyperuricemia: a cross-sectional study from baseline data of ELSA-Brasil cohort
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Dório, Murillo

; Benseñor, Isabela M.

; Lotufo, Paulo

; Santos, Itamar S.

; Fuller, Ricardo

Advances in Rheumatology

Journal Metrics
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2022, Volume 62 elocation 15

Abstract: En | Text: En | PDF: En

Abstract Background: Most of the few studies that have established reference ranges for serum uric acid (SUA) have not taken into account factors which may interfere with its levels and followed rigorous laboratory quality standards. The aim of this study was to establish reference ranges for SUA and determine the prevalence of hyperuricemia. Method: Cross-sectional study including 15,100 participants (all sample) aged 35 to 74 years from baseline data of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicentric cohort of volunteer civil servants from five universities and one research institute located in different regions of Brazil. It was established a reference sample excluding participants with factors that directly influence SUA levels: glomerular filtration rate lower than 60 ml/min, excessive alcohol intake, use of diuretics, aspirin, estrogen or urate-lowering therapy. SUA was measured using the uricase method and following rigorous international quality standards. Reference ranges were defined as values between percentiles 2.5 (P2.5) and 97.5 (P97.5) of SUA distribution in the reference sample, stratified by sex. Hyperuricemia was defined as SUA ≥ 7 mg/100 ml in the all sample. Results: The reference sample was composed of 10,340 individuals (55.3% women, median age 50 years). Reference ranges (P2.5 to P97.5) for SUA were: 4.0 to 9.2 mg/100 ml for men and 2.8 to 6.9 mg/100 ml for women. Sex was a major determinant for SUA levels (median [IQR], mg/100 ml: 6.1 [5.3–7.0] for men versus 4.5 [3.9–5.3] for women, p < 0.001). Higher levels of SUA were found in patients with higher BMI. Higher age had (a modest) influence only for women. The prevalence of hyperuricemia for all sample (N = 15,100) was 31.9% (95% confidence interval [CI] 30.8– 33.0%) in men and 4.8% (95% CI 4.3–5.3%) in women. Conclusion: SUA reference ranges were 4.0 to 9.2 mg/100 ml for men and 2.8 to 6.9 mg/100 ml for women. Prevalence of hyperuricemia was 31.9% in men and 4.8% in women. Updated SUA reference ranges and prevalence of hyperuricemia are higher nowadays and might be used to guide laboratories and the screening for diseases related to SUA.

https://doi.org/10.1186/s42358-022-00246-3

14.

Estresse no trabalho e níveis de hemoglobina glicada: o papel da escolaridade. Dados da linha de base do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil)
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Santos, Raíla de Souza

; Griep, Rosane Harter

; Fonseca, Maria de Jesus Mendes da

; Chor, Dóra

; Santos, Itamar Souza

; Melo, Enirtes Caetano Prates

Revista Brasileira de Saúde Ocupacional

Journal Metrics
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2022, Volume 47 elocation e5

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Introdução: as condições estressantes do trabalho estão associadas ao aumento dos níveis glicêmicos, mas pouco se conhece sobre o papel da escolaridade neste contexto. Objetivos: analisar a associação entre o estresse psicossocial no trabalho e os níveis de hemoglobina glicada (HbA1c) e a influência da escolaridade como modificador de efeito. Métodos: estudo transversal com dados de 11.922 trabalhadores ativos da linha de base do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). O estresse psicossocial no trabalho foi avaliado pelo modelo demanda-controle. Foram empregadas a regressão logística multinomial e interações multiplicativas. Resultados: em trabalhadoras do sexo feminino com baixa escolaridade, observou-se associação entre baixo uso de habilidades no trabalho (OR 1,56; IC95% 1,09-2,24) e HbA1c elevada. A baixa autonomia no trabalho foi relacionada à HbA1c limítrofe (OR 1,21; IC95% 1,01-1,45) e elevada (OR 1,73; IC95% 1,19-2,51). Entre trabalhadores do sexo masculino com baixa escolaridade, o trabalho de alto desgaste (OR 1,94; IC95% 1,18-3,21), o baixo uso de habilidades (OR 2,00; IC95% 1,41-2,83) e a baixa autonomia no trabalho (OR 1,58; IC95% 1,13-2,21) foram associados à HbA1c elevada. Conclusão: o estresse psicossocial no trabalho foi associado a níveis limítrofes e elevados de HbAlc para trabalhadores com baixa escolaridade de ambos os sexos. Assim, ações para modificar as relações de trabalho e prevenir doenças crônicas devem ser priorizadas.

Abstract Introduction: stressful work conditions are associated to increased glycemic levels, but little is known about the role of educational attainment in this association. Objectives: to analyze the association between psychosocial stress at work, levels of glycated hemoglobin (HbA1c), and the role of educational attainment as an effect modifier. Methods: a cross-sectional study with baseline data from 11,922 active workers who participated in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Psychosocial stress at work was measured via the Demand-Control model. Multinomial logistic regression and multiplicative interactions were performed. Results: among female workers with low educational attainment, there was an association of low skill discretion and elevated HbA1c (OR 1.56; 95% CI 1.09-2.24). Low decision authority was associated to borderline (OR 1.21; 95% CI 1.01-1.45) and high (OR 1.73; 95% CI 1.19-2.51) HbA1c. Among male workers with low educational attainment, high strain (OR 1.94; 95% CI 1.18-3.21), low skill discretion (OR 2.0; 95% CI 1.41-2.83), and low decision authority (OR 1.58; 95% CI 1.13-2.21) were associated to high HbA1c. Conclusion: Stress at work was associated to high and borderline levels of HbAlc in workers from both genders with low educational attainment. Actions to modify work relations and to prevent chronic diseases should be prioritized for this group.

https://doi.org/10.1590/2317-6369/24319pt2022v47e5

15.

