Arterial stiffness in elderly patients with normotension and hypertension in Brazil

Data on arterial stiffness in older populations, according to blood pressure (BP) levels, are scarce in Brazil. The objective of this study was to establish reference values for core measures of arterial stiffness, including carotid‐femoral pulse wave velocity (cf‐PWV) and aortic augmentation index (AIx), in a cohort of older individuals with normotension (NT) and hypertension. Cross‐sectional analysis was performed with applanation tonometry data from 1192 patients aged 60 years or older. The authors classified patients according to their BP levels as having NT, controlled hypertension (CH), and uncontrolled hypertension (UH). The cf‐PWV values were 9.11 ± 0.16 m/s (NT), 9.12 ± 0.18 m/s (CH), and 9.42 ± 2.2 m/s (UH) (P < 0.005; UH vs NT and CH). The AIx was 33.3% for the entire cohort and similar across all groups. The cf‐PWV increased with age but reached a ceiling at 75 years. Compared with men, women had a higher AIx but similar cf‐PWV levels. In conclusion, the markers of arterial stiffness were similar among individuals with NT/CH and higher among individuals with UH.     

Sensibilidade e Especificidade de Pontos de Corte para Frequência Cardíaca em Repouso de 6.794 Adolescentes Brasileiros: Um Estudo Transversal

Background Resting heart rate (RHR) may be a useful screening tool for cardiovascular risk. However, RHR cutoff points, an interesting clinical approach, have never been described in young populations.Objective To establish RHR cutoff points in Brazilian adolescents and to analyze whether cutoff points are associated with cardiovascular risk factors.Methods The sample was composed of 6,794 adolescents (10 to 19 years old). Blood pressure and RHR were assessed by oscillometric device. Body mass index and waist circumference were also assessed. Receiver operating characteristic curve was adopted to analyze the sensitivity and specificity, and associations of high RHR with cardiovascular risk factors were analyzed by binary logistic regression. A p value < 0.05 was considered statistically significant for all the analyses.Results Mean RHR values were higher among participants ages 10 to 14 years than 15 to 19 years, for boys (p < 0.001) and girls (< 0.001). The proposed RHR cutoff points for cardiovascular risk factors detection were significant for boys ages 10 to 14 (> 92 bpm) and 15 to 19 years (> 82 bpm), as well as for girls ages 15 to 19 years (> 82 bpm) (p < 0.05 for all), whereas no cutoff point was identified for girls ages 10 to 14 years (p > 0.05). Proposed RHR cutoff points were associated with abdominal obesity, overweight, and high blood pressure in boys in girls. RHR cutoff points were associated with the cluster of cardiovascular risk factors in adolescents ages 15 to 19 years.Conclusion The proposed RHR cutoff points were associated with cardiovascular risk factors in adolescents.     

Aumento de Óbitos Domiciliares devido a Parada Cardiorrespiratória em Tempos de Pandemia de COVID-19

BackgroundCardiovascular diseases constitute an important group of causes of death in the country. Ischemic heart diseases that are the main causes of cardiopulmonary arrest, leading to an impact on the mortality of the cardiovascular diseases in the health system.ObjectiveAssess the number of home deaths by cardiopulmonary arrest notified by the Mobile Emergency Medical Service (SAMU) in March 2018, 2019 and 2020.MethodsObservational study carried out from the analysis of cardiopulmonary arrest mortality data of citizens assisted by SAMU in Belo Horizonte, Minas Gerais, Brazil. Social and clinical characteristics and occurrence information of the patients were analyzed. The mortality rate due to cardiopulmonary arrest in relation to the total number of attendances was assessed. A significance level of 95% was considered.ResultsThere was increase of home deaths due to cardiopulmonary arrest in March 2020 compared to March 2018 (p<0.001) and March 2019 (p=0.050). Of the deaths reported in 2020, 63.8% of the patients were aged 60 years or older, 63.7% of the occurrences were performed in the afternoon and approximately 87% of the cardiopulmonary arrest notified had associated clinical comorbidities, with systemic arterial hypertension and heart failure represented by 22.87% and 13.03% of the reported cases, respectively. The majority of the evaluated sample of this study did not have any medical care follow-up (88.7%).ConclusionConsidering the increase in the number of the deaths, we suggest reflections and readjustments regarding the monitoring of chronic non-transmissible diseases during a pandemic, as well as improvements in death surveillance. (Arq Bras Cardiol. 2021; 116(2):266-271)     

Care in times of COVID-19: the impact of the pandemic on informal caregiving in Austria

