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The impact of diabetes and subclinical hypothyroidism association with coronary artery calcium: results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) calcium ELSABrasil ELSA Brasil (ELSA-Brasil
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Spilack, Aída de Melo

; Goulart, Alessandra C.

; Janovsky, Carolina C. P. S.

; Almeida-Pittito, Bianca de

; Lotufo, Paulo A.

; Bittencourt, Márcio Sommer

; Generoso, Giuliano

; Santos, Itamar de Souza

; Bensenor, Isabela M.

Archives of Endocrinology and Metabolism

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2024, Volume 68 elocation e220375

Resumo: En | Texto: En | PDF: En

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

Associations of TSH, free T3, free T4, and conversion ratio with incident hypertension: results from the prospective Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) TSH T3 T T4 hypertension ELSABrasil ELSA Brasil (ELSA-Brasil
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Birck, Marina Gabriela

; Janovsky, Carolina C. P. S.

; Goulart, Alessandra Carvalho

; Meneghini, Vandrize

; Pititto, Bianca de Almeida

; Sgarbi, José Augusto

; Teixeira, Patrícia de Fátima dos Santos

; Bensenor, Isabela M.

Archives of Endocrinology and Metabolism

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2024, Volume 68 elocation e230301

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective: To evaluate the association of TSH, free T3 (FT3), free T4 (FT4), and conversion (FT3:FT4) ratio values with incident hypertension. Materials and methods: The study included data from participants of the ELSA-Brasil study without baseline hypertension. Serum TSH, FT4 and FT3 levels, and FT3:FT4 ratio values were assessed at baseline, and incident hypertension (defined by blood pressure levels ≥ 140/90 mmHg) was estimated over a median of 8.2 years of follow-up. The risk of incident hypertension was evaluated considering a 1-unit increase in TSH, FT4, FT3, and conversion ratio values and after dividing these variables into quintiles for further analysis using Poisson regression with robust variance. The results are presented as relative risks (RR) and 95% confidence intervals (CIs) before and after adjustment for multiple variables. Results: The primary analysis incorporated data from 5,915 euthyroid individuals, and the secondary analysis combined data from all euthyroid individuals, 587 individuals with subclinical hypothyroidism, and 31 individuals with subclinical hyperthyroidism. The rate of incident hypertension was 28% (95% CI: 27%-29.3%). The FT4 levels in the first quintile (0.18-1.06 ng/dL) were significantly associated with incident hypertension (RR: 1.03, 95% CI: 1.01-1.06) at follow-up. The association between FT4 levels in the first quintile and incident hypertension was also observed in the analysis of combined data from euthyroid individuals and participants with subclinical thyroid dysfunction (RR: 1.04, 95% CI: 1.01-1.07). The associations were predominantly observed with systolic blood pressure levels in euthyroid individuals. However, in the combined analysis incorporating euthyroid participants and individuals with subclinical thyroid dysfunction, the associations were more pronounced with diastolic blood pressure levels. Conclusion: Low FT4 levels may be a mild risk factor for incident hypertension in euthyroid individuals and persons with subclinical thyroid dysfunction. Objective TSH T FT , (FT3) (FT4) FT3FT4 FTFT (FT3:FT4 methods ELSABrasil ELSA Brasil FT3:FT defined 14090 140 90 140/9 mmHg 82 8 2 8. followup. followup follow up. up follow-up 1unit unit 1 variance RR (RR 95 CIs (CIs Results 5915 5 915 5,91 58 hypothyroidism 3 hyperthyroidism 28 (95 CI 27%29.3%. 27293 27% 29.3% . 27 29 27%-29.3%) 0.181.06 018106 0.18 1.06 0 18 06 (0.18-1.0 ng/dL ngdL ng dL 103 03 1.03 1.011.06 101106 1.01 01 1.01-1.06 104 04 1.04 1.011.07. 101107 1.07 07 1.01-1.07) However Conclusion (FT3 (FT4 FT3FT (FT3:FT 1409 14 9 140/ 591 91 5,9 (9 27%29.3% 2729 293 29.3 27%-29.3% 181 0.181.0 01810 018 0.1 106 1.0 (0.18-1. 10 011 1.011.0 10110 101 1.01-1.0 1.011.07 107 1.01-1.07 (FT 59 5, ( 27%29.3 272 29. 27%-29.3 0.181. 0181 0. 1. (0.18-1 1.011. 1011 1.01-1. 27%29. 27%-29. 0.181 (0.18- 1.011 1.01-1 27%29 27%-29 (0.18 1.01- 27%2 27%-2 (0.1 27%- (0. (0

