Há 40 anos...

Publicado na Revista Manguinhos
1978 - Memória de Inquérito Epidemiológico sobre pressão arterial e alguns fatores de risco para doenças cardiovasculares e crônicas, realizado no Estado do RS, em amostra representativa da população  adulta de 20 a 74 anos dividida em  quatro estratos: Porto Alegre, Cinturão Metropolitano, Interior Urbano e Interior Rural.
Artigo original (link), no qual se baseou a Revista Manguinhos para a publicação de outubro do anos passado.
O feito foi memorável, pioneiro, oportunizou discussão de aspectos muito relevantes, e envolveu a participação de muita gente, entre tantos: Eduardo de Azeredo Costa, Carlos Henrique Klein Maria do Carmo Leal, Ayrton Fischmann, Sérgio Luiz Bassanesi, Célia Szwarcwald. A não valorização da memória pelos editores atuais deve estar relacionada às transformações que o próprio trabalho ajudou a construir. Parabéns e um grande abraço aos companheiros da aventura.

Cardiovascular Disease Prevention

JJOINT ESC GUIDELINES

European Guidelines on cardiovascular disease

prevention in clinical practice (version 2012)

The Fifth Joint Task Force of the European Society of Cardiology

and Other Societies on Cardiovascular Disease Prevention in Clinical

Practice (constituted by representatives of nine societies

and by invited experts)

Developed with the special contribution of the European Association

for Cardiovascular Prevention & Rehabilitation (EACPR)

†

Authors/Task Force Members: Joep Perk (Chairperson)et al

(13) European Guidelines on Cardiovascular Disease Prevention in Clinical Practice (Version 2012) : The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (Constituted by Representatives of Nine Societies and by Invited Experts).. Available from: https://www.researchgate.net/publication/232648860_European_Guidelines_on_Cardiovascular_Disease_Prevention_in_Clinical_Practice_Version_2012_The_Fifth_Joint_Task_Force_of_the_European_Society_of_Cardiology_and_Other_Societies_on_Cardiovascular_Diseas [accessed Sep 20, 2017].

Devices Risk Heart Surgery

Open-Heart Surgery Devices Putting Patients at Risk

The warning from the CDC comes after at least 11 people were sickened

• By Eric Boodman, STAT on October 16, 2016

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Credit: CORBIS

The Centers for Disease Control and Prevention on Thursday warned that contaminated medical devices used in open-heart surgeries could be to blame for a rash of infections in patients in the United States and Europe.

Data published in the CDC’s Morbidity and Mortality Weekly Report indicate that at least 11 patients in the US were infected with bacteria from a heater-cooler device that maintains patients’ internal temperatures during surgery. Previous reports indicated that six people in Switzerland were infected, and dozens of Americans have come forward with symptoms.

CDC issued an advisory for health care providers, and urged patients who have had open-heart surgery to seek medical care if they are experiencing symptoms associated with infections. The agency estimated that some 250,000 patients undergo surgeries using the device every year.

Oct4

Gene helps prevent heart attack, stroke; may also block effects of aging

May 20, 2016

May turn out to be the "fountain-of-youth gene," say researchers University of Virginia School of Medicine have discovered that a gene called Oct4 — which scientific dogma insists is inactive in adults — actually plays a vital role in preventing ruptured atherosclerotic plaques inside blood vessels, the underlying cause of most heart attacks and strokes. The researchers found that Oct4 controls the conversion of smooth … more…

Framinghan - Escore de Risco em 10 anos Actual Apps Medical Pedro Lima has recommended that you check out Framinghan - Escore de Risco em 10 anos: Estamos lançando alguns aplicativos para o iPad. Em breve o SAME 8 com exportação para iPhone e iPad. Abraço Pedro Lima

ACCF/AHA 2011 Key Data Elements and Definitions of a Base Cardiovascular Vocabulary for Electronic Health Records

