Fundamento: A síndrome metabólica (SM) é um agregado de fatores predisponentes para doenças cardi... more Fundamento: A síndrome metabólica (SM) é um agregado de fatores predisponentes para doenças cardiovasculares e diabete melito, cujas características epidemiológicas são insuficientemente conhecidas nos níveis regional e nacional.
A Hipertensão Arterial Resistente (HAR) é definida quando a Pressão Arterial (PA) permanece acima... more A Hipertensão Arterial Resistente (HAR) é definida quando a Pressão Arterial (PA) permanece acima das metas recomendadas com o uso de três fármacos anti-hipertensivos com ações sinérgicas em doses máximas preconizadas e toleradas, sendo um deles preferencialmente um diurético, ou quando em uso de quatro ou mais fármacos anti-hipertensivos, mesmo com a PA controlada 1 .
Background Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk... more Background Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces
Background Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk... more Background Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces
in African-Americans. In this study 55 African-American boys and 71 girls aged 15-18 years underw... more in African-Americans. In this study 55 African-American boys and 71 girls aged 15-18 years underwent a 5-hour stress protocol (2 hour baseline, 1 hour stress, 2 hour recovery) after being brought into similar levels of sodium balance. Dual-energy x-ray absorptiometry was performed to determine total percent body fat. Both girls and boys showed significant increases from baseline to stress and significant decreases from stress to recovery for blood pressure and sodium excretion (PϽ0.01 for all), with greater changes for boys (PϽ0.01 for all). For girls, blood pressure during stress was related to urinary sodium excretion (rϭ0.31; PϽ0.005) but not for boys. For boys, body fat was negatively correlated with the change in sodium excretion from baseline to stress (rϭ-0.37; PϽ0.006) and sodium excretion during stress (rϭ-0.28; PϽ0.04), which in turn was related to angiotensin II (rϭ-0.41; PϽ0.41). Body fat was also negatively related to the post-stress decline in blood pressure (rϭ-0.24; PϽ0.04) which was positively correlated with the stressinduced change in angiotensin II. In contrast, body fat was not correlated with sodium handling, blood pressure, or angiotensin II in girls. These results may help to explain how the interactions between salt, stress, and obesity contribute to the increased incidence and prevalence of HTN in African-American males. The mechanisms responsible for the gender difference is unclear, however, we speculate that the natriuretic and vasodilatory properties of the female sex hormones may facilitate stressinduced pressure natriuresis.
RESUMO A falta de adesão ao tratamento da hipertensão arte-rial é o maior desafio para todos os q... more RESUMO A falta de adesão ao tratamento da hipertensão arte-rial é o maior desafio para todos os que trabalham e investigam esta área. Aumenta os custos e os riscos de eventos cardiovasculares em conseqüência do controle inadequado da pressão, provocado por esta prática. ...
O papel do aluno de graduação em Medicina no atendimento a pacientes de enfermarias de longa perm... more O papel do aluno de graduação em Medicina no atendimento a pacientes de enfermarias de longa permanência de um hospital-escola
Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an i... more Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces the incidence of major cardiovascular events. In the absence of higher baseline risk, the use of BP agents reduces the incidence of hypertension. The PREVER-prevention trial aims to investigate the efficacy, safety and feasibility of a population-based intervention to prevent the incidence of hypertension and the development of target-organ damage. This is a randomized, double-blind, placebo-controlled clinical trial, with participants aged 30 to 70 years, with pre-hypertension. The trial arms will be chlorthalidone 12.5 mg plus amiloride 2.5 mg or identical placebo. The primary outcom...
If weight and height data given by the patients were accurate, direct measurements would be made ... more If weight and height data given by the patients were accurate, direct measurements would be made redundant and unnecessary, bringing about substantial savings in terms of cost and time, during epidemiological studies. Data from direct measurements were compared to those given by the individuals, during a house visit. In order to assemble a representative population of 119,570 people, domiciles that
Fundamento: A síndrome metabólica (SM) é um agregado de fatores predisponentes para doenças cardi... more Fundamento: A síndrome metabólica (SM) é um agregado de fatores predisponentes para doenças cardiovasculares e diabete melito, cujas características epidemiológicas são insuficientemente conhecidas nos níveis regional e nacional.
