Sugestão de artigos para inclusão no site da SBH Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível na íntegra Baixa adesão ao plano alimentar DASH está associada com maior risco cardiovascular em hipertensos tratados Low Concordance with the DASH Plan Is Associated with Higher Cardiovascular Risk in Treated Hypertensive Patients Casanova MA, Medeiros F, Oigman W, Neves MF ISRN Hypertension. Volume 2014 (2014), Article ID 618710, 8 pages http://dx.doi.org/10.1155/2014/618710 This study aimed at analyzing the alimentary habits of treated hypertensive patients identifying the degree of concordance with Dietary Approaches to Stop Hypertension (DASH) plan. Anthropometry and blood pressure (BP) were evaluated, and the 10year risk for general cardiovascular disease was estimated and used to calculate vascular age. A DASH concordance score was obtained using food frequency questionnaire and the cutoff points were established for eight food groups. Subjects were divided into two groups according to the median of DASH concordance score: lower concordance (LC group < 4.5 points, n = 33) and higher concordance (HC group ≥ 4.5 points, n = 47). LC group was associated with higher BP, vascular age, and cardiovascular risk. DASH concordance score was positively correlated with intake of fiber, calcium, potassium, and magnesium (p < 0.001) and negatively correlated with BP, cardiovascular risk, and vascular age (p < 0.05). After logistic regression adjusted for age and gender, only cardiovascular risk (β = 0.154, p = 0.031) was independently associated with DASH concordance score. Hypertensive patients with dietary patterns less concordant with the DASH plan had higher BP levels and increased cardiovascular risk, indicating the relevance of management in the treatment of these patients. Link para pdf Artigos para o site\1 Low concordance with the DASH plan is associated with highercardiovascular risk.pdf Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível na íntegra Análise espectral da pressão arterial sistólica e da variabilidade da frequência cardíaca e sua associação com performance cognitiva em hipertensos idosos Spectral analyses of systolic blood pressure and heart rate variability and their association with cognitive performance in elderly hypertensive subjects. Santos WB , Matoso JM , Maltez M , Gonçalves T , Casanova M , Moreira IF , Lourenço RA , Monteiro WD , Farinatti PT , Soares PP , Oigman W , Neves MF , Correia ML . J Hum Hypertens. 2014 Dec 18. doi: 10.1038/jhh.2014.119. [Epub ahead of print] Systolic hypertension is associated with cognitive decline in the elderly. Altered blood pressure (BP) variability is a possible mechanism of reduced cognitive performance in elderlyhypertensives. We hypothesized that altered beattobeat systolic BP variability is associated with reduced global cognitive performance in elderly hypertensive subjects. In exploratory analyses, we also studied the correlation between diverse discrete cognitive domains and indices of systolic BP and heart rate variability. Disproving our initial hypothesis, we have shown that hypertension and low education, but not indices of systolic BP and heart rate variability, were independent predictors of lower global cognitive performance. However, exploratory analyses showed that the systolic BP variability in semiupright position was an independent predictor of matrix reasoning (B=0.0 ±.03, Pvalue=0.005), whereas heart rate variability in semiupright position was an independent predictor of the executive function score (B=6.36±2.55, Pvalue=0.02). We conclude that myogenic vascular and sympathetic modulation of systolic BP do not contribute to reduced global cognitive performance in treated hypertensive subjects. Nevertheless, our results suggest that both systolic BP and heart rate variability might be associated with modulation of frontal lobe cognitive domains, such as executive function and matrix reasoning. Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível íntegra na Estudo vascular funcional em hipertensos com diabetes tipo 2 em uso de losartana ou amlodipina. Functional vascular study in hypertensive subjects with type 2 diabetes using losartan or amlodipine. Pozzobon CR , Gismondi RA , Bedirian R , Ladeira MC , Neves MF , Oigman W . Arq Bras Cardiol . 2014 Jul;103(1):519. Epub 2014 Jul9. Background : Antihypertensive drugs are used to control blood pressure (BP) and reduce macro and microvascular complications in hypertensive patients with diabetes. Objectives: The present study aimed to compare the functional vascular changes in hypertensive patients with type 2 diabetes mellitus after 6 weeks of treatment with amlodipine or losartan. Methods: Patients with a previous diagnosis of hypertension and type 2 diabetes mellitus were randomly divided into 2 groups and evaluated after 6 weeks of treatment with amlodipine (5 mg/day) or losartan (100 mg/day). Patient evaluation included BP measurement, ambulatory BP monitoring, and assessment of vascularparameters using applanation tonometry, pulse wave velocity (PWV), and flowmediated dilation (FMD) of the brachial artery. Results: A total of 42 patients were evaluated (21 in each group), with a predominance of women (71%) in both groups. The mean age of the patients in both groups was similar (amlodipine group: 54.9 ± 4.5 years;losartan group: 54.0 ± 6.9 years), with no significant difference in the mean BP [amlodipine group: 145 ± 14 mmHg (systolic) and 84 ± 8 mmHg (diastolic); losartan group: 153 ± 19 mmHg (systolic) and 