Qualidade de vida: percepção de idosos de uma unidade de saúde da família

Objective: to investigate the perception of a group of elderly in a Family Health Unit of Recife/PE, about quality of life. Method: qualitative study, conducted with ten elderly during home visits in April 2011, using semi-structured interview using a voice recorder. The material was analyzed through content analysis technique. Results: three categories were extracted: the definition of what is quality of life for the elderly, the significance of the loss of functional capacity and autonomy and the importance of home and family relationships. Conclusion: emerged clearly from the perception of older people that for them the quality of life is conditioned by the absence of disease, possession of a good financial resources, access to health services and family support to carry out their daily activities and caringObjetivo: investigar la percepción de un grupo de ancianos en una Unidad de Salud de la Familia de Recife/PE, sobre la calidad de vida. Método: estudio cualitativo, realizado con diez ancianos durante las visitas domiciliarias, en abril de 2011, mediante entrevista semi-estructurada con una grabadora de voz. El material fue analizado mediante la técnica de análisis de contenido. Resultados: fueron extraídas tres categorías: la definición de lo que es calidad de vida de los ancianos, el significado de la pérdida de capacidad funcional y de la autonomía y la importancia del hogar y las relaciones familiares. Conclusión: se percibió claramente la percepción de los ancianos que para ellos la calidad de vida está condicionada por la ausencia de enfermedad, la posesión de recursos financieros, el acceso a los servicios de salud y apoyo familiar para llevar a cabo sus actividades diarias y el cuidado.http://dx.doi.org/10.5902/217976925240Objetivo: investigar a percepção de um grupo de idosos de uma Unidade de Saúde da Família de Recife/PE, sobre qualidade de vida. Método: estudo qualitativo, realizado com dez idosos durante as visitas domiciliares em abril de 2011, utilizando a entrevista semiestruturada com uso de gravador de voz. O material foi analisado por meio da Técnica de Análise de Conteúdo. Resultados: foram extraídas três categorias: definição do que é qualidade de vida para os idosos; o significado da perda da capacidade funcional e da autonomia e a importância do lar e das relações familiares. Conclusão: emergiu claramente a percepção dos idosos de que para eles a qualidade de vida está condicionada a ausência de doenças, posse de um bom recurso financeiro, acesso aos serviços de saúde e apoio familiar para o desempenho das suas atividades cotidianas e no cuidar

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

Effectiveness of chlorthalidone plus amiloride for the prevention of hypertension the PREVER-Prevention Randomized Clinical Trial

Background-—Prehypertension is associated with higher cardiovascular risk, target organ damage, and incidence of hypertension. The Prevention of Hypertension in Patients with PreHypertension (PREVER-Prevention) trial aimed to evaluate the efficacy and safety of a low-dose diuretic for the prevention of hypertension and end-organ damage. Methods and Results-—This randomized, parallel, double-blind, placebo-controlled trialwas conducted in 21 Brazilian academicmedical centers. Participants with prehypertensionwho were aged 30 to70 years andwho did not reach optimal blood pressure after 3 months of lifestyle intervention were randomized to a chlorthalidone/amiloride combination pill or placebo and were evaluated every 3 months during 18 months of treatment. The primary outcome was incidence of hypertension. Development or worsening of microalbuminuria, new-onset diabetes mellitus, and reduction of left ventricular mass were secondary outcomes. Participant characteristics were evenly distributed by trial arms The incidence of hypertension was significantly lower in 372 study participants allocated to diuretics compared with358 allocated to placebo (hazard ratio 0.56, 95%CI 0.38–0.82), resulting in a cumulative incidence of11.7% in the diuretic arm versus 19.5% in the placebo arm(P=0.004). Adverse events; levels of blood glucose, glycosylated hemoglobin, creatinine, and microalbuminuria; and incidence of diabetes mellitus were no different between the 2 arms. Left ventricular mass assessed through Sokolow-Lyon voltage and voltage-duration product decreased to a greater extent in participants allocated to diuretic therapy compared with placebo (P=0.02). Conclusions-—A combination of low-dose chlorthalidone and amiloride effectively reduces the risk of incident hypertension and beneficially affects left ventricular mass in patients with prehypertension

Effectiveness of chlorthalidone plus amiloride for the prevention of hypertension the PREVER-Prevention Randomized Clinical Trial

Background-—Prehypertension is associated with higher cardiovascular risk, target organ damage, and incidence of hypertension. The Prevention of Hypertension in Patients with PreHypertension (PREVER-Prevention) trial aimed to evaluate the efficacy and safety of a low-dose diuretic for the prevention of hypertension and end-organ damage. Methods and Results-—This randomized, parallel, double-blind, placebo-controlled trialwas conducted in 21 Brazilian academicmedical centers. Participants with prehypertensionwho were aged 30 to70 years andwho did not reach optimal blood pressure after 3 months of lifestyle intervention were randomized to a chlorthalidone/amiloride combination pill or placebo and were evaluated every 3 months during 18 months of treatment. The primary outcome was incidence of hypertension. Development or worsening of microalbuminuria, new-onset diabetes mellitus, and reduction of left ventricular mass were secondary outcomes. Participant characteristics were evenly distributed by trial arms The incidence of hypertension was significantly lower in 372 study participants allocated to diuretics compared with358 allocated to placebo (hazard ratio 0.56, 95%CI 0.38–0.82), resulting in a cumulative incidence of11.7% in the diuretic arm versus 19.5% in the placebo arm(P=0.004). Adverse events; levels of blood glucose, glycosylated hemoglobin, creatinine, and microalbuminuria; and incidence of diabetes mellitus were no different between the 2 arms. Left ventricular mass assessed through Sokolow-Lyon voltage and voltage-duration product decreased to a greater extent in participants allocated to diuretic therapy compared with placebo (P=0.02). Conclusions-—A combination of low-dose chlorthalidone and amiloride effectively reduces the risk of incident hypertension and beneficially affects left ventricular mass in patients with prehypertension