Type 2 diabetes increases the risk of cardiovascular mortality and these patients, even without previous myocardial infarction, run the risk of fatal coronary heart disease similar to non-diabetic patients surviving myocardial infarction. There is evidence showing that particulate matter air pollution is associated with increases in cardiopulmonary morbidity and mortality. The present study was carried out to evaluate the effect of diabetes mellitus on the association of air pollution with cardiovascular emergency room visits in a tertiary referral hospital in the city of São Paulo. Using a time-series approach, and adopting generalized linear Poisson regression models, we assessed the effect of daily variations in PM10, CO, NO2, SO2, and O3 on the daily number of emergency room visits for cardiovascular diseases in diabetic and non-diabetic patients from 2001 to 2003. A semi-parametric smoother (natural spline) was adopted to control long-term trends, linear term seasonal usage and weather variables. In this period, 45,000 cardiovascular emergency room visits were registered. The observed increase in interquartile range within the 2-day moving average of 8.0 µg/m³ SO2 was associated with 7.0% (95%CI: 4.0-11.0) and 20.0% (95%CI: 5.0-44.0) increases in cardiovascular disease emergency room visits by non-diabetic and diabetic groups...

As doenças cardiovasculares (DCVs) são as doenças não transmissíveis com maiores taxas de morbidade e mortalidade no Brasil e no mundo, tendo grande impacto socioeconômico. Dentre os fatores de risco (FRs) biopsicossociais estudados, a personalidade tipo D (PTD) destaca-se como um FR psicossocial emergente e crônico que se refere à personalidade não patológica que torna o indivíduo mais suscetível a outros FRs, aumentando as chances de estabelecimento e prognóstico desfavorável de DCVs. Caracteriza-se pela apresentação simultânea dos traços de personalidade Afetividade Negativa (AN) e Inibição Social (IS), podendo ser detectada pela DS-14, escala composta por 14 itens (subescalas de AN e de IS, cada uma com sete itens) cujas opções de resposta variam em escala Likert de cinco pontos, de zero (False) a quatro (True). Este trabalho teve por objetivo realizar a adaptação da DS-14 para o Brasil, além de comparar sua manifestação em pessoas com e sem DCV. O processo de tradução e adequação cultural baseou-se nas recomendações da American Academy of Orthopaedic Surgeons e do Institute of Work and Health, e teve a participação de dois tradutores, dois retrotradutores e uma linguista. As versões elaboradas foram testadas para confirmação de adequação. Para a verificação de evidências de validade...

Background: Cardiovascular Diseases (CVD) are the leading cause of death in Brazil. Objective: To estimate total CVD, cerebrovascular disease (CBVD), and ischemic heart disease (IHD) mortality rates in adults in the counties of the state of Rio de Janeiro (SRJ), from 1979 to 2010. Methods: The counties of the SRJ were analysed according to their denominations stablished by the geopolitical structure of 1950, Each new county that have since been created, splitting from their original county, was grouped according to their former origin. Population Data were obtained from the Brazilian Institute of Geography and Statistics (IBGE), and data on deaths were obtained from DataSus/MS. Mean CVD, CBVD, and IHD mortality rates were estimated, compensated for deaths from ill-defined causes, and adjusted for age and sex using the direct method for three periods: 1979–1989, 1990–1999, and 2000–2010, Such results were spatially represented in maps. Tables were also constructed showing the mortality rates for each disease and year period. Results: There was a significant reduction in mortality rates across the three disease groups over the the three defined periods in all the county clusters analysed, Despite an initial mortality rate variation among the counties...

OBJECTIVE To assess the association of sociodemographic and self-rated health in the presence of cardiovascular diseases and the association of this perception with the type of disease. METHODS A cross-sectional population survey study carried out with 1,232 individuals aged between 20 and 59 years of both genders living in the metropolitan region of Maringá-PR. Data were analyzed using multiple and simple logistic regression. RESULTS In multivariate analysis, the age range and self-rated health were associated with cardiovascular disease, and in the univariate analysis self-rated regular health was associated with arterial hypertension, while self-rated poor health was associated to heart failure, stroke, and to acute myocardial infarction (heart attack). CONCLUSION The differences in association of self-rated health with these diseases can indicate how individuals with certain characteristics cope with the disease, allowing for more individualized and specific health care.

