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Friday, October 28, 2005

MDGs: chronic diseases are not on the agenda

The Lancet:
Valentin Fuster and Janet Voûte

"2005 marks the fifth anniversary of the adoption of the UN's Millennium Declaration, signed by 189 countries and translated into eight Millennium Development Goals (MDGs) to be accomplished by the year 2015. The medical and public-health communities should rejoice that these eight goals include three specifically focused on health. There is a growing recognition worldwide that the time has come to fulfil the long-standing pledge to make health services available for all.1 The three explicit health goals elaborated in 2000 were: to reduce child mortality by two-thirds relative to 1990; to improve maternal health, including reducing maternal mortality by three-quarters relative to 1990; and to prevent the spread of HIV/AIDS, malaria, and other diseases. But, in 2000, and again during a ten-taskforce review in 2005, cardiovascular disease (CVD) and other chronic diseases are not mentioned. This omission can, and must, be rectified."/.../

Thursday, October 27, 2005


De: Carlos Alberto Machado []
Enviada em: quinta-feira, 27 de outubro de 2005 22:26
Assunto: Fw: Fórum Hiperdia

Por favor, divulguem.

Carlos Alberto Machado
----- Original Message -----
From: "Patricia Serapião Coimbra"
Sent: Wednesday, October 26, 2005 3:07 PM
Subject: Fórum Hiperdia

Prezados membros da Comunidade Hiperdia:

Um dos mais freqüentes desejos dos técnicos e usuários do
Sistema Hiperdia tem sido a solicitação para a formação de um espaço
destinado à troca de experiências, críticas e sugestões.

Rotineiramente, a equipe de desenvolvimento e manutenção do
*Sistema Hiperdia* recebe mensagens e ligações dos muitos usuários, ora
fazendo consultas, ora elogiando o produto, ora apresentando
dificuldades, ora sugerindo modificações... enfim, um grande número de
pessoas que formam a Comunidade de Usuários do Hiperdia!

Assim sendo, nós, da Equipe Hiperdia, estamos comunicando a
criação de um FÓRUM para a discussão de assuntos ligados à Hipertensão e

Para acessar, clique aqui: *Fórum do Hiperdia*

Este espaço terá dois canais, assim dispostos:

O primeiro objetiva permitir a troca de informações sobre o
Programa (CNHD): - dúvidas sobre
medicamentos, acompanhamentos, fichas, adesão, etc...

O outro será indicado aos usuários e operadores do Sistema
hiperdia: - consultas sobre
backup, importação, transmissão, etc...

É nosso desejo que o *Fórum do Hiperdia*
se torne um importante
canal de comunicação envolvendo todos aqueles que se debruçam sobre esta
importante causa...

Obs.: Para utilizar o Fórum é necessário cadastrar-se através do botão
Registrar, localizado no menu de opções da página principal do
/ ou clicando no endereço abaixo:


Equipe Hiperdia

Tuesday, October 25, 2005

The Forgotten Majority. Unfinished Business in Cardiovascular Risk Reduction

The Forgotten Majority. Unfinished Business in Cardiovascular Risk Reduction
Peter Libby, MD
Boston, Massachusetts

Recommended by Marcelo Gustavo Colominas []Available on request.
Despite meaningful progress in the identification of risk factors and the development of highly effective clinical tools, deaths from cardiovascular disease continue to increase worldwide. Sparked by an obesity epidemic, the metabolic syndrome and the rising incidence of type 2 diabetes have led to an upsurge of cardiovascular risk. Although pharmacologic treatments with the statin class of drugs have reduced cholesterol levels and lowered mortality rates, several large controlled clinical trials, including the Scandinavian Simvastatin Survival Study, the Cholesterol and Recurrent Events trial, the Air Force/Texas Coronary Atherosclerosis Prevention studies, and Long-term Intervention with Pravastatin in Ischemic Disease study, have indicated that cardiovascular events continue to occur in two thirds of all patients. Follow-up studies, such as the Heart Protection Study and the Pravastatin or Atorvastatin Evaluation and Infection Therapy/Thrombolysis In Myocardial Infarction-22 trials, reinforced these earlier results. Although therapy with gemfibrozil, a fibric acid derivative, showed reduced occurrence of cardiovascular events in the Helsinki Heart Study and the Veterans Affairs HDL Intervention Trial, results of other studies, e.g., the Bezafibrate Intervention Program and the Diabetes Atherosclerosis Intervention study, showed less encouraging results. Although lifestyle modifications, such as improved diet and increased exercise levels, benefit general health and the metabolic syndrome and insulin resistance in particular, most people continue to resist changes in their daily routines. Thus, physicians must continue to educate their patients regarding an optimal balance of drug therapy and personal behavior. (J Am Coll Cardiol 2005;46:1225– 8) © 2005 by the American College of Cardiology Foundation

