Development, validation, and reproducibility of food group-based frequency questionnaires for clinical use in Brazil : a pre-hypertension and hypertension diet assessment

The Blood pressure control diet is well described; however, it has not been implemented in clinical care, possibly due to the impracticability of the diet assessment in these contexts. In order to facilitate the dietary assessment, we developed and assessed the validity and reproducibility of two food group-based food frequency questionnaires (FG-FFQs), with a one-week (7-day FG-FFQ) and a one-month (30-day FG-FFQ) period of coverage for patients with pre-hypertension or hypertension. In 2010, 155 men and women, 30–70 years old, were invited to participate in a prospective study in two outpatient clinics in Porto Alegre, southern Brazil. The participants responded to two 30-day, two 7-day FG-FFQ, four 24-h dietary recalls, and underwent demographic, anthropometric, and blood pressure assessments. The validity and reproducibility were assessed using partial correlation coefficients adjusted for sex and age, and the internal validity was tested using the intra-class correlation coefficient. The participants were aged 61 ( 10) years and 60% were women. The validity correlation coefficient was higher than r = 0.80 in the 30-day FG-FFQ for whole bread (r = 0.81) and the 7-day FG-FFQ for diet/light/zero soda and industrialized juices (r = 0.84) in comparison to the 24-h dietary recalls. The global internal validity was = 0.59, but it increased to = 0.76 when 19 redundant food groups were excluded. The reproducibility was higher than r = 0.80 for pasta, potatoes and manioc, bakery goods, sugar and cocoa, and beans for both versions. The 30-day had a slightly higher validity, both had good internal validity, and the 7-day FG-FFQ had a higher reproducibility

Alterações morfométricas, metabólicas e hemodinâmicas em ratos sumetidos à dieta de cafeteria

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Prevention of hypertension in patients with pre-hypertension: protocol for the PREVER-prevention trial

<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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 outcomes will be the incidence of hypertension, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new sub-clinical atherosclerosis, and sudden death. The study will last 18 months. The sample size was calculated on the basis of an incidence of hypertension of 14% in the control group, a size effect of 40%, power of 85% and P alpha of 5%, resulting in 625 participants per group. The project was approved by the Ethics committee of each participating institution.</p> <p>Discussion</p> <p>The early use of blood pressure-lowering drugs, particularly diuretics, which act on the main mechanism of blood pressure rising with age, may prevent cardiovascular events and the incidence of hypertension in individuals with hypertension. If this intervention shows to be effective and safe in a population-based perspective, it could be the basis for an innovative public health program to prevent hypertension in Brazil.</p> <p>Trial Registration</p> <p>Clinical Trials <a href="http://www.clinicaltrials.gov/ct2/show/NCT00970931">NCT00970931</a>.</p

Efeitos do suco de uva preta na modulação redox sensível do remodelamento ventricular direito em modelo de hipertensão arterial pulmonar

Este estudo foi delineado com o objetivo de investigar o envolvimento de vias de sinalização redox-sensíveis e a modulação destas pelo tratamento com suco de uva preta na progressão da hipertrofia ventricular compensatória à insuficiência cardíaca (IC) direita em resposta a sobrecarga de pressão crônica em modelo de hipertensão arterial pulmonar (HAP) induzida por monocrotalina (MCT). Para avaliarmos esta hipótese, utilizamos ratos Wistar machos recém desmamados, divididos quatro grupos experimentais, controle água; MCT água; controle suco; e MCT suco; tratados por seis semanas com água ou suco (10ml/kg/dia) através de sonda intragástrica. Na terceira semana, uma dose única de MCT (60mg/kg) foi administrada i.p. Ao final do protocolo, foram realizadas as avaliações ecocardiográficas e hemodinâmicas. Após os animais foram mortos por deslocamento cervical, o coração foi retirado e as câmaras separadas para as avaliações morfométricas. Todas as análises foram realizadas no tecido ventricular direito e constaram da determinação das concentrações de H2O2 e imunodetecção do conteúdo de Trx1, p-ERK1/2, p-Akt, p-JNK e caspase-3, através da técnica de Western blot. A indução de HAP por MCT após três semanas resultou em aumento na resistência vascular pulmonar, pressão sistólica e diastólica final do ventrículo direito, sem alterações na função ventricular esquerda. A presença de hipertrofia ventricular direita foi constatada, e acompanhada da ativação de p-ERK1/2 mediada pelo sistema H2O2-Trx1, associada ao aumento da expressão de caspase-3, mas não p-JNK ou p-Akt. O pré-tratamento com suco de uva resultou em melhora da resistência vascular pulmonar e parâmetros hemodinâmicos. Apesar de não reduzir a hipertrofia ventricular direita, resultou em inibição da sinalização mediada pelo H2O2 através do aumento da imunodetecção de Trx1 e redução de caspase-3. A indução de adaptação através de uma ação pró-oxidante do suco de uva pode ser um dos fatores envolvidos na melhora das respostas cardíacas.This study was designed with the aim of investigate the involvement of redox-sensitive pathways and the role of purple grape juice treatment in the progression of compensatory ventricular hypertrophy to right heart failure in response to chronic pressure overload in monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH). To test this hypothesis, we used just-weaned male Wistar rats separated in four groups: water control; water MCT; juice control; and juice MCT, treated for 6 weeks with water or purple grape juice (10ml/kg) by gavage. On the third week, a single injection of MCT (60 mg/kg body weight i.p.) or equal volume of saline was administrated. At the end of the protocol animals were assessed echocardiographycally and hemodynamically. After that, animals were killed by cervical dislocation, the heart was removed and chambers separated to morphological evaluations. All analysis was performed in the right ventricle tissue and consisted to the determination of H2O2 concentration, and protein expression of Trx1, p-ERK1/2, p-JNK and cleaved caspase-3, through Western blot technique. MCT-induced PAH resulted, after three weeks, in increased pulmonary vascular resistance, right ventricle systolic and final diastolic pressure, without any change in the left ventricular function. The right ventricle hypertrophy was evidenced and followed by H2O2-Trx1 system activation of ERK1/2 related to increased cleaved caspase-3 expression, but not p-JNK or p-Akt. The pre-treatment with purple grape juice decreased pulmonary vascular resistance and hemodynamic parameters. Despite that no changes in ventricular hypertrophy were seen, purple grape juice was capable to inhibit H2O2 signaling through a potentiaded imunodetection of Trx1 and reduced cleaved caspase-3 expression. Purple grape juice induced an adaptation process acting as a pro-oxidant agent wich may be one of the factors involved in the improvement of cardiac performance