The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) support their members' goal to improve the prevention and care of cardiovascular diseases through professional education, research, and development ofguidelines and standards and by fostering policy that supports optimal patient outcomes. The ACCF and AHA recognize the importance of the use of clinical data standards for patient management, assessment of outcomes, and conduct of research, and the importance of defining the processes and outcomes of clinical care, whether in randomized trials, observational studies, registries, or quality-improvement initiatives.
Hence, clinical data standards strive to define and standardize data relevant to clinical topics in cardiology, with the primary goal of assisting data collection by providing a platform of data elements and definitions applicable to various conditions. Broad agreement on a common vocabulary with reliable definitions used by all is vital to pool and/or compare data across studies to promote interoperability of electronic health records (EHRs) and to assess the applicability of research to clinical practice. The increasing national focus on adoption of certified EHRs along with financial incentives for providers to demonstrate "meaningful use" of those EHRs to improve healthcare quality render even more imperative and urgent the need for such definitions and standards. Therefore, the ACCF and AHA have undertaken to define and disseminate clinical data standards—sets of standardized data elements and corresponding definitions—to collect data relevant to cardiovascular conditions. The ultimate purpose of clinical data standards is to contribute to the infrastructure necessary to accomplish the ACCF/AHA mission of fostering optimal cardiovascular care and disease prevention and building healthier lives, free of cardiovascular diseases and stroke.
The specific goals of clinical data standards are

1. To establish a consistent, interoperable, and universal clinical vocabulary as a foundation for both clinical care and clinical research. 
2. To promote the ubiquitous use of EHRs and facilitate the exchange of data across systems through harmonized, standardized definitions of key data elements. 
3. To facilitate the further development of clinical registries, quality- and performance-improvement programs, outcomes evaluations, and clinical research, including the comparison of results within and across these initiatives./.../

Toothbrushing less than twice a day linked to increased CV risk

MAY 28, 2010 | Sue Hughes

 Download slides

London, UK - Individuals who do not brush their teeth twice a day have an increased risk of heart disease, a new study shows [1].

The study was published online May 27, 2010 in BMJ; the corresponding author is Prof Richard Watt(University College London, UK).

The researchers note that while it has been established that inflammation in the body (including mouth and gums) plays an important role in the buildup of atherosclerosis, this is the first study to investigate whether the number of times individuals brush their teeth has any bearing on the risk of developing heart disease.

They analyzed data from more than 11 000 adults who took part in the Scottish Health Survey, in which individuals were asked about lifestyle behaviors such as smoking, physical activity, and oral health routines. Questions asked included how often they visited the dentist and how often they brushed their teeth (twice a day, once a day, or less than once a day). Information was also collated on medical history and family history of heart disease and blood pressure. Blood samples were taken from a subgroup of participants and tested for CRP and fibrinogen levels. The data gathered from the interviews were linked to hospital admissions and deaths./.../

potential for reducing coronary heart disease mortality in the USA

Cardiovascular risk factor trends and potential for reducing coronary heart disease mortality in the United States of America

Simon Capewell ^a, Earl S Ford ^b, Janet B Croft ^c, Julia A Critchley ^d, Kurt J Greenlund ^c & Darwin R Labarthe ^c

a. Division of Public Health, University of Liverpool, Liverpool, L69 3GB, England.
b. Division of Adult and Community Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America (USA).
c. Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
d. Institute of Health and Society, Newcastle University, Newcastle, England.

Correspondence to Simon Capewell (e-mail: capewell@liverpool.ac.uk).

(Submitted: 18 August 2008 – Revised version received: 30 December 2008 – Accepted: 07 June 2009 – Published online: 08 December 2009.)

Bulletin of the World Health Organization 2010;88:120-130. doi: 10.2471/BLT.08.057885

INTRODUCTION

Coronary heart disease (CHD) accounted for over 450 000 deaths in the United States of America in 2004.^1,2 The burden of CHD in the United States is enormous; more than 13 million people are affected, and the costs of direct health care exceed US$ 150 billion annually.^1,2

Since the late 1970s, age-adjusted CHD mortality rates have been halved in most industrialized countries, including the United States. However, between 1990 and 2000 this decrease diminished, and in younger age groups it nearly ceased.^1,2 Many adults in the United States are still at high risk for cardiovascular disease. Total blood cholesterol levels exceed 200 mg/dl among more than 100 million adults; approximately 70 million have or are being treated for high blood pressure (systolic blood pressure 140 mmHg or diastolic blood pressure 90 mmHg), and over 50 million people still smoke.^2–4

