scholarly journals Arterial hypertension and cerebrovascular accidents. epidemiological profile of patients attended between 2013 and 2019 in Joinville, Santa Catarina, Brazil

2021 ◽  
Author(s):  
Pedro Eugênio Deboni Daudt ◽  
Alexandre Grunfeld Starling Jardim ◽  
Felipe Ibiapina dos Reis

Introduction: Cerebrovascular accident (CVA) is the second cause of death in the world, and arterial hypertension (AH) is the main risk factor. Objectives: To evaluate the prevalence of AH and the epidemiological profile of patients who suffered CVA, first and recurrent events, registered at JOINVASC, between 2013 and 2019. Methodology: An observational, descriptive, retrospective study, analyzing demographic data and risk factors, in patients that suffered CVA, first or recurrent event, was done. Results: In the study period, 6057 CVA events were registered, 4402(72.6%) patients were classified as hypertensive, (122 were excluded due to incomplete data), 4387 registers were analyzed. In this group, 2149 (51.2%) were male, mean age was 68.4±14.7(18 a 102 years), BMI was 27.5±5.1(14 a 59), 4330(39.9%) with Diabetes, 2559(58.8%) were smokers or ex-smokers, 3174(7.42%) were sedentary, and 504(11.5%) had controlled AH. In the group with recurrent event (1392-31.7%) (52.3%, p<0.001) were females, mean age was (69.4± 11.5) (p<0.002); BMI was lower (p=0.02). There was more cardiopathy (47.6%) (p<0,001) ,smokers or ex-smokers (66.2)(p<.005), diabetes (46.7%) (p<0.001) and deaths (32.3%)(p<0.001), less physical activity (22.0%)(p<0.001), use of antihypertensive drugs was greater (1.52±0,93)(p<0.001),. Logistic regression showed that female sex, BMI, DM, cardiopathy, physical activity, and more anti- hypertension drugs, were significant predictors for recurrence of neurologic event. Discussion: Despite advances in primary health care and prevention campaigns, the prevalence of AH in patients with CVA is high, and still has lowlevels of control, even in patients with recurrent CVA.

2021 ◽  
Author(s):  
Pedro Eugênio Deboni Daudt ◽  
Alexandre Grunfeld Starling Jardim ◽  
Felipe Ibiapina dos Reis

Introduction: Cerebrovascular accident (CVA) is the second cause of death in the world, and arterial hypertension (AH) is the main risk factor. Objetives: To evaluate the prevalence of AH and the epidemiological profile of patients who suffered CVA, first and recurrent events, registered at JOINVASC, between 2013 and 2019. Methodology: An observational, descriptive, retrospective study, analyzing demographic data and risk factors, in patients that suffered CVA, first or recurrent event, was done. Results: In the study period, 6057 CVA events were registered, 4402(72.6%) patients were classified as hypertensive, (122 were excluded due to incomplete data), 4387 registers were analyzed. In this group, 2149 (51.2%) were male, mean age was 68.4±14.7(18 a 102 years), BMI was 27.5±5.1(14 a 59), 4330(39.9%) with Diabetes, 2559(58.8%) were smokers or ex-smokers, 3174(7.42%) were sedentary, and 504(11.5%) had controlled AH. In the group with recurrent event (1392-31.7%) (52.3%, p<0.001) were females, mean age was (69.4± 11.5) (p<0.002); BMI was lower (p=0.02). There was more cardiopathy (47.6%) (p<0,001) ,smokers or ex-smokers (66.2)(p<.005), diabetes (46.7%) (p<0.001) and deaths (32.3%)(p<0.001), less physical activity (22.0%)(p<0.001), use of antihypertensive drugs was greater (1.52±0,93)(p<0.001),. Logistic regression showed that female sex, BMI, DM, cardiopathy, physical activity, and more anti- hypertension drugs, were significant predictors for recurrence of neurologic event. Discussion: Despite advances in primary health care and prevention campaigns, the prevalence of AH in patients with CVA is high, and still has low levels of control, even in patients with recurrent CVA.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E A Smirnova ◽  
S S Yakushin ◽  
Y V Terekhovskaya ◽  
A N Vorobyev

