Brazil – ABC CARDIOL

IJCS

Letter to the Editor

Comments on "Assessment of Overweight/Obesity and Elevation of Blood Pressure in Schools in Rural and Urban Areas in the Backlands of Bahia – A Cross-Sectional Study"

Dear Editor,

I recently came across the article titled “Assessment of Overweight/Obesity and Elevation of Blood Pressure in Schools in Rural and Urban Areas in the Backlands of Bahia – A Cross-Sectional Study,” and I felt compelled to write in. First and foremost, I want to commend the authors for tackling a subject that’s growing more urgent with each passing year. Childhood obesity and elevated blood pressure are emerging earlier and becoming more frequent across the globe, and this study makes a meaningful contribution by examining the problem in a region that’s often overlooked.

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Original Article

Epidemiological Analysis of Emergency Hospitalizations in Brazil Due to Cardiovascular Diseases From 2013 to 2023

Yago Souza Luiz et al. Vitor Moreira Alvarenga Mikaela de Miranda Lopes Lara Gomes Silva

Abstract

Introduction:

Cardiovascular diseases (CVDs) remain among the leading causes of morbidity and mortality worldwide, posing a significant public health challenge. Thus, analyzing their prevalence over time is crucial.

Objective:

To perform an epidemiological analysis of emergency hospital admissions due to CVD in Brazil between 2013 and 2023.

Methods:

This is an ecological, descriptive study based on data from the DATASUS database. Cardiovascular morbidities classified by ICD-10, along with variables such as sex and age group, were selected for analysis. Data was collected in October 2024 and organized into graphs and tables.

Results:

From January 2013 to December 2023, 8,208,282 patients were admitted for emergency cardiovascular conditions, 53.7% of whom were male, with 26% aged between 60 and 69 years. A significant reduction in hospital admissions was observed in 2020 and 2021. Ischemic heart diseases were the most frequent cause of hospitalization, accounting for 29.72% of cases. A notable increase in mortality was recorded in 2021 and 2022, with higher mortality rates among male patients and those admitted for cerebrovascular diseases.

Conclusion:

The observed increase in hospitalizations is attributed to the demographic transition occurring in the country, while the sharp decline in 2020 and 2021 appears to be a consequence of COVID-19-related measures, which is a trend also observed in other countries. These findings underscore the importance of studying the epidemiology of CVD in Brazil and reinforce the need for public investment aimed at reducing their prevalence.

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ABC

Artigo Original

Delineamento e Racional do Estudo Rosa dos Ventos: Estudo Multicêntrico do Tipo Coorte de Pacientes com Insuficiência Cardíaca com Fração de Ejeção Reduzida ou Moderadamente Reduzida no Brasil

Dhayn Cassi de Almeida Freitas et al. Larissa Maria de Paula Rebouças da Costa Wilson Nadruz Jr. Fabiana G. Marcondes-Braga … Jefferson Luis Vieira Sabrina Bernardez-Pereira Wilson Rodrigues Barbosa Neto Silvia Marinho Martins Alves Gabriela Arcoverde Wanderley Camila Nogueira Leandro Lira Lucas Yugi de Souza Terui Ana Luísa Guedes de França e Silva Alana de Oliveira Castro Aguinaldo F. Freitas Jr. José Albuquerque de Figueiredo Neto Renato D. Lopes Miguel Morita Fernandes-Silva Odilson Marcos Silvestre

Resumo

Fundamento:

O Brasil é um país com diferentes biomas e desigualdades sociais. Existem poucos dados disponíveis sobre as diferenças regionais e o prognóstico da insuficiência cardíaca (IC) no país.

Objetivo:

O estudo Rosa dos Ventos tem como objetivo investigar as diferenças regionais e o prognóstico atual de pacientes com IC com fração de ejeção reduzida ou moderadamente reduzida no Brasil.

Métodos:

Este é um estudo prospectivo, multicêntrico, observacional, do tipo coorte que incluirá pacientes ambulatoriais com idade superior a 18 anos com IC e fração de ejeção < 50% em 30 centros privados distribuídos nas regiões brasileiras. Um total de 2500 pacientes serão incluídos entre junho de 2021 e outubro de 2023, com um período de 12 meses de seguimento. Coletaremos dados sobre status clínico e socioeconômico, prescrição médica e resultados de exames cardiológicos. Serão realizados telefonemas para o seguimento dos pacientes seis e 12 meses após a inclusão para coleta de informações sobre visitas ao departamento de emergência, internações e mortalidade.

Conclusão:

O estudo Rosa dos Ventos permitirá uma caracterização mais precisa da IC crônica no Brasil. Essa iniciativa proverá informações relevantes para o desenvolvimento de estratégias de manejo efetivas para mitigar o impacto dessa condição sobre os pacientes e o sistema de saúde.

