Prevention and Control

IJCS

Original Article

Diet Quality and Associated Factors in Atherosclerotic Cardiovascular Disease Patients with and without Diabetes at a Specialized Outpatient Clinic in the City of Pelotas, Brazil

Fernanda Vighi Dobke et al. Aline Longo Bruna Luiza Paulina Ribas Bernardete Weber … Eduardo Gehling Bertoldi Lúcia Rota Borges Renata Torres Abib Bertacco

Abstract

Background

In most cases, atherosclerotic cardiovascular disease (ACVD) is preventable through primary prevention and control of traditional risk factors, such as smoking cessation, regular physical activity, and adherence to healthy dietary patterns. The assessment of diet quality of ACVD patients would be important for a dietary intervention.

Objectives

This study aimed to evaluate diet quality of ACVD patients and its association with clinical conditions.

Methods

This cross-sectional study was nested within a randomized clinical trial entitled “Programa Alimentar Cardioprotetor Brasileiro.” Baseline data of 80 patients from Pelotas, Brazil, were obtained. Food consumption was assessed using 24-h food recall and the Revised Diet Quality Index (IQD-R). Data on smoking status and comorbidities were reported by the patients during medical history taking. To analyze the associations between IQD-R and clinical variables, unpaired Student’s t-test or the analysis of variance was performed. The significance level was 5%.

Results

Most of the sample consisted of men (66.5%), elderly individuals (52.50%), patients with hypertension (78.75%), dyslipidemia (58.75%), and overweight (73.75%). The average IQD-R score was 56.7 ± 12.6 points. Better quality of diet was observed for patients with diabetes compared to those without diabetes (61.1 ± 11.8 versus 54.0 ± 12.6 points; p=0.014).

Conclusion

There is a need to improve diet quality of ACVD patients. Patients ACVD and diabetes had better diet quality compared to those without diabetes.

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IJCS

Review Article

Depression and Cardiovascular Disease in Women

Maria Alayde Mendonça Rivera et al. Ivan Romero Rivera Walkiria Avila Celi Marques-Santos … Francisco Assis Costa Carlos Romério Ferro Jose Maria Gonçalves Fernandes

Abstract

The prevalence of depression varies from 1 to 17% in different geographic regions, and its incidence is 70% higher in women than men. Today, depression affects more than 300 million people worldwide, affecting twice as many women from adolescence to adulthood. In addition to this earlier onset, depression in women tends to be more severe. Cardiovascular disease and depression are chronic diseases that have a major impact on cardiovascular and all-cause morbidity and mortality, with evidence of a two-way relationship between them, in which depression is a predictor of cardiovascular disease and vice versa. In females, the degree of illness and prognosis are more severe when both diseases are present, than when diagnosed alone. In patients with acute or chronic cardiovascular disease, especially women, a systematic screening for depression should be considered as a preventive strategy of cardiovascular events, aiming to reduce the risk of future events. There are still no clinical studies designed to assess the impact of antidepressant treatment on cardiovascular outcomes in women.

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IJCS

Editorial

Mortality from Cardiovascular Disease in Bahia

Gilson Feitosa

The adoption of preventive measures against cardiovascular diseases based on greater knowledge and dissemination of information regarding the risk factors that determine their occurrence, has positively modified the incidence of these diseases, especially those of atherosclerotic or hypertensive nature. This is a worldwide record.

However, two factors must be considered: first, cardiovascular disease continues to be the main cause of death in the contemporary world, and second, this favorable reduction behavior is not seen evenly everywhere.

[…]

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IJCS

Editorial

Metabolic Syndrome

Elizabete Viana de Freitas et al. Kalil Lays Mohallem

Introduction

Metabolic Syndrome (MS) is a complex disorder characterized by a group of Risk Factors (RF), including changes in glycemic levels, insulin resistance, lipid profile, blood pressure levels and central obesity (visceral adipose tissue – VAT), which increase the incidence of cardiovascular diseases often associated with ageing.

It is estimated to affect over 20% of the global adult population, and women are at greater risk. Central (visceral) obesity is thought to be the predominant RF for MS, especially among overweight and low-educated elderly.

[…]

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IJCS

Original Article

Evaluation of Cardiovascular Risk in Hypertensive Individuals Attending a Primary Health Care Center

Tiago Ricardo Moreira et al. Luana Vieira Toledo Érica Toledo Mendonça Renata Maria Colodette … Luciana Saraiva Silva Rosângela Minardi Mitre Cotta

Abstract

Background:

Cardiovascular risk (CVR) stratification has traditionally been used as a strategy for the prevention of cardiovascular diseases in asymptomatic people.