https://doi.org/10.20945/2359-4292-2023-0301

Negative life events and depression by gender in the Brazilian Longitudinal Study of Adult Health (ELSA-Brazil) ELSABrazil ELSA Brazil (ELSA-Brazil
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Silva, Simone V.

; Santos, Itamar S.

; Lima, Danielle B.

; Goulart, Alessandra C.

; Varella, Ana C.

; Lotufo, Paulo A.

; Brunoni, Andre R.

; Bensenor, Isabela M.

Clinics

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2024, Volume 79 elocation 100488

Resumo: En | Texto: En | PDF: En

Abstract Objective Gender differences may interfere with the association between Negative Life Events (NLEs) and prevalent/incident depression. This study evaluated the effect of gender in this association using data from the ELSA-Brazil cohort. Methods The authors analyzed 15,088 participants (mean age, 52.1 (9.1), 54.4 % women). NLEs (robbery, hospitalization, death of a close relative, financial hardship, and rupture of a love relationship) were accessed at baseline. Depression was assessed at baseline and follow-ups. The authors built logistic (Odds Ratio [OR], 95 % Confidence Interval [95 % CI]) and Poisson regression models (Relative Risk [RR], [95 % CI]) to evaluate this association. Results Women reported more NLEs compared to men. The authors found associations between NLEs and prevalent depression: for men, hospitalization (OR = 1.83; 95 % CI 1.16‒2.91), financial hardship (OR = 2.42; 95 % CI 1.69‒3.49), rupture of a love relationship (OR = 2.54; 95 % CI 1.50‒4.29), and any NLE (OR = 2.30; 95 % CI 1.59‒3.35); and for women, robbery (OR = 1.81; 95 % CI 1.31‒2.49), hospitalization (OR = 1.46; 95 % CI 1.11‒1.92), financial hardship (OR = 1.76; 95 % CI 1.43‒2.17), rupture of a love relationship (OR = 1.66; 95 % CI 1.20‒2.32), and any NLE (OR = 1.65; 95 % CI 1.34‒2.04). For incident depression only financial hardship (RR = 2.09; 95 % CI 1.55‒2.83) was associated with depression in men, while, for women, robbery (RR = 1.54; 95 % CI 1.16‒2.04); hospitalization (RR = 1.36; 95 % CI 1.07‒1.74), financial hardship (RR = 1.37; 95 % CI 1.14‒1.65), and any NLE (RR = 1.25; 95 % CI 1.04‒1.49) were associated with incident depression. No association was found between the death of a close relative and prevalent/incident depression. Conclusion NLEs were associated with depression in men and women, with a higher impact in the latter. (NLEs prevalentincident ELSABrazil ELSA Brazil cohort 15088 15 088 15,08 mean age 521 52 1 52. 9.1, 91 9.1 , 9 (9.1) 544 54 4 54. women. women . women) robbery, (robbery followups. followups follow ups. ups follow-ups Odds OR, OR [OR] [9 CI] Relative RR, RR [RR] 1.83 183 83 1.16‒2.91, 116291 1.16‒2.91 16 2 1.16‒2.91) 2.42 242 42 1.69‒3.49, 169349 1.69‒3.49 69 3 49 1.69‒3.49) 2.54 254 1.50‒4.29, 150429 1.50‒4.29 50 29 1.50‒4.29) 2.30 230 30 1.59‒3.35 159335 59 35 1.59‒3.35) 1.81 181 81 1.31‒2.49, 131249 1.31‒2.49 31 1.31‒2.49) 1.46 146 46 1.11‒1.92, 111192 1.11‒1.92 11 92 1.11‒1.92) 1.76 176 76 1.43‒2.17, 143217 1.43‒2.17 43 17 1.43‒2.17) 1.66 166 66 1.20‒2.32, 120232 1.20‒2.32 20 32 1.20‒2.32) 1.65 165 65 1.34‒2.04. 