RESUMO
BACKGROUND: Atherosclerotic ischaemic heart disease is the second leading cause of general mortality in Mexico due to the growing prevalence of atherosclerotic risk factors in our society. The data of the FRIMEX study (Factores de Riesgo en México, Risk Factors in Mexico), considered together with those of other contemporary epidemiological surveys, will aid in our comprehension of the current state of cardiovascular epidemics in Mexico. METHODS: Frequencies of obesity, hypertension and smoking, and total cholesterol and glucose in capillary blood were estimated in a non-probabilistic sample comprised of 140017 individuals (aged 44+/-13 years; 42% men and 58% women), from six Mexican cities (Mexico City, Guadalajara, Monterrey, Puebla, Leon and Tijuana). RESULTS: Obesity or overweight status was found in 71.9% of participants. Hypertension was found in 26.5%, and the proportions of awareness, treatment and control for this disease were 49.3, 73 and 36%, respectively. Prevalence of hypertension increased with age; while it was higher in men under 60 years of age, in the more aged individuals it was higher in women. Hypercholesterolaemia was found in 40% of the individuals and cholesterolaemia > or =240 mg/dl was significantly higher in women. Thirty-five and a half percent of men and 18.1% of women were smokers. Type 2 diabetes mellitus was found in 10.4% of participants. There was significant Pearson's correlation between body mass index and blood pressure, between hypertension and glucose levels, and between hypertension and total cholesterol concentrations. CONCLUSIONS: We conclude that this population has a high cardiovascular risk profile and a high probability of the occurrence of metabolic syndrome.
Assuntos
Doenças Cardiovasculares/epidemiologia , Saúde da População Urbana/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos Epidemiológicos , Humanos , Hipercolesterolemia/epidemiologia , Hipertensão/epidemiologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Obesidade/complicações , Prevalência , Fatores de Risco , Fumar/efeitos adversosRESUMO
Hyperlipidemia is common in type 2 diabetic patients and is an independent risk factor for cardiovascular disease. The aim of this trial was to evaluate the efficacy and safety of once-daily atorvastatin 10-80 mg for the treatment of hyperlipidemia in type 2 diabetics with plasma low-density lipoprotein cholesterol (LDL-C) levels exceeding 3.4 mmol/l (130 mg/dl). One hundred and two patients met the study criteria and received 10 mg/day atorvastatin. Patients who reached the target LDL-C level of
Assuntos
Anticolesterolemiantes/uso terapêutico , Diabetes Mellitus Tipo 2/complicações , Ácidos Heptanoicos/uso terapêutico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hiperlipidemias/tratamento farmacológico , Pirróis/uso terapêutico , Anticolesterolemiantes/efeitos adversos , Atorvastatina , Feminino , Ácidos Heptanoicos/efeitos adversos , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Hiperlipidemias/sangue , Hiperlipidemias/complicações , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Pirróis/efeitos adversosRESUMO
The vascular dynamics of children with a parental history of hypertension has not been defined. The purpose of the current study was to determine whether or not these children have different arterial stiffness compared to the offspring of normotensive parents. One hundred healthy, nonobese subjects (ages 10-21 years) were divided into two groups of 50. Group A included the offspring of hypertensive patients and group B the offspring of normotensive parents. The variables studied were body surface area, blood pressure, and systolic and diastolic diameters of the aortic and carotid arteries as well as maximum velocity flow of these vessels. Carotid and aortic stiffness were calculated. Children and adolescents with a parental history of hypertension had higher carotid stiffness and smaller carotid diameters. These differences continued to be significant when correcting for body surface area. A higher blood pressure and a greater body surface area were also found.
Assuntos
Aorta/diagnóstico por imagem , Artéria Carótida Primitiva/diagnóstico por imagem , Hipertensão/fisiopatologia , Adolescente , Adulto , Aorta/fisiopatologia , Velocidade do Fluxo Sanguíneo , Pressão Sanguínea , Artéria Carótida Primitiva/fisiopatologia , Criança , Ecocardiografia , Elasticidade , Feminino , Humanos , Hipertensão/diagnóstico por imagem , Hipertensão/genética , Masculino , Contração Miocárdica , Núcleo Familiar , Ultrassonografia Doppler de Pulso , Resistência VascularRESUMO
A severely diseased aortocoronary venous by-pass graft is reported. A successful angioplasty plus stenting was performed, via right radial artery, without using a guiding-catheter.
Assuntos
Cateterismo Cardíaco/métodos , Ponte de Artéria Coronária , Doença da Artéria Coronariana/terapia , Complicações Pós-Operatórias/terapia , Artéria Radial , Stents , Angioplastia Coronária com Balão , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Diagnostic and interventional cardiac catheterization using the femoral approach demands hospitalization for more than 24 hours, and occasionally it is complicated by vascular events. This paper informs about out first 95 catheterizations using the radial percutaneous approach. We describe the technique, duration, length of hospitalization and complications. Eighty three male and 12 female patients, aged 54 +/- 12 years were included, 87 of them with coronary heart disease. There were 71 diagnostic procedures, 11 PTCA and 13 elective stenting. The initial success rate was 63% that reached 97% after three months. The mean duration was 46' for diagnostic procedures, 51' for PTCAs and 87' for stenting. Hospitalization length was 5, 31 and 39 hours respectively. Three patients lost the radial pulse, without distal ischemia. Pain was noticed in 16% of the cases. There were not other vascular complications. It is concluded that the percutaneous radial artery approach allows diagnostic and therapeutic procedures, with lesser hospitalization lengths and few vascular complications.
