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When Is the Best Moment to Assess the Ankle Brachial Index: Pre- or Post-Hemodialysis?

Cabrera Jimenez, Zaida Noemy; de Castro, Lsac; Pereira, Benedito Jorge; de Oliveira, Rodrigo Bueno; Romao, Joao Egidio, Jr.; Elias, Rosilene Motta
Fonte: KARGER; BASEL Publicador: KARGER; BASEL
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
96.51%
Background: Cardiovascular disease is an important cause of death in patients on dialysis. Peripheral arterial disease (PAD) is a prognostic factor for cardiovascular disease. The ankle brachial index (ABI) is a noninvasive method used for the diagnosis of PAD. The difference between ABI pre- and post-dialysis had not yet been formally tested, and it was the main objective of this study. Methods:The ABI was assessed using an automated oscillometric device in incident patients on hemodialysis. All blood pressure readings were taken in triplicate pre- and post-dialysis in three consecutive dialysis sessions (times 1, 2, and 3). Results: One hundred and twenty-three patients (85 men) aged 53 +/- 19 years were enrolled. We found no difference in ABI pre- and post-dialysis on the right or left side, and there was no difference in times 1, 2, and 3. In patients with a history of PAD, the ABI pre- versus post-dialysis were of borderline significance on the right side (p = 0.088). Conclusion: ABI measured pre- and post-dialysis presented low variability. The ABI in patients with a history of PAD should be evaluated with caution. The applicability of the current method in predicting mortality among patients on hemodialysis therefore needs further investigation. Copyright (C) 2012 S. Karger AG...

Perioperative cardiovascular evaluation: heads or tails?

Carmo, Gabriel Assis Lopes do; Calderaro, Daniela; Yu, Pai Ching; Gualandro, Danielle Menosi; Marques, André Coelho; Bittar, Cristina Salvadori; Pastana, Adriana Feio; Caramelli, Bruno
Fonte: ASSOC MEDICA BRASILEIRA; SAO PAULO Publicador: ASSOC MEDICA BRASILEIRA; SAO PAULO
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
66.48%
When dealing with surgical patients, a perioperative evaluation is essential to anticipate complications and institute measures to reduce the risks. Several algorithms and exams have been used to identify postoperative cardiovascular events, which account for more than 50% of perioperative mortality. However, they are far from ideal. Some of these algorithms and exams were proposed before important advances in cardiology, at a time when pharmacological risk reduction strategies for surgical patients were not available. New biomarkers and exams, such as C-reactive protein, brain natriuretic peptide, and multislice computed tomography have been used in cardiology and have provided important prognostic information. The ankle-brachial index is another significant marker of atherosclerosis. However, specific information regarding the perioperative context of all these methods is still needed. The objective of this article is to evaluate cardiovascular risk prediction models after noncardiac surgery.

Ankle-Brachial Index: A Simple Way to Predict Mortality among Patients on Hemodialysis - A Prospective Study

Cabrera Jimenez, Zaida Noemy; Pereira, Benedito Jorge; Romao, Joao Egidio, Jr.; da Silva Makida, Sonia Cristina; Abensur, Hugo; Affonso Moyses, Rosa Maria; Elias, Rosilene Motta
Fonte: PUBLIC LIBRARY SCIENCE; SAN FRANCISCO Publicador: PUBLIC LIBRARY SCIENCE; SAN FRANCISCO
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
76.34%
Background: Ankle-brachial index (ABI) can access peripheral artery disease and predict mortality in prevalent patients on hemodialysis. However, ABI has not yet been tested in incident patients, who present significant mortality. Typically, ABI is measured by Doppler, which is not always available, limiting its use in most patients. We therefore hypothesized that ABI, evaluated by a simplified method, can predict mortality in an incident hemodialysis population. Methodology/Principal Findings: We studied 119 patients with ESRD who had started hemodialysis three times weekly. ABI was calculated by using two oscillometric blood pressure devices simultaneously. Patients were followed until death or the end of the study. ABI was categorized in two groups normal (0.9-1.3) or abnormal (<0.9 and >1.3). There were 33 deaths during a median follow-up of 12 months (from 3 to 24 months). Age (1 year) (hazard of ratio, 1.026; p = 0.014) and ABI abnormal (hazard ratio, 3.664; p = 0.001) were independently related to mortality in a multiple regression analysis. Conclusions: An easy and inexpensive technique to measure ABI was tested and showed to be significant in predicting mortality. Both low and high ABI were associated to mortality in incident patients on hemodialysis. This technique allows nephrologists to identify high-risk patients and gives the opportunity of early intervention that could alter the natural progression of this population.; Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)...