The Healthy People 2010 (HP2010) initiative promoted by the government of the United States contains targets for heart disease and stroke that explicitly address risk factor prevention, detection and management, along with prevention of recurrent events. HP2010 objectives include a 20% reduction in age-adjusted CHD mortality rates (from an overall rate of 203 per 100 000 population in 1998 to 162 per 100 000 in 2010).³ They also include specific targets for reducing mean total blood cholesterol (to 199 mg/dl), smoking (to 12% of the population), hypertension (to 16%), diabetes (to 6%), obesity (to 15%) and inactivity (to 20%).³ Inactivity was measured in the Behavioral Risk Factor Surveillance System of the United States Centers for Disease Control and Prevention as the proportion of adults engaging in no physical activity.⁵ If those targets are achieved, what reduction in CHD mortality might actually result by 2010?/.../

AHA: Focus on cardiovascular health, not disease

AHA: Focus on cardiovascular health, not disease

DECEMBER 18, 2009 | Lisa Nainggolan

Chicago, IL - The traditional annual report on heart disease and stroke from the American HeartAssociation is, this year, being used to revisit the concept of cardiovascular health, rather than concentrating on cardiovascular disease [1].

"The AHA is refocusing efforts on lifestyle factors that can prevent the development of cardiovascular disease in the first place, and some of the statistics in this document show us just how far we have to go," lead author Dr Donald Lloyd-Jones (Northwestern University, Chicago, IL), who is chair of the AHA statistics committee, told heartwire.

Despite showing that cardiovascular disease mortality is still declining, the most recent literature shows that reductions in coronary heart disease deaths are starting to level off, indicating a ticking time bomb unless radical action is taken soon, he said.

The year-end report, published online December 17, 2009 in Circulation, highlights depressingly familiar statistics: high rates of inactivity, inadequate use of lipid-lowering therapies, and strikingly, high rates of men (25%) and women (20%) continuing to smoke. Although the numbers show that acute cardiovascular events are being handled more aggressively—with procedure rates rising 33% in 2006—the system will be unable to cope with the financial cost of further increases in the future if risk factors continue to increase as predicted, Lloyd-Jones said./.../

Influenza e Mortalidade por DCV em São Paulo

Artigo publicado no último número dos ABC, descrevendo em SP a relação entre Gripe e mortalidade por DCV, na mesma linha na qual nossa AMICOR Maria Inês Reinert Azambuja vem trabalhando há mais de 25 anos e motivo pelo qual se encontra hoje em Praha e viaja em seguida para Edimburgo (UK)

Vacina contra o Vírus da Influenza e Mortalidade por Doenças Cardiovasculares na Cidade de São Paulo

Vaccination against the Influenza virus and Mortality due to Cardiovascular Diseases in the city of Sao Paulo

Antonio de Padua Mansur, Desidério Favarato, José Antonio F. Ramires

Instituto do Coração (InCor) – HCFMUSP, São Paulo, SP - Brasil

Resumo

Fundamento: A influência da vacinação contra o vírus da gripe na mortalidade por doenças cardiovasculares (DCV) é controversa.

Objetivo: Analisar a mortalidade por DCV antes e depois do início da vacinação contra a gripe na cidade de São Paulo.

Métodos: Analisou-se a mortalidade por doenças isquêmicas do coração (DIC), doenças cerebrovasculares (DCbV) e por causas externas (CE) na população da região metropolitana de São Paulo com idade ≥ 60 anos, antes e depois do programa de vacinação contra a gripe. As estimativas da população e os dados de mortalidade foram, respectivamente, obtidos do Instituto Brasileiro de Geografia e Estatística (IBGE; www.ibge.gov.br) e do Ministério da Saúde (www.datasus.gov.br) para o período entre 1980 e 2006. O risco de morte foi ajustado pelo método direto, em que se utilizou a população padrão (mundial) referente a 1960.