Assuntos
Cateterismo Cardíaco/métodos , Artéria Radial , Adulto , Idoso , Cateterismo Cardíaco/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Several studies have associated the hostility complex (part of type A personality) to the development of coronary atherosclerosis. The complex is composed by aggressive behavior, frequent rage outbursts, intolerance to waiting lines and sense of urgency. To investigate the occurrence of this behavioral trait, 50 post-myocardial infarction men were compared against 50 normal male subjects of the same age. In all of them sphygmomanometric blood pressure was obtained, total blood cholesterol was measured and hostility was quantified by means of the Cook and Medley's questionnaire and an arbitrary ad hoc scale. Diastolic blood pressure was significatively higher in post-infarction patients (82 +/- 10 vs 77 +/- 9, p < 0.001), as well as the cholesterol level (231 +/- 55 vs 197 +/- 43, p < 0.001). Also, hostility score was higher in the post-infarcted men (16 +/- 4 vs 13 +/- 5, p < 0.001). The hostility score showed correlation with the occurrence of myocardial infarction (p < 0.02). These results establish that post-myocardial infarction patients express more hostility than control subjects. It was not possible to establish the true nature of the relationship among hostility and diastolic blood pressure, total cholesterol and the occurrence of coronary events. Nevertheless, this study confirms that the hostility complex is frequently present in atherosclerotic patients.
Assuntos
Hostilidade , Infarto do Miocárdio/psicologia , Adulto , Pressão Sanguínea , Colesterol/sangue , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/fisiopatologia , Doença da Artéria Coronariana/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/sangue , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/fisiopatologia , PersonalidadeRESUMO
With a growing elderly population, the incidence of isolated systolic hypertension (ISH) has increased. This study characterizes dynamic vascular changes that occur with advanced age and with ISH. Fifty-five healthy individuals and seven with ISH were distributed in seven age groups from the second to the seventh decade. An index of aortic stiffness (delta P/delta V) was derived using a mercury sphygmomanometer to obtain pulse pressure, and ultrasonographic measurements were used to estimate aortic volumes applying the "cylinder formula." The mathematic derivation of this formula is explained in detail. Pulse pressure showed no significant change with age, but showed a significant increase with ISH. A decrease in volume change from systole to diastole was found with advanced age. Normotensive subjects aged 65 +/- 2 years had a 2.6-fold increase in aortic stiffness compared with young individuals. Elderly patients with ISH had a 7-fold increase in aortic stiffness compared with Group 1 (15 +/- 2 years) (p < 0.001) and a 2.7-fold increase compared with Group 6 (normotensive subjects aged 65 +/- 2 years). A strong correlation between systolic pressure and arterial stiffness was observed (r = 0.953) (p < 0.001). The proposed stiffness index was compared with the one described by Hirai, obtaining a high correlation, that is, r = 0.989 (p < 0.001). When compared with Stefanadis' index of distensibility, our index showed a correlation of r = 0.932 (p < 0.003). It is concluded that while systolic pressure is a main determinant of arterial stiffness, the delta P/delta V is a more sensitive method to estimate dynamic changes in elastic arteries such as the aorta.
Assuntos
Aorta/fisiopatologia , Hipertensão/fisiopatologia , Adolescente , Adulto , Idoso , Envelhecimento/fisiologia , Criança , Eletrocardiografia , Feminino , Hemodinâmica , Humanos , Masculino , Matemática , Pessoa de Meia-IdadeAssuntos
Quilo , Quilotórax/etiologia , Fístula/congênito , Fístula/complicações , Pericárdio , Ducto Torácico/anormalidades , Pré-Escolar , Quilotórax/terapia , Terapia Combinada , Feminino , Fístula/terapia , Humanos , Doenças Linfáticas/complicações , Doenças Linfáticas/congênito , Doenças Linfáticas/terapia , Nutrição Parenteral , Técnicas de Janela Pericárdica , ReoperaçãoRESUMO
Five groups of 20 patients each were studied to analyze the vascular dynamics and structure of the elastic arteries. Group I consisted of healthy young individuals (27 +/- 4 years); Group II of healthy adults (46 +/- 9 years); Group III of normotensive hypercholesterolemic adults (45 +/- 12 years and serum cholesterol > 239 mg/dl); Group IV of hypertensive normocholesterolemic adults (56 +/- 13 years); and Group V of hypertensive hypercholesterolemic adults (56 +/- 9 years). The differential arterial pressure was estimated and divided by the volume change (delta P/delta V) of the aorta and the carotid and brachial arteries. The volume change was calculated using the "cylinder formula", measuring the radius from the ultrasonographic vessel image and assigning the cylinder a height of 1 cm. The A/E index of the Doppler transmitral spectrum and the maximum velocity flow using Doppler in the above arteries were calculated. The presence of carotid atherosclerosis was observed and given an arbitrary scoring grade of 0, 1, or 2. A higher arterial and ventricular stiffness was found in the hypertensive patients regardless of the presence of hypercholesterolemia. A higher fall in Doppler velocity and an increase in atherosclerosis lesions were found in Group V. Based on the results of this study, it was concluded that vascular and left ventricular stiffness have a close relationship with arterial hypertension but not with hypercholesterolemia. The hypercholesterolemic patients had a higher prevalence of carotid atherosclerosis and a higher scoring grade of severity.