Tuesday, October 18, 2005

Quotes: Geoffrey Rose

Quotes: Geoffrey Rose:
"It makes little sense to expect individuals to behave differently from their peers; it is more appropriate to seek a general change in behavioural norms and in the circumstances which facilitate their adoption.
Rose, Geoffrey, The strategy of preventive medicine. Oxford (Oxford University Press), 1992, here: 102
Measures to improve public health, relating as they do to such obvious and mundane matters as housing, smoking, and food, may lack the glamour of high-technology medicine, but what they lack in excitement they gain in their potential impact on health, precisely because they deal with the major causes of common disease and disabilities.
Rose, Geoffrey, The strategy of preventive medicine. Oxford (Oxford University Press), 1992, here: 101"

Stockholm Challenge

Stockholm Challenge: "The Stockholm Challenge Award 2006
THE STOCKHOLM CHALLENGE AWARD 2006 invites excellent ICT projects from all over the world to compete for the prestigious Challenge trophies. The Challenge is searching for the best initiatives that accelerate the use of information technology for the social and economic benefit of citizens and communities. The objective is to help local entrepreneurs, who work to close the digital divide, by bringing in research communities, development organisations and strong corporate initiatives.
THE AWARDS WILL BE HANDED OUT IN SIX CATEGORIES in the City Hall - on May 11, 2006. Special focus will be on projects in countries and regions with the greatest needs. There will also be an international Challenge conference in Stockholm on issues related to the role of ICTs in global development work.
THE AWARD IS OPEN FOR ENTRIES until December 31st 2005. The application form is easily accessible on the home page.
The Stockholm Challenge is headquartered at the IT University - a joint initiative by KTH (The Royal Institute of Technology) and Stockholm University. It is managed by a consortium that also includes the City of Stockholm, Ericsson and Sida, the Swedish International Development Cooperation Agency.
For more information, please contact:
Project Manager
Ulla Skid�n
Telephone: + 46 8 7904469
Cell: +46 70 678 72 82"

Sunday, October 16, 2005

TIME Magazine - Global Health Conference


Speakers Include Bill Gates, Richard Branson, Lee Jong-wook, Ted Turner, Ann Veneman, Paul Farmer, Madeleine Albright, Paul Wolfowitz, Agnes Binagwaho, Rick Warren, Julie Gerberding and Bono

New York - TIME magazine will focus America's attention on global health during the TIME Global Health Summit, November 1-3, 2005, in New York City. Supported by the Bill & Melinda Gates Foundation, the TIME Summit will convene leaders in medicine, government, business, public policy and the arts to develop actions and solutions to health crises.

TIME is partnering with PBS, as well as ABC News, to reach a broad audience. On Monday, October 31, a TIME special issue on global health will hit newsstands, reaching more than 27 million readers around the world. On Nov. 1-3 from 9-11 pm (check local listings), PBS will premiere Rx for Survival "A Global Health Challenge, a six-part documentary series narrated by Brad Pitt. The series is co-produced by the WGBH/NOVA Science Unit and Vulcan Productions. Also this fall, ABC News will provide expanded coverage of global health issues. The TIME Summit will be on-the-record and open to credentialed media for news coverage.

'The developed nations of the world can no longer ignore the health crisis faced by millions of people every day,' said Jim Kelly, managing editor of TIME magazine. 'With the rapid spread of so many diseases that can be treated "and in many cases prevented " with simple interventions, TIME hopes this summit will inspire American leaders and the general public to commit the necessary resources to stop the needless deaths. This is not an insurmountable task. We have the drugs, the vaccines and the medical knowledge. "

Risk score for predicting death, myocardial infarction, and stroke in patients with stable angina

Clayton et al. 331 (7521): 869 -- BMJ"Results 1063 patients either died from any cause or sustained myocardial infarction or disabling stroke. The five year risk of this composite ranged from 4% for patients in the lowest tenth of risk to 35% for patients in the highest tenth. The risk score combines 16 routinely available clinical variables (in order of decreasing contribution): age, left ventricular ejection fraction, smoking, white blood cell count, diabetes, casual blood glucose concentration, creatinine concentration, previous stroke, at least one angina attack a week, coronary angiographic findings (if available), lipid lowering treatment, QT interval, systolic blood pressure 155 mm Hg, number of drugs used for angina, previous myocardial infarction, and sex. Fitting the same model separately to all cause death, myocardial infarction, and stroke gave similar results. The risk score did not seem to predict the nature of the event (death in 39%, myocardial infarction in 46%, and disabling stroke in 15%) or the incidence of angiography or revascularisation, which occurred in 29% of patients. Conclusion This risk score is an objective aid in deciding on further management of patients with stable angina with the aim of reducing serious outcome events. The score can also be used in planning future trials. "/.../