Objective:

To identify the CVR in hypertensive patients attending a primary health care center, using the Framingham risk score, and to evaluate possible associations and correlations with sociodemographic, clinical and laboratory variables not included in this score. This cross-sectional study was conducted with hypertensive patients treated in a primary health care center in Brazil (n = 166).

Methods:

Data collection, administration of questionnaires, anthropometric measurements and laboratory tests were performed from July to August 2013. Multiple linear regression was used in the analysis. A two-tailed p-value < 0.05 was considered significant.

Results:

High CVR was independently associated with male sex (B = 8.73; 95%CI: 6.27: 11.19), high serum levels of total cholesterol (B = 0.05; IC95%: 0.02: 0.08), number of drugs used (B = 0.55; 95%Ci: 0.12: 0.98) and a low glomerular filtration rate (GFR) (B = -0.11; 95%CI: -0.18 : -0.03).

Conclusion:

The results of this study reinforce the importance of continuous and longitudinal care practices directed to hypertensive patients aiming at early detection of risk factors and appropriate intervention to improve the prognosis of this population.

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IJCS

Original Article

Association between Central Obesity and Biochemical Markers of Cardiometabolic Risk in Elderly Attended in Geriatric Ambulatory – Lagarto/SE

Ana Caroline de Souza Almeida et al. Carolina Cunha de Oliveira Emanuelle Dias Costa Adenilda Queiroz S Deiró

Abstract

Backgroud:

Central obesity, especially visceral adipose tissue (VAT), represents a health risk due to its endocrine and metabolic capacity, contributing to the development of the atherogenic profile and strongly associating with cardiovascular morbimortality.

Objective:

To identify the association between central obesity and biochemical markers of cardiometabolic risk in elderly patients treated at a geriatric outpatient clinic in Lagarto-SE.

Method:

This is a cross-sectional study of 159 elderly people of both sexes. Central adiposity was considered an independent variable, identified by measuring the Waist Circumference (WC). Total Cholesterol (TC), LDL-c, HDL-c, non-HDL-c, triglycerides, glycemia and Castelli I and II indices were considered dependent variables. Pearson’s chi-square test was used to evaluate the association between central obesity and biochemical markers of cardiometabolic risk. Those with p < 0.20 were used in the bivariate regression analysis, adopting a 95% confidence interval.

Results:

Mean age was 70.9 ± 7.5 years. Central obesity was present in 43.2% of males and 56.8% of females (p = 0.002). There was statistically significant association between HDL-c, HDL-C and Castelli I Index and central obesity. Individuals with central obesity are 2.48 and 3.13 times more likely to develop changes in HDL-C and Castelli I index, respectively.

Conclusion:

There is an association between central obesity and biochemical markers of cardiometabolic risk in the elderly.

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IJCS

Original Article

Internal Validation of a Risk Score for Prediction of Postoperative Atrial Fibrillation after Cardiac Surgery

Rafael de March Ronsoni et al. Tiago Luiz Luz Leiria Leonardo Martins Pires Marcelo Lapa Kruse … Edemar Pereira Rogerio Gomes da Silva Gustavo Glotz de Lima

Abstract

Background:

Postoperative atrial fibrillation (POAF) after cardiac surgery has great clinical and economic implications. Many attempts have been made to identify risk factors aiming at a better evaluation of prophylactic treatment strategies.

Objective:

To perform an internal validation of a risk score for POAF.

Methods:

A prospective cohort of 1,054 patients who underwent myocardial revascularization and/or valve surgery was included. The risk score model was developed in 448 patients, and its performance was tested in the remaining 606 patients. Variables with a significance level of 5% in the cohort were included and subjected to a multiple logistic regression model with backward selection. Performance statistics was performed using the c-statistic, the chi-square and the Hosmer-Lemeshow (HL) goodness-of-ﬁt, Pearson’s correlation coefﬁcient.

Results:

Four variables were considered predictors of outcome: age (≥ 70 years), mitral valve disease, the non-use or discontinuation of beta-blockers and a positive water balance (> 1,500 mL). The ROC curve was 0.76 (95% confidence interval [CI]: 0.72-0.79). The risk model showed a good ability according to the performance statistics – HL test x⁽²⁾ = 0.93; p = 0.983 and r = 0.99 (Pearson’s coefficient). There was an increase in the frequency of POAF with the increase of the score: very low risk = 0.0%; low risk = 3.9%; intermediate risk = 10.9%; and high risk = 60.0%; p < 0.0001.

Conclusion:

The predictive variables of POAF allowed us to construct a simplified risk score. This scoring system showed good accuracy and can be used in routine clinical practice.

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