Author
Ana Luiza Lima Souza
Bio: Ana Luiza Lima Souza is an academic researcher from Universidade Federal de Goiás. The author has contributed to research in topics: Medicine & Morning. The author has an hindex of 3, co-authored 10 publications receiving 124 citations.
Topics: Medicine, Morning, Evening, Exercise intensity, Pulse wave velocity
Papers
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Federal University of Rio de Janeiro1, Rio de Janeiro State University2, Oswaldo Cruz Foundation3, Brazilian Institute of Geography and Statistics4, Sao Paulo State University5, Federal University of Pará6, Universidade Federal de Goiás7, State University of Feira de Santana8, Universidade Federal do Rio Grande do Sul9, Federal University of Amazonas10, Universidade Federal de Minas Gerais11, Universidade Federal do Amapá12, Universidade Federal do Espírito Santo13, University of São Paulo14, Universidade Federal de Santa Catarina15, Federal University of Rio Grande do Norte16, Universidade Federal de Mato Grosso17, State University of Campinas18, Federal University of Bahia19, Pontifícia Universidade Católica do Paraná20, Federal University of Pernambuco21, University of Brasília22, Universidade Federal de Rondônia23, Federal University of Piauí24, Universidade Federal do Acre25, Federal University of Maranhão26, Federal University of Ceará27, Universidade Federal de Sergipe28, Federal University of Paraíba29, Federal University of Alagoas30, Federal University of Roraima31
TL;DR: The study findings will be instrumental to the development of public policies aiming at the prevention of obesity, atherosclerotic diseases and diabetes in an adolescent population.
Abstract: The Study of Cardiovascular Risk in Adolescents (Portuguese acronym, “ERICA”) is a multicenter, school-based country-wide cross-sectional study funded by the Brazilian Ministry of Health, which aims at estimating the prevalence of cardiovascular risk factors, including those included in the definition of the metabolic syndrome, in a random sample of adolescents aged 12 to 17 years in Brazilian cities with more than 100,000 inhabitants. Approximately 85,000 students were assessed in public and private schools. Brazil is a continental country with a heterogeneous population of 190 million living in its five main geographic regions (North, Northeast, Midwest, South and Southeast). ERICA is a pioneering study that will assess the prevalence rates of cardiovascular risk factors in Brazilian adolescents using a sample with national and regional representativeness. This paper describes the rationale, design and procedures of ERICA.
143 citations
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TL;DR: A participacao da enfermagem, junto com a equipe de saude tem propiciado maior eficacia do servico, oferecendo excelente campo de treinamento a profissionais em formacao.
Abstract: A liga de Hipertensao Arterial (LHA) criada em 1989, visando ser centro de tratamento, ensino e pesquisa em hipertensao, tem funcionado de maneira modelar, possibilitando trabalho multidisciplinar, valorizando as acoes da equipe saude. Nesta estrutura, a enfermagem representa importante pilar de sustentacao, participando com 50% das acoes. Seu trabalho consiste no atendimento propriamente dito (pre-consultas, pos-consultas e consultas), participacao nas reunioes da equipe com os pacientes (Clube do Hipertenso), elaboracao e execucao de projetos de pesquisa e coordenacao de servico. A participacao da enfermagem, junto com a equipe de saude tem propiciado maior eficacia do servico, oferecendo excelente campo de treinamento a profissionais em formacao.
10 citations
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TL;DR: In this paper , Dzau et al. define a continuum of envelhecimento vascular, which is defined as the interação entre genética, idade cronológica, and fatores externos.