Type 2 diabetes increases the risk of cardiovascular mortality and these patients, even without previous myocardial infarction, run the risk of fatal coronary heart disease similar to non-diabetic patients surviving myocardial infarction. There is evidence showing that particulate matter air pollution is associated with increases in cardiopulmonary morbidity and mortality. The present study was carried out to evaluate the effect of diabetes mellitus on the association of air pollution with cardiovascular emergency room visits in a tertiary referral hospital in the city of São Paulo. Using a time-series approach, and adopting generalized linear Poisson regression models, we assessed the effect of daily variations in PM10, CO, NO2, SO2, and O3 on the daily number of emergency room visits for cardiovascular diseases in diabetic and non-diabetic patients from 2001 to 2003. A semi-parametric smoother (natural spline) was adopted to control long-term trends, linear term seasonal usage and weather variables. In this period, 45,000 cardiovascular emergency room visits were registered. The observed increase in interquartile range within the 2-day moving average of 8.0 µg/m³ SO2 was associated with 7.0% (95%CI: 4.0-11.0) and 20.0% (95%CI: 5.0-44.0) increases in cardiovascular disease emergency room visits by non-diabetic and diabetic groups...

Cardiovascular diseases (CVDs) are known to be associated with poor sleep quality in general populations, but they have not been consistently associated with specific work schedules. Studies of CVD generally do not simultaneously consider sleep and work schedules, but that approach could help to disentangle their effects. We investigated the association between insomnia and a self-reported physician diagnosis of CVD in day and night workers, considering all sleep episodes during nocturnal and diurnal sleep. A cross-sectional study was conducted in 1307 female nursing professionals from 3 public hospitals, using baseline data from the “Health and Work in Nursing - a Cohort Study.” Participants were divided into two groups: i) day workers with no previous experience in night shifts (n=281) and whose data on insomnia were related to nocturnal sleep and ii) those who worked exclusively at night (n=340) and had data on both nocturnal and diurnal sleep episodes, as they often sleep at daytime. Multiple logistic regression analysis was performed. Among day workers...

INTRODUCTION: In recent years, there has been growing concern about an increasing rate of cardiovascular diseases in human immunodeficiency virus-infected patients, which could be associated with side effects of highly active antiretroviral therapy. It is likely that the metabolic disorders related to anti-human immunodeficiency virus treatment will eventually translate into a increased cardiovascular risk in patients submitted to such regimens. OBJECTIVE: To evaluate if human immunodeficiency virus-infected patients receiving highly active antiretroviral therapy are at higher risk of cardiovascular diseases than human immunodeficiency virus infected patients not receiving highly active antiretroviral therapy, or the general population. RESEARCH DESIGN AND METHODS: We conducted a computer-based search in representative databases, and also performed manual tracking of citations in selected articles. RESULT: The available evidence suggests an excess risk of cardiovascular events in human immunodeficiency virus-infected persons compared to non-human immunodeficiency virus infected individuals. The use of highly active antiretroviral therapy is associated with increased levels of total cholesterol, triglycerides, low-density lipoprotein and morphological signs of cardiovascular diseases. Some evidence suggested that human immunodeficiency virus-infected individuals on highly active antiretroviral therapy regimens are at increased risk of dyslipidemia...

The aim of this study was to conduct a systematic review of the literature regarding the prevalence of sexual dysfunction in patients with cardiovascular diseases. An article search of the ISI Web of Science and PubMed databases using the search terms "sexual dysfunction”, “cardiovascular diseases”, “coronary artery disease", “myocardial infarct" and “prevalence” was performed. In total, 893 references were found. Non-English-language and repeated references were excluded. After an abstract analysis, 91 references were included for full-text reading, and 24 articles that evaluated sexual function using validated instruments were selected for this review. This research was conducted in October 2012, and no time restrictions were placed on any of the database searches. Reviews and theoretical articles were excluded; only clinical trials and epidemiological studies were selected for this review. The studies were mostly cross-sectional, observational and case-control in nature; other studies used prospective cohort or randomized clinical designs. In women, all domains of sexual function (desire, arousal, vaginal lubrication, orgasm, sexual dissatisfaction and pain) were affected. The domains prevalent in men included erectile dysfunction and premature ejaculation and orgasm. Sexual dysfunction was related to the severity of cardiovascular disease. When they resumed sexual activity...