Much attention has been paid to the effects of the COVID-19 pandemic on long-term care but the impact on informal caregivers has remained speculative. In Austria, like in other European countries, informal care is carried out overwhelmingly by (non-cohabiting) relatives. Limited care services available during the pandemic, social-distancing, increased unemployment and competing care needs within households (e.g. due to school closures) may have changed the prevalence and intensity of informal caregiving. Moreover, these changes may have increased the psychological strain experienced by caregivers. Focusing on Austria, this study aims to empirically analyse the following research questions: how have the prevalence and intensity of informal care changed due to the pandemic? How has the psychological well-being of informal caregivers been affected? We use a pre- and post-onset of the pandemic research design based on a representative survey carried out in Austria in June 2020 (N = 2000) in combination with comparable 2015 data from the European Social Survey. Findings suggest that neither prevalence nor intensity of informal care changed significantly due to the pandemic. However, the psychological well-being gap between carers and non-carers increased with the start of the pandemic, especially among men. Findings are discussed in relation to the policy measures implemented and possible policy implications for the future.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10433-021-00611-z.     

Osteomuscular symptoms on motorcycles in the city of Rio Branco,Acre, Brazil,West Amazon

Musculoskeletal disorders gradually affect workers in different parts of the world, compromising their occupational health and quality of life. Professionals exposed to these symptoms include the motorcycle taxi driver, whose pain is due to the overuse of the musculoskeletal system and little time to recover it.To identify the prevalence of musculoskeletal symptoms in motorcycle taxi drivers in the city of Rio Branco, Acre, Brazil, West Amazon.Cross-sectional study, involving 296 motorcycle taxi drivers in the city of Rio Branco-Acre, Brazil, male, from December 2016 to February 2017. The Nordic Musculoskeletal Questionnaire was used to collect information related to symptoms (pain, discomfort, or numbness) in the last 7 days of work. For the exclusion criteria were, being female; not reside outside the city of Rio Branco, Acre; having less than 3 months of work activity; not be carrying out their work activities at the time of application of the protocol; be limited by clinical or physical issues at the time of application of the protocol. The data obtained in the questionnaire were entered into the Epidata program (Epidata Association, Odense, Denmark) and then transferred to the STATA 10 statistical program (Stata Corp., College Station), for categorization and statistical analysis.The study population is over 36 years old; most reported having a partner and a higher education level. The average daily working hours of the participants were 12 hours, with the majority working over 12 hours daily. Most of the epidemiological variables factors were associated with musculoskeletal pain when the prevalence and prevalence ratio analyzes were performed. Higher prevalence of musculoskeletal symptoms in the lumbar region is with 17.9%. In the lower limbs, the most affected joint was the ankle (5.7%), followed by the hip (5.07%) and knee (5.07%), respectively. Insomnia was present in 55.35% and self-reported headache in 49.4% of participants.The musculoskeletal disorders generated by the daily service of motorcycle taxi drivers are directly affecting the quality of life of these professionals.     

Pacientes Naïve Infectados por HIV Apresentam Disfunção Concomitante com Diminuição de Anticorpos Naturais contra Autoantígenos Derivados da Apolipoproteína B Definidos

Fundamento:Fatores de risco definidos para HIV e tradicionais podem estar associados a um aumento de eventos cardiovasculares. Estudos recentes sugerem que a resposta imune humoral à LDL modificada pode estar associada ao processo de aterosclerose.Objetivos:Avaliar a presença de anti-LDL oxidada e de peptídeos derivados da Apolipoproteína B no sangue, bem como sua associação à função endotelial na infecção por HIV.Métodos:Este estudo incluiu consecutivamente sujeitos com idade, sexo e dados demográficos correspondentes em dois grupos: (1) indivíduos infectados com HIV e naïve para terapia antiviral e (2) indivíduos não infectados. A aterosclerose subclínica foi avaliada pela espessura íntima-média, utilizando-se a ultrassonografia das artérias carótidas. A função endotelial foi determinada pela dilatação mediada por fluxo (DMF) da artéria braquial por ultrassonografia. Os níveis de autoanticorpos (IgM, IgG) de lipoproteínas de baixa densidade antioxidadas (LDL-ox), fragmentos de peptídeos antiapolipoproteína B (peptídeos ApoB-D e 0033G-Cys), e citocina foram avaliados por meio de ELISA.Resultados:Os resultados deste estudo não mostraram diferenças na aterosclerose subclínica entre os grupos. Entretanto, os sujeitos infectados com HIV apresentaram uma DMF mais baixa, em comparação com os sujeitos não infectados. Portanto, os sujeitos infectados com HIV apresentaram níveis mais altos de citocinas inflamatórias, títulos de IgG anti-LDL-ox, e IgG anti-ApoB-D. Em contraste, títulos de IgM anti-ApoB-D foram mais baixos em indivíduos infectados com HIV e associados a funções endoteliais diminuídas.Conclusões:Os resultados deste estudo mostram que a infecção por HIV, em sujeitos naïve, está associada à disfunção endotelial e à diminuição de anticorpos naturais para antígenos Apo-B.