Resultados: As comparações entre as inclinações das linhas de regressão foram semelhantes para as DCbV (p = 0,931) e CE (p = 0,941), porém, para as DIC (p = 0,022), observou-se significativa redução da linha do período pós-vacina quando comparada com a linha do período pré-vacina. Mudança na tendência da mortalidade após 1996 foi significativa somente para as DIC (p = 0,022), permanecendo inalterada para as DCbV (p = 0,931) e CE (p = 0,941).

Conclusão: A vacinação contra a gripe associou-se a significativa redução da mortalidade por DIC. (Arq Bras Cardiol 2009; 93(4) : 395-399)

Palavras-chave: Doenças cardiovasculares/epidemiologia, isquemia miocárdica, vacinas contra influenza, influenza humana.

Progenitor cells identified from human fetal hearts

July 1, 2009 | Fran Lowry

Boston, MA - Stem-cell researchers have identified a diverse set of human fetal islet-1 (ISL1⁺) cardiovascular progenitors that can differentiate into a family of cells that form the essential portions of the human heart. The discovery will allow the development of human models to study cardiovascular disease as well as new approaches for human regenerative cardiovascular medicine, they write in the July 2, 2009 issue of Nature [1].

Using two independent transgenic and gene-targeting approaches in human embryonic cell lines, the researchers, led by Dr Lei Bu (Massachusetts General Hospital, Boston, and Harvard Stem Cell Institute, Cambridge, MA), showed that the purified ISL1⁺ primordial progenitors are able to self-renew and expand before they differentiate into cardiomyocytes and smooth-muscle- and endothelial-cell lineages./.../

Oseltamivir After Influenza:Associated With Reduced Incidence of Recurrent Adverse Cardiovascular Outcomes

Use of Oseltamivir After Influenza Infection Is Associated With Reduced Incidence of Recurrent Adverse Cardiovascular Outcomes Among Military Health System Beneficiaries With Prior Cardiovascular Diseases

S. Ward Casscells, MD; Elder Granger, MD, FACP, FACPE; Amii M. Kress, MPH; Andrea Linton, MS;Mohammad Madjid, MD, MSc and Linda Cottrell, BS

From Health Affairs (S.W.C.), TRICARE Management Activity (E.G.), and Health Program Analysis and Evaluation (A.M.K., A.L., L.C.), West Falls Church, Va; and Texas Heart Institute and Baylor College of Medicine (M.M.), Houston, Tex.

Correspondence to Andrea Linton, MS, TRICARE Management Activity/Health Program Analysis and Evaluation, 5111 Leesburg Pike, Suite 810, Falls Church, VA 22041-3206. E-mail andrea.linton@wowway.com

Background: Influenza infection has been associated with increased risk of adverse cardiac and cerebral vascular outcomes. Oseltamivir, a treatment for influenza, has been shown to decrease the severity of an influenza episode, but few data exist regarding its potentiallyprotective effect against recurrent vascular outcomes among influenza patients with a history of vascular disease.

Methods and Results: Electronic healthcare service and pharmacy records for 37 482 TRICARE beneficiaries, aged 18 and older, with a coded history of cardiovascular (CV) disease and a subsequent diagnosis of influenza from October 1, 2003, through September 30, 2007, were examined. Subjects were grouped according to whether they had filled a prescription for oseltamivir within 2 days of their influenza diagnosis. The incidence of recurrent CV events within 30 days after the influenza diagnosis among oseltavmivir-treated and untreated subjects was 8.5% and 21.2%, respectively (P<0.005). Subject age was a persistent and significant contributor to the likelihood of recurrent CV outcomes. After controlling for the differences in demographics among treated and untreated cohorts using a propensity-scored logistic regression model, a statistically significant protective effect was associated with oseltamivir treatment (odds ratio, 0.417; 95% CI, 0.349 to 0.498).

Conclusions: Our findings suggests that oseltamivir treatment for influenza is associated with significant decrease in the risk of recurrent CV events in subjects with a history of CV disease. These findings merit confirmation in further prospective and controlled studies. Meanwhile, in patients with CV disease, strict adherence withcurrent practice guidelines for prevention and treatment of influenza is recommended.