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Viewpoint

Disparities in Women's Cardiovascular Health in Brazil

Larissa Franco de Andrade et al. Paolo Blanco Villela Jose Lucas Peres Bichara Luiz Antonio Viegas de Miranda Bastos Glaucia Maria Moraes de Oliveira

Cardiovascular diseases (CVD) are the leading cause of death in women worldwide, responsible for 30.4% of female deaths in 2021, according to the Global Burden Disease (GBD) study. In Brazil, between 1990 and 2020, CVD was the leading cause of death in the female population, represented mainly by ischemic heart disease (IHD) and stroke. In 2021, during the coronavirus pandemic period, COVID-19 was the major cause of death among Brazilian women, reaching 21.9% of total deaths, and the percentage of deaths attributed to IHD and CVD was 8.5% and 7.8%, respectively (). Additionally, from 1990 to 2021, proportional mortality from CVD was higher in females compared to males, with a similar percentage of deaths from IHD between the sexes and a higher percentage of deaths from stroke in women.

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Original Article

The Medical Burden of Heart Failure: A Comparative Delineation with Cancer in Brazil

Dirceu Rodrigues de Almeida et al. Antonio Carlos Pereira-Barretto Francisco Jose Forestiero Juliana S. Nakamuta André Bichels

Abstract

Background:

Due to its poor prognosis and mortality rates, heart failure (HF) has been recognized as a malignant condition, comparable to some cancers in developed countries.

Objectives:

To compare mortality from HF and prevalent cancers using data from a nationwide database in Brazil.

Methods:

This was a descriptive, cross-sectional study using secondary data obtained from Brazilian administrative databases of death records and hospitalization claims maintained by the Ministry of Health. Data were analyzed according to main diagnosis, year of occurrence (2005-2015), sex and age group. Descriptive analyses of absolute number of events, hospitalization rate, mortality rate, and in-hospital mortality rate were performed.

Results:

The selected cancers accounted for higher mortality, lower hospitalization and higher in-hospital mortality rates than HF. In a group analysis, HF showed mortality rates of 100-150 per 100,000 inhabitants over the period, lower than the selected cancers. However, HF had a higher mortality rate than each type of cancer, even when compared to the most prevalent and deadly ones. Regarding hospitalization rates, HF was associated with a higher risk of hospitalization when compared to cancer-related conditions as a group.

Conclusions:

Our findings indicate that HF has an important impact on mortality, hospitalization and in-hospital mortality, comparable to or even worse than some types of cancer, representing a potential burden to the healthcare system.

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Editorial

Challenges in Telemedicine: Even When the Road is Hard, Never Give up

Erito Marques de Souza Filho et al. Alexandra Monteiro

“Even when the road is hard, never give up” – Tupac Shakur and The Outlawz

The above quote is from the hit song “Baby Don’t Cry” immortalized by Tupac and The Outlawz. The song is about a young woman who faces challenges and receives encouragement to persevere and not give up. In a similar way, telemedicine faces several challenges on an arduous path. In this way, imbued with a tenacious spirit, its users have had remarkable experiences. In the current issue of the International Journal of Cardiovascular Sciences, Esmerio and colleagues presented a successful application of a telecardiology service. They emphasized that the work contributed to reducing the distance between patients and specialized professionals, and they highlighted a high level of satisfaction for both patients and health Professionals. Experiences like this represent the relevant role of telemedicine in providing quality health services and generating value. However, these tools still face important challenges that need to be overcome.

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Original Article

Mortality from Cardiovascular Diseases: A Comparative Analysis between the Medical and Non-Medical Populations in Brazil

Giulia Guimarães Matos et al. Roberta Luise Carrilho Bittencourt Pacheco Lucélia Batista Neves Cunha Magalhães Katia de Miranda Avena

Abstract

Background:

Cardiovascular disease (CVD) is the leading cause of death worldwide, including among physicians. Professional peculiarities increase cardiovascular risk in this population, making it relevant to analyze mortality in the medical population (MPop) and non-medical population (NMPop).

Objectives:

To compare the CVD mortality coefficient (MC) in between MPop and NMPop in Brazil by analyzing the epidemiological profile and the main causes of deaths from CVD.

Methods:

Time-series study with data obtained from the Mortality Information System of the Federal Council of Medicine and the Brazilian Institute of Geography and Statistics, from 2014 to 2018. The variables age group, sex, race, occupation, and CVD that caused the death were assessed in MPop and NMPop. MC, relative risk and odds ratio between the populations were calculated. Tests for difference in proportions, with approximation to the normal distribution, and chi-squared tests were performed, assuming p<0.01 as statistically significant.

Results:

Both MPop and NMPop had a predominance of men (86.7% and 52.3%), senior citizens (85.9% and 79.7%) and white individuals (86.4% and 52.2%). The MCs of the MPop and NMPop was 92.2 and 255.1 deaths/100,000 individuals, respectively. The main cause of death was acute myocardial infarction (AMI) (32.5% and 24.6% in MPop and NMPop, respectively) followed by cerebrovascular accident (CVA) (5.1% and 10.5% in MPop and NMPop, respectively).

Conclusion:

In Brazil, mortality from CVD was more prevalent in white elderly males, and mainly caused by AMI and CVA. Being a doctor, man and over 60 years old represents a greater chance of death from CVD in comparison with non-physicians.