Risco cardiovascular na hipertensão do avental branco: avaliação do Índice Tornozelo Braquial; Cardiovascular risk in white coat hypertension evaluation of ankle brachial index

Freitas, Dayana
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 03/10/2012 Português
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96.6%
As alterações vasculares são complicações clínicas secundárias a elevação da pressão arterial que podem comprometer a capacidade funcional e aumentar o risco de mortalidade. Um instrumento utilizado como marcador de doença arterial obstrutiva periférica que vem merecendo amplo interesse clínico e científico é o Índice Tornozelo-Braquial (ITB). Segundo diretrizes para a prática clínica, valores de ITB <=0,9 ou >=1,3 são considerados patológicos e associados a uma alta incidência de morbimortalidade cardiovascular. Este estudo descritivo e de corte transversal teve por objetivo identificar o risco cardiovascular em hipertensos do avental branco por meio da determinação do ITB com uso de esfigmomanômetros oscilométricos automáticos. Foi desenvolvido em um município localizado ao Nordeste do Estado de São Paulo, no período de agosto de 2010 a junho de 2011. Os participantes foram divididos em normotensos, hipertensos e hipertensos do avental branco, classificados de acordo com o diagnóstico médico e resultado da Monitorização Ambulatorial da Pressão Arterial (MAPA). As variáveis investigadas foram: idade, cor da pele, situação familiar conjugal, naturalidade, índice de escolaridade...

Avaliação da medida do índice tornozelo-braquial em portadores de hipercolesterolemia familiar; Assessment ot the ankle-brachial index in patients with familial hypercholesterolemia

Pereira, Carolina
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 20/02/2014 Português
Relevância na Pesquisa
96.48%
A hipercolesterolemia familiar (HF) é uma doença de herança genética autossômica dominante caracterizada pela elevação dos níveis séricos de colesterol total e das lipoproteínas de baixa densidade (LDL- c). Conhecida por estar estreitamente relacionada ao processo aterosclerótico, a HF pode determinar o desenvolvimento de lesões obstrutivas precoces em distintos leitos arteriais. Nesse contexto, a HF também tem sido proposta como um fator de risco para a doença arterial periférica (DAP). Avaliamos assim de forma sistemática por meio de um estudo transversal e observacional, a prevalência de DAP em uma população brasileira de portadores de HF. Estudamos também sua associação com diversos fatores de risco cardiovascular, incluindo sexo, idade, hipertensão arterial sistêmica, diabetes mellitus, tabagismo, perfil lipídico, níveis séricos de glicemia e creatinina. Avaliou-se também a associação da DAP com histórico prévio de doença cardiovascular (DCV) bem como sua associação com marcadores de aterosclerose subclínica representados pela angiotomografia coronariana e escore de cálcio coronário. Foram estudados 212 portadores de HF, sendo que em 86% foi comprovada presença de mutação do receptor da LDL e um grupo de comparação composto por 524 indivíduos normolipidêmicos. O rastreamento da DAP foi realizado por dois avaliadores treinados...

