RESUMO
Study of immigrant populations may contribute to a better understanding of the epidemiology of diseases associated with the aging process. We examined the prevalence of cardiovascular risk factors, including apolipoprotein E (ApoE) polymorphism, in elderly subjects who were born in Japan, migrated to South Brazil and have lived in that region for over 40 years, versus a group of elderly, locally born Brazilians living in the same region. These Japanese subjects came to Brazil after World War II (1950-1960) from several Japanese cities, mainly Nagasaki, Kumamoto and Hokkaido. Among 1007 subjects genotyped for ApoE polymorphism, we selected 540 elderly subjects (>60 years old), consisting of 270 Japanese-Brazilians and 270 Brazilians of European ancestry from Rio Grande do Sul State (Gaucha population). The Japanese-Brazilian group had significantly lower prevalences of obesity, type 2 diabetes mellitus, dyslipidemia, and metabolic syndrome than did the Gaucho population group. ApoE polymorphism frequencies were similar in the two groups. The differences in cardiovascular risk factors observed in the two populations cannot be explained by ApoE polymorphism; they could be related to conservation of Japanese lifestyle habits, such as diet.
Assuntos
Apolipoproteínas E/genética , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/genética , Emigrantes e Imigrantes , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Brasil/epidemiologia , Sistema Cardiovascular/patologia , Dieta/etnologia , Feminino , Genótipo , Humanos , Hipertensão/epidemiologia , Japão/etnologia , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Fatores de RiscoRESUMO
1. Japanese immigrants from Okinawa living in Brazil have a higher mortality from cardiovascular diseases and have their mean life expectancy shortened compared with their counterparts living in Japan. 2. A cross-sectional study comparing Okinawans living in Okinawa (OO) and Okinawan immigrants living in Brazil (OB) was designed to characterize the dietary factors that could interfere with the profile of cardiovascular risk factors and with this reduction on the life expectancy when Okinawans emigrate to Brazil. 3. In total, 234 OO and 160 OB (aged 45-59 years) were recruited to the present study to undergo medical and dietary history, blood pressure measurement, electrocardiograph (ECG), blood tests and 24 h food/urine collection. 4. In the present study, OO subjects presented with 37% less obesity and 50% less systemic hypertension than OB. The OB subjects used threefold more antihypertensive medication than OO. Meat intake was 34% higher in OB than OO, whereas fish intake was sevenfold higher in OO than OB. Serum potassium levels were 10% higher in OO than OB. Urinary taurine (an index of seafood intake) was 43% higher in OO than OB. Urinary isoflavones (an index of the intake of soy products) were significantly lower in OB than in OO. Of acid (20:5) and docosahexaenoic acid (22:6) were two- and threefold higher in OO than OB, respectively. 5. The rate of ischaemic ECG changes in OO subjects was only 50% of that of OB subjects. 6. There were no differences in the smoking rate between OO and OB subjects. 7. The results of the present study suggest that coronary risk factors and cardiovascular health are not only regulated by genetic factors, but that the impact of lifestyle (mainly diet) can be large enough to modulate the expression of genes.
Assuntos
Povo Asiático , Doenças Cardiovasculares/epidemiologia , Emigrantes e Imigrantes , Obesidade/epidemiologia , Animais , Brasil/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/metabolismo , Estudos Transversais , Dieta , Ácidos Docosa-Hexaenoicos/sangue , Ácido Eicosapentaenoico/sangue , Feminino , Peixes , Humanos , Isoflavonas/urina , Masculino , Carne , Pessoa de Meia-Idade , Obesidade/metabolismo , Potássio/sangue , Fatores de Risco , Taurina/urina , Organização Mundial da SaúdeRESUMO
BACKGROUND: Studies of immigrant populations are useful for analysis of the effects of environmental factors on cardiovascular disease. We have examined the association between dietary habit of fish intake and cardiovascular risk. METHODS: Population-based samples of 433 middle-aged Japanese men and women in Japan (Shimane (group JS) and Okinawa (group JO)) and 269 Japanese immigrants in Brazil (Sâo Paulo (group BS) and Campo Grande (group BC)), who had originally moved to Brazil mainly from Shimane and Okinawa, were recruited to the study. They underwent blood pressure measurement, 24-h urine collection, blood tests and electrocardiographic examination, and completed a dietary questionnaire. RESULTS: There was a significant gradient through the groups, from JS to JO, BS and BC with respect to the prevalence of obesity, hypertension, increased glycohaemoglobin concentrations and ST-T segment change on the electrocardiogram (prevalences for men and women combined: group JS 2.0%, group JO 3.8%, group BS 3.9% and group BC 9.0%; P < 0.025). The prevalence of hypercholesterolaemia was noted more frequently in groups BS and BC. Twenty-four-hour urinary taurine excretion in both sexes and n-3 polyunsaturated fatty acids (n-3 PUFA) in plasma phospholipids in men were significantly higher in groups JS and JO than in groups BS and BC. A striking negative gradient in the frequency of fish intake per week was found from group JS (men/women, 4.7/4.8) to groups JO (3.8/3.6), BS (1.9/1.6) and BC (0.5/0.5). CONCLUSIONS: This study suggests a possible association between fish intake and reduced cardiovascular risk, through the beneficial effects of taurine and n-3 PUFA and a habitual low intake of calories and fat.