Abstract: Resumo O envelhecimento biológico é reflexo da interação entre genética, idade cronológica e fatores externos; é a base para novos conceitos em envelhecimento vascular, cuja progressão é determinada pela diferença entre idade biológica e cronológica. Do ponto de vista estrutural, os efeitos do envelhecimento vascular são mais evidentes na camada média das grandes artérias elásticas e resultam em aumento da rigidez arterial, da dilatação do lúmen e da espessura da parede. Esses efeitos são descritos no continuum de envelhecimento cardiovascular (proposto por Dzau em 2010) em que as etapas progressivas de lesões da microvasculatura de coração, rins e cérebro, têm início a partir do processo de envelhecimento. O aumento da rigidez arterial pode ser verificado de forma não invasiva por vários métodos. Os eventos cardiovasculares têm sido tradicionalmente previstos utilizando escores que combinam fatores de risco convencionais para aterosclerose. No continuum cardiovascular clássico (Dzau, 2006), é desafiador avaliar o peso exato da contribuição de cada fator de risco; entretanto, por refletir o dano precoce e cumulativo desses fatores de riscos cardiovascular, a rigidez arterial reflete o verdadeiro dano à parede arterial. Este artigo fornece uma visão geral dos mecanismos da fisiopatogenia, alterações estruturais das artérias e consequências hemodinâmicas do envelhecimento arterial; métodos não invasivos para a avaliação da rigidez arterial e da medida central da pressão arterial; o continuum de envelhecimento cardiovascular, e aplicação do conceito de rigidez arterial na estratificação de risco cardiovascular.
8 citations
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TL;DR: A BP control rate around 70% was found in patients attending a multidisciplinary team care center for hypertension, and focus on patients with diabetes, younger than 60 years and males should be given to further improve these results.
Abstract: Resumo Fundamento Apesar de se recomendar a intervencao em equipe no tratamento da hipertensao, resultados dessa abordagem em ambientes do mundo real sao escassos na literatura. Objetivos Apresentar os resultados de uma estrategia terapeutica baseada em equipe, de longo prazo, de pacientes hipertensos em um servico de saude. Metodos Dados de pacientes hipertensos acompanhados em um centro de tratamento multidisciplinar localizado na regiao centro-oeste do Brasil em junho de 2017 com pelo menos duas visitas de acompanhamento foram avaliados retrospectivamente. [...]
8 citations
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TL;DR: This study is the first to establish reference and normal values for PWV, combining a sizeable European population after standardizing results for different methods of PWV measurement.
Abstract: Aims Carotid–femoral pulse wave velocity (PWV), a direct measure of aortic stiffness, has become increasingly important for total cardiovascular (CV) risk estimation. Its application as a routine tool for clinical patient evaluation has been hampered by the absence of reference values. The aim of the present study is to establish reference and normal values for PWV based on a large European population. Methods and results We gathered data from 16 867 subjects and patients from 13 different centres across eight European countries, in which PWV and basic clinical parameters were measured. Of these, 11 092 individuals were free from overt CV disease, non-diabetic and untreated by either anti-hypertensive or lipid-lowering drugs and constituted the reference value population, of which the subset with optimal/normal blood pressures (BPs) (n = 1455) is the normal value population. Prior to data pooling, PWV values were converted to a common standard using established conversion formulae. Subjects were categorized by age decade and further subdivided according to BP categories. Pulse wave velocity increased with age and BP category; the increase with age being more pronounced for higher BP categories and the increase with BP being more important for older subjects. The distribution of PWV with age and BP category is described and reference values for PWV are established. Normal values are proposed based on the PWV values observed in the non-hypertensive subpopulation who had no additional CV risk factors. Conclusion The present study is the first to establish reference and normal values for PWV, combining a sizeable European population after standardizing results for different methods of PWV measurement.