Uso do índice tornozelo-braquial como preditor de eventos cardiovasculares no pós-operatório de cirurgias não cardíacas; Ankle-brachial index estimating cardiac complications after general surgery

Carmo, Gabriel Assis Lopes do
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 25/04/2014 Português
Relevância na Pesquisa
96.6%
A avaliação perioperatória é uma etapa importante antes de encaminhar o paciente para a realização de uma operação. Algoritmos e escores podem ajudar durante este processo de estratificação de risco e na tomada de decisões. Entretanto, a maior parte deles foram descritos e desenvolvidos em um contexto diferente que pode não representar a realidade médico atual. O índice tornozelo-braquial (ITB) é capaz de quantificar o risco cardiovascular na população em geral. É um método barato e passível de ser realizado ambulatorialmente e poderia ser útil antes da realização de procedimentos cirúrgicos. O trabalho atual é um estudo observacional e prospectivo que avaliou pacientes de risco cardiovascular perioperatório intermediário a alto antes de serem submetidos a cirurgias não cardíacas. O ITB foi aferido em todos os pacientes. Um valor <=0,9 foi considerado alterado, definindo o grupo portador de doença arterial periférica. Os demais pacientes constituíram o grupo controle. Traçados eletrocardiográficos e dosagem sérica de troponina foram obtidos em todos os pacientes nas primeiras 72 horas após o procedimento. Todos os pacientes foram seguidos por um período de 30 dias, sendo o desfecho primário um combinado de eventos cardiovasculares (mortalidade cardiovascular...

Associação entre diferentes parâmetros de variabilidade da pressão sistólica fornecidos pela monitorização ambulatorial de pressão arterial (mapa) e o índice tornozelo-braquial

Wittke, Estefania Inez
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Dissertação Formato: application/pdf
Português
Relevância na Pesquisa
66.67%
Introdução: Tem sido demonstrada uma associação entre a variabilidade da pressão arterial avaliada por diferentes índices e lesão em órgão-alvo, independentemente dos valores de pressão arterial. O índice tornozelo-braquial (ITB) é útil no diagnóstico de doença arterial oclusiva periférica, sendo reconhecido como marcador de aterosclerose sistêmica. Objetivo: Avaliar a associação entre três diferentes métodos de estimar a variabilidade da pressão arterial sistólica (taxa de variação da pressão no tempo - índice "time-rate", coeficiente de variabilidade, desvio padrão das médias da pressão arterial sistólica de 24 horas) e o índice tornozelo-braquial (ITB). Métodos: Em um estudo transversal, pacientes atendidos no ambulatório de hipertensão realizaram medida de ITB e Monitorização Ambulatorial da Pressão Arterial de 24 horas (MAPA). Três parâmetros de variabilidade foram avaliados: o índice "time-rate" definido como a primeira derivada da pressão arterial sistólica em relação ao tempo; desvio padrão (DP) das médias da pressão arterial sistólica (PAS) de 24 horas e coeficiente de variabilidade (CV=DP/média pressóricaX100%). O ITB aferido por doppler foi obtido pela razão entre a maior pressão arterial sistólica do tornozelo ou pediosa e a maior pressão sistólica dos braços. O ponto de corte para o diagnóstico de doença arterial periférica foi ITB <= 0...