PURPOSE: This study aims to examine whether specific anxiety disorder comorbidity alters the purported association between depression and specific cardiovascular diseases (CVDs). METHODS: In 4,181 representative German participants of the general population, 12-month prevalence of psychiatric disorders was assessed through the Composite International Diagnostic Interview and CVDs by physician verified diagnosis. Adjusting for conventional risk factors logistic regression analyzed the association between CVDs (peripheral vascular disease (PVD), hypertension, cerebrovascular disease and heart disease) and combinations of comorbidity between depression and anxiety disorder types (panic disorder, specific phobia, social phobia and generalized anxiety). RESULTS: There were 770 cases of hypertension (18.4 %), 763 cases of cerebrovascular disease (18.2 %), 748 cases of PVD (17.9 %), and 1,087 cases of CVD (26.0 %). In adjusted analyses phobia comorbid with depression was associated with cerebrovascular disease (odds ratio (OR) 1.61; 95 % confidence interval (CI) 1.04-2.50) as was panic disorder (OR 2.89; 95 % CI 1.47-5.69). PVD was significantly associated with panic disorder (adjusted OR 2.97; 95 % CI 1.55-5.69). Panic disorder was associated with CVDs (adjusted OR 2.28; 95 % CI 1.09-4.77) as was phobia (adjusted OR 1.35; 95 % CI 1.04-1.78). CONCLUSIONS: Classification of anxiety and depression according to comorbidity groups showed discrete effects for panic disorder and specific phobia with CVDs...

INTRODUCTION: Cardiovascular diseases are the leading cause of death and hospital expenses in the state of Mato Grosso, Brazil. OBJECTIVE: To describe the temporal variation on risk and protective factors for cardiovascular diseases in adults (≥18 years old). METHODS: Data were obtained from population-based telephone surveys carried out between 2006 and 2009 in Cuiabá, the capital of Mato Grosso, Brazil. The prevalence of smoking, alcohol abuse, markers of diet quality consumption, physical activities, leisure, domestic work, and commute was estimated. Statistical significance of temporal variations in these estimators was estimated by logistic regression models, whose dependent variables were the analyzed risk factors (absent = 0; present = 1) and independent variable was the year of the survey. RESULTS: There was an increase in the proportion of men who reported to never have smoked (from 53 to 61%, p = 0.04). The frequency of regular soft drink consumption was reduced by 23% (p < 0.01). Overall, the reference to the consumption of fruits and vegetables increased by 19% (p = 0.02), and among men this increase was clearer (49%; p < 0.01). There was a reduction in domestic work (p < 0.01) and in leisure physical activity among women (from 14 to 10%; p = 0.02). Conversely...

Background: Cardiovascular Diseases (CVD) are the leading cause of death in Brazil. Objective: To estimate total CVD, cerebrovascular disease (CBVD), and ischemic heart disease (IHD) mortality rates in adults in the counties of the state of Rio de Janeiro (SRJ), from 1979 to 2010. Methods: The counties of the SRJ were analysed according to their denominations stablished by the geopolitical structure of 1950, Each new county that have since been created, splitting from their original county, was grouped according to their former origin. Population Data were obtained from the Brazilian Institute of Geography and Statistics (IBGE), and data on deaths were obtained from DataSus/MS. Mean CVD, CBVD, and IHD mortality rates were estimated, compensated for deaths from ill-defined causes, and adjusted for age and sex using the direct method for three periods: 1979–1989, 1990–1999, and 2000–2010, Such results were spatially represented in maps. Tables were also constructed showing the mortality rates for each disease and year period. Results: There was a significant reduction in mortality rates across the three disease groups over the the three defined periods in all the county clusters analysed, Despite an initial mortality rate variation among the counties...

The study aimed at identifying explanatory factors of the mortality rate of elderly men due to cardiovascular diseases in the 187 micro regions of Northeast Brazil, in 2000, based on indicators of life conditions and vulnerability of that population, using the structural equations modeling. The following methodological steps were taken: (1) using Censo 2000's microdata, 10 indicators were selected to the latent exogenous construct 'life conditions and vulnerability'. Using the Information System of Mortality from the Brazilian Ministry of Health, data about deaths from the four major basic causes of cardiovascular diseases were collected, which composed the endogenous latent construct as the outcome variable; (2) qualitative analysis of mortality data; (3) statistical analysis using the structural equation modeling through two phases: adjustment of the outcome variables measurement model and adjustment of the obtained structural model. Due to the multicollinearity observed, three indicators showed significance for the measurement model: years of study, percentage of elderly men in households with bathroom/plumbing and survival probability at 60 years of age. The structural model indicated adjustment adequacy of the model, which the measurement of standardized coefficient was considered of strong effect (SC = 0.81...