Em sintonia com a tendência científica mundial e a orientação da Associação Médica Brasileira, as... more Em sintonia com a tendência científica mundial e a orientação da Associação Médica Brasileira, as IV Diretrizes Brasileiras de Hipertensão fundamentam suas orientações segundo Graus de Recomendação baseados em níveis de evidência dos estudos clínicos de referência:
Objetivo: Estimar a prevalência da hipertensão arterial (HA) e de alguns fatores de risco cardiov... more Objetivo: Estimar a prevalência da hipertensão arterial (HA) e de alguns fatores de risco cardiovasculares na população adulta de uma capital brasileira.
For hypertensive patients, the indication is to control BP in such a way as not to exceed <140... more For hypertensive patients, the indication is to control BP in such a way as not to exceed <140/90mm Hg. In diabetic patients (DM) treatment goals are more rigorous (126 mg/dl and/or those who were taking hypoglycemic drugs or insulin) were studied. They were evaluated in the first (M1) and last visit (M2), in terms of BP, Body Mass Index (BMI),
To assess the validity of self-reported weight and height at the time of diagnosing obesity, and ... more To assess the validity of self-reported weight and height at the time of diagnosing obesity, and to identify the sociodemographic and individual characteristics that might be a source of information bias. This was a cross-sectional population-based study carried out in the city of Goiânia in 2001. Interviews were conducted with 1,023 individuals aged 20-64 years, in their homes, to collect sociodemographic and self-reported weight and height information. On the same occasion, weight and height measurements were made on these individuals. The mean differences and correlation coefficients between self-reported and measured data were calculated according to age, body mass index (BMI), schooling, income and height. Both the men and women overestimated their heights (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05), by 0.9 cm and 2.2 cm, respectively. There was no difference between self-reported and measured weights, either for the men (-0.44 kg; p=0.06) or for the women (-0.03 kg; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). The behavior of overestimating height was influenced by age, schooling, height and body mass index. Although this index obtained from the self-reported data was underestimated (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05), by 0.27 kg/m(2) and 0.67 kg/m(2) for men and women respectively, the measured and self-reported data presented a high degree of agreement. Both the sensitivity and specificity of the self-reported body mass index were high, in relation to identifying the measured index. In epidemiological studies for monitoring the prevalence of excess weight in populations, self-reported weights and heights constitute reliable data, which gives validity to the methodology utilized.
Background: Hypertension is a public health problem, considering its high prevalence, low control... more Background: Hypertension is a public health problem, considering its high prevalence, low control rate and cardiovascular complications. Objective: Evaluate the control of blood pressure (BP) and cardiovascular outcomes in patients enrolled at the Reference Center for Hypertension and Diabetes, located in a medium-sized city in the Midwest Region of Brazil. Methods: Population-based study comparing patients enrolled in the service at the time of their admission and after an average follow-up of five years. Participants were aged ≥18 years and were regularly monitored at the Center up to 6 months before data collection. We assessed demographic variables, BP, body mass index, risk factors, and cardiovascular outcomes. Results: We studied 1,298 individuals, predominantly women (60.9%), and with mean age of 56.7±13.1 years. Over time, there was a significant increase in physical inactivity, alcohol consumption, diabetes, dyslipidemia, and excessive weight. As for cardiovascular outcomes...
Adolescents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;a... more Adolescents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; body image (BI) may not match their nutritional status. This study selected representative sample of healthy adolescents aged between 12 and 18 from public and private schools. Anthropometric measures were performed in order to calculate the body mass index (BMI) percentile. The silhouette scale proposed by Childress was used to evaluate BI, making it possible to assess BI satisfaction and BI distortion. The sample was composed of 1168 adolescents with a mean age of 14.7 years; 52.9% were female, 50.9% were fair-skinned, 62.4% had consumed or still consume alcohol and 67% attended public school. Male adolescents presented more overweight and obesity (28.4%) (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05) than the female (17.1%). It was observed that 69.4% were dissatisfied with BI, 91.1% of the obese and 69.8% of those with overweight wished to lose body weight and 82.5% of those underweight wished to gain body weight. BI distortion was identified, since 35% of the adolescents who were underweight did not regard themselves thin, 39.1% of the overweight individuals and 62.1% of the obese did not see themselves in their adequate classifications. Adolescents with overweight/obesity were those who presented higher dissatisfaction with BI, mainly the females. Male individuals presented a greater wish of gaining weight. BI distortion was present in adolescents of all classes of BMI percentile.
