Worldwide trends in blood pressure from 1975 to 2015 : a pooled analysis of 1479 population-based measurement studies with 19?1 million participants.

Background Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defi ned as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. Methods For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure. Findings We pooled 1479 studies that had measured the blood pressures of 19?1 million adults. Global age-standardised mean systolic blood pressure in 2015 was 127?0 mm Hg (95% credible interval 125?7?128?3) in men and 122?3 mm Hg (121?0?123?6) in women; age-standardised mean diastolic blood pressure was 78?7 mm Hg (77?9?79?5) for men and 76?7 mm Hg (75?9?77?6) for women. Global age-standardised prevalence of raised blood pressure was 24?1% (21?4?27?1) in men and 20?1% (17?8?22?5) in women in 2015. Mean systolic and mean diastolic blood pressure decreased substantially from 1975 to 2015 in high-income western and Asia Pacifi c countries, moving these countries from having some of the highest worldwide blood pressure in 1975 to the lowest in 2015. Mean blood pressure also decreased in women in central and eastern Europe, Latin America and the Caribbean, and, more recently, central Asia, Middle East, and north Africa, but the estimated trends in these super-regions had larger uncertainty than in high-income super-regions. By contrast, mean blood pressure might have increased in east and southeast Asia, south Asia, Oceania, and sub-Saharan Africa. In 2015, central and eastern Europe, sub-Saharan Africa, and south Asia had the highest blood pressure levels. Prevalence of raised blood pressure decreased in high-income and some middle-income countries; it remained unchanged elsewhere. The number of adults with raised blood pressure increased from 594 million in 1975 to 1?13 billion in 2015, with the increase largely in low-income and middle-income countries. The global increase in the number of adults with raised blood pressure is a net eff ect of increase due to population growth and ageing, and decrease due to declining age-specifi c prevalence. Interpretation During the past four decades, the highest worldwide blood pressure levels have shifted from high-income countries to low-income countries in south Asia and sub-Saharan Africa due to opposite trends, while blood pressure has been persistently high in central and eastern Europe

Desigualdades demográficas e socioeconômicas entre brancos e indígenas no Brasil

Using data from the 2000 Brazilian Demographic Census of Brazilian Institute of Geography and Statistics (IBGE), the fifteen municipalities with the highest percentage of indigenous people were analyzed. The fact of indigenous people represents a significant portion of total population in these fifteen municipalities does not mean they have demographic and socioeconomic conditions similar to those of white population.Este artigo descreve e compara alguns dos principais indicadores demográficos e socioeconômicos entre brancos e indígenas no Brasil. Utilizando os dados da amostra do Censo Demográfico 2000 do Instituto Brasileiro de Geografia e Estatística – IBGE, são analisados os 15 municípios brasileiros com maior percentual de indígenas. Os resultados mostram que o fato de os indígenas representarem uma parcela significativa da população dos municípios estudados não implica condições demográficas e socioeconômicas semelhantes às da população branca

Prevalence of schistosomiasis mansoni in indigenous Maxakali villages, Minas Gerais, Brazil

Intestinal parasitic infections are a common health problem among Amerindian populations and schistosomiasis represents one of the most prevalent diseases in Maxakali people. The Kato-Katz is the diagnostic method recommended by WHO for epidemiological studies; however, one of the technique’s limitations is the failure to detect parasites in individuals with low parasite load. The aim of this study was to establish the prevalence of Schistosoma mansoni in indigenous Maxakali villages, evaluating the TF-Test® performance for diagnosis compared to the Kato-Katz technique. Stool samples from 545 individuals were processed by the TF-Test® (1 sample) and Kato-Katz (1 slide). The positivity rate for S. mansoni by Kato-Katz was 45.7%. The rate by the TF-Test® was 33.2%, and 51.9% by the combined parasitological techniques. The amplitude of parasite load was 24 to 4,056 eggs per gram of feces (epg), with a geometric mean of 139 epg. The co-positivity, co-negativity, and accuracy values by TF-Test® in relation to Kato-Katz were 59.0%, 88.5%, and 75.0%, respectively. The agreement between these techniques was moderate (k=0.486) as determined by the kappa index. Thus, the results of this study demonstrated that the performance of Kato-Katz was superior (