OBJECTIVE: to identify the prevalence of arterial hypertension and its association with cardiovascular risk factors among adults. METHOD: cross-sectional, population-based, descriptive study conducted with 408 adult individuals. Data were collected through a questionnaire and measurements of weight, height and waist circumference. Person's Chi-square and multiple logistic regression were used in the data analysis. RESULTS: 23.03% of the individuals reported hypertension with a higher prevalence among women. Odds Ratio indicated that smoking, body mass index, waist circumference, diabetes mellitus and dyslipidemia were positively associated with arterial hypertension. CONCLUSION: high self-reported hypertension and its association with other cardiovascular risk factors such as diabetes, obesity and dyslipidemia show the need for specific nursing interventions and the implementation of protocols focused on minimizing complications arising from hypertension...

Quinoa is considered a pseudocereal with proteins of high biological value, carbohydrates of low glycemic index, phytosteroids, and omega-3 and 6 fatty acids that bring benefits to the human health. The purpose of this study was to investigate the effects of quinoa on the biochemical and anthropometric profile and blood pressure in humans, parameters for measuring risk of cardiovascular diseases. Twenty-two 18 to 45-year-old students were treated daily for 30 days with quinoa in the form of a cereal bar. Blood samples were collected before and after 30 days of treatment to determine glycemic and biochemical profile of the group. The results indicated that quinoa had beneficial effects on part of the population studied since the levels of total cholesterol, triglycerides, and LDL-c showed reduction. It can be concluded that the use of quinoa in diet can be considered beneficial in the prevention and treatment of risk factors related to cardiovascular diseases that are among the leading causes of death in today's globalized world. However, further studies are needed to prove the benefits observed.

OBJETIVO: Investigar a estrutura de defasagem entre exposição à poluição do ar e internações hospitalares por doenças cardiovasculares em idosos, separada por gênero. MÉTODOS: Os dados de saúde de pessoas com mais de 64 anos de idade foram estratificados por gênero, na cidade de São Paulo, entre 1996 e 2001. Os níveis diários de poluentes do ar (CO, PM10, O3, NO2, SO2) e os dados de temperatura mínima e umidade relativa do ar foram também foram analisados. Foram utilizados modelos restritos de distribuição polinomial em modelos aditivos generalizados de regressão de Poisson para estimar os efeitos dos poluentes no dia da exposição e até 20 dias após, controlando-se para sazonalidades de longa e curta durações, feriados e fatores meteorológicos. RESULTADOS: Variações interquartis de PM10 (26,21 mig/m³) e SO2 (10,73 mig/m³) foram associados com aumentos de 3,17% (IC 95%: 2,09-4,25) nas admissões por insuficiência cardíaca congestiva e de 0,89% (IC 95%: 0,18-1,61) para admissões por todas as doenças cardiovasculares no dia da exposição, respectivamente. Os efeitos foram predominantemente agudos e maiores para o gênero feminino. Além disso, foi observado efeito colheita. CONCLUSÕES: Os achados mostraram que as doenças cardiovasculares em São Paulo são fortemente afetadas pela poluição do ar.; OBJECTIVE: To assess the lag structure between air pollution exposure and elderly cardiovascular diseases hospital admissions...

OBJETIVO: Investigar associação entre alguns indicadores de nível socioeconômico e mortalidade de adultos por doenças cardiovasculares no Brasil. MÉTODOS: Foram analisados os óbitos de adultos (35 a 64 anos), ocorridos entre 1999 a 2001, por doenças cardiovasculares, e pelos subgrupos das doenças isquêmicas do coração e doenças cerebrovasculares-hipertensivas, obtidos no Sistema de Informação sobre Mortalidade. Foram selecionados para análise 98 municípios brasileiros, com melhor qualidade de informação. Para analisar a associação entre indicadores socioeconômicos e a mortalidade por doenças cardiovasculares, foi utilizada a regressão linear simples e múltipla. RESULTADOS: Na análise univariada, verificou-se associação negativa para a mortalidade por doenças cardiovasculares e o subgrupo das cerebrovasculares-hipertensivas com renda e escolaridade, e associação direta com taxa de pobreza e condições precárias de moradia. Quanto às doenças isquêmicas, houve associação inversa com taxa de pobreza e escolaridade, e direta com condições precárias de moradia. A escolaridade, após ajuste pelo modelo de regressão linear múltipla, permaneceu associada à mortalidade pela doença investigada e seus subgrupos. A cada ponto percentual de aumento na proporção de adultos com alta escolaridade...