Ankle-brachial index, vascular calcifications and mortality in dialysis patients

Adragao, Teresa; Pires, Ana; Branco, Patricia; Castro, Rui; Oliveira, Ana; Nogueira, Cristina; Bordalo, Joaquim; Curto, Jose Dias; Prata, Mateus Martins
Fonte: Oxford University Press Publicador: Oxford University Press
Tipo: Artigo de Revista Científica
Publicado em /01/2012 Português
Relevância na Pesquisa
96.48%
WOS:000299957700048 (Nº de Acesso Web of Science); “Prémio Científico ISCTE-IUL 2013”; Background. The ankle-brachial index (ABI) is a noninvasive method to evaluate peripheral artery disease (PAD). ABI <0.9 diagnoses PAD; ABI >1.3 is a false negative caused by noncompressible arteries. The aim of this study is to evaluate the association between ABI with vascular calcifications (VC) and with mortality, in haemodialysis (HD) patients. Methods. We studied 219 HD patients (60% male; 20% diabetic). At baseline, ABI was evaluated by a Doppler device. VCs were evaluated by two methods: the abdominal aorta calcification score (AACS) in a lateral plain X-ray of the abdominal aorta and the simple vascular calcification score (SVCS) in plain X-rays of the pelvis and hands. VC were also classified by their anatomical localization in main vessels (aorta and iliac-femoral axis) and in peripheral or distal vessels (pelvic, radial or digital). The cutoff values for the different VC scores in relation with ABI were determined by receiver operating characteristic curve analysis. Biochemical parameters were time averaged for the 6 months preceding ABI evaluation. Results. An ABI <0.9, an ABI >1.3 or a normal ABI were found, respectively...

Ankle-Brachial Index: Nurses Strategy To Cardiovascular Disease Risk Factors Identification

Maggi,Daniela Luisa; Quadros,Leyla Regina Dal Piva de; Azzolin,Karina de Oliveira; Goldmeier,Silvia
Fonte: Universidade de São Paulo, Escola de Enfermagem Publicador: Universidade de São Paulo, Escola de Enfermagem
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2014 Português
Relevância na Pesquisa
96.57%
Elevated risk of fatal and non-fatal cardiovascular events is associated with high prevalence of peripheral arterial disease, with assessment through the ankle-brachial index (ABI). This study aimed to demonstrate that the ABI and the Edinburgh Claudication Questionnaire are tools to be used by nurses in prevention and/or treatment of CVD (cardiovascular disease). A cross-sectional study was carried out with patients from a cardiovascular clinic. The Edinburgh Claudication Questionnaire was applied and the ABI was measured with the formula (ABI= Blood Pressure Ankle/Blood Pressure Brachial). A total of 115 patients were included, most were females (57.4%), aged 60.6 ± 12.5 years. The most prevalent risk factors were hypertension (64.3%), physical inactivity (48.7%) and family history (58.3%). The study showed that abnormal ABI was frequently found and 42.6% of the patients with abnormal ABI showed intermittent claudication. The method to evaluate the ABI associated to the Edinburg Claudication Questionnaire, can be easily used by nurses in the clinical evaluation of asymptomatic and symptomatic CVD patients.

Validity, reliability and accuracy of oscillometric devices, compared with Doppler ultrasound, for determination of the Ankle Brachial Index: an integrative review

Gengo e Silva,Rita de Cassia; Melo,Vanessa Ferreira Amorim de; Lima,Maria Aparecida de Medeiros
Fonte: Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) Publicador: Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2014 Português
Relevância na Pesquisa
96.48%
INTRODUCTION: The conventional method for measuring the ankle-brachial index (ABI) requires a vascular Doppler machine and a trained professional, which is a barrier to the examination becoming more widely adopted across health services. For this reason, the possibility of substituting Doppler monitors for other types of device has been investigated. The objective of this study was to assess the validity, reliability and accuracy of taking ABI measurement using oscillometric devices and compare them to vascular Doppler. METHODS: This is an integrative literature review of four articles. RESULTS: There was very little uniformity between the four studies in terms of ample populations or the methodological procedures used to measure systolic pressures. The results for sensitivity, specificity and positive and negative predictive values varied and so did measures of reliability. CONCLUSIONS: The results of these studies do not provide a basis from which conclusions can be drawn on the validity, reliability or accuracy of employing oscillometric devices as a substitute for Doppler for determination of ABI.