Use of dried blood sample for serological diagnosis of toxoplasmosis in goats

Eluates of 183 dried caprine blood samples on filter paper were tested for anti-Toxoplasma gondii antibodies, using IFA, ELISA and dot-ELISA, and compared with results obtained by direct observations on comparable sera, usin the same tests. The results has showed that papers with dried blood can be preserved for up to 45 days at room temperature and for six months at 4°C, provided they are protected against humid conditions by using desiccating agents such as silica-gel. Comparison between serum and eluate reactions revelated 97-100% correspondance. The antibody titers remained constant throughout the study period.Foi realizada pesquisa de anticorpos anti-Toxoplasma gondii em 183 amostras de sangue dessecado em papel de filtro utilizando as reações de imunofluorescência indireta ELISA e dot-ELISA, tomando como referência os resultados obtidos nos soros. A análise dos resultados demonstrou que papéis com sangue dessecado podem ser conservados por um período mínimo de 45 dias à temperatura ambiente e por seis meses a 4°C, desde que mantidos livres de umidade pela utilização de agentes dessecantes como a sílica-gel. A reprodutibilidade das reações, avaliada por meio da curva dos títulos de anticorpos no decorrer do tempo após a coleta do sangue em papéis de filtro, demonstrou uma concordância de 97 a 100% entre os resultados obtidos nos soros e eluatos. Os títulos de anticorpos permaneceram estáveis durante o período observado. Os resultados obtidos com eluato de sangue dessecado foram semelhantes na RIFI, ELISA e dot-ELISA, indicando que qualquer uma das três reações pode ser utilizada em eluatos de sangue dessecado para o diagnóstico da toxoplasmose caprina

Soroprevalência da doença de Chagas em escolares de dois municípios do Vale do Jequitinhonha, Minas Gerais, Brasil, seis anos após a implantação da vigilância epidemiológica

Six years after the beginning of the epidemiological surveillance of Chagas disease in Berilo and José Gonçalves de Minas, Jequitinhonha Valley, MG, Brazil, a serological inquiry was performed to observe whether the transmission of this endemy was occurring in this area. A randomized sample of 1,412 children seven to 14 years old, was screened. Six asymptomatic children were found to be positive, leading to 0.4% of prevalence. Hemoculture confirmed infection in five out of the six positive cases. Additional epidemiological investigation revealed important antecedents, such as disease reports in relatives and predisposing ecological and housing conditions. Our results demonstrated similar seroprevalence (0.4%) in schoolchildren, ranging from seven to 14 years old, and that were observed six years ago (0.2%) for children 0-9 year-old. Thus, considering the constant presence of Panstrogylus megistus in the peridomicile these findings emphasize the need of continuous improved epidemiological surveillance of Chagas disease in this region.Seis anos após o início da vigilância epidemiológica para doença de Chagas em Berilo e José Gonçalves de Minas, Vale do Jequitinhonha, MG, Brasil, foi realizado um inquérito sorológico para verificar se a transmissão desta endemia estava ocorrendo naquela área. Uma amostra aleatória de 1.412 crianças, de 7 a 14 anos, foi avaliada. Foram encontradas seis crianças positivas assintomáticas, totalizando uma prevalência de 0,4%. Hemocultura confirmou a infecção em cinco dos seis casos positivos. Uma investigação epidemiológica adicional, revelou importantes antecedentes, tais como: casos da doença em parentes e condições de moradia e ecológicas predisponentes. Nossos resultados demonstram uma soroprevalência similar (0,4%) em escolares de 7 a 14 anos àquela observada há seis anos (0,2%) em crianças de 0-9 anos. Dessa forma, considerando a presença constante de Panstrogylus megistus estes achados reforçam a necessidade de uma vigilância epidemiológica contínua e aperfeiçoada para Doença de Chagas naquela região

Ability of body mass index to predict abnormal waist circumference : receiving operating characteristics analysis.