Efeitos do suco de uva preta na modulação redox sensível do remodelamento ventricular direito em modelo de hipertensão arterial pulmonar

Este estudo foi delineado com o objetivo de investigar o envolvimento de vias de sinalização redox-sensíveis e a modulação destas pelo tratamento com suco de uva preta na progressão da hipertrofia ventricular compensatória à insuficiência cardíaca (IC) direita em resposta a sobrecarga de pressão crônica em modelo de hipertensão arterial pulmonar (HAP) induzida por monocrotalina (MCT). Para avaliarmos esta hipótese, utilizamos ratos Wistar machos recém desmamados, divididos quatro grupos experimentais, controle água; MCT água; controle suco; e MCT suco; tratados por seis semanas com água ou suco (10ml/kg/dia) através de sonda intragástrica. Na terceira semana, uma dose única de MCT (60mg/kg) foi administrada i.p. Ao final do protocolo, foram realizadas as avaliações ecocardiográficas e hemodinâmicas. Após os animais foram mortos por deslocamento cervical, o coração foi retirado e as câmaras separadas para as avaliações morfométricas. Todas as análises foram realizadas no tecido ventricular direito e constaram da determinação das concentrações de H2O2 e imunodetecção do conteúdo de Trx1, p-ERK1/2, p-Akt, p-JNK e caspase-3, através da técnica de Western blot. A indução de HAP por MCT após três semanas resultou em aumento na resistência vascular pulmonar, pressão sistólica e diastólica final do ventrículo direito, sem alterações na função ventricular esquerda. A presença de hipertrofia ventricular direita foi constatada, e acompanhada da ativação de p-ERK1/2 mediada pelo sistema H2O2-Trx1, associada ao aumento da expressão de caspase-3, mas não p-JNK ou p-Akt. O pré-tratamento com suco de uva resultou em melhora da resistência vascular pulmonar e parâmetros hemodinâmicos. Apesar de não reduzir a hipertrofia ventricular direita, resultou em inibição da sinalização mediada pelo H2O2 através do aumento da imunodetecção de Trx1 e redução de caspase-3. A indução de adaptação através de uma ação pró-oxidante do suco de uva pode ser um dos fatores envolvidos na melhora das respostas cardíacas.This study was designed with the aim of investigate the involvement of redox-sensitive pathways and the role of purple grape juice treatment in the progression of compensatory ventricular hypertrophy to right heart failure in response to chronic pressure overload in monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH). To test this hypothesis, we used just-weaned male Wistar rats separated in four groups: water control; water MCT; juice control; and juice MCT, treated for 6 weeks with water or purple grape juice (10ml/kg) by gavage. On the third week, a single injection of MCT (60 mg/kg body weight i.p.) or equal volume of saline was administrated. At the end of the protocol animals were assessed echocardiographycally and hemodynamically. After that, animals were killed by cervical dislocation, the heart was removed and chambers separated to morphological evaluations. All analysis was performed in the right ventricle tissue and consisted to the determination of H2O2 concentration, and protein expression of Trx1, p-ERK1/2, p-JNK and cleaved caspase-3, through Western blot technique. MCT-induced PAH resulted, after three weeks, in increased pulmonary vascular resistance, right ventricle systolic and final diastolic pressure, without any change in the left ventricular function. The right ventricle hypertrophy was evidenced and followed by H2O2-Trx1 system activation of ERK1/2 related to increased cleaved caspase-3 expression, but not p-JNK or p-Akt. The pre-treatment with purple grape juice decreased pulmonary vascular resistance and hemodynamic parameters. Despite that no changes in ventricular hypertrophy were seen, purple grape juice was capable to inhibit H2O2 signaling through a potentiaded imunodetection of Trx1 and reduced cleaved caspase-3 expression. Purple grape juice induced an adaptation process acting as a pro-oxidant agent wich may be one of the factors involved in the improvement of cardiac performance