Fundamento: A síndrome metabólica (SM) é um agregado de fatores predisponentes para doenças cardi... more Fundamento: A síndrome metabólica (SM) é um agregado de fatores predisponentes para doenças cardiovasculares e diabete melito, cujas características epidemiológicas são insuficientemente conhecidas nos níveis regional e nacional.
A Hipertensão Arterial Resistente (HAR) é definida quando a Pressão Arterial (PA) permanece acima... more A Hipertensão Arterial Resistente (HAR) é definida quando a Pressão Arterial (PA) permanece acima das metas recomendadas com o uso de três fármacos anti-hipertensivos com ações sinérgicas em doses máximas preconizadas e toleradas, sendo um deles preferencialmente um diurético, ou quando em uso de quatro ou mais fármacos anti-hipertensivos, mesmo com a PA controlada 1 .
Background Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk... more Background Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces
Background Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk... more Background Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces
in African-Americans. In this study 55 African-American boys and 71 girls aged 15-18 years underw... more in African-Americans. In this study 55 African-American boys and 71 girls aged 15-18 years underwent a 5-hour stress protocol (2 hour baseline, 1 hour stress, 2 hour recovery) after being brought into similar levels of sodium balance. Dual-energy x-ray absorptiometry was performed to determine total percent body fat. Both girls and boys showed significant increases from baseline to stress and significant decreases from stress to recovery for blood pressure and sodium excretion (PϽ0.01 for all), with greater changes for boys (PϽ0.01 for all). For girls, blood pressure during stress was related to urinary sodium excretion (rϭ0.31; PϽ0.005) but not for boys. For boys, body fat was negatively correlated with the change in sodium excretion from baseline to stress (rϭ-0.37; PϽ0.006) and sodium excretion during stress (rϭ-0.28; PϽ0.04), which in turn was related to angiotensin II (rϭ-0.41; PϽ0.41). Body fat was also negatively related to the post-stress decline in blood pressure (rϭ-0.24; PϽ0.04) which was positively correlated with the stressinduced change in angiotensin II. In contrast, body fat was not correlated with sodium handling, blood pressure, or angiotensin II in girls. These results may help to explain how the interactions between salt, stress, and obesity contribute to the increased incidence and prevalence of HTN in African-American males. The mechanisms responsible for the gender difference is unclear, however, we speculate that the natriuretic and vasodilatory properties of the female sex hormones may facilitate stressinduced pressure natriuresis.
RESUMO A falta de adesão ao tratamento da hipertensão arte-rial é o maior desafio para todos os q... more RESUMO A falta de adesão ao tratamento da hipertensão arte-rial é o maior desafio para todos os que trabalham e investigam esta área. Aumenta os custos e os riscos de eventos cardiovasculares em conseqüência do controle inadequado da pressão, provocado por esta prática. ...
O papel do aluno de graduação em Medicina no atendimento a pacientes de enfermarias de longa perm... more O papel do aluno de graduação em Medicina no atendimento a pacientes de enfermarias de longa permanência de um hospital-escola
Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an i... more Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces the incidence of major cardiovascular events. In the absence of higher baseline risk, the use of BP agents reduces the incidence of hypertension. The PREVER-prevention trial aims to investigate the efficacy, safety and feasibility of a population-based intervention to prevent the incidence of hypertension and the development of target-organ damage. This is a randomized, double-blind, placebo-controlled clinical trial, with participants aged 30 to 70 years, with pre-hypertension. The trial arms will be chlorthalidone 12.5 mg plus amiloride 2.5 mg or identical placebo. The primary outcom...
If weight and height data given by the patients were accurate, direct measurements would be made ... more If weight and height data given by the patients were accurate, direct measurements would be made redundant and unnecessary, bringing about substantial savings in terms of cost and time, during epidemiological studies. Data from direct measurements were compared to those given by the individuals, during a house visit. In order to assemble a representative population of 119,570 people, domiciles that
Fundamento: A síndrome metabólica (SM) é um agregado de fatores predisponentes para doenças cardi... more Fundamento: A síndrome metabólica (SM) é um agregado de fatores predisponentes para doenças cardiovasculares e diabete melito, cujas características epidemiológicas são insuficientemente conhecidas nos níveis regional e nacional.