Critical Review of the Ankle Brachial Index

Khan, Tahir H; Farooqui, Falahat A; Niazi, Khusrow
Fonte: Bentham Science Publishers Ltd. Publicador: Bentham Science Publishers Ltd.
Tipo: Artigo de Revista Científica
Publicado em /05/2008 Português
Relevância na Pesquisa
66.48%
Ankle brachial index (ABI) has been utilized in the management of peripheral arterial disease (PAD).ABI is a surrogate marker of atherosclerosis and recent studies indicate its utility as a predictor of future cardiovascular disease and all-cause mortality. Even so, this critical test is underutilized. The purpose of this review is to summarize available evidence associated with ABI methodology variances, ABI usage in the treatment of PAD, and ABI efficacy in predicting cardiovascular disease. This review further evaluates how ABI is used in the prognosis and follow-up of lower extremity arterial disease.We reviewed the most current American College of Cardiology guidelines for the management of PAD, the Trans Atlantic Intersociety Consensus (TASC) working group recommendations, and searched the Medline for the following words: ankle brachial index, ABI sensitivity and specificity, and peripheral arterial disease.

The Relevance of Different Methods of Calculating the Ankle-Brachial Index: The Multi-Ethnic Study of Atherosclerosis

Allison, Matthew A.; Aboyans, Victor; Granston, Tanya; McDermott, Mary M.; Kamineni, Aruna; Ni, Hanyu; Criqui, Michael H.
Fonte: Oxford University Press Publicador: Oxford University Press
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
66.58%
The authors aimed to determine differences in the prevalence of peripheral arterial disease (PAD) and its associations with cardiovascular disease (CVD) risk factors, using different methods of calculating the ankle-brachial index (ABI). Using measurements taken in the bilateral brachial, dorsalis pedis, and posterior tibial arteries, the authors calculated ABI in 3 ways: 1) with the lowest ankle pressure (dorsalis pedis artery or posterior tibial artery) (“ABI-LO”), 2) with the highest ankle pressure (“ABI-HI”), and 3) with the mean of the ankle pressures (“ABI-MN”). For all 3 methods, the index ABI was the lower of the ABIs calculated from the left and right legs. PAD was defined as an ABI less than 0.90. Among 6,590 subjects from a multiethnic cohort (baseline examination: 2000–2002), in comparison with ABI-HI, the relative prevalence of PAD was 3.95 times higher in women and 2.74 times higher in men when ABI-LO was used. The relative magnitudes of the associations were largest between PAD and both subclinical atherosclerosis and CVD risk factors when ABI-HI was used, except when risk estimates for PAD were less than 1.0, where the largest relative magnitudes of association were found using ABI-LO. PAD prevalence and its associations with CVD risk factors and subclinical atherosclerosis measures depend on the ankle pressure used to compute the ABI.

Cardiovascular Risk Factors and Distributions of the Ankle-Brachial Index among Type 2 Diabetes Mellitus Patients

Doza, Badaruddoza; Kaur, Manpreet; Chopra, Sonia; Kapoor, Rohit
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
66.66%
Background. The aim of present study is to observe the association between the levels of ankle-brachial index (ABI) and cardiovascular risk factors among people with type 2 diabetes mellitus in north India. A cross-sectional study was carried out at a centre for heart and diabetic clinic in the state of Punjab on 1121 subjects (671 males and 450 females) with type 2 diabetes mellitus. History of symptoms related to cardiovascular diseases was noted, and blood pressure and anthropometric measurements were recorded. Ankle-brachial index (ABI) was measured using ultrasonic Doppler flow detector. Subjects with ABI ≤0.9 and ≥1.30 were classified as having low and high ABI, respectively. Females had a higher BMI and brachial-ankle pulse wave velocity (P < 0.001). Whereas, males had higher diastolic blood pressure and duration of type 2 diabetes mellitus. The differences of systolic blood pressure and ankle-brachial index were not found significant between the sexes. The prevalence of low ABI (<0.9) was 4.47% in men and 4.67% in women and high ABI (≥1.30) was prevalent in 14% of men and 10.45% of women. Age, BMI, baPWV, and blood pressures were significantly associated with ABI value in both sexes. The results suggested that the ABI might be used as a strong indicator for cardiovascular risk factors in type 2 diabetic subjects.