134204 1.34‒2.04 34 04 1.34‒2.04) 2.09 209 09 1.55‒2.83 155283 55 while 1.54 154 1.16‒2.04 116204 1.16‒2.04) 1.36 136 36 1.07‒1.74, 107174 1.07‒1.74 07 74 1.07‒1.74) 1.37 137 37 1.14‒1.65, 114165 1.14‒1.65 14 1.14‒1.65) 1.25 125 25 1.04‒1.49 104149 latter 1508 08 15,0 5 9. (9.1 [OR [ [RR 1.8 18 8 11629 1.16‒2.9 2.4 24 16934 1.69‒3.4 6 2.5 15042 1.50‒4.2 2.3 23 1.59‒3.3 15933 13124 1.31‒2.4 1.4 11119 1.11‒1.9 1.7 7 14321 1.43‒2.1 1.6 12023 1.20‒2.3 13420 1.34‒2.0 0 2.0 1.55‒2.8 15528 1.5 1.16‒2.0 11620 1.3 13 10717 1.07‒1.7 11416 1.14‒1.6 1.2 12 1.04‒1.4 10414 150 15, (9. 1. 1162 1.16‒2. 2. 1693 1.69‒3. 1504 1.50‒4. 1.59‒3. 1593 1312 1.31‒2. 1111 1.11‒1. 1432 1.43‒2. 1202 1.20‒2. 1342 1.34‒2. 1.55‒2. 1552 1071 1.07‒1. 1141 1.14‒1. 1.04‒1. 1041 (9 116 1.16‒2 169 1.69‒3 1.50‒4 1.59‒3 159 131 1.31‒2 111 1.11‒1 143 1.43‒2 120 1.20‒2 134 1.34‒2 1.55‒2 155 107 1.07‒1 114 1.14‒1 1.04‒1 104 ( 1.16‒ 1.69‒ 1.50‒ 1.59‒ 1.31‒ 1.11‒ 1.43‒ 1.20‒ 1.34‒ 1.55‒ 10 1.07‒ 1.14‒ 1.04‒ 1.16 1.69 1.50 1.59 1.31 1.11 1.43 1.20 1.34 1.55 1.07 1.14 1.04 1.1 1.0

https://doi.org/10.1016/j.clinsp.2024.100488

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 Nº 6 elocation e000640

Resumo: En | Texto: 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

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Nov 2022, Volume 119 Nº 5 Páginas 724 - 731

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

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

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]

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

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2022, Volume 56 elocation 28

Resumo: En | Texto: 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

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

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2022, Volume 56 elocation 28

Resumo: En | Texto: En | PDF: En

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

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.

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2022, Volume 77 elocation 100013

Resumo: En | Texto: 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

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

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2022, Nº ahead

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

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

10.

Diagnóstico de Fibrilação Atrial na Comunidade Utilizando Eletrocardiograma e Autorrelato: Análise Transversal do ELSA-Brasil
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Santos, Itamar S.

; Lotufo, Paulo A.

; Brant, Luisa

; Pinto Filho, Marcelo M.

; Pereira, Alexandre da Costa

; Barreto, Sandhi Maria

; Ribeiro, Antonio L.

; Thomas, G Neil

; Lip, Gregory Y. H.

; Bensenor, Isabela M.