Body mass index (BMI) and waist circumference (WC) are the most used anthropometric measures to identify obesity. While BMI is considered to be a simple and accurate estimate of general adiposity, WC is an alternative surrogate measure of visceral obesity. However, WC is subject to significant inter-examiner variation. The aim of the present study was to correlate BMI and WC measures in a group of Brazilian adults to determine the most accurate BMI values for predicting abnormal WC

Espesor del músculo aductor del pulgar en adolescentes brasileños y asociaciones con el estado nutricional, la maduración sexual y la actividad física (Estudio EVA-JF)

Objective: The present study aims to assess the associations of adductor pollicis muscle thickness (APMT) with age, skin color, sexual maturation, anthropometric indicators and physical activity in Brazilian adolescents. Materials and methods: Cross-sectional study of adolescents aged 14-19 years. Weight, height, body mass index (BMI), arm circumference (AC), APMT, body fat, fat-free mass (FFM), fat-free mass index (FFMI), sexual maturation, time of physical activity and skin color were evaluated. APMT was associated with categorical variables using Mann-Whitney or Kruskal-Wallis tests and correlated with anthropometric variables using Spearman’s correlation. Linear regression was used with APMT as a dependent and the other variables as predictors. Data analysis was carried out in SPSS® software (version 17.0) with a 5% significance level. Results: 828 adolescents were evaluated, 57.6% female, with a mean age of 16.13 ± 1.20 years. APMT had an average value of 18.0 mm in females and 21.0 mm in males. The measure was greater in males, in more advanced stages of sexual maturation, overweight and physical activity. It presented a moderate correlation with FFM, FFMI, body fat and AC. In the final model of multiple linear regression for females, the variables AC and body fat explain 20.1% of the APMT variability. For men, the variables AC and FFMI explain 30.5% of the APMT variability. Conclusion: It is recommended that APMT be used in a complementary manner in the nutritional assessment of adolescents.Objetivo: El presente estudio tiene como objetivo evaluar las asociaciones del grosor del músculo aductor del pulgar (EMAP) con la edad, el color de la piel, la maduración sexual, los indicadores antropométricos y la actividad física en adolescentes brasileños. Material y métodos: estudio transversal con adolescentes de 14 a 19 años. Peso, talla, índice de masa corporal (IMC), circunferencia del brazo (CB), EMAP, grasa corporal, masa libre de grasa (MLG), índice de masa libre de grasa (IMLG), maduración sexual, tiempo de actividad física y color de piel fueron juzgado. EMAP se asoció con variables categóricas mediante pruebas de Mann-Whitney o Kruskal-Wallis y se correlacionó con variables antropométricas mediante la correlación de Spearman. Se utilizó regresión lineal con EMAP como variable dependiente y el resto de variables como predictores. El análisis de los datos se realizó mediante el software SPSS® (versión 17.0) con un nivel de significancia del 5%. Resultados: se evaluaron 828 adolescentes, 57,6% mujeres, con una edad media de 16,13 ± 1,20 años. EMAP tuvo un valor promedio de 18.0 mm en mujeres y 21.0 mm en hombres. La medida fue mayor en varones, en estadios más avanzados de maduración sexual, sobrepeso y practicantes de actividad física. Presentó una correlación moderada con MLG, IMLG, grasa corporal y CB. En el modelo final de regresión lineal múltiple para mujeres, las variables CB y grasa corporal explican el 20,1%; para los hombres, las variables CB y MLG explican el 30,5% de la variabilidad EMAP. Conclusión: Se recomienda que EMAP se utilice de forma complementaria en la valoración nutricional de adolescentes

Indicadores de adiposidade como m?todo de rastreamento para polissonografia em trabalhadores de turno.