Lower ankle-brachial index is associated with poor sleep quality in patients with essential hypertension

Yamaki, Michiyasu; Sato, Toshiaki; Fujii, Hiromi
Fonte: e-Century Publishing Corporation Publicador: e-Century Publishing Corporation
Tipo: Artigo de Revista Científica
Publicado em 20/03/2015 Português
Relevância na Pesquisa
66.53%
Background: The ankle-brachial index (ABI), ratio of leg blood pressure to arm blood pressure is used extensively as a screening test for stratification of cardiovascular risk. The problems in sleep disturbed nocturnal fall in blood pressure and may relate to development of hypertension. However, the role of sleep quality on ankle-brachial index remains unclear. Methods and Results: This study examined 101 patients with essential hypertension. We analyzed the association with ABI on age, sex, body height, body weight, body mass index, waist circumference, blood pressure, HDL-cholesterol, LDL-cholesterol, HbA1c, sleep quality evaluated by Pittsburgh Sleep Quality Index (PSQI), smoking habits, alcohol habits. The ABI is associated with the following seven parameters; body height (r = 0.36, p < 0.001), body weight (r = 0.30, p < 0.005), systolic BP (r = -0.23, p < 0.05), HbA1c (r = -0.24, p < 0.05), PSQI score (rho = -0.31, p < 0.005), alcohol intake (rho = 0.23, p < 0.05) and sex (F = 6.65, p < 0.05). By a multiple linear regression analysis with ABI as the dependent variable after forcing the seven parameters above into the model, body height, HbA1c and PSQI score were significantly associated with ABI (R 2 for the model = 25%, p < 0.001). Conclusion: Poor sleep quality was independently associated with lower ABI in patients with essential hypertension. The results may provide new insight related to the interaction between sleep quality and blood pressure.

Ankle brachial index combined with Framingham risk score to predict cardiovascular events and mortality: a meta-analysis

Jamrozik, K.
Fonte: Amer Medical Assoc Publicador: Amer Medical Assoc
Tipo: Artigo de Revista Científica
Publicado em //2008 Português
Relevância na Pesquisa
66.6%
Context: Prediction models to identify healthy individuals at high risk of cardiovascular disease have limited accuracy. A low ankle brachial index (ABI) is an indicator of atherosclerosis and has the potential to improve prediction. Objective: To determine if the ABI provides information on the risk of cardiovascular events and mortality independently of the Framingham risk score (FRS) and can improve risk prediction. Data Sources: Relevant studies were identified. A search of MEDLINE (1950 to February 2008) and EMBASE (1980 to February 2008) was conducted using common text words for the term ankle brachial index combined with text words and Medical Subject Headings to capture prospective cohort designs. Review of reference lists and conference proceedings, and correspondence with experts was conducted to identify additional published and unpublished studies. Study Selection: Studies were included if participants were derived from a general population, ABI was measured at baseline, and individuals were followed up to detect total and cardiovascular mortality. Data Extraction: Prespecified data on individuals in each selected study were extracted into a combined data set and an individual participant data meta-analysis was conducted on individuals who had no previous history of coronary heart disease. Results: Sixteen population cohort studies fulfilling the inclusion criteria were included. During 480 325 person-years of follow-up of 24 955 men and 23 339 women...