Risk score for predicting death, myocardial infarction, and stroke in patients with stable angina, based on a large randomised trial cohort of patient

Risk score for predicting death, myocardial infarction, and stroke in patients with stable angina, based on a large randomised trial cohort of patients -- Clayton et al. 331 (7521): 869 -- BMJ: "Results 1063 patients either died from any cause or sustained myocardial infarction or disabling stroke. The five year risk of this composite ranged from 4% for patients in the lowest tenth of risk to 35% for patients in the highest tenth. The risk score combines 16 routinely available clinical variables (in order of decreasing contribution): age, left ventricular ejection fraction, smoking, white blood cell count, diabetes, casual blood glucose concentration, creatinine concentration, previous stroke, at least one angina attack a week, coronary angiographic findings (if available), lipid lowering treatment, QT interval, systolic blood pressure 155 mm Hg, number of drugs used for angina, previous myocardial infarction, and sex. Fitting the same model separately to all cause death, myocardial infarction, and stroke gave similar results. The risk score did not seem to predict the nature of the event (death in 39%, myocardial infarction in 46%, and disabling stroke in 15%) or the incidence of angiography or revascularisation, which occurred in 29% of patients. Conclusion This risk score is an objective aid in deciding on further management of patients with stable angina with the aim of reducing serious outcome events. The score can also be used in planning future trials. "/.../

Saturday, October 15, 2005

Evolution of the Heart from Bacteria to Man

Evolution of the Heart from Bacteria to Man -- BISHOPRIC 1047 (1): 13 -- Annals of the New York Academy of Sciences: "Evolution of the Heart from Bacteria to Man

This review provides an overview of the evolutionary path to the mammalian heart from the beginnings of life (about four billion years ago ) to the present. Essential tools for cellular homeostasis and for extracting and burning energy are still in use and essentially unchanged since the appearance of the eukaryotes. The primitive coelom, characteristic of early multicellular organisms (800 million years ago), is lined by endoderm and is a passive receptacle for gas exchange, feeding, and sexual reproduction. The cells around this structure express genes homologous to NKX2.5/tinman, and gradual specialization of this 'gastroderm' results in the appearance of mesoderm in the phylum Bilateria, which will produce the first primitive cardiac myocytes. Investment of the coelom by these mesodermal cells forms a 'gastrovascular' structure. Further evolution of this structure in the bilaterian branches Ecdysoa (Drosophila) and Deuterostoma (amphioxus) culminate in a peristaltic tubular heart, without valves, without blood vessels or blood, but featuring a single layer of contracting mesoderm. The appearance of Chordata and subsequently the vertebrates is accompanied by a rapid structural diversification of this primitive li"/.../

ASCOT: a tale of two treatment regimens

(referred by Marcelo Gustavo Colominas [])
ASCOT: a tale of two treatment regimens Better blood pressure, fewer deaths, and less diabetes with newer antihypertensive agents
Each year in the United Kingdom alone there are 20 000 preventable deaths from cardiovascular disease attributable to hypertension. Much of the excess mortality and associated morbidity arises from poor control of blood pressure among people known to have hypertension. For the past two years in the United Kingdom, general practitioners have had the prime responsibility for tackling this problem, along with financial incentives to meet targets for detecting and controlling high blood pressure. Yet, despite many clinical trials and guidelines, they may be unsure about which antihypertensive drug to use first and how to combine treatments.
In 2004 the National Institute for Health and Clinical Excellence (NICE) recommended thiazide or thiazide-like diuretics as the first line treatment for most patients, with the addition of blockers as the next step.w1 This echoed the advice given in the US Joint National Committee's guidelines the previous year.w2 Near simultaneous guidance from the British Hypertension Society, however, recommended for the first time drugs acting on the renin-angiotensin system—angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers—as first line treatment for "younger, non-black" patients. In effect, the resulting confusion endorsed earlier European guidelines which advocated leaving the choice of drug to individual practitioners./.../

Saturday, October 08, 2005

El corralito aumentó nueve veces el riesgo de eventos vasculares |

Fabiola Czubaj
El corralito aumentó nueve veces el riesgo de eventos vasculares | LA NACION LINE
: "Apenas estalló en el país la crisis de 2001, muchos argentinos trataron de buscar ayuda psicológica y médica para proteger su salud ante el malestar que produce la sensación de estar a la deriva social. A otros, en cambio, el afán de recuperar sus ahorros los empujó a descuidar el equilibrio que su psiquis necesitaba para seguir adelante.