Objective: to verify the discriminatory power of adiposity indicators in the prediction of obstructive sleep apnoea (OSA) in shift workers. Methods: a crosssectional study carried out in an iron ore extraction company, in Minas Gerais, Brazil. Anthropometric data were collected and polysomnography (PSG) was performed in 118 male shift workers who owned at least one overall risk factor for cardiovascular disease. Results: the OSA prevalence in the sample was 84.7%. Among the adiposity indicators used to predict OSA (? 5 events/hour), body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and total body fat (TBF) showed sensitivity values higher than 70%. Visceral fat (VF), neck circumference (NC), and neck-to-height ratio (NHtR) were the most effective in correctly identifying workers without OSA (specificity values higher than 70%). The areas under the receiver operating characteristic (ROC) curves for WC and NHtR were greater than 0.7, which indicated the test was effective in discriminating individuals with OSA. Conclusions: alterations in abdomen and neck adiposity indicators have a significant relationship with the presence of OSA and showed effectiveness as a screening method for PSG. WC and NHtR are considered good indicators for OSA prediction.Objetivo: verificar o potencial discriminat?rio dos indicadores de adiposidade na predi??o da apneia obstrutiva do sono (AOS) em trabalhadores de turnos. M?todos: estudo transversal realizado em uma empresa de extra??o de min?rio de ferro, em Minas Gerais, Brasil. Dados antropom?tricos foram coletados e polissonografia (PSG) foi realizada em 118 trabalhadores de turno do sexo masculino que possu?am ao menos um fator de risco global para doen?a cardiovascular. Resultados: a preval?ncia de AOS na amostra foi de 84,7%. Entre os indicadores de adiposidade usados para predizerem a AOS (? 5 eventos/ hora), o ?ndice de massa corporal (IMC), a circunfer?ncia da cintura (CC), a rela??o cintura/estatura (RCE) e a gordura corporal total (GCT), revelaram valores de sensibilidade acima de 70%. Gordura visceral (GV), circunfer?ncia do pesco?o (CP) e rela??o pesco?o-estatura (RPE) foram as mais efetivas em identificar corretamente trabalhadores sem AOS (valores de especificidade acima de 70%). As ?reas sob a curva de Caracter?stica de Opera??o do Receptor (COR) para CC e RPE foram maiores que 0,7, o que indicou que o teste foi eficaz na discrimina??o de indiv?duos com AOS. Conclus?es: altera??es nos indicadores de adiposidade abdominal e cervical t?m rela??o significativa com a presen?a de AOS e demostraram efic?cia como m?todo de rastreamento para PSG. CC e RPE s?o considerados bons indicadores para predizerem a AOS

IGF2, LEPR, POMC, PPARG, and PPARGC1 gene variants are associated with obesity-related risk phenotypes in Brazilian children and adolescents.

Association studies of genetic variants and obesity and/or obesity-related risk factors have yielded contradictory results. The aim of the present study was to determine the possible association of five single-nucleotide polymorphisms (SNPs) located in the IGF2, LEPR, POMC, PPARG, and PPARGC1 genes with obesity or obesity-related risk phenotypes. This case-control study assessed overweight (n=192) and normal-weight (n=211) children and adolescents. The SNPs were analyzed using minisequencing assays, and variables and genotype distributions between the groups were compared using one-way analysis of variance and Pearson?s chi-square or Fisher?s exact tests. Logistic regression analysis adjusted for age and gender was used to calculate the odds ratios (ORs) for selected phenotype risks in each group. No difference in SNP distribution was observed between groups. In children, POMC rs28932472(C) was associated with lower diastolic blood pressure (P=0.001), higher low-density lipoprotein (LDL) cholesterol (P=0.014), and higher risk in overweight children of altered total cholesterol (OR=7.35, P=0.006). In adolescents, IGF2 rs680(A) was associated with higher glucose (P=0.012) and higher risk in overweight adolescents for altered insulin (OR=10.08, P=0.005) and homeostasis model of insulin resistance (HOMA-IR) (OR=6.34, P=0.010). PPARG rs1801282(G) conferred a higher risk of altered insulin (OR=12.31, P=0.003), and HOMA-IR (OR=7.47, P=0.005) in overweight adolescents. PARGC1 rs8192678(A) was associated with higher triacylglycerols (P=0.005), and LEPR rs1137101(A) was marginally associated with higher LDL cholesterol (P=0.017). LEPR rs1137101(A) conferred higher risk for altered insulin, and HOMA-IR in overweight adolescents. The associations observed in this population suggested increased risk for cardiovascular diseases and/or type 2 diabetes later in life for individuals carrying these allele

