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Artigo de Periódico Acesso aberto (Open Access) ERICA: prevalences of hypertension and obesity in Brazilian adolescents(Universidade Federal do Pará, 2016) BLOCH, Katia Vergetti; KLEIN, Carlos Henrique; SZKLO, Moyses; KUSCHNIR, Maria Cristina Caetano; ABREU, Gabriela de Azevedo; BARUFALDI, Laura Augusta; VEIGA, Gloria Valeria da; SCHAAN, Beatriz D'Agord; SILVA, Thiago Luiz Nogueira da; MORAES, Ana Júlia Pantoja de; OLIVEIRA, Ana Mayra Andrade de; TAVARES, Bruno Mendes; MAGLIANO, Erika da Silva; OLIVEIRA, Cecília Lacroix de; CUNHA, Cristiane de Freitas; GIANNINI, Denise Tavares; BELFORT, Dilson Rodrigues; SANTOS, Eduardo Lima; LEON, Elisa Brosina de; OLIVEIRA, Elizabete Regina Araújo; FUJIMORI, Elizabeth; BORGES, Ana Luiza Vilela; VASCONCELOS, Francisco de Assis Guedes; AZEVEDO, George Dantas de; BRUNKEN, Gisela Soares; GUIMARÃES, Isabel Cristina Britto; FARIA NETO, José Rocha; OLIVEIRA, Juliana Souza; CARVALHO, Kenia Mara Baiocchi de; GONÇALVES, Luis Gonzaga de Oliveira; MONTEIRO, Maria Inês; SANTOS, Marize Melo dos; JARDIM, Paulo César B. Veiga; FERREIRA, Pedro Antônio Muniz; MONTENEGRO JUNIOR, Renan Magalhães; GURGEL, Ricardo Queiroz; VIANNA, Rodrigo Pinheiro; VASCONCELOS, Sandra Mary Lima; GOLDBERG, Tamara Beres LedererOBJECTIVE:To estimate the prevalence of arterial hypertension and obesity and the population attributable fraction of hypertension that is due to obesity in Brazilian adolescents. METHODS: Data from participants in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), which was the first national school-based, cross-section study performed in Brazil were evaluated. The sample was divided into 32 geographical strata and clusters from 32 schools and classes, with regional and national representation. Obesity was classified using the body mass index according to age and sex. Arterial hypertension was defined when the average systolic or diastolic blood pressure was greater than or equal to the 95th percentile of the reference curve. Prevalences and 95% confidence intervals (95%CI) of arterial hypertension and obesity, both on a national basis and in the macro-regions of Brazil, were estimated by sex and age group, as were the fractions of hypertension attributable to obesity in the population. RESULTS:We evaluated 73,399 students, 55.4% female, with an average age of 14.7 years (SD = 1.6). The prevalence of hypertension was 9.6% (95%CI 9.0-10.3); with the lowest being in the North, 8.4% (95%CI 7.7-9.2) and Northeast regions, 8.4% (95%CI 7.6-9.2), and the highest being in the South, 12.5% (95%CI 11.0-14.2). The prevalence of obesity was 8.4% (95%CI 7.9-8.9), which was lower in the North region and higher in the South region. The prevalences of arterial hypertension and obesity were higher in males. Obese adolescents presented a higher prevalence of hypertension, 28.4% (95%CI 25.5-31.2), than overweight adolescents, 15.4% (95%CI 17.0-13.8), or eutrophic adolescents, 6.3% (95%CI 5.6-7.0). The fraction of hypertension attributable to obesity was 17.8%. CONCLUSIONS:ERICA was the first nationally representative Brazilian study providing prevalence estimates of hypertension in adolescents. Regional and sex differences were observed. The study indicates that the control of obesity would lower the prevalence of hypertension among Brazilian adolescents by 1/5. DESCRIPTORS:Adolescent. Obesity, epidemiology. Hypertension, epidemiology. Cross-Sectional Studies.Artigo de Periódico Acesso aberto (Open Access) ERICA: sexual initiation and contraception in Brazilian adolescents(Universidade Federal do Pará, 2016-02) BORGES, Ana Luiza Vilela; FUJIMORI, Elizabeth; KUSCHNIR, Maria Cristina Caetano; CHOFAKIAN, Christiane Borges do Nascimento; MORAES, Ana Júlia Pantoja de; AZEVEDO, George Dantas de; SANTOS, Karine Ferreira dos; VASCONCELLOS, Mauricio Teixeira Leite deOBJECTIVE: To estimate the prevalence of sexual initiation and contraceptive use at the last sexual