Esto motivó a un grupo de investigadores argentinos, dirigidos por los doctores Fernando Taragano, profesor titular de psiquiatría, y Ricardo Allegri, profesor de neurología, ambos investigadores principales del Cemic, a estudiar desde fines de 2001 las consecuencias clínicas de ambas conductas. Luego de 31 meses de seguimiento, el equipo halló que el riesgo de daño cardíaco o cerebral era nueve veces mayor en los argentinos que habían sufrido de gran ansiedad y no habían aceptado ayuda. "

La crisis económica causó 20.000 muertes cardíacas

"La crisis económica causó 20.000 muertes cardíacas
(enviado por Marcelo Gustavo Colominas [])
Se debió al deterioro de los recursos hospitalarios; hubo 10.000 infartos no fatales por estrés

La crisis que produjo la última recesión y que llevó a la Argentina a una de las etapas más dramáticas de su historia no sólo provocó muertes en las calles en diciembre de 2001. En silencio, el deterioro hospitalario causado por el derrumbe de la economía local produjo 20.000 muertes cardíacas más que lo habitual, entre abril de 1999 y diciembre de 2002, período en el que el estrés y la depresión sin contención social provocaron 10.000 infartos más, pero no fatales.
Así lo demuestra el primer estudio que relaciona mortalidad y crisis no provocada por guerras, ataques terroristas o desastres naturales, realizado por investigadores de la Fundación Favaloro y de la Universidad de Massachussetts, Estados Unidos.
"Esta es la primera información epidemiológica oficial mundial de una crisis financiera, social y econômica que se asocia a mayor mortalidad e infarto. Hubo argentinos que sufrieron infarto por torpeza en el manejo de la cosa pública. Una proyección nacional haría presumir que hubo 20.000 muertes coronarias más entre 1999 y 2002. Esto debería servirnos de advertencia, ya que, si vuelve a pasar, los responsables de tomar las decisiones estarían provocando un genocidio', afirmó a LA NACION el doctor Enrique Gurfinkel, jefe de la Unidad Coronaria de la Fundación Favaloro y autor principal del estudio. "

Friday, October 07, 2005

WHO calls for 2% reduction a year in chronic disease mortality -- Zarocostas 331 (7520): 798 -- BMJ

WHO calls for 2% reduction a year in chronic disease mortality -- Zarocostas 331 (7520): 798 -- BMJ: "WHO calls for 2% reduction a year in chronic disease mortality
Geneva John Zarocostas
The World Health Organization has called on governments to mount a serious response to the looming 'invisible' global epidemic of chronic disease.
To ensure that sustained actions are taken worldwide, WHO has set out, in a report published this week, a new target to reduce the death rate from chronic disease by 2% each year until 2015.
This would prevent 36 million deaths "mostly in poor and middle income countries" from chronic diseases such as heart disease, stroke, cancer, respiratory diseases, and diabetes.
Of the estimated 58 million people who will die in 2005 about 35 million (60%) will die from chronic disease, the report says, and it cautions that the percentage will rise by a further 17% in the next 10 years unless urgent action is taken.
In the meantime, the number of deaths from infectious diseases is projected to decline by 3% over the next 10 years, it notes.
'This is a very serious situation, both for public health and for the societies and economies affected,' said Lee Jong-wook, WHO's director general. He added, 'The cost of inaction is clear and unacceptable.'
The report, which draws on the latest findings in nine countries (Brazil, Canada, China, India, Nigeria, Pakistan, Russia, the United Kingdom, and Tanzania), says, 'It is vitally important that the impending chronic disease pandemic is recognized, understood and acted on urgently.'
Anbumani Ramadoss, India's minister of health and family welfare, said, 'The scale of the problem we face is clear, with the projected number of deaths in India attributable to chronic diseases r"

CVD Calendar

ProCOR - Home Page:
"ProCOR's CVD Calendar compiles events taking place globally that are relevant to the prevention of cardiovascular disease in developing countries.
To submit information about an event to the calendar, email details to

CVD Calendar
� 2005
� 2006
� Links for additional events "

Thursday, October 06, 2005

Investing in Children's health: economic benefits

This paper argues that investing in children’s health is a sound economic decision for governments to take, even if the moral justifications for such programmes are not considered. The paper also outlines dimensions that are often neglected when public investment decisions are taken. The conclusion that can be drawn from the literature studying the relationship between children’s health and the economy is that children’s health is a potentially valuable economic investment.

The literature shows that making greater investments in children’s health results in better educated and more productive adults, sets in motion favourable demographic changes, and shows that safeguarding health during childhood is more important than at any other age because poor health during children’s early years is likely to permanently impair them over the course of their life.

In addition, the literature confirms that more attention should be paid to poor health as a mechanism for the intergenerational transmission of poverty. Children born into poor families have poorer health as children, receive lower investments in human capital, and have poorer health as adults. As a result, they will earn lower wages as adults, which will affect the next generation of children who will thus be born into poorer families.