1,371 citations
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715 citations
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Federal University of Rio de Janeiro1, Oswaldo Cruz Foundation2, Rio de Janeiro State University3, Universidade Federal do Rio Grande do Sul4, Brazilian Institute of Geography and Statistics5, Federal University of Pará6, University of São Paulo7, State University of Feira de Santana8, Universidade Federal de Minas Gerais9, Universidade Federal do Amapá10, Federal University of Amazonas11, Universidade Federal do Espírito Santo12, Universidade Federal de Santa Catarina13, Federal University of Rio Grande do Norte14, Universidade Federal de Mato Grosso15, Federal University of Bahia16, Pontifícia Universidade Católica do Paraná17, Federal University of Pernambuco18, University of Brasília19, Universidade Federal de Rondônia20, State University of Campinas21, Federal University of Piauí22, Universidade Federal de Goiás23, Federal University of Maranhão24, Federal University of Ceará25, Universidade Federal de Sergipe26, Federal University of Paraíba27, Federal University of Alagoas28, Sao Paulo State University29
TL;DR: The study indicates that the control of obesity would lower the prevalence of hypertension among Brazilian adolescents by 1/5 and the fractions of hypertension attributable to obesity in the population by 17.8%.
Abstract: OBJECTIVE To estimate the prevalence of arterial hypertension and obesity and the population attributable fraction of hypertension that is due to obesity in Brazilian adolescents. METHODS Data from participants in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), which was the first national school-based, cross-section study performed in Brazil were evaluated. The sample was divided into 32 geographical strata and clusters from 32 schools and classes, with regional and national representation. Obesity was classified using the body mass index according to age and sex. Arterial hypertension was defined when the average systolic or diastolic blood pressure was greater than or equal to the 95th percentile of the reference curve. Prevalences and 95% confidence intervals (95%CI) of arterial hypertension and obesity, both on a national basis and in the macro-regions of Brazil, were estimated by sex and age group, as were the fractions of hypertension attributable to obesity in the population. RESULTS We evaluated 73,399 students, 55.4% female, with an average age of 14.7 years (SD = 1.6). The prevalence of hypertension was 9.6% (95%CI 9.0-10.3); with the lowest being in the North, 8.4% (95%CI 7.7-9.2) and Northeast regions, 8.4% (95%CI 7.6-9.2), and the highest being in the South, 12.5% (95%CI 11.0-14.2). The prevalence of obesity was 8.4% (95%CI 7.9-8.9), which was lower in the North region and higher in the South region. The prevalences of arterial hypertension and obesity were higher in males. Obese adolescents presented a higher prevalence of hypertension, 28.4% (95%CI 25.5-31.2), than overweight adolescents, 15.4% (95%CI 17.0-13.8), or eutrophic adolescents, 6.3% (95%CI 5.6-7.0). The fraction of hypertension attributable to obesity was 17.8%. CONCLUSIONS ERICA was the first nationally representative Brazilian study providing prevalence estimates of hypertension in adolescents. Regional and sex differences were observed. The study indicates that the control of obesity would lower the prevalence of hypertension among Brazilian adolescents by 1/5.
147 citations
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TL;DR: The diets of Brazilian adolescents were characterized by the intake of traditional Brazilian food, such as rice and beans, as well as by high intake of sugar through sweetened beverages and processed foods, associated with an excessive intake of sodium, saturated fatty acids and free sugar.
Abstract: OBJECTIVE To describe food and macronutrient intake profile and estimate the prevalence of inadequate micronutrient intake of Brazilian adolescents. METHODS Data from 71,791 adolescents aged from 12 to 17 years were evaluated in the 2013-2014 Brazilian Study of Cardiovascular Risks in Adolescents (ERICA). Food intake was estimated using 24-hour dietary recall (24-HDR). A second 24-HDR was collected in a subsample of the adolescents to estimate within-person variability and calculate the usual individual intake. The prevalence of food/food group intake reported by the adolescents was also estimated. For sodium, the prevalence of inadequate intake was estimated based on the Tolerable Upper Intake Level (UL). The Estimated Average Requirement (EAR) method used as cutoff was applied to estimate the prevalence of inadequate nutrient intake. All the analyses were stratified according to sex, age group and Brazilian macro-regions. All statistical analyses accounted for the sample weight and the complex sampling design. RESULTS Rice, beans and other legume, juice and fruit drinks, breads and meat were the most consumed foods among the adolescents. The average energy intake ranged from 2,036 kcal (girls aged from 12 to 13 years) to 2,582 kcal (boy aged from14 to 17 years). Saturated fat and free sugar intake were above the maximum limit recommended ( 50.0%). Sodium intake was above the UL for more than 80.0% of the adolescents. CONCLUSIONS The diets of Brazilian adolescents were characterized by the intake of traditional Brazilian food, such as rice and beans, as well as by high intake of sugar through sweetened beverages and processed foods. This food pattern was associated with an excessive intake of sodium, saturated fatty acids and free sugar.