Em sintonia com a tendência científica mundial e a orientação da Associação Médica Brasileira, as... more Em sintonia com a tendência científica mundial e a orientação da Associação Médica Brasileira, as IV Diretrizes Brasileiras de Hipertensão fundamentam suas orientações segundo Graus de Recomendação baseados em níveis de evidência dos estudos clínicos de referência:
Objetivo: Estimar a prevalência da hipertensão arterial (HA) e de alguns fatores de risco cardiov... more Objetivo: Estimar a prevalência da hipertensão arterial (HA) e de alguns fatores de risco cardiovasculares na população adulta de uma capital brasileira.
For hypertensive patients, the indication is to control BP in such a way as not to exceed <140... more For hypertensive patients, the indication is to control BP in such a way as not to exceed <140/90mm Hg. In diabetic patients (DM) treatment goals are more rigorous (126 mg/dl and/or those who were taking hypoglycemic drugs or insulin) were studied. They were evaluated in the first (M1) and last visit (M2), in terms of BP, Body Mass Index (BMI),
To assess the validity of self-reported weight and height at the time of diagnosing obesity, and ... more To assess the validity of self-reported weight and height at the time of diagnosing obesity, and to identify the sociodemographic and individual characteristics that might be a source of information bias. This was a cross-sectional population-based study carried out in the city of Goiânia in 2001. Interviews were conducted with 1,023 individuals aged 20-64 years, in their homes, to collect sociodemographic and self-reported weight and height information. On the same occasion, weight and height measurements were made on these individuals. The mean differences and correlation coefficients between self-reported and measured data were calculated according to age, body mass index (BMI), schooling, income and height. Both the men and women overestimated their heights (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05), by 0.9 cm and 2.2 cm, respectively. There was no difference between self-reported and measured weights, either for the men (-0.44 kg; p=0.06) or for the women (-0.03 kg; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). The behavior of overestimating height was influenced by age, schooling, height and body mass index. Although this index obtained from the self-reported data was underestimated (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05), by 0.27 kg/m(2) and 0.67 kg/m(2) for men and women respectively, the measured and self-reported data presented a high degree of agreement. Both the sensitivity and specificity of the self-reported body mass index were high, in relation to identifying the measured index. In epidemiological studies for monitoring the prevalence of excess weight in populations, self-reported weights and heights constitute reliable data, which gives validity to the methodology utilized.
Background: Hypertension is a public health problem, considering its high prevalence, low control... more Background: Hypertension is a public health problem, considering its high prevalence, low control rate and cardiovascular complications. Objective: Evaluate the control of blood pressure (BP) and cardiovascular outcomes in patients enrolled at the Reference Center for Hypertension and Diabetes, located in a medium-sized city in the Midwest Region of Brazil. Methods: Population-based study comparing patients enrolled in the service at the time of their admission and after an average follow-up of five years. Participants were aged ≥18 years and were regularly monitored at the Center up to 6 months before data collection. We assessed demographic variables, BP, body mass index, risk factors, and cardiovascular outcomes. Results: We studied 1,298 individuals, predominantly women (60.9%), and with mean age of 56.7±13.1 years. Over time, there was a significant increase in physical inactivity, alcohol consumption, diabetes, dyslipidemia, and excessive weight. As for cardiovascular outcomes...
Adolescents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;a... more Adolescents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; body image (BI) may not match their nutritional status. This study selected representative sample of healthy adolescents aged between 12 and 18 from public and private schools. Anthropometric measures were performed in order to calculate the body mass index (BMI) percentile. The silhouette scale proposed by Childress was used to evaluate BI, making it possible to assess BI satisfaction and BI distortion. The sample was composed of 1168 adolescents with a mean age of 14.7 years; 52.9% were female, 50.9% were fair-skinned, 62.4% had consumed or still consume alcohol and 67% attended public school. Male adolescents presented more overweight and obesity (28.4%) (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05) than the female (17.1%). It was observed that 69.4% were dissatisfied with BI, 91.1% of the obese and 69.8% of those with overweight wished to lose body weight and 82.5% of those underweight wished to gain body weight. BI distortion was identified, since 35% of the adolescents who were underweight did not regard themselves thin, 39.1% of the overweight individuals and 62.1% of the obese did not see themselves in their adequate classifications. Adolescents with overweight/obesity were those who presented higher dissatisfaction with BI, mainly the females. Male individuals presented a greater wish of gaining weight. BI distortion was present in adolescents of all classes of BMI percentile.
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