Abstract Aim To study the dynamics of the prevalence, awareness, risk factors (RF) and treatment of arterial hypertension (AH) among men and women according to a survey of a representative sample of the population of the Ryazan region (RR) in 2007–2016. Materials and methods In 2002, as a part of the Russian epidemiological “EPOCH” study, a representative sample of the RR population (2098 people, average age 44.8±18.6 years) was formed and surveyed using step-by-step randomization of medical institutions, medical districts and apartments. A repeated survey of the sample was conducted in 2007 (1,760 people, response 83.9%) and in 2016 (1,497 people, response 85.1%). The AH group included persons with blood pressure ≥140/90 mmHg detected during the double measurement and with normal blood pressure while receiving antihypertensive therapy. In individuals with AH the risk factors were assessed: smoking, alcohol abuse, salt abuse, obesity, burdened family history, low physical activity. Results The prevalence of AH over the past 9 years has increased from 39.3% to 43.9%, p<0.001. The age-standardized prevalence of AH among women is higher than among men as in 2007 (42.1% versus 34.8%, p<0.001) and in 2016 (46.9% vs. 41.8%, p<0.05). Women's awareness about having AH increased from 83.9% to 88.9%, p<0.05, in men it decreased (84.0% against 77.4% in 2007, p>0.05). In the group of persons with AH, the more common risk factors are older age (56.8%), hereditary predisposition (58.9%), low physical activity (96.0%) and obesity (34.3%) compared with persons without AH (12.9%, 48.2%, 84.5% and 9.2%, respectively), they smoke less often (10.7% versus 23.2%) and use extra salt less often (29.5% against 38.4%), p<0.001. The number of patients taking antihypertensive drugs reached 91.2% against 84.0% in 2007, p<0.001. There was a decrease in the number of AH patients who: are treated intermittently (from 12.3% to 3.6%, p<0.001), who take drugs only when blood pressure is high (from 16.2% to 6.2%, p<0.001). The most frequently used antihypertensive drugs are still ACE inhibitors (64.8%), beta-blockers (48.9%), diuretics (42.5%), ARBs (29.2%) and calcium channel blockers (21.3%). The ratio of effectively treated AH patients increased in men from 14.6% to 27.8%, p<0.001, in women from 25.0% to 39.5%, p<0.001. A negative influence on the effectiveness of therapy was caused by smoking (RR 1.23; CI 1.11–1.37, p=0.005), salt abuse (RR 1.11; CI 1.06–1.23, p=0.04) and obesity (RR 1.16; CI 1.06–1.27, p=0.003). Conclusion Over the past nine years, the prevalence of hypertension in both the men and women has significantly increased in the Ryazan region. Increased treatment coverage and positive changes in drug therapy led to an increase in the number of effectively treated patients (from 21.4% to 35.5%, p<0.001). Obesity, smoking, salt abuse are associated with an increased risk of non-effectiveness of hypertension therapy.


2019 ◽  
Author(s):  
Claudio Andre Barbosa de Lira ◽  
Rafaela Gomes Santos ◽  
Ariádny Brandão Gomes ◽  
Douglas Assis Teles Santos ◽  
Marília Santos Andrade ◽  
...  

Abstract Background Physical exercise is an important tool to manage systemic arterial hypertension. However, less is known about the effect of physical exercise on the number of antihypertensive drugs used by older adults. Objectives The aim was to compare the number of antihypertensive drugs used by older female adults with a low level of physical activity with the number used by those with a high level of physical activity, and to verify how many participants used more than two antihypertensive drugs. Methods Twenty-eight physically active older women with systemic arterial hypertension who participated in a physical activity program for community-dwelling older female adults were divided into two groups: participants that presented lower habitual physical activity levels were placed in group 1 and participants that presented higher habitual physical activity levels were placed in group 2, according to the Baecke questionnaire. In addition, the number of antihypertensive drugs used by participants was collected. Results The number of ingested antihypertensive tablets was 2.0 (median) for both groups investigated. There was no significant difference between groups regarding the number of antihypertensive tablets ingested (p>0.05). Although there was no statistical difference, a higher proportion of participants from the lower physical activity group used more than two antihypertensive drugs. Conclusions The level of habitual physical activity did not affect the number of antihypertensive tablets used by hypertensive women.


