Cardiovascular Diseases/physiopathology

IJCS

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.

Ler artigo completo

IJCS

Original Article

Factors Associated with Quality of Life in Patients with Systemic Arterial Hypertension

Gustavo O. Silva et al. Aluísio Andrade-Lima Antônio Henrique Germano-Soares Dalton de Lima-Junior … Sergio L. C. Rodrigues Raphael M. Ritti-Dias Breno Q. Farah

Abstract

Background

Hypertensive patients present, in addition to worse cardiovascular health, lower health-related quality of life compared to normotensive subjects. Factors such as functional capacity, functional status, pain, participation in social activities, mental and emotional health, fatigue and energy level, along with perception of general health, seem to be relevant for evaluation in this population. However, evidence is unclear in hypertensive patients.

Objective

To analyze the factors associated with quality of life in hypertensive patients.

Methods

Forty-five patients were recruited. The dependent variables of the present study are the quality of life domains. Demographic data and clinical conditions were considered independent variables. The Medical Outcomes Short-Form Health Survey (SF-36) questionnaire was used to measure quality of life. Handgrip strength, blood pressure and anthropometric indicators were evaluated. Crude and adjusted linear regression analysis was used.

Results

It was verified that education level, body mass index and muscle strength were associated with the functional capacity domain (p < 0,05), whereas systolic blood pressure was associated with the physical domain (p < 0,05). Women presented lower quality of life on the pain domain compared to men and educational level was associated with the social domain (p < 0,05).

Conclusion

Hypertensive patients with lower levels of body mass index, higher levels of education and muscle strength presented a better quality of life on the physical domain, while the social aspects presented a positive relationship with education level. Women presented a worse quality of life on the pain domain compared to men. (Int J Cardiovasc Sci. 2020; 33(2):133-142)

Ler artigo completo

IJCS

Original Article

Cardiovascular Risk and Metabolic Syndrome in Individuals with Mental Disorders

Sarah de Melo Rocha Cabral et al. Marize Melo dos Santos

Abstract

Background:

Patients with mental disorders are more susceptible to cardiovascular diseases and metabolic disorders compared to the general population.

Objective:

To evaluate cardiovascular risk and metabolic syndrome in individuals with mental disorders.

Materials and methods:

A cross-sectional study, conducted at the Psychosocial Care Centers. Socioeconomic, clinical, biochemical and anthropometric data were collected using a standard form. Cardiovascular risk was assessed by the Framingham risk score. Metabolic syndrome (MS) was determined by the World Health- Organization (WHO), the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF) criteria. Data were analyzed by descriptive statistics, and associations were evaluated by the chi-square test and Fisher’s exact test, as well as Odds Ratio. The significance level adopted for all statistical tests was 5%.

Results:

The chance of individuals diagnosed with MS be at intermediate-to-high cardiovascular risk was greater (12.22, 8.01 and 6.23 times higher according to WHO, NCEP and IDF criteria, respectively) than those without MS.

Conclusion:

A high percentage of patients with mental disorders were at intermediate / high cardiovascular risk, and this was significantly associated with MS.

Ler artigo completo

IJCS

Original Article

Behavior of Pulmonary Function after Hospital Discharge in Patients Submitted to Myocardial Revascularization

André Luiz Lisboa Cordeiro et al. Letícia Gardênia Romualdo da Silva Milena Oliveira Pinto Jaclene da Silva Araújo … André Raimundo Guimarães Jefferson Petto

Abstract

Background:

Coronary artery bypass grafting (CABG) is a type of surgery where there is a compromise in one or more coronary arteries, with the objective of restoring function to the areas that have been compromised in the heart, possibly leading to respiratory compromise and postoperative complications. The return time of the pulmonary function to the preoperative condition is still indeterminate in the literature.

Objective:

To describe the behavior of pulmonary function after hospital discharge in patients submitted to CABG.

Methods:

This is a prospective cohort study. Only patients undergoing MRI, whose lung function was evaluated preoperatively, at hospital discharge and 30 days after surgery, were evaluated. This evaluation consisted of maximum inspiratory pressure (MIP) and expiratory (MEP), vital capacity (VC) and expiratory flow peak (EFP).

Results:

A total of 30 patients were evaluated, of which 18 (60%) were males, mean age 62 ± 9 years. A reduction in lung function from preoperative time to hospital discharge was observed in all variables. There was improvement in MIP (88 ± 9 vs 109 ± 5, p < 0.001), MEP (67 ± 10 for 90 ± 8, p < 0.001) and EFP (310 ± 59 for 390 ± 32, p < 0.001), high for review. At the time of the review, no variables returned to their preoperative value: MIP (116 ± 5 for 109 ± 5, p = 0.43), MEP (111 ± 8 for 90 ± 8, p < 0.001), VC (45 ± 12 for 39 ± 7, p = 0.33) and EFP (430 ± 40 for 390 ± 32, p < 0.001).

Conclusion:

It is concluded that MRI surgery reduces lung function and is not reestablished after 30 days of the procedure. Being the expiratory muscular force and the peak of expiratory flow the most affected.

Ler artigo completo

IJCS

Editorial

Digital Tools and Cardiovascular Rehabilitation

Ricardo Stein et al. Leandro Tolfo Franzoni

Cardiovascular diseases are the leading cause of death worldwide. The inclusion of patients with such diseases in cardiovascular rehabilitation (CR) programs is an evidence-based conduct, since it has the potential to improve the individual’s clinical condition and manage several risk factors associated with these diseases. The association of aerobic and resistance exercises is a recommended combination in many CR programs. However, technological tools have been studied and used in order to increase the range of methods to optimize the results in the scenario of secondary prevention of cardiac diseases. In addition, combining modern strategies and conventional models can be a form of motivation for the patient by making CR interactive and funnier. In this case, virtual reality (VR) has also been used, including in our country.^,

A study published by Silva et al. in this issue of the International Journal of Cardiovascular Sciences compares the effects of conventional rehabilitation with VR on body composition and functional capacity of patients with cardiac diseases. It is a randomized controlled trial (RCT) in which 27 patients with cardiac diseases were enrolled to participate in an eight-week CR program. The sample was divided into two groups: a) conventional rehabilitation; b) rehabilitation with VR. The sessions lasted 60 minutes for both groups and the weekly frequency was twice a week. Conventional rehabilitation consisted of two parts: 25 minutes of aerobic exercise followed by 25 minutes of exercises with weights (upper and lower limbs). The intensity control during aerobic exercise was performed by monitoring the heart rate reserve determined by the Karvonen equation (50% and 80%). For resistance exercises, intensity was controlled by rating of perceived exertion (up to 13 on the Borg scale). Rehabilitation with VR was performed using Microsoft’s Xbox 360 with Kinect. The twenty-five minutes of games consisted of exercises for the upper and lower limbs and 25 minutes of dancing with the Dance Central 3 game. In the first part, velcro weights were used in the ankle and dumbbells in the hands for the resistance exercises. The intensity was only controlled in the first part of the activity. Functional capacity was measured through a 6-minute walk test, which significantly increased in both groups. Similarly, both groups had the capillary blood glucose reduced. However, as opposed to what was expected, none of the two strategies significantly reduced fat percentage and body weight. In fact, the VR group presented a significant increase in these two variables compared to the conventional rehabilitation group.

[…]

Ler artigo completo