Economic Burden of Severe Cardiovascular Diseases in Brazil

Economic Burden of Severe Cardiovascular Diseases in Brazil:
an Estimate Based on Secondary Data
Maria Inês Reinert Azambuja1, Murilo Foppa1,2, Mário Fernando de Camargo Maranhão3, Aloyzio Cechella Achutti2
Universidade Federal do Rio Grande do Sul, Medical School, Graduate studies in epidemiology1, Moinhos de Vento Hospital, Cardiology Division, Porto Alegre, RS2; Evangelical Medical School, Curitiba, PR3 - Brazil
Summary
Background: The scarce amount of data available in Brazil on the economic burden of cardiovascular diseases (CVD) does not justify the growing concern in regard to the economic burden involved.
Objective: The present study aims at estimating the costs of severe CVD cases in Brazil.
Methods: Cases of severe CVD were estimated based on hospitalized cases lethality and total CVD mortality rates. National data bases and sample studies were used to estimate costs of hospitalization, outpatient care, and social security benefits. Loss of income was estimated from the Burden of Disease in Brazil data.
Results: Approximately two million cases of severe CVD were reported in 2004 in Brazil. That accounts for 5.2% of the population over 35 years of age. The resulting annual cost was at least R$ 30.8 billion (U$1=R$2.93; 2004) (36.4% for health care, 8.4% for social security and employers’ reimbursements, and 55.2% due to loss in productivity). That corresponded to R$ 500.00 per capita (considering 35 year-old and older population) and R$ 9,400.00 per patient. Direct costs with health care from severe CVD cases accounted for 8% of total national expenditure on health and 0.52% of 2004 GNP (R$ 1,767 billion = US$ 602 billion). That corresponded to a yearly average direct cost of R$182.00 per capita (R$ 87.00 from public resources) and of R$ 3,514.00 per case.
Conclusion: Total annual costs per severe CVD case were estimated to be significant. Costs per capita and total costs corresponding to this sub-group of CVD patients are expected to escalate as the population ages and the prevalence of severe cases increases. (Arq Bras Cardiol 2008;91(3):148-155)
Key words: Cardiovascular diseases/epidemiology; ischemic heart disease/epidemiology; cerebrovascular disease/epidemiology; health economics.

SBC assina termo de cooperação com Ministério da Saúde

SBC assina termo de cooperação com Ministério da Saúde



Nesta quarta-feira, 3 de setembro, o ministro da Saúde José Gomes Temporão e o presidente da SBC, Antonio Carlos Palandri Chagas, assinam termo de cooperação, firmando parceria entre as duas entidades. A assinatura tem como finalidade implementar estratégias para aperfeiçoar a política de atenção em cardiologia do Sistema Único de Saúde.

A parceria é fato extremamente relevante e fruto de uma série de ações colocadas em prática pela atual diretoria da SBC para interferir positivamente na formulação das políticas públicas direcionadas à saúde cardiovascular. Na avaliação de Chagas, esse esforço bem-sucedido para influir na formatação desses projetos faz parte da missão maior da SBC, à medida que representa o viés social, também missão do cardiologista.

Entre os objetivos do acordo ainda estão:
• qualificar profissionais de saúde com o objetivo de melhorar o atendimento de usuários com doenças cardiovasculares nos diferentes níveis de atenção do SUS;
• elaborar protocolos técnicos científicos, utilizando a melhor evidência científica disponível, para utilização no âmbito do SUS;
• elaborar manuais e normas técnico-científicas sobre doenças cardiovasculares para a ampla utilização pelos profissionais e usuários do SUS;
• desenvolver campanhas educativas voltadas à prevenção dos agravos fatores de risco à saúde relacionados às doenças cardiovasculares.