Ideal cardiovascular health at ELSA-Brasil: non-additivity effects of gender, race, and schooling by using additive and multiplicative interactions
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Freitas, Roberta Souza

; Santos, Itamar de Souza

; Matos, Sheila Maria Alvim de

; Aquino, Estela Maria Leão de

; Amorim, Leila Denise Alves Ferreira

Cadernos de Saúde Pública

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2022, Volume 38 N. 8 elocation e00266221

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Este estudo visa avaliar a não-aditividade dos efeitos de gênero, raça e escolaridade na saúde cardiovascular ideal entre os participantes do Estudo Longitudinal de Saúde do Adulto - ELSA-Brasil. Trata-se de um estudo transversal utilizando dados da linha de base do ELSA-Brasil, realizado entre 2008-2010. A Associação Americana do Coração definiu a pontuação de saúde cardiovascular ideal (ICH) como a soma dos indicadores da presença de sete fatores e comportamentos favoráveis à saúde: não fumante, índice de massa corporal ideal, atividade física e dieta saudável, níveis adequados de colesterol total, pressão arterial normal e ausência de diabetes mellitus. Interações multiplicativas e aditivas entre gênero, raça e escolaridade foram avaliadas usando o modelo de Poisson, como uma abordagem para discutir a interseccionalidade. A pontuação média de saúde cardiovascular foi de 2,49 (DP = 1,31). Este estudo encontrou uma interação positiva entre gênero e escolaridade (mulheres com Ensino Médio e Superior), tanto na escala aditiva quanto na escala multiplicativa, para a pontuação de saúde cardiovascular ideal. Houve tendência para maiores valores médios de saúde cardiovascular com o aumento da escolaridade, com diferença acentuada entre as mulheres. As pontuações mais baixas de saúde cardiovascular observadas reforçam a importância de compreender-se as experiências psicossociais que influenciam as atitudes em relação aos serviços de saúde, ao acesso à saúde e às escolhas de estilo de vida saudável, que afetam a ICH, para reduzir as desigualdades em saúde e propor políticas públicas mais adequadas como uma estratégia de assistência e prevenção das doenças cardiovasculares.

This study aims to assess the non-additivity effects of gender, race, and schooling on ideal cardiovascular health among participants of the Brazilian Longitudinal Study of Adult Health - ELSA-Brasil. This is a cross-sectional study using data from the baseline of ELSA-Brasil, conducted from 2008 to 2010. The American Heart Association defined a score of ideal cardiovascular health (ICH) as the sum of indicators for the presence of seven favorable health factors and behaviors: non-smoking, ideal body mass index, physical activity and healthy diet, adequate levels of total cholesterol, normal blood pressure, and absence of diabetes mellitus. Multiplicative and additive interactions between gender, race, and schooling were assessed using the Poisson regression model to discuss intersectionality. The mean cardiovascular health score was 2.49 (SD = 1.31). This study showed a positive interaction between gender and schooling (women with high school and higher education) in both additive and multiplicative scales for the score of ideal cardiovascular health. We observed a trend towards higher mean values of cardiovascular health for increased schooling, with a marked difference among women. The lowest cardiovascular health scores observed reinforce the importance of understanding the psychosocial experiences that influence health attitudes, access to health care, and healthy lifestyle choices, which affect ICH, to reduce inequities in health and propose more adequate public policies that assist and prevent cardiovascular diseases.

Este estudio tiene como objetivo evaluar los efectos no aditivos de género, raza y educación en la salud cardiovascular ideal entre los participantes del Estudio Longitudinal de Salud del Adulto -ELSA-Brasil. Se trata de un estudio transversal realizado a partir de datos de línea de base de ELSA-Brasil entre 2008-2010. La Asociación Americana del Corazón definió el puntaje ideal de salud cardiovascular (ICH) como la suma de indicadores de la presencia de siete factores y comportamientos favorables a la salud: no fumador, índice de masa corporal ideal, actividad física y alimentación saludable, niveles adecuados de colesterol total, presión arterial normal y ausencia de diabetes mellitus. Las interacciones multiplicativas y aditivas entre género, raza y educación se evaluaron utilizando el modelo de Poisson como un enfoque para discutir la interseccionalidad. La puntuación media de salud cardiovascular fue de 2,49 (DE = 1,31). Este estudio encontró una interacción positiva entre el género y la educación (mujeres con educación secundaria y universitaria), tanto en la escala aditiva como en la escala multiplicativa, para puntajes ideales de salud cardiovascular. Hubo una tendencia a valores medios más altos de salud cardiovascular conforme aumenta el nivel de educación, con una marcada diferencia entre las mujeres. Los puntajes más bajos de salud cardiovascular refuerzan la importancia de comprender las experiencias psicosociales que influyen en las actitudes hacia la salud, el acceso a la salud y la elección de un estilo de vida saludable, que inciden en el ICH, para reducir las desigualdades en salud y proponer políticas públicas más adecuadas como estrategia de asistencia y prevención de enfermedades cardiovasculares.

https://doi.org/10.1590/0102-311xen266221

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