Atherothrombosis -

NPG web focus: Atherothrombosis - Focus home: "Nature Reviews Drug Discovery is pleased to present a collection of reviews on atherothrombosis, the leading cause of morbidity and mortality. As discussed in these articles, recent progress in the understanding of the pathogenesis of atherothrombosis, and in the application of approaches to assess disease progression, has provided new impetus to the discovery and development of novel drugs for this condition."

Prognosis and Effects of Intensive Statin Therapy After Acute Coronary Syndrome: Myocardial Ischemia Reduction with Statins

Entrez PubMed: "Relation of Characteristics of Metabolic Syndrome to Short-Term Prognosis and Effects of Intensive Statin Therapy After Acute Coronary Syndrome: An analysis of the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) trial.

Schwartz GG, Olsson AG, Szarek M, Sasiela WJ.

OBJECTIVE: We examined relations between characteristics of the metabolic syndrome, early cardiovascular risk, and effect of early, intensive statin therapy after acute coronary syndrome. RESEARCH DESIGN AND METHODS: A total of 3,038 patients in the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) trial were characterized by the presence or absence of a history of diabetes, a history of hypertension and/or blood pressure >/=130/>/=85, BMI >30 kg/m(2), HDL cholesterol <40 mg/dl (men) or <50 mg/dl (women), and triglycerides >/=150 mg/dl. Patients with three or more of these characteristics were categorized as having metabolic syndrome. RESULTS: A total of 38% of patients (n = 1,161) met criteria for metabolic syndrome as defined in this study and had a 19% incidence of a primary end point event (death, nonfatal myocardial infarction, cardiac arrest, or recurrent unstable myocardial ischemia) during the 16-week trial. Patients with two or fewer characteristics (n = 1,877) were classified as not having metabolic syndrome and had a 14% incidence of a primary end point event. In univariate analysis, the individual characteristics that bore a significant relation to risk were diabetes and low HDL cholesterol. In a multivariable model including age, sex, and randomized treatment ass"

Wednesday, October 05, 2005

The neglected epidemic of chronic disease

The Lancet: "Lancet Editor Richard Horton introduces the Chronic Diseases Series: 'Without concerted and coordinated political action, the gains achieved in reducing the burden of infectious disease will be washed away as a new wave of preventable illness engulfs those least able to protect themselves. Let this series be part of a new international commitment to deny that outcome.'
Horton R - (DOI: 10.1016/S0140-6736(05)67454-5)"

Parâmetros da boa saúde estão mais rígidos

O Globo On Line

05/10/2005 - 13h24m
Parâmetros da boa saúde estão mais rígidos

Cintia Parcias, do Globo Online
RIO - Alarmadas principalmente com o avanço da síndrome metabólica - que hoje atinge de 25% a 35% dos brasileiros e é caracterizada por alterações nos níveis de colesterol, triglicerídeos, glicose e pressão sanguínea, somadas a uma medida elevada da cintura - associações médicas vêm adotando novos padrões de avaliação e reformulando recomendações. Nos últimos anos, muita coisa mudou; mas nem todo mundo se deu conta. Abaixo, conheça a regras e parâmetros mais atualizados para garantir uma saúde de ferro e adotar um estilo mais saudável de vida.

Medidas corporais

Um dos critérios de avaliação de risco cardiovascular e de diagnóstico da síndrome metabólica é a medida da cintura. Até o início deste ano, considerava-se como limite uma circunferência de até 88 centímetros para as mulheres e 104 centímetros para os homens. Mas a partir do 65º Congresso da Associação Americana de Diabetes, realizado em junho, essas medidas baixaram.

- Ficou oficialmente estabelecido que, para se manterem na lista de pessoas saudáveis, as mulheres devem ter cintura inferior a 80 centímetros e os homens, inferior a 94 centímetros - conta o endocrinologista Walmir Coutinho, que vai presidir do 6º Congresso Latino-Americano de Obesidade, a partir do dia 25, no Rio de Janeiro. Para verificar o peso, continua valendo o cálculo do índice de massa corporal (IMC), que considera obesa a pessoa cujo resultado for superior a 30. ( Calcule o seu IMC na capa do Viver Melhor )


A pirâmide alimentar usada desde 1992 por profissionais e instituições de saúde para prescrever a alimentação mais adequada a cada pessoa sofreu alterações para se adaptar às Diretrizes Alimentares para os Americanos, de 2005. A nova pirâmide é resultado de diversas pesquisas realizadas pelo Departamento de Agricultura dos Estados Unidos (USDA).