O termo de cooperação terá vigência de cinco anos, a contar de sua assinatura, podendo ter sua duração prorrogada. A parceria considera:
• a relevância das doenças cardiovasculares no quadro epidemiológico brasileiro, sua alta incidência e prevalência e sua relação com elevados índices de morbi-mortalidade;
• a necessidade de uma estratégia específica voltada para detecção e controle destas doenças;
• que as doenças cardiovasculares são responsáveis por mais 30% dos óbitos totais no país e também pela incapacidade, perda de produtividade e reduzida qualidade de vida em muitos indivíduos em todas as faixas etárias;
• a necessidade de aprimorar as estratégias específicas para a promoção da saúde cardiovascular, prevenção das doenças, detecção precoce, tratamento e reabilitação voltadas para o conjunto da sociedade brasileira;
• a existência de propostas diretivas, oriundas de especialistas da Sociedade Brasileira de Cardiologia;
• e a necessidade de qualificação de profissionais de saúde para uma adequada abordagem das doenças cardiovasculares.

A assinatura acontecerá as 11h, no gabinete do ministro da Saúde, em Brasília.

Translating Research Into Practice for Healthcare Providers: The American Heart Association's Strategy for Building Healthier Lives, Free of Cardiovascular Diseases and Stroke -- Jones et al. 118 (6): 687 -- Circulation

Translating Research Into Practice for Healthcare Providers: The American Heart Association's Strategy for Building Healthier Lives, Free of Cardiovascular Diseases and Stroke -- Jones et al. 118 (6): 687 -- Circulation

Daniel W. Jones, MD, FAHA; Eric D. Peterson, MD, MPH, FAHA; Robert O. Bonow, MD, FAHA; Frederick A. Masoudi, MD, MSPH; Gregg C. Fonarow, MD, FAHA; Sidney C. Smith, Jr, MD, FAHA; Penelope Solis, JD; Meighan Girgus, MBA; Patricia C. Hinton, MA, MS; Anne Leonard, MPH, RN, FAHA; Raymond J. Gibbons, MD, FAHA
Abstract—The American Heart Association’s (AHA’s) mission is “to build healthier lives, free of cardiovascular diseases and stroke.” This first article in a 2-part series will serve to present an overview of the work the AHA has undertaken to translate evidence into practice for healthcare professionals. It describes the extensive work of the AHA to support and further the delivery of evidence-based medicine, which includes the following: (1) supporting scientific discovery and the next generation of healthcare professionals and researchers; (2) disseminating scientific information; (3) developing evidence-based guidelines and statements; (4) creating and advocating for the implementation of performance indicators/measures; (5) developing clinical decision support and quality improvement tools; and (6) developing directed-cause campaigns, all of which can lead to improved patient care. This article also discusses the need for novel approaches and some of the AHA’s evolving strategies to help address gaps in care. The second article, which will be published shortly after this one, will examine the AHA’s efforts to engage and empower healthcare consumers to become more involved with their own health and health care. (Circulation. 2008;118:687-696.)
Key Words: cardiovascular diseases
research
stroke

Corações Carentes

Matérias do Caderno Vida do Jornal Zero Hora (Jornalista Daniel Cardoso daniel.cardoso@zerohora.com.br) do dia 19 de julho p.p. relacionadas com nosso Estudo sobre Mortalidade Cardiovascular Precoce e Condições Socio-Econômicas em Porto Alegre:

http://zerohora.clicrbs.com.br/zerohora/jsp/default2.jsp?uf=1&local=1&source=a2055280.xml&template=3898.dwt&edition=10297&section=86http://zerohora.clicrbs.com.br/zerohora/jsp/default2.jsp?uf=1&local=1&source=a2055290.xml&template=3916.dwt&edition=10297&section=85http://zerohora.clicrbs.com.br/zerohora/jsp/default2.jsp?uf=1&local=1&source=a2055317.xml&template=3898.dwt&edition=10297&section=86http://zerohora.clicrbs.com.br/pdf/4715701.pdfhttp://zerohora.clicrbs.com.br/zerohora/jsp/default2.jsp?uf=1&local=1&source=a2055305.xml&template=3898.dwt&edition=10297&section=86

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2008000600004&lng=en&nrm=iso&tlng=en

Mortalidade Precoce por DCV POA.