Arquivos Brasileiros de Cardiologia

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Set 2021, Volume 117 Nº 3 Páginas 426 - 434

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Fundamento: A fibrilação ou flutter atrial (FFA) é a arritmia cardíaca sustentada mais comum. Existem poucos dados sobre a epidemiologia da FFA na América do Sul. Objetivo: O presente estudo procurou descrever a epidemiologia clínica da FFA e o uso de anticoagulantes na avaliação da linha de base do Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil). Métodos: Foram analisados dados de 13.260 participantes do ELSA-Brasil. A FFA foi definida pelo eletrocardiograma ou por autorrelato. Modelos de regressão logística foram construídos para analisar fatores associados à FFA. Este estudo também analisou se idade e sexo estavam associados ao uso de anticoagulantes para evitar acidente vascular cerebral. O nível de significância foi de 5%. Resultados: A idade mediana foi de 51 anos, e 7.213 (54,4%) participantes eram mulheres. A FFA foi detectada em 333 (2,5%) participantes. O aumento da idade (razão de chances [RC]:1,05; intervalo de confiança de 95% [IC95%]: 1,04-1,07), hipertensão (RC:1,44; IC95%:1,14-1,81) coronariopatia (RC: 5,11; IC95%:3,85–6,79), insuficiência cardíaca (RC:7,37; IC95%:5,00–10,87) e febre reumática (RC:3,38; IC95%:2,28–5,02) foram associadas à FFA. Dos 185 participantes com FFA e pontuação no CHA2DS2-VASc≥2, apenas 20 (10,8%) usavam anticoagulantes (50,0% entre aqueles com FFA no eletrocardiograma de linha de base). O uso de anticoagulantes nesse grupo foi associado a maior idade (1,8% vs 17,7% naqueles com idade ≤ 54 e ≥ 65 anos, respectivamente; p=0,013). Observou-se uma tendência ao menor uso de anticoagulantes em mulheres (7,1% vs. 16,4% em mulheres e homens, respectivamente; p=0,055). Conclusões: No recrutamento do ELSA-Brasil, 2,5% dos participantes tinham FFA. O baixo uso de anticoagulantes era comum, o que representa um desafio para os cuidados de saúde nesse cenário.

Abstract Background: Atrial fibrillation or flutter (AFF) is the most common sustained cardiac arrhythmia. Limited data can be found on AFF epidemiology in South America. Objective: The present study sought to describe the clinical epidemiology of AFF and the use of stroke prevention medication in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline assessment. Methods: This study analyzed data from 13,260 ELSA-Brasil participants. AFF was defined according to ECG recording or by self-report. Logistic regression models were built to analyze factors associated with AFF. This study also analyzed if age and sex were associated with anticoagulant use for stroke prevention. Significance level was set at 5%. Results: Median age was 51 years and 7,213 (54.4%) participants were women. AFF was present in 333 (2.5%) participants. Increasing age (odds ratio [OR]:1.05; 95% confidence interval [95%CI]: 1.04–1.07), hypertension (OR:1.44; 95%CI: 1.14–1.81), coronary heart disease (OR: 5.11; 95%CI: 3.85–6.79), heart failure (OR:7.37; 95%CI: 5.00–10.87), and rheumatic fever (OR:3.38; 95%CI: 2.28–5.02) were associated with AFF. From 185 participants with AFF and a CHA2DS2-VASc score ≥2, only 20 (10.8%) used anticoagulants (50.0% among those with AFF in the baseline ECG). Stroke prevention in this group was associated with a higher age (1.8% vs 17.7% in those aged ≤ 54 and ≥ 65 years, respectively; p=0.013). A trend towards a reduced anticoagulant use was observed in women (7.1% vs. 16.4% in women and men, respectively; p=0.055). Conclusions: At the ELSA-Brasil baseline, 2.5% of the participants had AFF. The lack of stroke prevention was common, which is an especially challenging point for healthcare in this setting.

https://doi.org/10.36660/abc.20190873 193 downloads

11.