- As mudanças são a tradução das descobertas científicas destes últimos anos. Entre as novidades, podemos citar a maior ênfase nos vegetais e nas frutas, a preferência por laticínios desnatados ou semi-desnatados, por grãos integrais, por frutas em vez de sucos e por gorduras líquidas em vez de sólidas. Foi ressaltada também a importância da atividade física. Antes a pirâmide nem falava nisso - explica a nutricionista Bia Rique, representante oficial no Brasil da Associação Dietética Americana no Exterior.

As divisões da atual pirâmide são verticais. Cada tira representa grupos de alimentos e têm uma largura diferente, conforme a recomendação de ingestão daqueles itens.

Atividade física

De acordo com as recomendações do Colégio Americano de Medicina, da Associação Americana do Coração e outros órgão oficiais de saúde, todos devem fazer no mínimo 30 minutos diários de atividade física moderada (como caminhada), para sair da lista de sedentários.

- Isso não garante um emagrecimento eficaz nem uma forma física invejável, mas é o básico para a pessoa ser minimamente ativa - comenta a professora de educação física Ana Paula Silva, que faz parte do Centro de Estudo do Laboratório de Aptidão Física de São Caetano do Sul (Celafiscs).

Estes 30 minutos podem ser divididos em três sessões de 10 minutos ou duas de 15. O importante é manter a freqüência.

- Será um primeiro movimento para incluir a prática de exercício no dia-a-dia. Mas a partir daí a pessoa deverá adotar um programa mais elaborado e especificamente voltado para as suas necessidades, seja perder peso, diminuir o colesterol ou fortalecer a musculatura - ressalta Ana Paula.


A hipertensão é um importante fator de risco para diversas doenças. Mas a pressão de 140 por 90, comumente usada para caracterizar a hipertensão, já não satisfaz mais a classe médica.

- Agora trabalhamos com um limite de 130 por 80, principalmente se o paciente apresenta outros fatores de risco para a síndrome metabólica - esclarece Walmir Coutinho.


Há alguns anos a taxa de colesterol máxima recomendável no sangue diminuiu de 260 para 200. Atualmente, porém, o colesterol total vem perdendo importância na análise geral do risco do paciente. Hoje se observam com mais atenção os níveis do bom e do mau colesterol isoladamente. Ainda não há consenso sobre a quantidade ideal de cada um. Tampouco sobre o que teria maior impacto para melhorar a saúde: aumentar o bom ou diminuir o ruim. Estes pontos serão, inclusive, tema de debate no próximo Congresso de Obesidade. Mesmo assim, a maior parte dos médicos está trabalhando com o seguinte padrão: HDL (colesterol bom) igual ou maior que 40 e LDL (o ruim) igual ou menor que 120.

WHO aims to avert 36m premature deaths from an 'invisible epidemic' / World / International economy - WHO aims to avert 36m premature deaths from an 'invisible epidemic': "WHO aims to avert 36m premature deaths from an 'invisible epidemic'
By Frances Williams in Geneva
Published: October 5 2005 03:00 | Last updated: October 5 2005 03:00

Global action to cut premature deaths from chronic diseases could save the lives of 36m people over the next decade, the World Health Organisation says in a report today.

Diseases such as cancer, diabetes and heart disease are by far the biggest killers, accounting for 60 per cent of all deaths around the world. That proportion is set to rise, WHO says.
Lifestyle changes such as urbanisation, a shift to processed foods and rising tobacco consumption are increasing the risks, especially in the developing world.
Eight in 10 of the projected 35m deaths from this 'invisible epidemic' in 2005 will be in low- and middle-income countries, with Africa now the only continent where chronic diseases are not the leading cause of death.
Cardiovascular disease (heart disease and strokes) will claim 17.5m lives this year, according to WHO, against 2.8m deaths from HIV/Aids, the most deadly infectious disease.
The report estimates that the economic impact of chronic diseases - through lower output and increased health spending - will cost countries such as China, India and Russia billions of dollars in national income over the next 10 years. Accumulated losses between 2005 and 2015 are put at $558bn (�465bn, �310bn) for China, $236bn for India and $303bn for Russia.
'The cost of inaction is clear and unacceptable,' says Lee Jong-wook, WHO director-general.
The world health agency is proposing a global goal to reduce the upward trend of chronic disease death rates by 2 per cent each year until 20"