Mortalidade Precoce por Doenças Cardiovasculares e Desigualdades Sociais em Porto Alegre: da Evidência à Ação.
Premature Mortality due to Cardiovascular Disease and Social Inequalities in Porto Alegre: from Evidence to Action
Sérgio Luiz Bassanesi, Maria Inês Azambuja, Aloyzio AchuttiUniversidade Federal do Rio Grande do Sul, Academia Sul-Riograndense de Medicina, Porto Alegre, RS - Brasil
Resumo
Fundamento: Duas perspectivas, a econômica (doença causando empobrecimento) e a social (pobreza causando adoecimento), têm disputado internacionalmente a justificação de políticas públicas de saúde.
Objetivo: Investigar a relação entre mortalidade precoce por doenças cardiovasculares (DCV) e condições socioeconômicas (SE) em Porto Alegre (PA), e discutir fundamentos e estratégias para a prevenção das DCV.
Métodos: Análise ecológica da associação entre mortalidade por DCV aos 45-64 anos e condições SE de 73 bairros de PA. Estimou-se o risco relativo (RR) e a fração do risco atribuível (FRA) às desigualdades entre bairros agrupados em 4 estratos SE.
Resultados: A mortalidade precoce por DCV foi 2,6 vezes maior nos bairros classificados no pior comparado ao melhor de 4 estratos SE. Entre bairros extremos, o RR chegou a 3,3 para as DCV e 3,9 para as doenças cerebrovasculares. Comparada à mortalidade no melhor estrato, 62% dos óbitos precoces do pior estrato e 45% dos da cidade como um todo seriam atribuíveis à desigualdade socioeconômica.
Conclusão: Quase a metade da mortalidade por DCV antes do 65 anos pode ser atribuída à pobreza. A doença, por sua vez, contribui para a pobreza e reduz a competitividade do país. É preciso reduzir o adoecimento e recuperar a saúde dos mais pobres com investimentos que resultem em desenvolvimento econômico-nacional e melhoria das condições sociais da população. (Arq Bras Cardiol 2008; 90(6): 403-412)
Palavras-chave: Mortalidade, doenças cardiovasculares, prevenção de doenças, iniqüidade social.

Summary
Background: Two perspectives, the economic (disease causing impoverishment) and social (poverty causing illness), have internationally disputed the justification for public health policies.
Objective: To investigate the relationship between early mortality by cardiovascular disease (CVD) and socioeconomic (SE) conditions in the city of Porto Alegre (PA), and discuss bases and strategies for the prevention of CVD.
Methods: An ecological analysis of the association between mortality by CVD at 45-64 years of age and SE conditions of 73 districts/neighborhoods in PA. The relative risk (RR) and the fraction of risk (FRA) attributable to inequality among the districts grouped into 4 SE strata were estimated.
Results: Early mortality by CVD was 2.6 times higher in the districts classified in the worst compared to the best of the 4 SE strata. Among the extreme districts, the RR reached 3.3 for CVD and 3.9 for cerebrovascular disease. Compared to the mortality in the best stratum, 62% of the early deaths in the worst stratum and 45% of those in the city as a whole could be attributed to socioeconomic inequality.
Conclusion: Almost half of the mortality by CVD before 65 years of age can be attributed to poverty. Disease, on the other hand, contributes towards poverty and reduces competitiveness of the country. It is necessary to reduce illness and recover the health of the poorest inhabitants with investments that result in national economic development and improvement of the social conditions of the population. (Arq Bras Cardiol 2008; 90(6): 370-379)
Key words: Mortality; cardiovascular diseases; disease prevention; social inequity.
Full texts in English - http://www.arquivosonline.com.br
Correspondência: Maria Inês Azambuja • Rua Ramiro Barcelos 2600/420 - 90035-003 - Bom Fim - Porto Alegre, RS - BrasilE-mail: miazambuja@terra.com.brArtigo recebido em 12/11/07; revisado recebido em 09/01/08; aceito em 15/01/08.

Doctor's Guide Weekly News - Cardiology.