Assuntos
Povo Asiático , Doenças Cardiovasculares/etnologia , Inquéritos sobre Dietas , Alimentos Marinhos , Análise de Variância , Animais , Brasil/epidemiologia , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etiologia , Colesterol/sangue , Proteínas Alimentares/administração & dosagem , Emigração e Imigração , Feminino , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Japão/epidemiologia , Japão/etnologia , Masculino , Carne , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Prevalência , Distribuição Aleatória , Fatores de Risco , Estudos de Amostragem , Distribuição por SexoRESUMO
1. The CARDIAC study, a world-wide cross-sectional epidemiological study on the relationship between alimentary factors and cardiovascular diseases, provided the initial evidence of ethnic differences in salt sensitivity; this was because despite much less urinary sodium excretion in Tanzania than in Brazil and the Japanese, the prevalence of hypertension was relatively higher in Tanzania than in the latter two populations. 2. To investigate this difference in salt sensitivity, a standardized clinical experiment was carried out: six to 13 male volunteers were placed on 2500 kcal basal diets containing 3 g salt/day. Eighteen grams of salt were added daily from the sixth to the 11th day in Tanzania and Brazil, while 22 g of salt were added in Japan. 3. Salt loading induced a significant rise in systolic blood pressure (SBP) on the second day of the high salt period (HSP) in Japan, the second and third day of HSP in Brazil, and all days of HSP in Tanzania. 4. Salt sensitivity was seen in 16.7% of the participants in Japan, 36.4% in Brazil and 46.2% in Tanzania. Further analysis of the effect of salt on blood pressure (BP) was carried out using the data from the CARDIAC study by multiple regression analysis. A within-centre comparison of fatty acid was also made. 5. The regression analysis revealed that the relationship of salt and blood pressure is more positively tight in Tanzania than Brazil and Japan after controlling for other confounding variables. Fatty acids in serum phospholipids contain significantly more palmitic acid and showed lower P/S ratios than those from Brazil and Japan.
Assuntos
Etnicidade , Hipertensão/etnologia , Sódio na Dieta/farmacologia , Adulto , Brasil , Meio Ambiente , Ácidos Graxos Insaturados/sangue , Humanos , Hipertensão/induzido quimicamente , Hipertensão/genética , Japão , Masculino , Análise de Regressão , TanzâniaRESUMO
The Cardiovascular Diseases and Alimentary Comparison (CARDIAC) Study (1) was designed to study the relationship of dietary factors to blood pressure (BP) and other major cardiovascular disease (CVD) in widely different populations of both industralized and developing countries. The primary aim of the research was to test specific hypotheses linking the intake of certain dietary constituents, e.g., sodium (Na), potassium (K), calcium (Ca), and protein, to BP (core study). The final aim was to contribute to the scientific information base required to guide the formulation of dietary goals for the primary prevention of CVD. The results of the preliminary analysis of data from Brazil in 57 inhabitants (22 men and 35 women) suggest a nonsignificant statistical correlation of Na intake estimated by urinary Na excretion and diastolic BP (DBP) and systolic BP (SBP) (p greater than 0.05), K intake estimated by urinary K excretion for DBP and SBP (p greater than 0.05), and taurine intake estimated by taurine urinary excretion for DBP and SBP (p greater than 0.05). A positive correlation was found between body mass index (BMI) and BP (p less than 0.01), for both DBP and SBP.
Assuntos
Doenças Cardiovasculares/epidemiologia , Dieta , Adulto , Idoso , Pressão Sanguínea , Peso Corporal , Brasil/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The effect of nonpharmacological measures--diet (restriction to salt), weight reduction, stress avoidance, stopping smoking, and exercise--are analyzed after being applied to 145 hypertensive individuals (average age 60.3 years) using antihypertensive drugs for 6 months without nonpharmacological therapy. The initial systolic arterial pressure was 177 mm Hg; at the end of 4 weeks of treatment, it was 151.3 mm Hg. The initial diastolic arterial pressure was 98.5 mm Hg; at the end of 4 weeks it was 89.8 mm Hg (p less than 0.001). The proposal for treating hypertension with nonpharmacological measures represents a challenge and opens a new horizon to scientific research.
Assuntos
Hipertensão/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea , Dieta Hipossódica , Feminino , Humanos , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estresse Fisiológico/terapia , Redução de PesoRESUMO
O probucol (4,4'-(isopropilideneditio) bis (2,6-di-t-butilfenol) foi administrado na dose de 1 g por dia, a 17 pacientes com hipercolesterolemia primaria, por um periodo de 2 meses. Ocorreu uma diminuicao da colesterolemia de 25% e 16% no 1o. e 2o. mes de tratamento, respectivamente. Os niveis do HDL-colesterol, diminuiram continuamente de 64,10 + ou - 13,34 mg/dl no periodo de controle para 63,40 + ou - 12,65 mg/dl no 1o mes e para 60,20 + ou - 10,39 mg/dl no 2o. mes, embora esta queda nao seja estatisticamente significante. O probucol nao diminuiu significativamente os niveis dos triglicerideos sanguineos Apenas um paciente apresentou disturbios gastrintestinais, o que levou a suspender o tratamento