It is currently known that the atherosclerosis process starts in childhood. Thus, in order to decrease the number of cardiovascular events in the adult population, it was necessary to establish strategies aimed at preventing the development of risk factors in children. Of these, obesity is one of the most accountable elements. Obesity and its consequences, especially in adolescents, has been an increasingly frequent reality in cardiologists’ offices. Studies have shown that a high body mass index means a greater probability of developing chronic diseases, including, and among them, atherosclerosis, systemic arterial hypertension, diabetes mellitus, dyslipidemia, metabolic syndrome and comorbidities, such as obstructive sleep apnea.^, These risk factors, also during growth and development, tend to join and act in favor of cardiovascular disease.

Overweight and obesity in children and adolescents are indeed a matter of concern. A close look shows that, in the last twenty years, their proportion has greatly increased in several countries.^,, Adolescence is characterized by significant changes in body composition, especially during puberty. The follow-up and monitoring are essential since weight, body fat and lean mass are predictive characteristics of the development of cardiovascular risk factors in adult life.^, This age group, within this scenario, has a five-fold greater risk of excessive adiposity in the future, thus becoming a marker of increased cardiometabolic risk.

[…]

Basic research is essential to generate and expand knowledge in several research areas. In recent decades, cardiology practice has substantially changed in response to advances in experimental research, which have provided a better understanding of the molecular mechanisms involved in cardiovascular diseases. Consequently, new diagnostic evaluation tools have been introduced and new drugs have been indicated for treating cardiovascular diseases.

Recent articles in Arquivos Brasileiros de Cardiologia, also known as ABC Cardiol, have shown great scientific advances in basic research, with studies originating from researchers from Brazil and from other countries. Additionally, knowledge from more diverse areas has been seen in national scientific output. In the last decade, the journal has seen a significant increase in the number of articles from different fields of research such as physical education, physiotherapy, nutrition, biology, biomedicine, etc. This Editorial focuses on basic research articles recently published in ABC Cardiol.

[…]

From May 1st to 10th, 1997, the First Brazilian Seminar on Cardiovascular Epidemiology, was held in the city of Gramado (RS), in the manner in which the World Federation of Cardiology has been promoting in various parts of the world since 1968 with The title Ten-Day International Didactic Seminars on Cardiovascular Epidemiology and Prevention.

The initiative came from the Scientific Advisory Board of the Faculty of Medicine of the Universidade Federal of Rio Grande do Sul (UFRGS) and the Cardiology Clinical Department and of the Committe de Epidemiology and Public Health of the Sociedade Brasileira de Cardiologia (SBC), under the auspices of the Coordination of Higher Education for Personal Development (CAPES), the World Heart Federation (at that time still called the International Society and Federation of Cardiology) and the Inter-American Heart Foundation.

[…]

Cardiovascular diseases are the leading cause of morbidity and mortality around the world, and particularly in Brazil, despite advances in their diagnosis and treatment. It is speculated that these adverse events are due in part to the lack of patients’ adherence to medical (pharmacological and non-pharmacological) recommendations^,. In this regard, the evaluation of adherence and, eventually, the identification of the causes of failure in adherence are recommended to be part of the cardiovascular anamnesis. In the study published by Oliveira-Filho et al in the Arquivos Brasileiros de Cardiologia entitled “Improving Post‑Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial”, the topic of adherence is approached in a randomized clinical study conducted by the authors. In this study, 61 patients diagnosed with cardiovascular disease were, upon discharge from the hospital, randomized to receive an intervention focused on education and information, including dosage simplification, and based on a 4-item adherence scale versus standard treatment. The authors compared adherence outcomes at 1 and 12 months of follow up, as well as clinical outcomes (hospital readmission and death) in the follow-up period. The adherence rate was assessed with the 8-item therapeutic adherence scale by Morisky^,. At 1-month follow-up, the adherence rate was significantly higher in the intervention group (83.3% versus 48.4%). During long-term follow-up, the adherence rate declined to a statistically non-significant difference between groups, but remained around 61% in the intervention group. As for readmissions and deaths, there was no significant difference between groups, although the study was not designed primarily to analyze these outcomes. However, we emphasize that taking into consideration the adherent patients regardless of allocation group, the rate of clinical outcomes was lower when compared with non-adherent patients. In a recent study, Castellano et al evaluated the polypill versus standard treatment in patients after acute myocardial infarction and observed an improvement in adherence rate, but not in cardiovascular outcomes. Dosage simplification, which was common to both studies, appears to be effective and may be a trend.

Methodologically well-planned and executed, the study by Oliveira-Filho et al provides lessons applicable to clinical practice and to the way physicians and health professionals interact with their patients. Patient education and simplification of dosage must be part of the strategy to improve patients’ adherence. In addition, the background of this study ultimately refers to behavior. In recent years, the term “behavioral cardiology” has been used to define a new frontier of action in cardiology and currently encompasses the relationship between mental and cardiovascular health, the influence of psychosocial factors on the incidence of cardiovascular diseases, and finally, behavioral aspects of the patients that determine higher or lower adherence to medical recommendations^,. Several behavioral theories complement each other and seek to explore the different domains that govern the behavior of a patient before a risk factor or a disease. Similarly, there are several examples in the literature demonstrating that health interventions, at an individual or population level, have a higher chance of success when based on a combination of behavioral theories, with emphasis on the health belief model, the stages of change, social cognitive theory, self-efficacy and positive reinforcement. In all these theories, the issues of information and patient education are central.

[…]