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Original Article

Physical Fitness Test (PFT) in Police and Military in Brazil: A Systematic Review

Bráulio Nascimento Lima et al. Renato Silveira de Assis Junior Klebson da Silva Almeida Leandro Borelli de Camargo … Ricardo Pablo Passos Carlos Henrique Prevital Fileni Divaldo Martins de Souza Guanis de Barros Vilela Junior

Abstract

Background

Physical Fitness Tests (PFTs) are part of military routines and are usually administered to applicants for the Brazilian corps member, including the civil police.

Objective

To identify in the literature, scientific articles aimed at assessing physical fitness of police and military personnel in Brazil, using PFTs.

Methods

This was a systematic review, using the PRISMA systematization, using the following search keywords “police”, “military”, “physical fitness test” and ” PFT”, in English and Portuguese. The databases used were ScienceDirect, PubMed, BVS (Lilacs) and Scielo. Only original works performed with police and military personnel in Brazil were selected, through the application of inclusion and exclusion criteria.

Results

After the screening process, 11 articles were selected from a total of 1,487.

Conclusions

The data collected from the selected articles suggest that older age is related to a decrease in physical fitness, and better performance in the tests is related to a lower risk of comorbidities. Although high-intensity training improves physical fitness and anthropometric data, it is associated with injury rates; physically active lifestyle is associated with better flexibility.

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Viewpoint

Marginalization, Vulnerability and Economic Dynamics in COVID-19

Andres Felipe Valencia Rendon et al. Isabela Mendes Volschan Manoella de Novais Pereira Alessandra de Freitas Pimentel … Wagner Lima Monteiro Gláucia Maria Moraes de Oliveira

Abstract

COVID-19, caused by the coronavirus family SARS-CoV-2 and declared a pandemic in March 2020, continues to spread. Its enormous and unprecedented impact on our society has evidenced the huge social inequity of our modern society, in which the most vulnerable individuals have been pushed into even worse socioeconomic situations, struggling to survive.

As the pandemic continues, we witness the huge suffering of the most marginalized populations around the globe, even in developed, high-income latitudes, such as North America and Europe. That is even worse in low-income regions, such as Brazil, where the public healthcare infrastructure had already been struggling before the pandemic.

Cities with even more evident social inequity have been impacted the most, leaving the most socioeconomically disadvantaged ones, such as slum residents and black people, continuously inflating the statistics of COVID-19 sufferers.

Poverty, marginalization, and inequity have been well-known risk factors for morbidity and mortality from other diseases. However, COVID-19 has deepened our society’s wound. It is up to us to heal it up. If we really care for the others and want to survive as a species, we must fight social inequity.

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Viewpoint

Research and Publication in Brazil: Where we are and Where we Head to

Marcelo Antônio Cartaxo Queiroga Lopes et al. David Brasil Gláucia Maria Moraes de Oliveira

In a report by Clarivate Analytics for the Brazilian Coordination for the Improvement of Higher-Level-Education Personnel (CAPES) about the Brazilian research productivity between 2013 and 2018, Brazil ranked 13th (250 680 publications) among countries with the highest research productivity, corresponding to 11% and 16% of the first ranked countries, United States and China, respectively.^, In that period, the publications in Brazil increased by 30%, twice the global mean, with over 50 000 articles published in 2018 only.

A good example of that increase has been described in the study analyzing the number of papers published in Nature and Science from the University of São Paulo, University of Campinas, and the Federal University of Rio de Janeiro, from 1980 onwards. The publication counts were categorized by decade from 1980 to 2010 and for 2017. The authors have reported that those institutions together published 0.08 papers, on average, in each edition of those two journals. The total number of papers from those universities increased by 2200% from 1980 to 2017, with a higher representativity in the past decade (from 7 papers in 2010 to 23 in 2017). It is worth noting the increase in partnership with international institutions for the publication of scientific papers.

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Original Article

Epidemiological characteristics of congenital heart diseases in Londrina, Paraná South Brazil

José Carlos dos Santos Guitti

OBJECTIVE: To determine the prevalence and other epidemiological characteristics of congenital heart diseases. METHODS: A retrospective population based study of children who were born in Londrina, from January ’89 to December ’98 (80,262 live births). Diagnoses were confirmed through autopsy, surgery, catheterization, or echocardiography. RESULTS: A total of 441 patients was as certained what corresponds to a prevalence of 5.494:1,000 live births. Ventricular septal defect was the commonest lesion. A small number of transpositions of the great vessels and of left ventricular hypoplasia was observed. A high propation of ventricular septal defect (28.3%) and atrioventricular septal defects (8.1%) occurred. Fifty-one (11.35%) affected children had syndromic diseases and 52 (12.01%) children had nonsyndromic anomalies. CONCLUSION: The prevalence of congenital heart diseases in Londrina is in accordance with that of other regions of the globe. This prevalence also may reflect the reality in the southern region of Brazil, because population characteristics are very similar in the 3 southernmost Brazilian states.

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