82 citations
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Rio de Janeiro State University1, Federal University of Rio de Janeiro2, Oswaldo Cruz Foundation3, Universidade Federal do Rio Grande do Sul4, Brazilian Institute of Geography and Statistics5, Federal University of Pará6, University of São Paulo7, State University of Feira de Santana8, Federal University of Amazonas9, Universidade Federal de Minas Gerais10, Universidade Federal do Amapá11, Universidade Federal do Espírito Santo12, Universidade Federal de Santa Catarina13, Federal University of Rio Grande do Norte14, Universidade Federal de Mato Grosso15, Federal University of Bahia16, Pontifícia Universidade Católica do Paraná17, Federal University of Pernambuco18, University of Brasília19, Universidade Federal de Rondônia20, State University of Campinas21, Federal University of Piauí22, Universidade Federal do Acre23, Universidade Federal de Goiás24, Federal University of Maranhão25, Federal University of Ceará26, Universidade Federal de Sergipe27, Federal University of Paraíba28, Federal University of Alagoas29, Federal University of Roraima30, Sao Paulo State University31
TL;DR: Despite the prevalence of Metabolic Syndrome being low, the high prevalences of some components and participation of others in the syndrome composition shows the importance of early diagnosis of this changes, even if not grouped within the metabolic syndrome.
Abstract: OBJECTIVE To determine the prevalence of metabolic syndrome and its components in Brazilian adolescents. METHODS We evaluated 37,504 adolescents who were participants in the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, school-based, national study. The adolescents, aged from 12 to 17 years, lived in cities with populations greater than 100,000 inhabitants. The sample was stratified and clustered into schools and classes. The criteria set out by the International Diabetes Federation were used to define metabolic syndrome. Prevalences of metabolic syndrome were estimated according to sex, age group, school type and nutritional status. RESULTS Of the 37,504 adolescents who were evaluated: 50.2% were female; 54.3% were aged from 15 to 17 years, and 73.3% were from public schools. The prevalence of metabolic syndrome was 2.6% (95%CI 2.3-2.9), slightly higher in males and in those aged from 15 to 17 years in most macro-regions. The prevalence was the highest in residents from the South macro-region, in the younger female adolescents and in the older male adolescents. The prevalence was higher in public schools (2.8% [95%CI 2.4-3.2]), when compared with private schools (1.9% [95%CI 1.4-2.4]) and higher in obese adolescents when compared with nonobese ones. The most common combinations of components, referring to 3/4 of combinations, were: enlarged waist circumference (WC), low HDL-cholesterol (HDL-c) and high blood pressure; followed by enlarged WC, low HDL-c and high triglycerides; and enlarged WC, low HDL-c, high triglycerides and blood pressure. Low HDL was the second most frequent component, but the highest prevalence of metabolic syndrome (26.8%) was observed in the presence of high triglycerides. CONCLUSIONS ERICA is the first Brazilian nation-wide study to present the prevalence of metabolic syndrome and describe the role of its components. Despite the prevalence of Metabolic Syndrome being low, the high prevalences of some components and participation of others in the syndrome composition shows the importance of early diagnosis of this changes, even if not grouped within the metabolic syndrome.
76 citations