Hearing loss, tinnitus, and hypertension: analysis of the baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
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Samelli, Alessandra Giannella

; Santos, Itamar Souza

; Padilha, Fernanda Yasmim Odila Maestri Miguel

; Gomes, Raquel Fornaziero

; Moreira, Renata Rodrigues

; Rabelo, Camila Maia

; Matas, Carla Gentile

; Bensenor, Isabela M.

; Lotufo, Paulo A.

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2021, Volume 76 elocation e2370

Resumo: En | Texto: En | PDF: En

OBJECTIVES: To investigate the association among hypertension, tinnitus, and sensorineural hearing loss and evaluate the influence of other covariates on this association. METHODS: Baseline data (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were analyzed. Altogether, 900 participants were evaluated. The baseline assessment consisted of a 7-hour examination to obtain clinical and laboratory variables. Hearing was measured using pure-tone audiometry. RESULTS: Overall, 33.3% of the participants had hypertension. Participants with hypertension were more likely to be older, male, and diabetic compared to those without hypertension. The prevalence of tinnitus was higher among hypertensive participants and the odds ratio for tinnitus was higher in participants with hypertension than in those without hypertension. However, the difference was not significant after adjusting for age. Audiometric results at 250-8,000 Hz were worse in participants with hypertension than in those without hypertension in the crude analysis; however, the differences were not significant after adjustment for age, sex, diagnosis of diabetes, and exposure to noise. No significant difference was observed in hearing thresholds among participants having hypertension for <6 years, those having hypertension for ≥6 years, and individuals without hypertension. CONCLUSION: Hearing thresholds were worse in participants with hypertension. However, after adjusting for age, sex, diagnosis of diabetes, and exposure to noise, no significant differences were observed between participants with and without hypertension. A higher prevalence of tinnitus was observed in participants with hypertension compared to those without hypertension, but without significance after adjusting for age.

https://doi.org/10.6061/clinics/2021/e2370 377 downloads

12.

Frequência e Motivos para a não Administração e Suspensão de Medicamentos durante um Evento de Síndrome Coronariana Aguda. Estudo ERICO
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Santos, Rafael C. O.

; Bensenor, Isabela M.

; Goulart, Alessandra C.

; Lotufo, Paulo A.

; Santos, Itamar S.

Arquivos Brasileiros de Cardiologia

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Nov 2020, Volume 115 Nº 5 Páginas 830 - 839

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Fundamentos: Poucos estudos discutiram causas para o subtratamento medicamentoso na SCA. Objetivos: Avaliar a não-administração e suspensão de medicamentos durante o tratamento intra-hospitalar da SCA na Estratégia de Registro de Síndrome Coronariana Aguda (estudo ERICO). Métodos: Analisamos prontuários de 563 participantes ERICO para avaliar a frequência e motivos da não administração e/ou suspensão de medicamentos. Construímos modelos de regressão logística para avaliar se sexo, idade ≥65 anos, nível educacional ou subtipo de SCA estavam associados com (a) não administração de ≥1 medicamentos; e (b) não administração ou suspensão de ≥1 medicamentos. O nível de significância foi 5%. Resultados: A amostra é composta por 58,1% de homens e com idade mediana de 62 anos. Em 183 (32,5%) participantes ≥1 medicamentos não foram administrados e 288 (51,2%) apresentaram ≥1 medicamentos não administrados ou suspensos. As causas mais frequentes foram risco de sangramento (aspirina, clopidogrel e heparina), insuficiência cardíaca (betabloqueadores) e hipotensão (inibidores da enzima conversora da angiotensina e bloqueadores dos receptores da angiotensina). Indivíduos com idade ≥65 anos (razão de chances [RC]:1,51; intervalo de confiança de 95% [IC95%]:1,05-2,19) e com angina instável (RC:1,72; IC95%:1,07-2,75) tiveram maior chance de não-administração. Considerando apenas pacientes com infarto do miocárdio, idade ≥65 anos foi associada tanto à não administração quanto à não administração ou suspensão. Conclusões: A não administração ou suspensão de ≥1 medicamento não foi rara no estudo ERICO. Indivíduos com idade ≥65 anos ou com angina instável tiveram maior chance de não administração e podem ser subtratados nesse cenário.

