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

The 2008 financial crisis: government discourses and strategies and pension funds in Brazil

Dans cet article, on examine la crise commencée en 2008. Sous l'inspiration des travaux de Lebaron (2010; 2011) et Grun (2010), on essaie de saisir la "dimension cognitive" de la crise, à travers les discours produits (et reproduits) par des membres du gouvernement engagés dans le contrôle de la crise et du secteur des fonds de pension, ainsi que de leurs stratégies effectives. La méthode couvre l'analyse de documents produits par le secteur des fonds de pension et par le gouvernement Lula pendant l'année 2008, ainsi que les retombées des discours et des stratégies menées. Le texte montre la construction d'un discours soulignant l'importance de la régulation par l'État (par opposition au discours de l'autorégulation du marché) et la participation centrale des fonds de pension pendant le processus, puisque ceux-ci avaient abandonné en partie les titres publics et migré vers l'investissement productif, alliés au secteur de private equity, surtout en ce qui concerne le financement des chantiers du Programme d'Accélération de la Croissance.This article focuses on the financial crisis beginning in 2008. Drawing on the work of Lebaron (2010; 2011) and (Grün 2010), the study seeks to grasp the "cognitive dimension" of the crisis through the discourses produced (and reproduced) by members of the Brazilian government involved in controlling the crisis and by the pension fund sector and its strategies. The method was based on analysis of documents produced by the pension fund sector and the Lula Administration in 2008 and the spinoffs of the discourses and strategies. The text indicates the construction of a discourse emphasizing the importance of state regulation (as opposed to market self-regulation) and the central role of pension funds during the process, since they partially abandoned government bonds and migrated to productive investment, in alliance with the private equity sector, especially in financing construction works under the Growth Acceleration Program

FERREIRA, Mary. Os bastidores da tribuna: mulher, política e poder no Maranhão.

http://dx.doi.org/10.1590/S0104-026X201200030002

“Domesticação” e/ou “Moralização do Capitalismo” no Governo Lula: Inclusão Social Via Mercado e Via Fundos de Pensão

Dans cet article, on suggère l'inclusion sociale dans le gouvernement Lula par le biais du marché et surtout via Fonds de Pension. Le dialogue entre le gouvernement et les syndicats, les centrales syndicales et le marché financier montre une convergence d'intérêts des acteurs cités, qui s'exprime par différentes actions symboliques/ discursives et effectives dans le marché financier. L'argument présenté, c'est que la politique d'inclusion sociale, par le marché, traduit le projet de "domestication" et/ou "moralisation" du capitalisme défendu et mis en uvre par le Parti des Travailleurs (PT). On a utilisé des publications de la presse nationale, des revues spécialisées, des secteurs représentant les assurances santé privées, et des entretiens avec des syndicalistes brésiliens et avec des membres du gouvernement Lula.The article suggests social inclusion via the market and especially via pension funds in the Lula Administration. It shows how the dialogue between government, trade unions, union confederations, and the financial market reveals a convergence of interests among the above-mentioned actors, expressed in various symbolic/discursive actions in the financial market. The argument is that social inclusion policy via the market translates the project of "domestication and/or moralization" of capitalism as defended and practiced by the Brazilian Workers' Party (PT). The article uses empirical material collected from the Brazilian press, specialized journals, representative agencies from the private pension sector, and interviews with Brazilian trade union leaders and members of the Lula Administration

Presença de centrais e sindicatos no mercado financeiro: criação e gestão de fundos de pensão

This article addresses the interest of central trade unions and unions for the creation and management of pension funds in Brazil during the Lula government, and points out the reasons and beliefs generated by the union members engaged in this strategy. Our conclusion indicates that until the present time (the end of the Lula government), union funds were not effectively regulated by the government, but union members occupy key positions in the financial market and in managing public pension funds, such as Previ and Petros, directly and indirectly infl uencing the precise configuration of contemporary capitalism in Brazil.O texto aborda o interesse de sindicatos e centrais sindicais pela criação e gestão de fundos de pensão no Brasil, durante o governo Lula, apontando as justificativas e crenças criadas pelos sindicalistas engajados nessa estratégia. Conclui que até o momento atual (fim do governo Lula), os fundos sindicais não foram efetivamente consolidados pelo governo, mas que sindicalistas ocupam postoschaves no mercado financeiro e na gestão de fundos de pensão de patrocínio público, tais como Previ e Petros, infl uenciando direta e indiretamente nas configurações precisas do capitalismo contemporâneo brasileiro