Associação dos achados morfofuncionais cardíacos, renais e vasculares com as alterações do índice tornozelo-braço em pacientes hipertensos diabéticos; Association of cardiac, renal and vascular morphological and functional findings with changes in ankle brachial index in diabetic hypertensive patients

Pompeu Filho, José Carlos Jucá
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 12/08/2015 Português
Relevância na Pesquisa
96.48%
Introdução: Inúmeros estudos estabeleceram correlações entre o índice tornozelo-braço (ITB), um marcador de aterosclerose subclínica, e o prognóstico cardiovascular em diferentes populações. No entanto, poucos estudos avaliaram a correlação entre os valores do ITB e lesões cardiovasculares e renais, exclusivamente, em pacientes com hipertensão arterial e diabetes. Objetivo: Estudar a prevalência de alterações morfofuncionais cardíacas, carotídeas, retinianas e renais de acordo com a presença ou não de valores de ITB alterados (ITB <= 0,9 ou ITB > 1,4) em pacientes hipertensos com diabetes tipo 2. Métodos: Foram incluídos no estudo 99 pacientes hipertensos diabéticos com idade entre 50 e 80 anos. A aferição do ITB foi realizada em todos os pacientes por método validado e estes foram classificados em Grupo 1 (ITB normal, n = 49) ou Grupo 2 (ITB alterado, n =50). Todos os pacientes foram submetidos, em até 06 meses, à realização de ecodopplercardiograma, ultrassonografia de carótidas, retinografia colorida, aferição da taxa de filtração glomerular (TFG) e da albuminúria de 24h. Os pacientes foram analisados para a ocorrência ou não de um desfecho-composto ecocardiográfico que incluiu alterações morfológicas e funcionais cardíacas relevantes para a prática clínica. Os pacientes dos grupos 1 e 2 foram também comparados quanto à prevalência de placas carotídeas com ou sem repercussão hemodinâmica...

Relation of Socioeconomic Position with Ankle-Brachial Index

Agha, G.; Murabito, J.; Lynch, J.; Abrahamowicz, M.; Harper, S.; Loucks, E.
Fonte: Excerpta Medica Inc Publicador: Excerpta Medica Inc
Tipo: Artigo de Revista Científica
Publicado em //2011 Português
Relevância na Pesquisa
96.48%
Potential upstream determinants of coronary heart disease (CHD) include life-course socioeconomic position (e.g., childhood socioeconomic circumstances, own education and occupation); however, several plausible biological mechanisms by which socioeconomic position (SEP) may influence CHD are poorly understood. Several CHD risk factors appear to be more strongly associated with SEP in women than in men; little is known as to whether any CHD risk factors may be more strongly associated with SEP in men. Objectives were to evaluate whether cumulative life-course SEP is associated with a measurement of subclinical atherosclerosis, the ankle-brachial index (ABI), in men and women. This study was a prospective analysis of 1,454 participants from the Framingham Heart Study Offspring Cohort (mean age 57 years, 53.8% women). Cumulative SEP was calculated by summing tertile scores for father's education, own education, and own occupation. ABI was dichotomized as low (≤1.1) and normal (>1.1 to 1.4). After adjustment for age and CHD risk factors cumulative life-course SEP was associated with low ABI in men (odds ratio [OR] 2.04, 95% confidence interval [CI] 1.22 to 3.42, for low vs high cumulative SEP score) but not in women (OR 0.86, 95% CI 0.56 to 1.33). Associations with low ABI in men were substantially driven by their own education (OR 4.13...

Risco cardiovascular, adesão ao tratamento medicamentoso anti-hipertensivo e fragilidade em idosos hipertensos; Cardiovascular risk, adherence to antihypertensive medication and frailty in hypertensive elderly

Thaís Cristina Coelho
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 22/01/2013 Português
Relevância na Pesquisa
66.53%
A presença da hipertensão arterial sistêmica, doença arterial periférica e de outras comorbidades, podem potencializar as chamadas síndromes geriátricas, como a síndrome da fragilidade. Embora seja um fator de risco modificável para doenças cardiovasculares, o percentual de controle da pressão arterial é baixo, sendo uma das causas, a baixa adesão ao tratamento. Tendo em vista que estas condições estão relacionadas ao desenvolvimento de incapacidades, piora da qualidade de vida dos idosos e aumento dos custos para os serviços de saúde, o objetivo desse trabalho foi investigar as relações entre hipertensão arterial, risco cardiovascular e adesão ao tratamento medicamentoso anti-hipertensivo na fragilidade do idoso. Participaram do estudo 111 idosos hipertensos, usuários de um ambulatório de atenção secundária. Foram realizadas medidas da pressão arterial e do índice tornozelo-braço (ITB), índice de massa corporal, avaliação da adesão ao tratamento medicamentoso anti-hipertensivo através do Teste de Morisk-Green e dos critérios de fragilidade (perda de peso não intencional, fadiga, diminuição da força de preensão manual, lentidão de marcha e inatividade física). Idosos que apresentaram 3 ou mais critérios de fragilidade foram considerados frágeis...