Abstract Background: Few studies have discussed the reasons for pharmacological undertreatment of Acute Coronary Syndrome (ACS). Objectives: To determine the frequency and reasons for the non-administration and suspension of medications during in-hospital treatments of ACS in the Strategy of Registry of Acute Coronary Syndrome (ERICO) study. Methods: The present study analyzed the medical charts of the 563 participants in the ERICO study to evaluate the frequency and reasons for the non-administration and/or suspension of medications. Logistic regression models were built to analyze if sex, age ≥65 years of age, educational level, or ACS subtype were associated with (a) the non-administration of ≥1 medications; and (b) the non-administration or suspension of ≥1 medications. The significance level was set at 5%. Results: This study's sample included 58.1% males, with a median of 62 years of age. In 183 (32.5%) participants, ≥1 medications were not administered, while in 288 (51.2%), ≥1 medications were not administered or were suspended. The most common reasons were the risk of bleeding (aspirin, clopidogrel, and heparin), heart failure (beta blockers), and hypotension (angiotensin-converting enzyme inhibitors and angiotensin receptor blockers). Individuals aged ≥65 (odds ratio [OR]:1.51; 95% confidence interval [95% CI]:1.05-2.19) and those with unstable angina (OR:1.72; 95% CI:1.07-2.75) showed a higher probability for the non-administration of ≥1 medication. Considering only patients with myocardial infarction, being ≥65 years of age was associated with both the non-administration and the non-administration or suspension of ≥1 medication. Conclusions: Non-administration or suspension of ≥1 medication proved to be common in this ERICO study. Individuals of ≥65 years of age or with unstable angina showed a higher probability of the non-administration of ≥1 medication and may be undertreated in this scenario. (Arq Bras Cardiol. 2020; 115(5):830-839)

https://doi.org/10.36660/abc.20190317 630 downloads

13.

Self-Reported High-Cholesterol Prevalence in the Brazilian Population: Analysis of the 2013 National Health Survey
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Lotufo, Paulo A.

; Santos, Raul D.

; Sposito, Andrei C.

; Bertolami, Marcelo

; Rocha-Faria Neto, Jose

; Izar, M. Cristina

; Szwarcwald, Celia

; Prado, Rogério R.

; Stoppa, Sheila R.

; Malta, Deborah C.

; Bensenor, Isabela M.

Arquivos Brasileiros de Cardiologia

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Mai 2017, Volume 108 Nº 5 Páginas 411 - 416

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Fundamento: A prevalência de hipercolesterolemia no Brasil não é conhecida para todo o país, havendo somente inquéritos em algumas cidades. Objetivo: Avaliar a prevalência de diagnóstico médico de colesterol alto autorreferido na população adulta brasileira, utilizando-se dos dados da Pesquisa Nacional de Saúde (PNS) de 2013. Métodos: Estudo descritivo que avaliou os dados da PNS de 2013, um inquérito epidemiológico de base domiciliar, representativo para o Brasil, com informações autorreferidas. A amostra compreendeu 60.202 indivíduos entrevistados com autorrelato de diagnóstico médico de colesterol. Calculou-se a prevalência de ponto e o intervalo de confiança de 95% (IC95%) para diagnóstico médico de colesterol/triglicerídeos alto(s) por sexo, idade, cor da pele, região geográfica, escolaridade. Foram calculadas as razões de chance ajustadas. Resultados: Dos 60.202 participantes adultos, 14,3% (IC95%=13,7-14,8) nunca tiveram colesterol ou triglicerídeos dosados, sendo que um maior número de mulheres, idosos, indivíduos com instrução superior completa e de raça branca relatou aferição há menos de um ano. A prevalência de diagnóstico médico de colesterol alto foi de 12,5%, maior nas mulheres (15,1%) do que nos homens (9,7%). A frequência de diagnóstico médico de colesterol alto foi maior naqueles com idade até 59 anos, em brancos ou aqueles de origem asiática, em pessoas com maior escolaridade e entre os moradores das macrorregiões Sul e Sudeste do país. Conclusão: A importância do conhecimento da dislipidemia no atual contexto epidemiológico brasileiro deve ser ressaltada para orientar as ações de prevenção das doenças coronarianas, que representam a primeira causa de óbito no Brasil e no mundo.