Prevalence and risk factors associated with peripheral arterial disease in the hearts of Brazil project

FUNDAMENTO: A doença arterial obstrutiva periférica (DAOP) está associada ao maior índice de risco cardiovascular. No Brasil, faltam dados sobre sua prevalência e fatores de risco. OBJETIVO: Avaliar prevalência e fatores de risco associados à DAOP nas cidades brasileiras com > cem mil habitantes. MÉTODOS: Estudo transversal, multicêntrico, que avaliou 1.170 indivíduos (>18 anos), em 72 centros urbanos, participantes do Projeto Corações do Brasil. O diagnóstico de DAOP baseou-se na medida do índice tornozelo-braquial (ITB) < 0,90. A análise estatística utilizou teste Qui-quadrado (Pearson) corrigido para amostras complexas e intervalos de confiança. P < 0,05 foi considerado significativo. RESULTADOS: A prevalência de DAOP foi de 10,5% e apenas 9% dos portadores da doença apresentaram claudicação. A DAOP esteve associada à presença de diabetes, obesidade total e abdominal, acidente vascular cerebral (AVC) e doença isquêmica do coração (DIC). Houve tendência a maior prevalência de DAOP na presença de hipertensão, insuficiência cardíaca, insuficiência renal dialítica e tabagismo >20 anos/maço. Mulheres coronariopatas apresentaram risco 4,9 vezes maior de ter DAOP, do que aquelas sem coronariopatia e, entre homens diabéticos, o risco de DAOP foi 6,6 maior em comparação aos não diabéticos. CONCLUSÃO: A prevalência de DAOP foi elevada, considerando-se a baixa média de idade da população avaliada (44&plusmn;14,7 anos). A minoria dos portadores apresentava claudicação, o que denota o grande contingente de indivíduos assintomáticos. Os fatores mais fortemente associados à doença foram diabetes, obesidade, AVC e DIC. Os autores concluíram que a medida do ITB deve ser considerada na avaliação de pacientes de moderado e alto risco cardiovascular.BACKGROUND: Peripheral arterial disease (PAD) is associated with increased cardiovascular risk. In Brazil, data on PAD prevalence and risk factors are scarce. OBJECTIVE: To assess prevalence and risk factors related to PAD in Brazilian urban centers with more than 100,000 inhabitants. METHODS: National, multicenter, cross-sectional study of 1,170 individuals (>18 years), from 72 major Brazilian urban centers participating in the "Hearts of Brazil Project". PAD diagnosis was based on ankle-brachial index (ABI) < 0.90. The statistical analysis used the corrected Chi-square (Pearson) test for complex samples and confidence intervals. P< 0.05 was considered statitically significant. RESULTS: PAD prevalence was 10.5%. Intermittent claudication (IC) was present in only 9% of PAD patients. A significant association was found between PAD and the following factors: diabetes, total and abdominal obesity, stroke and ischemic heart disease (IHD). There was a trend of higher PAD prevalence among individuals with hypertension, heart failure, chronic renal failure on dialysis, as well as those who had smoked over 20 pack-years. For females, presence of IHD was associated with a 4.9-fold greater risk of PAD. Among males, a 6.6-fold increased risk of PAD was found for diabetic in comparison to non-diabetic individuals. CONCLUSION: PAD prevalence was markedly high, considering the low mean age of the studied population (44&plusmn;14.7 yrs). IC was detected in a minority of PAD subjects, indicating a considerable number of asymptomatic individuals. Diabetes, obesity, stroke and IHD were the stronger predictors of PAD. The authors concluded that ABI measurement should be considered in the evaluation of moderate to high cardiovascular risk patients.Empresa Libbs Farmacêutic