2020 ◽  
Author(s):  
Claudio Andre Barbosa de Lira ◽  
Rafaela Gomes dos Santos ◽  
Ariádny Brandão Gomes ◽  
Douglas de Assis Teles Santos ◽  
Marilia Santos Andrade ◽  
...  

Abstract Background: Physical activity is an important tool to manage systemic arterial hypertension. However, less is known about the relationship of physical activity with the number of antihypertensive drugs used by older adults. The aim of this study was to compare the number of antihypertensive drugs used by older female adults (aged ≥ 60 years) with a low level of physical activity with the number used by those with a high level of physical activity, and to verify how many participants used more than two antihypertensive drugs. The habitual level of physical activity was evaluated by the Baecke questionnaireMethods: Twenty-eight physically active older women with systemic arterial hypertension who participated in a physical activity program for community-dwelling older female adults were divided into two groups: participants who presented lower habitual physical activity levels were placed in group 1 and participants that presented higher habitual physical activity levels were placed in group 2, according to the Baecke questionnaire. In addition, the number of antihypertensive drugs used by participants was collected.Results: The number of prescribed antihypertensive tablets was 2.0 (median) for both groups investigated. There was no significant difference between groups regarding the number of antihypertensive tablets prescribed (p>0.05). There was no statistical difference in proportion of participants from the lower physical activity group used more than two antihypertensive drugs.Conclusions: The level of habitual physical activity did not affect the number of antihypertensive tablets used by hypertensive elderly women.


2019 ◽  
Vol 14 (2) ◽  
Author(s):  
Lintang Dian Saraswati ◽  
Ari Udiyono ◽  
Dian Sutrisni ◽  
Muh Fauzi

Sexual dysfunction is associated with pain during sexual intercourse. Diabetes mellitus (DM) has been reported to be one of the causal factors for sexual dysfunction in women. This cross-sectional study was conducted to describe the status of sexual dysfunction in women with DM in the Tlogosari Kulon Primary Health Care, Semarang, Indonesia, in March 2017. A total of 103 women with DM attending the health center participated in this study. Data were collected using a questionnaire-guided interview and through measurements (blood pressure and random blood glucose test). Results showed that 74.8% of women with DM had sexual dysfunction. The proportion of sexual dysfunction was higher among women in the clinical phase, with uncontrolled blood glucose levels, hypertension grade II, prolonged duration of DM of ≥ 5 years, undergoing insulin treatment, in menopause, grand multiparity, having used the tubectomy contraception method, low physical activity, depression, and consumption of antihypertensive drugs. The aging process, menopausal status, and consumption of antihypertensive drugs will increase the risk for sexual dysfunction in women with DM. It is recommended that women with DM maintain their physical activity, blood sugar levels, blood pressure, and their depression status.


2020 ◽  
Vol 91 (4) ◽  
pp. 352-357
Author(s):  
Jessica Tedford ◽  
Valerie Skaggs ◽  
Ann Norris ◽  
Farhad Sahiar ◽  
Charles Mathers