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TOP READ in the past 7 daysNew oral anticoagulants in atrial fibrillationThis paper reviews the mechanism of platelet inhibition and vitamin K antagonism in the prevention of stroke among patients with atrial fibrillation, the possible adverse pharmacological effects of these agents, the targets for novel anticoagulants, and the new agents in various stages of clinical development...Full Story

Most read Cardiology news in the past 7 daysPapers and articles, pertaining to Cardiology, most read by your colleagues in the past 7 days
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N-acetylcysteine for prevention of acute renal failure in patients with chronic renal insufficiency undergoing cardiac surgery: A prospective, randomized, clinical trial* (Crit Care Med)
Curing atrial fibrillation: Two decades of progress (J Interv Card Electrophysiol)
Management of ST-segment elevation myocardial infarction in EDs (Am J Emerg Med)
Less increase of BNP and NT-proBNP levels in obese patient with decompensated heart failure Interpretation of natriuretic peptides in obesity (Int J Cardiol)
Endovenous 980-nm laser treatment of saphenous veins in a series of 500 patients (J Vasc Surg)
From 'optimal' to 'borderline' blood pressure in subjects under chronic antihypertensive therapy (J Hypertens)
Paraoxonase (PON1) is associated with familial combined hyperlipidemia (Atherosclerosis)
Effectiveness and tolerability of administration of granulocyte colony-stimulating factor on left ventricular function in patients with myocardial infarction: A meta-analysis of randomized controlled trials (Clin Ther)
Long-term survival in patients older than 80 years hospitalised for heart failure. A 5-year prospective study (Eur J Heart Failure)

Social Determinants of the Premature Cardiovascular Mortality

De: Ruggiero, Mrs. Ana Lucia (WDC) [mailto:ruglucia@paho.org]

Enviada em: segunda-feira, 29 de outubro de 2007 18:38

Assunto: Presentacion: Factores Sociales Determinantes de la Muerte Prematura debida a Enfermedades cardiovasculares Porto Alegre – Brazil

Prof. Sergio Luiz Bassanesi
Departamento de Medicina Social
Facultad de Medicina Universidad Federal de Rio Grande do Sul - Brazil
Monday 29 October 2007 in Room C
PAHO/WHO - Health Surveillance and Disease Management Area, HDM

Recording link to Elluminate web conference session:
https://sas.elluminate.com/p.jnlp?psid=2007-10-29.1009.M.1BC839C524B0BA4B8BF53A3EC0770F.vcr

Link to: PPT presentation:
http://portal.paho.org/sites/IKM/WorkSpaces/ikmbrownbag/Documents/Cardiovascular%20Diseases%20OPAS.ppt

8th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke

Abstracts
8th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke
May 9–11, 2007 Omni Shoreham Hotel, Washington, DC
Sponsored by the American Heart Association’s Quality of Care and Outcomes. Research Interdisciplinary Working Group. Cosponsored by the Councils on Cardiovascular Nursing, Clinical Cardiology, and Stroke
Conference Program Committee
John A. Spertus, MD, MPH, Conference Chair; John S. Rumsfeld, MD, PhD, Conference
Vice-chair Ralph G. Brindis, MD, MPH, FACC; Kim C. Coley, PharmD; Elizabeth R. DeLong, PhD; T. Bruce Ferguson, Jr, MD; Matthew E. Fitzgerald, DrPH; William A. Ghali, MD; David C. Goff, Jr, MD, PhD, FAHA; Edward P. Havranek, MD; Kathy A. Hebert, MD, MMM, MPH; Harlan M. Krumholz, MD, SM; Frederick A. Masoudi, MD, MSPH; Rita F. Redberg, MD, MSc, FACC; Anne Sales, MSN, PhD; Lee H. Schwamm, MD, FAHA; Richard E. Shaw, MA, PhD, FACC, FACA; Henry H. Ting, MD, MBA
Increasingly there is interest in efforts to assess and improve clinical and health care delivery
performance. This has been the focus of the Forum on Quality of Care and Outcomes Research. The meeting is held annually in Washington, DC and includes workshops, plenary sessions, concurrent sessions, and both oral and poster abstract presentations. This year, abstracts were accepted from more than 15 countries covering broad topics in outcomes research.