Abstract Background: Data on the prevalence of dyslipidemia in Brazil are scarce, with surveys available only for some towns. Objective: To evaluate the prevalence of the self-reported medical diagnosis of high cholesterol in the Brazilian adult population by use of the 2013 National Health Survey data. Methods: Descriptive study assessing the 2013 National Health Survey data, a household-based epidemiological survey with a nationally representative sample and self-reported information. The sample consisted of 60,202 individuals who reported a medical diagnosis of dyslipidemia. The point prevalence and 95% confidence interval (95%CI) for the medical diagnosis of high cholesterol/triglyceride by gender, age, race/ethnicity, geographic region and educational level were calculated. Adjusted odds ratio was calculated. Results: Of the 60,202 participants, 14.3% (95%CI=13.7-14.8) never had their cholesterol or triglyceride levels tested, but a higher frequency of women, white individuals, elderly and those with higher educational level had their cholesterol levels tested within the last year. The prevalence of the medical diagnosis of high cholesterol was 12.5% (9.7% in men and 15.1% in women), and women had 60% higher probability of a diagnosis of high cholesterol than men. The frequency of the medical diagnosis of high cholesterol increased up to the age of 59 years, being higher in white individuals or those of Asian heritage, in those with higher educational level and in residents of the Southern and Southeastern regions. Conclusion: The importance of dyslipidemia awareness in the present Brazilian epidemiological context must be emphasized to guide actions to control and prevent coronary heart disease, the leading cause of death in Brazil and worldwide.

https://doi.org/10.5935/abc.20170055 5316 downloads

14.

Impact of High Risk for Obstructive Sleep Apnea on Survival after Acute Coronary Syndrome: Insights from the ERICO Registry
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Maia, Flavia C

; Goulart, Alessandra C.

; Drager, Luciano F.

; Staniak, Henrique L.

; Santos, Itamar de Souza

; Lotufo, Paulo Andrade

; Bensenor, Isabela M.

Arquivos Brasileiros de Cardiologia

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Jan 2017, Volume 108 Nº 1 Páginas 31 - 37

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Fundamento: Apneia obstrutiva do sono (AOS) é uma condição clínica muito frequente, que pode estar associada a alto risco de mortalidade, particularmente em doença arterial coronariana (DAC). Nem sempre o diagnóstico de AOS acha-se disponível por polissonografia, o método padrão-ouro. Objetivo: Avaliar, usando o Questionário de Berlim como substituto, a influência a longo prazo do alto risco para AOS nos desfechos fatal e não fatal após síndrome coronariana aguda (SCA) na Estratégia de Registro de Insuficiência Coronariana (estudo ERICO). Métodos: O Questionário de Berlim, para triagem de AOS, foi aplicado a 639 casos de SCA 30 dias após o evento índice. Usou-se o modelo de riscos proporcionais de Cox para calcular a razão de risco (HR) para mortalidade por todas as causas, por doença cardiovascular e por IAM (infarto agudo do miocárdio), assim como os desfecho combinado infarto do miocárdio fatal e recorrente não fatal. Resultados: O grupo de alto risco para AOS apresentou maior frequência de história pessoal/familiar de DAC e diabetes, assim como pior sobrevida livre de evento, quando comparado ao de baixo risco (p-log-rank = 0,03). A HR para IAM fatal e recorrente não fatal foi 4,26 (intervalo de confiança 95%: 1,18-15,36) para os pacientes de alto risco para AOS em comparação àqueles de baixo risco após seguimento médio de 2,6 anos. Conclusões: Usando o Questionário de Berlim, conseguimos identificar alto risco para AOS como fator preditivo independente de reinfarto não fatal ou mortalidade por IAM após SCA em seguimento em longo prazo.

