RESUMO
INTRODUÇÃO: A Hipertensão do Avental Branco (HAB) éuma condição clínica caracterizada por níveis elevados de pressãoarterial no consultório que não se mantêm nas medidas realizadasna ausência do médico. Artigos recentes têm demonstradoque tal condição não é tão benigna quanto se imaginava noque diz respeito a lesão de órgãos alvos e alterações metabólicas.OBJETIVO: Rever e discutir os achados recentes da literaturaque abordam esta condição clínica. MÉTODOS: A pesquisa foirealizada nas bases de dados eletrônicas Lilacs e Medline com osseguintes descritores: hipertensão do avental branco; monitorizaçãoambulatorial da pressão arterial e lesões em órgãos-alvo.62 artigos originais escritos em português ou inglês de 1986a 2015 foram incluídos, sendo que após exclusões permaneceramapenas 13 artigos para análise. RESULTADOS: Verificou--se que a HAB esteve associada com uma maior prevalência deisquemia miocárdica (p<0,001) e microalbuminúria (p<0,001)em comparação com pacientes normotensos, sendo que a espessuraíntima-média da carótida também foi significativamentemaior entre os indivíduos com HAB. Em relaçao à sindromemetabólica, a HAB esteve associada mais frequentemente à intolerânciaà glicose, níveis elevados de triglicerídeos e colesteroltotal plasmáticos, além de maior prevalência de diabetes quandocomparados com os normotensos. Histórico familiar de hipertensãotambém esteve mais presente nos portadores de HAB em comparação aos normotensos ;p<0.05. CONCLUSÃO:Os dados acima descritos sugerem que a HAB é uma condiçãoclínica que se associa a alterações cardiológicas, nefrológicas,vasculares e metabólicas, devendo ser mais investigada e monitorizadade perto pelo médico assistente.(AU)
INTRODUCTION: White Coat Hypertension (WCH) is aclinical condition characterized by high levels of blood pressurein the office, which do not remain in the doctor?s absence.Recent studies have shown that this condition is not as benignas imagined in relation to target organ damage and metabolicalterations. OBJECTIVE: To review and discuss the literatureaddressing this clinical condition. METHODOLOGY: Thesurvey was conducted in electronic databases Lilacs andMedline with the following keywords: white coat hypertension;ambulatory blood pressure and damage to target organs. A totalof 62 original articles written in portuguese or english from1986 to 2015 were included. After exclusions only 13 articlesremained for analysis. RESULTS: It was found that WCH wasassociated with a higher prevalence of coronary artery disease(p<0.001), microalbuminuria (p<0.001) and higher intimamediathickness of the carotid artery. This condition was alsomore often associated with glucose intolerance, elevated levelsof triglycerides and total cholesterol plasma, as well as higherprevalence of diabetes compared with normotensive. Familyhistory of hypertension was also more prevalent in patients withWCH compared to normotensive; p<0.05. CONCLUSION:The data suggest that WCH is a condition associated withdamage to the heart, kidneys, brain and blood vessels as wellas deleterious metabolic changes. New longitudinal studies andclinical trials are needed to clarify whether there is an associationbetween WCH with fatal and non-fatal cardiovascular eventsand need for pharmacological treatment.(AU)
Assuntos
Humanos , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Determinação da Pressão Arterial , Monitorização Ambulatorial da Pressão ArterialRESUMO
AIM: To use the capture-recapture method to estimate the number of street children and adolescents in Maceió and Arapiraca, north-east Brazil, and describe the characteristics of the two populations. METHODS: The number of children and adolescents on the street in Maceió and Arapiraca was estimated using the multi-list capture-recapture method. Two street surveys and an official list from the social services department were compared. The characteristics of the children were recorded during the street surveys using a questionnaire. RESULTS: The estimated number of street children and adolescents was 5225 in Maceió and 1191 in Arapiraca. According to the official records, the population registered was 565 and 157, respectively. Most individuals were male (71.4% and 71.8%, respectively). They still maintain contact with their families (85.5% in Maceió and 89.6% in Arapiraca) and attend school regularly (43.4% and 49.7%). Drug use was admitted by 46.9% of the individuals in Maceió and by 26.9% in Arapiraca. In both cities, glue inhalation, associated or not with other drugs, was most frequently cited. CONCLUSIONS: Children and adolescents on the streets are a common and underestimated occurrence in Maceió and Arapiraca. They have similar characteristics to street children from other countries and other cities in Brazil. The method of capture-recapture seems to be suited to study populations such as street children.