Chronic illnesses called epidemic among poor - The Boston Globe

Chronic illnesses called epidemic among poor - The Boston Globe: "Chronic illnesses called epidemic among poor
Report urges global action
By John Donnelly, Globe Staff | October 5, 2005
MAMELODI, South Africa -- Aaron Mathe, 17, took shallow breaths. He had learned four years earlier that he had Hodgkin's lymphoma, and received chemotherapy treatment. But the 10th grader said his doctor recently gave him bad news: His illness appears to be terminal.
''He said he had nothing more he could give me, because the chemotherapy hurts my heart,' Mathe said softly.
Here, in the midst of this vast township of 1 million people a few miles east of Pretoria, Mathe's situation is emblematic of what the World Health Organization calls a ''largely invisible epidemic' -- the overwhelming number of chronic disease cases in poor countries.
In a report released today, the WHO estimates that 80 percent of chronic illnesses such as heart disease, stroke, cancer, and diabetes were in low- to middle-income countries, contrary to popular belief that these diseases largely afflict people in wealthy countries.
The report also estimates that 17 million people die prematurely each year from these chronic diseases, and calls for a 2 percent annual reduction in deaths from these diseases. If that goal is reached, according to the report, countries would prevent the deaths of 36 million people in the next decade -- and nearly half the people would be under the age of 70.
Of the projected 58 million total deaths worldwide this year, an estimated 35 million people will die from chronic diseases -- more than double the number of deaths from infectious diseases such as AIDS, malaria, and tuberculosis, according to the WHO.
''We can stop this global epidemi"

WHO sees 'global epidemic' of chronic disease

Health News Article |
WHO sees 'global epidemic' of chronic disease
Tue Oct 4, 2005 8:10 PM ET

By Stephanie Nebehay

GENEVA (Reuters) - Developing countries can tackle a "global epidemic" of chronic disease by adopting cheap measures that have helped cut heart disease deaths in some rich nations by up to 70 percent, the World Health Organization (WHO) said.

In a report published on Wednesday, the WHO said nearly half of all deaths from heart disease, cancer, respiratory infections, strokes and diabetes -- to which about 35 million people will succumb this year -- were preventable.

The report, "Preventing Chronic Diseases -- a Vital Investment", said developing countries, where most such deaths occur, must copy Western nations by discouraging tobacco use and curbing salt, sugar and saturated fats in food.

"Today we have a major epidemic and we know that if nothing is done, it will evolve rapidly and even more dramatically," Catherine Le Gales-Camus, WHO assistant director-general of non-communicable disease, told a news briefing.

The WHO, a United Nations agency, said its goal was to prevent the deaths of 36 million people by 2015, by reducing death rates from chronic disease by 2 percent each year.

"It is achievable. We want to stop people dying at an early age, prematurely and painfully, from a preventable condition," said Robert Beaglehole, WHO's director of chronic diseases and health promotion.

Eighty percent of all heart disease, stroke and type 2 diabetes cases, and over 40 percent of cancer cases, could be prevented, the report said.

Chronic disease also has a huge economic impact. The WHO estimates that such illnesses will cost China $558 billion over the next decade, the Russian Federation $303 billion and India $237 billion.

Low and middle income countries, where the epidemic is worst, need to look to the example of industrialized nations. Some 80 percent of deaths from chronic diseases occur in developing countries, and half are women.

"There is a very pervasive misunderstanding that chronic diseases affect only wealthy men in wealthy countries," Beaglehole said.

Alerting the public to the dangers of high cholesterol levels or blood pressure have paid off in Western countries, the report said. Heart disease death rates have fallen by up to 70 percent in the last three decades in Australia, Britain, Canada and the United States.

Poland lowered death rates among young adults by 10 percent per year in the 1990s at low cost, mainly by ensuring fruits and vegetables were available and by removing subsidies on butter which made it competitive with healthier vegetable oils, according to Beaglehole.

Over one billion people worldwide are overweight or obese -- putting them at risk of deadly heart disease --- and the figure could rise to 1.5 billion in a decade, the report warned.

About 22 million children under age five are overweight.

Child obesity was "a number one public health problem," and talks are scheduled next week with the food and beverage industry to discuss a "plan of action", Le Gales-Camus said.

"Reports of type 2 diabetes in children and adolescents -- previously unheard of -- have begun to mount worldwide," the WHO report said, referring to a form of the disease previously known as adult-onset diabetes.

Wang Longde, China's vice-minister of health, said in an introduction to the report: "We have an obesity epidemic, with more than 20 percent of our 7-17 year old children in urban centers tipping the scales as either overweight or obese".