INTRODUCTION: Atrial fibrillation (AF) is one of the most common cardiac arrhythmias in the general population and is considered disqualifying aeromedically. This study is a unique examination of significant outcomes in aviators with previous history of both AF and stroke.METHODS: Pilots examined by the FAA between 2002 and 2012 who had had AF at some point during his or her medical history were reviewed, and those with an initial stroke or transient ischemic attack (TIA) during that time period were included in this study. All records were individually reviewed to determine stroke and AF history, medical certification history, and recurrent events. Variables collected included medical and behavior history, stroke type, gender, BMI, medication use, and any cardiovascular or neurological outcomes of interest. Major recurrent events included stroke, TIA, cerebrovascular accident, death, or other major events. These factors were used to calculate CHA2DS2-VASc scores.RESULTS: Of the 141 pilots selected for the study, 17.7% experienced a recurrent event. At 6 mo, the recurrent event rate was 5.0%; at 1 yr, 5.8%; at 3 yr 6.9%; and at 5 yr the recurrent event rate was 17.3%. No statistical difference between CHA2DS2-VASc scores was found as it pertained to number of recurrent events.DISCUSSION: We found no significant factors predicting risk of recurrent event and lower recurrence rates in pilots than the general population. This suggests CHA2DS2-VASc scores are not appropriate risk stratification tools in an aviation population and more research is necessary to determine risk of recurrent events in aviators with atrial fibrillation.Tedford J, Skaggs V, Norris A, Sahiar F, Mathers C. Recurrent stroke risk in pilots with atrial fibrillation. Aerosp Med Hum Perform. 2020; 91(4):352–357.


2020 ◽  
pp. 19-28
Author(s):  
E. Yu. Ebzeeva ◽  
O. D. Ostroumova ◽  
N. M. Doldo ◽  
E. E. Pavleeva

Arterial hypertension (AH) remains one of the most significant medical and social problems in the world, its prevalence among the adult population is 30–45%. Along with this, the modern population is characterized by a high incidence of chronic kidney disease (CKD), including due to their secondary damage in the framework of hypertension. In turn, CKD is an important independent risk factor for the development and progression of cardiovascular diseases, including fatal ones. The use of existing approaches to nephroprotection in the treatment of patients with hypertension will significantly improve the prognosis both in patients with risk factors for developing renal dysfunction and in patients with pre-existing kidney disease. According to current recommendations for hypertension in such clinical situations, therapy should begin with fixed combinations of antihypertensive drugs. The combination of an angiotensin converting enzyme inhibitor (ACE) and a dihydropyridine calcium channel blocker (CCВ) demonstrated the greatest effectiveness according to evidence-based medicine in patients with high-risk hypertension, including from the standpoint of nephroprotection. In the presented clinical case, the successful use of a fixed combination of ACE and CCВ in a patient with hypertension and microalbuminuria is described.


2019 ◽  
Vol 25 (1) ◽  
pp. 17-22
Author(s):  
I.S. Dronyk ◽  
◽  
O.Y. Yavorsky ◽  
O.Y. Sklyarov ◽  
R.S. Pshyk ◽  
...  

2014 ◽  
Vol 62 (2) ◽  

In Slovenia, the role of general practitioners in counselling physical activity for prevention of cardiovascular disease (CVD) is well recognized. The role of general practitioners in advising healthy lifestyle for individuals who are at risk of developing CVD is formally defined in the National Program for Primary Prevention of Cardiovascular Disease, which has been running since 2001. Part of the program is counselling on healthy lifestyle including physical activity, performed in all health centres across the country. First a screening and medical examination is performed. In case of higher risk for CVD (>20%) the physician should give advice on the particular risk factor and direct patients to health-education centres, where they can participate in healthy lifestyle workshops lead by health professionals. Physicians and other health professionals who are involved in the implementation of prevention activities within the program need knowledge and skills that are crucial for successful counselling on healthy lifestyle. The educational program “basic education in health promotion and prevention of chronic non-communicable diseases in primary health care/family medicine” consists of two parts. The first part of the training is open to all health professionals working within the program. The second part is intended for health professionals working in health-education workshops. In the last few years a new family practice model has been introduced and disseminated. Some duties of the family physician, including health promotion and counselling, are being transferred to graduate nurses who become part of the family practice team. This new division of work undoubtedly brings many advantages, both in terms of the work organization, and of high-quality patient care. Nevertheless preventive action cannot be fully passed on to graduate nurses. Careful planning and education are needed to ensure a comprehensive approach in healthy life style counselling.


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