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Editorial

Adherence, Compliance and Persistency in High Cholesterol Treatment

Lack of adherence to cholesterol-lowering medications remains a critical issue in managing cardiovascular risk. Despite advancements in treatment, many patients fail to follow their prescribed regimens, leading to increased risks of heart attack, stroke, and other cardiovascular events. As described in the study, adherence challenges in the Brazilian population illustrate a global problem. However, there are several promising strategies for increasing adherence, including the active involvement of pharmacists and the distribution of medications in larger volumes through public or private healthcare systems.

Medication adherence, or the degree to which patients follow their prescribed regimens, is fundamental to achieving optimal health outcomes in chronic conditions like high cholesterol. Compliance is the consistency with which patients take their medication over time, while persistence refers to how long they continue treatment without interruption. Cholesterol-lowering drugs, particularly statins, are widely used to reduce cardiovascular risk, but non-adherence remains a barrier to their full effectiveness.

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IJCS

Original Article

Family Functioning of Adolescents with Congenital Cardiopathy in a Sample from Public Schools in Porto Alegre – RS

Ângela Piccoli et al. Lucas Neiva-Silva Lucia Campos Pellanda

Abstract

Background

The impact of chronic diseases on the patient and the family ranges from minimal to severe distress. Family functioning has been often investigated as a psychosocial measure having an essential role for social adjustment in chronic diseases.

Objectives

To compare family functioning among families of adolescents with congenital heart disease (CHD) and healthy controls (H) in relation to cohesion, adaptability, and family risk.

Method

Cross-sectional exposed-control study with 2 groups of adolescents (12 -18 years). The exposed group included adolescents with congenital heart disease (CHD), from a specialized public health system hospital (SUS), and adolescents from 7 public schools, considered healthy, composed the control group. In the hospital, the data collection was individual, before the medical consultation. In schools, the collection took place in groups. Adolescents and parents responded to the FACES III scale. The following statistical tests were used: Pearson’s chi-square, Fisher’s test, T-test for independent samples, Poisson multivariate regression analysis with 95% reliability, significance established at 5% and a statistical power at 99% (ß = 0.01).

Results

A total of 161 (41.6%) adolescents with CHD and 226 (58.4%) healthy adolescents participated. There was greater family cohesion among adolescents with CHD, with a higher frequency of connected families, while among healthy adolescents, there are more families of the disengaged type. Regarding adaptability, a higher proportion of families of the chaotic type were found among healthy adolescents compared to adolescents with CHD. A higher frequency of high-risk families was identified among healthy adolescents (16.8%).

Conclusion

The families of the adolescents with CHD have a more balanced functioning and low risk when compared to the families of healthy adolescents; with greater cohesion between the members and greater adaptability. Congenital heart disease was not an independent factor for high-risk family. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0).

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ABC

Review Article

Heart failure with normal ejection fraction

Meliza Goi Roscani et al. Luiz Shiguero Matsubara Beatriz Bojikian Matsubara

Heart failure with normal ejection fraction (HFNEF) is a complex syndrome that has been broadly studied since the last decade. It is caused by diastolic ventricular dysfunction demonstrated by complementary methods, such as hemodynamic study or echocardiogram, in the presence of a normal ejection fraction (EF). It affects primarily elderly individuals with comorbidities, such as systemic arterial hypertension, coronary failure and obesity. The physiopathological mechanisms are complex and multifactorial, involving the myocardial passive stiffness, the ventricular geometry, the pericardial restraint and the interaction between the ventricles. The main objectives of the treatment were to decrease the pulmonary venous congestion and the heart rate and control the comorbidities. There is no strong evidence that the use of specific medications, such as the angiotensin-converting enzyme inhibitors or beta-blockers can influence mortality. The poorer prognostic factors include advanced age, presence of kidney dysfunction, diabetes, functional class III and IV (NYHA) and advanced-stage diastolic dysfunction, with a restrictive pattern of ventricular filling. Another aspect that has been increasingly cited in the literature is the analysis of the role of the systolic function in HFNEF cases. All these aspects are analyzed in detail in the present review.

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Artigo Original

Relationship between regular attendance to ambulatory appointments and blood pressure control among hypertensive patients

Eduardo Barbosa Coelho et al. Miguel Moysés Neto Raquel Palhares Maria Camila de Miranda Cardoso … Tufik José Magalhães Geleilete Fernando Nobre

OBJECTIVE: Our objective was to determine the rate of hypertensive patients with controlled BP (BP <140X90 mmHg) and to study its relationship with regular attendance to ambulatory appointments. METHODS: A total of 245 medical records from patients followed up at the Unidade Clínica de Hipertensão Arterial (Clinical Unit of Arterial Hypertension) HCFMRP-USP for a period of one year were randomly and retrospectively reviewed. The patients were classified as assiduous (A) and as regularly absent to scheduled appointments (F), with the second group being defined as those who failed to appear longer than 30 days after the scheduled appointment. The mean of three measurements prior to the date of the scheduled appointment was calculated to determine the rate of patients with controlled BP. Compliance with the treatment was inferred through a questionnaire applied by the nurse team before the appointment. RESULTS: From the 245 patients analyzed, 220 were classified as A (89.7%) and 25 (10.3%) as F. Group A patients showed a higher rate of BP control than F patients (30% vs. 8%, p=0.02, Fischer exact test). Compliance with pharmacological treatment was higher in A patients than in F patients (91% vs. 56 %, p<0.05) as well as to non-pharmacological treatment (63% vs. 44%, p<0.05). CONCLUSION: Although the rate of blood pressure control was low in the population studied, lower compliance with the treatment and BP control was observed in individuals who usually missed the scheduled appointments.

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Adherence, Compliance and Persistency in High Cholesterol Treatment

Family Functioning of Adolescents with Congenital Cardiopathy in a Sample from Public Schools in Porto Alegre – RS

Abstract

Background

Objectives

Method

Results

Conclusion

Heart failure with normal ejection fraction

Relationship between regular attendance to ambulatory appointments and blood pressure control among hypertensive patients

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