intercourse of Brazilian adolescents, according to sociodemographic features. METHODS: The data were obtained from the Study of Cardiovascular Risks in Adolescents (ERICA), a national school-based cross-sectional study. We included 74,589 adolescents from 32 geographic strata (27 capitals and five sets of municipalities with more than 100,000 inhabitants of each of the five macro-regions of the Country). Information on sexual initiation and contraceptive use at the last sexual intercourse (male condom and oral contraceptive pill) has been used. We have estimated prevalence and confidence intervals (95%CI) considering sample weights according to sex, age, type of school, residence status, macro-region and capitals. RESULTS: We observed that 28.1% (95%CI 27.0-29.2) of the adolescents had already initiated sexual life, with higher prevalence among those aged 17 years (56.4%, 95%CI 53.9-58.9), males (33.5%, 95%CI 31.8-35.2), studying at public schools (29.9%, 95%CI 28.5-31.4), and from the Northern region (33.9%, 95%CI 32.3-35.4), mainly from Macapa, Manaus, and Rio Branco. Among those who had started their sexual life, 82.3% (95%CI 81.1-83.4) reported the use of contraceptive methods at the last intercourse, and the prevalence of use was higher among adolescents aged 17 years (85.3%, 95%CI 82.7-87.6), females (85.2%, 95%CI 83.8-86.5) and those living in the Southern region (85.9%, 95%CI 82.9-88.5). Male condom was used by 68.8% (95%CI 66.9-70.7), with no difference by type of school or macro-regions; the contraceptive pill was used by 13.4% (CI95% 12.2-14.6), and more frequently used among women (24.7%, 95%CI 22.5-27,0) and 17-year-old adolescents (20.8%, 95%CI 18.2-23.6) from urban settings(13.7%, 95%CI 12.5-14.9) and from the Southern region (22.6%, 95%CI 19.0-26.8), and less often in the Northern region. CONCLUSIONS: ERICA’s data analysis on sexuality and contraception shows heterogeneities in the prevalence of sexual initiation and use of contraceptive methods among Brazilian adolescents, depending on their age, where they live, and the type of school they study at. Younger adolescents and those living in the Northern region seem to be more vulnerable to the consequences of unprotected sexual intercourses. descriptors: Adolescent. Sexual Behavior. Contraception. Sexual and Reproductive Health. Cross-Sectional Studies.Dissertação Acesso aberto (Open Access) Protocolo de rastreio e tratamento da dislipidemia no paciente adulto com Diabetes Mellitus(Universidade Federal do Pará, 2023-05-15) PALÁCIOS, Amanda de Oliveira Góes; FELÍCIO, João Soares; http://lattes.cnpq.br/8482132737976863Diabetes mellitus (DM) is a highly prevalent metabolic disease that keep rising, and its main cause of mortality is atherosclerotic cardiovascular diseases. Classically, besides the concomitance with other comorbidities that increase this risk, DM presents a dyslipidemic triad also favorable to this outcome: increased triglycerides, reduced HDL-c, and formation of small and dense LDL-c molecules. Aiming to guide the appropriate treatment of dyslipidemia in diabetic patients, it is necessary to prepare a scientific material that addresses the subject in a didactic manner, based on current scientific evidence and adapted to the reality of the Brazilian population. The protocol developed fulfills this purpose and, for this, it was carried out an integrative review of the literature in the PubMed database. As a result, flowcharts, tables, and figures were elaborated to guide the drug treatment of hypercholesterolemia and hypertriglyceridemia according to established goals after defining the cardiovascular risk. The stratification of this risk was intentionally made through criteria that would make this assessment feasible regardless of the use of calculators or other means, giving autonomy to the professional performing it. The material aims to serve from primary to tertiary care and is indicated for general practitioners and specialists.