Tuesday, October 04, 2005

WHO Department of Chronic Diseases and Health Promotion (CHP)

WHO | Department of Chronic Diseases and Health Promotion (CHP)
The rapid rise of chronic, noncommunicable diseases represents one of the major health challenges to global development. The principle chronic diseases are: stroke, cancer, diabetes and chronic respiratory diseases. Chronic diseases currently account for some 60% of global deaths and almost one third of the global burden of disease. The Department of Chronic Diseases and Health Promotion (CHP) leads the global efforts to prevent and control chronic diseases and promote health./.../

Increased GGT Linked to Cardiovascular Mortality

Increased GGT Linked to Cardiovascular Mortality: "NEW YORK (Reuters Health) Sept 30 - An elevated level of gamma-glutamyltransferase (GGT) is an independent risk factor for death from cardiovascular disease, according to a report in the October 4th issue of Circulation: Journal of the American Heart Association.
'People with high GGT had more than a 1.5-fold risk of dying from cardiovascular diseases in comparison to people with normal low levels of GGT,' senior author Dr. Hanno Ulmer, from Innsbruck Medical University in Austria, said in a statement. 'For people under 60 years of age, this risk is even higher, amounting to more than twofold.'
Recent reports have linked GGT levels with cardiovascular disease (CVD), but most studies have had inadequate sample sizes to investigate any association with CVD mortality.
The new findings are based on a study of 163,944 Austrian adults who had GGT levels measured and were followed for up to 17 years.
In both men and women, a high GGT level was independently associated with CVD mortality and a clear dose-response relationship was observed.
In men, a high GGT was linked to death from chronic coronary heart disease, heart failure, and ischemic or hemorrhagic stroke. By contrast, the association with fatal acute MI did not reach statistical significance.
In women, a high GGT was significantly associated with death from all cardiovascular diseases, except for hemorrhagic and ischemic strokes.
In a related editorial, Dr. Michele Emdin, from the National Research Council in Pisa, Italy, and colleagues comment that 'elevation in serum GGT activity predicts outcomes in unselected populations and in patients with ascertained ischemic heart disease, independently of myocardial damage, thus adding to prognostic information provided by traditional risk factors.'
Circulation 2005."

Prêmio Zerbini de Cardiologia 2005

Ref: Novas formas de inscrição de trabalhos para o Prêmio Zerbini de Cardiologia – Edição 2005.
Prezado pesquisador,
Informamos a V. Sa. que as inscrições de trabalhos concorrentes ao “Prêmio Zerbini de Cardiologia – Edição 2005”, poderão ser efetuadas das seguintes formas:
1- Através do website da Fundação Zerbini. (
2- Mediante o envio do trabalho para seguinte endereço eletrônico:
3- Mediante o envio do trabalho em CD-Rom/ Disquete via correio para o seguinte endereço: Fundação Zerbini - Av. Brigadeiro Faria Lima – n. 1884 – 2. andarBairro: Jd. Paulistano / São Paulo – SPCEP 01451-000
Assim sendo, consideramos que estas novas oportunidades de envio de trabalhos irão facilitar a inscrição de trabalhos por parte de V. Sa.
Ressaltamos que a data limite para as inscrições é o dia 28 de outubro.
Estamos desde o momento à sua disposição para eventuais dúvidas e informações adicionais.
Agradecemos antecipadamente,

Kleber Di Pardi (55) (11) 3038 5301
Ricardo Duailibi(55) (11) 3038

Sunday, October 02, 2005

Acidente Vascular Cerebral

-----Mensagem original-----De: Isaac Roitman [] Enviada em: domingo, 2 de outubro de 2005 17:54Para: Aloyzio AchuttiAssunto: Fw: Derrame - Importante - repassando

----- Original Message -----
From: Henrique Galinkin
To: Undisclosed-Recipient:;
Sent: Friday, September 30, 2005 6:37 PM
Subject: Fw: Derrame - Importante - repassando
Subject: Derrame - Importante

Um cardiologista afirma: "Se cada um que receber este e-mail mandá-lo para mais dez pessoas, você pode apostar que, no mínimo, uma vida será salva".
Sintomas de um derrame:
Às vezes, os sintomas de um derrame são difíceis de identificar. Infelizmente, a falta de reconhecimento provoca um estrago. A vítima de um derrame pode sofrer danos cerebrais quando as pessoas em redor não reconhece os sintomas do derrame. Agora, os médicos contam que alguém que convive com a pessoa em questão pode reconhecer o derrame mediante três testes simples.
1. Pedindo à ela para rir
2. Pedindo à ela para levantar os dois braços;
3. Pedindo à ela para falar uma frase simples; se ela tem dificuldade com um destes testes, chame imediatamente o pronto socorro e conte sobre os sintomas a quem atender ao telefone.
Depois de fazer com que um grupo de voluntários não-médicos fosse capaz de identificar um problema facial, um problema nos braços ou dificuldade em falar, cientistas querem que estes os três testes sejam conhecidos pelo maior número possível de pessoas. Eles apresentaram suas conclusões na American Stroke Association na reunião anual em fevereiro de 2004.O uso comum destes testes pode dar oportunidade de uma diagnose imediata e um tratamento de derrame, e prevenir um prejuízo do cérebro.Por favor, partilhe este artigo com quantos amigos for possível......................