OBJETIVO: Estimar a prevalência e identificar fatores associados ao acúmulo de comportamentos de risco para doenças cardiovasculares entre adultos. MÉTODOS: Estudo transversal de base populacional com amostra representativa de 2.732 adultos de ambos os sexos de Pelotas, RS, em 2010. Os fatores de risco comportamentais investigados foram: tabagismo; inatividade física no lazer; consumo habitual de gordura aparente da carne; e consumo diário de embutidos, carne vermelha e leite integral. O desfecho do estudo foi o escore de aglomeração de fatores de risco comportamentais, variando de zero a três: nenhum fator de risco comportamental para doenças cardiovasculares ou exposição a 1, 2 ou >; 3 fatores de risco comportamentais. Realizou-se regressão logística multinomial para avaliar o efeito ajustado das características individuais sobre o acúmulo de fatores de risco comportamentais, tendo como categoria de referência indivíduos sem qualquer dos fatores. RESULTADOS: A inatividade física foi o fator de risco mais prevalente (75,6%), seguido do consumo habitual de gordura aparente da carne (52,3%). Dois terços da população apresentaram dois ou mais fatores de risco comportamentais. A combinação de inatividade física e consumo habitual de gordura aparente da carne ocorreu em 17...

As doenças cardiovasculares são a principal causa de morte no Brasil. Os principais fatores de risco para essas doenças são a hipertensão arterial, a dislipidemia, tabagismo e diabetes. Uma fórmula de previsão na população em geral da probabilidade de doença coronariana é calculada baseada nos resultados do Framingham Heart Study. De acordo com faixa etária, sexo, valores de pressão arterial sistólica, valores da razão entre o colesterol total e a fração HDL, presença de tabagismo e diagnóstico de diabetes, é possível estabelecer o risco de infarto do miocárdio e angina do peito em dez anos. O escore de Framingham pode ser útil na comparação de populações, mas traz pouca utilidade na prática clínica.; Cardiovascular diseases are the main cause of deaths in Brazil. The most important cardiovascular risk factors are high blood pressure, dyslipedemia, smoking and diabetes. The prediction of coronary heart disease event can be calculated applying an equation based on risk observed in the Framingham Heart Study. The risk of myocardial infarction and angina pectoris can be calculated according to age-strata, gender, levels of systolic blood pressure, the ratio of total cholesterol to HDL-cholesterol, smoking habit and diagnosis of diabetes. The Framingham score is a useful tool for epidemiologic purposes...

The study aimed at identifying explanatory factors of the mortality rate of elderly men due to cardiovascular diseases in the 187 micro regions of Northeast Brazil, in 2000, based on indicators of life conditions and vulnerability of that population, using the structural equations modeling. The following methodological steps were taken: (1) using Censo 2000's microdata, 10 indicators were selected to the latent exogenous construct 'life conditions and vulnerability'. Using the Information System of Mortality from the Brazilian Ministry of Health, data about deaths from the four major basic causes of cardiovascular diseases were collected, which composed the endogenous latent construct as the outcome variable; (2) qualitative analysis of mortality data; (3) statistical analysis using the structural equation modeling through two phases: adjustment of the outcome variables measurement model and adjustment of the obtained structural model. Due to the multicollinearity observed, three indicators showed significance for the measurement model: years of study, percentage of elderly men in households with bathroom/plumbing and survival probability at 60 years of age. The structural model indicated adjustment adequacy of the model, which the measurement of standardized coefficient was considered of strong effect (SC = 0.81...

Ischaemic heart disease, the largest cause of death worldwide, is rapidly becoming a major threat in low- and middle-income countries. Experience in a variety of populations has demonstrated that lowering certain risk factors, such as hypertension and hypercholesterolaemia, reduces illness and deaths from cardiovascular diseases. A dual approach is recommended: screening and intervening in cases of relatively high risk, while fostering population-wide preventive activities. This is both feasible and affordable. Now is the time to make such efforts.