Abstract Background: Obstructive sleep apnea (OSA) is a very often clinical condition that can be associated with high mortality risk, particularly in coronary heart disease (CHD). The diagnosis of OSA is not always accessible via the gold-standard method polysomnography. Objective: To evaluate long-term influence of the high risk for OSA on fatal and non-fatal outcomes after acute coronary syndrome (ACS) in the Acute Coronary Syndrome Registry Strategy (ERICO) Study using the Berlin questionnaire as a surrogate. Methods: Berlin questionnaire, a screening questionnaire for OSA, was applied in 639 cases of ACS 30 days after the index event. Cox regression proportional-hazards model was used to calculate the hazard ratio (HR) of all-cause, cardiovascular and CHD (myocardial infarction) mortality, as well as, the combined endpoint of fatal or recurrent non-fatal CHD. Results: The high-risk group for OSA had higher frequencies of previous personal/family history of CHD and diabetes, in addition to a poorer event-free survival, as compared to the low-risk group (p-log-rank=0.03). The HR for fatal or recurrent non-fatal CHD was 4.26 (95% confidence interval, 1.18 - 15.36) in patients at high risk for OSA compared to those at low risk for OSA after a 2.6-year mean follow-up. Conclusions: Using Berlin questionnaire, we were able to identify high risk for OSA as an independent predictor of non-fatal reinfarction or CHD mortality in post-ACS individuals in a long-term follow-up.

https://doi.org/10.5935/abc.20160195 3038 downloads

15.

Circulating early biomarkers of atherogenesis in participants of the Longitudinal Study of Adult Health (ELSA-Brasil) without diabetes or cardiovascular disease
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Almeida-Pititto, Bianca de

; Ribeiro-Filho, Fernando Flexa

; Barreto, Sandhi

; Duncan, Bruce B.

; Schmidt, Maria Inês

; Lotufo, Paulo A.

; Bensenor, Isabela M.

; Ferreira, Sandra R. G.

Archives of Endocrinology and Metabolism

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Dez 2016, Volume 60 Nº 6 Páginas 573 - 581

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective Our aim was to describe the distribution of selected biomarkers according to age and sex, adjusted for HOMA-IR and adiposity, in a subset of middle-aged individuals of Brazilian Longitudinal Study of Adult Health-ELSA without diabetes mellitus or CVD. Subjects and methods This cross-sectional study was conducted in 998 participants of the ELSA-Brasil without diabetes and/or cardiovascular disease. In addition to the traditional risk factors, several biomarkers concentrations were compared according to sex, age groups (35-44; 45-54 yrs) and HOMA-IR tertiles. Linear regression was used to examine independent associations of sex and age with selected novel biomarkers, adjusted for body adiposity and HOMA-IR. Results Fifty-five percent were women. Men had higher mean values of body mass index, waist circumference, blood pressure, plasma glucose, HOMA-IR, worse lipid profile and higher E-selectin and lower leptin concentrations than women; while women had higher levels of HDL-cholesterol and leptin than men. Mean values of waist circumference, systolic BP, plasma glucose and apolipoprotein B (Apo B) increased with age in both sexes. Leptin and E-selectin concentrations increased across HOMA-IR tertiles. Independent associations of Apo B with age were found only in male sex, while of leptin with body mass index and HOMA-IR, and of E-selectin with HOMA-IR in both sexes. Conclusions In conclusion, our data indicate age, sex, adiposity and, consequently, insulin resistance, influence circulating levels of Apo B, leptin and E-selectin, suggesting that those aspects should be taken into consideration when assessing these parameters for research or clinical purposes in individuals at relatively low cardiometabolic risk.

https://doi.org/10.1590/2359-3997000000205 1305 downloads

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