Ankle-brachial index as a predictor of coronary disease events in elderly patients submitted to coronary angiography

Papa,Eduardo D. E.; Helber,Izo; Ehrlichmann,Manes R.; Alves,Claudia Maria Rodrigues; Makdisse,Marcia; Matos,Livia N.; Borges,Jairo Lins; Lopes,Renato D.; Stefanini,Edson; Carvalho,Antonio Carlos
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2013 Português
Relevância na Pesquisa
96.79%
OBJECTIVES: To correlate the importance of the ankle-brachial index in terms of cardiovascular morbimortality and the extent of coronary arterial disease amongst elderly patients without clinical manifestations of lower limb peripheral arterial disease. METHODS: We analyzed prospective data from 100 patients over 65 years of age with coronary arterial disease, as confirmed by coronary angiography, and with over 70% stenosis of at least one sub-epicardial coronary artery. We measured the ankle-brachial index immediately after coronary angiography, and a value of <0.9 was used to diagnose peripheral arterial disease. RESULTS: The patients' average age was 77.4 years. The most prevalent risk factor was hypertension (96%), and the median late follow-up appointment was 28.9 months. The ankle-brachial index was <0.9 in 47% of the patients, and a low index was more prevalent in patients with multiarterial coronary disease compared to patients with uniarterial disease in the same group. Using a bivariate analysis, only an ankle-brachial index of <0.9 was a strong predictive factor for cardiovascular events, thereby increasing all-cause deaths and fatal and non-fatal acute myocardial infarctions two- to three-fold. CONCLUSION: In elderly patients with documented coronary disease...

Ankle-brachial index as a predictor of coronary disease events in elderly patients submitted to coronary angiography

Papa, Eduardo D.E.; Helber, Izo; Ehrlichmann, Manes R.; Alves, Claudia Maria Rodrigues; Makdisse, Marcia; Matos, Livia N.; Borges, Jairo Lins; Lopes, Renato D.; Stefanini, Edson; Carvalho, Antonio Carlos
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; Formato: application/pdf
Publicado em 31/12/2013 Português
Relevância na Pesquisa
96.78%
OBJECTIVES: To correlate the importance of the ankle-brachial index in terms of cardiovascular morbimortalityand the extent of coronary arterial disease amongst elderly patients without clinical manifestations of lowerlimb peripheral arterial disease.METHODS: We analyzed prospective data from 100 patients over 65 years of age with coronary arterial disease,as confirmed by coronary angiography, and with over 70% stenosis of at least one sub-epicardial coronaryartery. We measured the ankle-brachial index immediately after coronary angiography, and a value of ,0.9was used to diagnose peripheral arterial disease.RESULTS: The patients’ average age was 77.4 years. The most prevalent risk factor was hypertension (96%), andthe median late follow-up appointment was 28.9 months. The ankle-brachial index was ,0.9 in 47% of thepatients, and a low index was more prevalent in patients with multiarterial coronary disease compared topatients with uniarterial disease in the same group. Using a bivariate analysis, only an ankle-brachial index of,0.9 was a strong predictive factor for cardiovascular events, thereby increasing all-cause deaths and fatal andnon-fatal acute myocardial infarctions two- to three-fold.CONCLUSION: In elderly patients with documented coronary disease...