To assess the clinical and demographic characteristics of a population with ischemic heart disease admitted in the final decades of the 20th century.
This study retrospectively assessed patients ...hospitalized with ischemic heart disease divided into the following 2 groups: acute group - 11.181 patients with acute myocardial infarction admitted from 1/1/82 to 12/31/94; and chronic group - 4.166 patients undergoing coronary artery bypass graft surgery from 1/1/84 to 12/31/94.
In the acute group, an increase in the percentage of females (from 22.7% to 27.7%, P<0.001) and diabetic individuals (from 12.4% to 17.5%, P<0.001) was observed, as was an increase in age (from 57.4 +/- 11.5 to 59.9 +/- 12.1 years, P<0.05). In-hospital mortality was greater among females (27.8% and 15.7%, P=0.001), among diabetic individuals (24.2% and 17.8%, P=0.001), and among the elderly (60.9 +/- 15.2 and 57.7 +/- 11.8 years, P=0.0001). In the chronic group, an increase in the percentage of females (from 17.5% to 27.2%, P=0.001) was observed, as was an increase in age (from 56.3 +/- 8.6 to 60.5 +/- 9.6 years, P=0.0001). In-hospital mortality was greater among females (8.3% and 5.8%, P<0.05) and among the elderly (58.1 +/- 9.1 and 62.1 +/- 7.9 years, P=0.0001).
The characteristics of the population studied with ischemic heart disease point towards a worse prognosis, due to the greater percentages of females, older patients, and diabetic patients, groups known to have greater in-hospital mortality.
To screen the risk of developing diabetes mellitus type 2 (DM2) in adult individuals.
Several risk factors for DM2 (sedentary lifestyle, previous coronary artery disease, hyperglycemia-inducing ...medications, body mass index BMI, blood pressure, serum triglyceride, and HDL-cholesterol levels) were assessed in 314 adults as a function of gender and age group.
73.2% of the population had two or more concurrent risk factors and 26.8% had less than two factors. The occurrence of risk factors for DM2 development was observed even in young adults, and the risk factors are likely associated with aging. Differences in risk factors and incidence were observed between men and women in the same age group.
Regardless the age studied, the most prevalent risk factors associated with DM2 were: BMI, sedentary lifestyle, and reduced serum HDL-cholesterol, which are modifiable, thus increasing the importance of preventive measures. Discrepancies found in prevalent risk factors in men and women also suggest that sociocultural differences influence the risk of developing DM.
Este trabalho objetivou rastrear em indivíduos adultos o risco de vir a desenvolver diabetes mellitus (DM) tipo 2.
Diversos fatores de risco para DM (sedentarismo, doença coronariana prévia, uso de medicação hiperglicemiante, índice de massa corporal (IMC), pressão arterial, níveis séricos de triglicerídeos e colesterol HDL-col) foram avaliados em 314 adultos, em função do sexo e faixa etária.
73,2% da população somou dois ou mais fatores de risco simultaneamente, e 26,8% apresentaram menos de dois fatores. Observou-se a ocorrência de fatores de risco para o desenvolvimento da DM mesmo entre adultos jovens, e a ocorrência dos mesmos tende a estra associada com o avanço da idade. Foram observadas diferenças nos fatores e incidência de risco entre homens e mulheres na mesma faixa etária.
Independentemente da idade estudada, os fatores de risco associados a DM de maior prevalência foram: IMC, sedentarismo e diminuição do HDL-colesterol, os quais podem ser modificáveis, reforçando a importância de medidas preventivas. Divergências encontradas entre os fatores de risco prevalentes em homens e mulheres sugerem também que diferenças socioculturais influenciam o risco de desenvolvimento da DM.
Ischemic heart disease is associated with high rates of mortality and it is the most prevalent among cardiovascular diseases. It is a multifactorial disease, and its prevention depends on control of ...risk factors. Resting electrocardiogram can be used to detect manifestations of ischemic heart disease, since some electrocardiographic abnormalities are indicative of coronary disease in asymptomatic subjects. The aim of the study was to analyze the relationship between electrocardiographic abnormalities and risk factors for ischemic heart disease in an adult population from the metropolitan area of São Paulo.
A cross-sectional study was carried out in an adult population (age 20 years and over) from Cotia, near São Paulo, southeastern of Brazil. The study population comprised 1067 subjects. The subjects were interviewed using a questionnaire. The variables studied were: gender, age, smoking behaviour, physical activity, body mass index, waist-to-hip ratio, blood pressure, diabetes mellitus, blood lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides) and electrocardiographic abnormalities. Electrocardiographic abnormalities were grouped according to the classification: ST-T changes, left ventricular hypertrophy and abnormalities non related to ischemic myocardial disease or without abnormalities.
The population was relatively -young (79% younger than 50 years, mean age 39.8 +/- 13.2 years old), and 59.3% were female. The resting electrocardiogram showed ST-T changes in 9.5% of the subjects and left ventricular hypertrophy in 3.3%. Female gender, age over 65 years for women and 55 years for men, diabetes, hypertension, total cholesterol >/= 200 mg/dl, LDL-cholesterol >/=130 mg/dl, Triglycerides >/=200 mg/dl, body mass index >/= 25 Kg/m2 and abnormal waist-to-hip ratio, were positively related to ST-T changes. Male gender, diabetes, hypertension and smoking behaviour were positively related to left ventricular hypertrophy. In the presence of ST-T changes on the ECG, we observed an odds ratio of 3.54 for the diagnosis of systolic hypertension an of 1.83 for total cholesterol >/= 200 mg/dl. In the presence of left ventricular hypertrophy on the ECG, we found an odds ratio of 5.92 for systolic hypertension diagnosis. Among the three most important risk factors correlated to electrocardiographic abnormalities indicative of myocardial ischemia, two can be controlled by nutritional intervention (hypertension and total cholesterol >/= 200 mg/dl). This findings suggest the importance of its early detection. Future studies should determine the predictive value of the electrocardiogram, a simple and inexpensive method, suggesting the presence of cardiovascular risk factors in epidemiological and nutritional studies.
To screen the risk of developing diabetes mellitus type 2 (DM2) in adult individuals.
Several risk factors for DM2 (sedentary lifestyle, previous coronary artery disease, hyperglycemia-inducing ...medications, body mass index BMI, blood pressure, serum triglyceride, and HDL-cholesterol levels) were assessed in 314 adults as a function of gender and age group.
73.2% of the population had two or more concurrent risk factors and 26.8% had less than two factors. The occurrence of risk factors for DM2 development was observed even in young adults, and the risk factors are likely associated with aging. Differences in risk factors and incidence were observed between men and women in the same age group.
Regardless the age studied, the most prevalent risk factors associated with DM2 were: BMI, sedentary lifestyle, and reduced serum HDL-cholesterol, which are modifiable, thus increasing the importance of preventive measures. Discrepancies found in prevalent risk factors in men and women also suggest that sociocultural differences influence the risk of developing DM.
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