90 ± 9 mmHg (diastolic)]. The augmentation index (30% ± 9% and 36% ± 8%, p = 0.025) and augmentation pressure (16 ± 6 mmHg and 20 ± 8 mmHg, p = 0.045) were lower in the amlodipine group when compared with the losartan group. PWV and FMD were similar in both groups. Conclusions: Hypertensive patients with type 2 diabetes mellitus treated with amlodipine exhibited an improved pattern of pulse wave reflection in comparison with those treated with losartan. However, the use oflosartan may be associated with independent vascular reactivity to the pressor effect. Artigos para o site\3 Functional vascular study in hypertensive subjects with type 2diabetes using losartan or amlodipine..pdf Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível na íntegra Hipotensão pósexercício de caminhada em pacientes com claudicação intermitente Postwalking exercise hypotension in patients with intermittent claudication. Cucato GG , ChehuenMda R , RittiDias RM , Carvalho CR , Wolosker N , Saxton JM , Forjaz CL Med Sci Sports Exerc. 2015 Mar;47(3):4607. doi: 10.1249/MSS.0000000000000450. Purpose: This study aimed to investigate the acute effect of intermittent walking exercise (WE) on blood pressure (BP) responses in patients with intermittent claudication (IC). Secondly, this study aimed to gain improved insight into the physiological mechanisms controlling BP regulation after intermittent WE in this patient group. Methods : Twenty patients with IC participated in two experimental sessions in a random order, as follows: WE (15 × 2min bouts of WE interpolated with 2min rest intervals) and control (standing rest on a treadmill for 60 min). BP, cardiac output (CO: CO2 rebreathing), and cardiovascular autonomic modulation (spectral analysis of HR variability) were assessed before and after both experimental sessions during supine rest, and stroke volume (SV) and systemic vascular resistance (SVR) were calculated. Data were analyzed using twoway ANOVA. Results: WE decreased systolic, diastolic, and mean BP, with net effects of 13 ± 2, 5 ± 2, and 7 ± 2 mm Hg versus control, respectively (all P < 0.05). WE also decreased SV (5.62 ± 1.97 mL, P < 0.05) and CO (0.05 ± 0.13 L·min(1), P < 0.05) versus preintervention and prevented the observed increase in SVR in the control condition (+4.2 ± 1.4 U, P < 0.05). HR showed a decrease (P < 0.05), consistent with evidence of increased vagal modulation, in the control condition. BP measurements over the subsequent 24 h were similar between experimental conditions. Conclusions: In patients with IC, WE induced a postexercise hypotension response that had a significant magnitude versus control but was not maintained over the next 24 h of daily activities. The acute postexercisehypotension response was mediated by a decrease in CO and SV, which was not compensated by an augmentation of SVR, as observed in the control arm of the study. Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível íntegra na As barreiras para a prática de atividade física são iguais para todos os pacientes com doença arterial periférica? Are the barriers for physical activity practice equal for all peripheral artery disease patients? Cavalcante BR , Farah BQ , dos A Barbosa JP , Cucato GG , da Rocha Chehuen M , da Silva Santana F , WoloskerN , de Moraes Forjaz CL , RittiDias RM . Arch Phys Med Rehabil. 2015 Feb;96(2):24852. doi: 10.1016/j.apmr.2014.09.009. Epub 2014 Oct2. Objective: To investigate barriers to physical activity related to the sociodemographic comorbidities and clinical variables of patients with intermittent claudication. Design: Crosssectional study. Setting: Ambulatory care. Participants: The medical histories of patients (N=145) aged ≥50 years with intermittent claudication were examined. Interventions: Not applicable. Main outcome measures: Sociodemographic data (sex, race, level of education, socioeconomic status, marital status), comorbidities (overweight, hypertension, dyslipidemia, diabetes, currently smoking, heartdisease), and clinical variables (initial claudication distance, total walking distance, anklebrachial index). Information on personal and environmental barriers was obtained by questionnaire. Results: Low economic status was most associated with "being afraid of falling" (odd ratios [OR]=2.22; 95% confidence interval [CI], 1.084.54). Low education level was most associated with "lack of street pedestrian crossing" (OR=3.34; 95% CI, 1.487.52). Diabetes was associated with lack of energy (OR=3.38; 95% CI, 1.686.79) and other medical conditions (eg, arthritis, angina) (OR=3.44; 95% CI, 1.657.16). Ankle brachial index was associated with "some difficulty in getting to a place where physical activity can be performed" (OR=2.75; 95% CI, 1.226.21). Walking capacity was strongly associated with barriers relating to leg pain (OR=7.39; 95% CI, 1.6632.88). Conclusions: Older patients, those with a low education level, patients with diabetes, low ankle brachial index, and those with a lower walking capacity are more likely to experience barriers to physical activity. Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível na íntegra A amlodipina reduz a pressão arterial durante exercícios dinâmicos de resistência em hipertensos. Amlodipine reduces blood pressure during dynamic resistance exercise in hypertensive patients. Souza DR , Gomides RS , Costa LA , Queiroz AC , Barros S , Ortega KC , Mion D Jr , Tinucci T , Forjaz CL . Scand J Med Sci Sports. 2015 Feb;25(1):5360. doi: 10.1111/sms.12152. Epub 2013 Nov 21. This study investigated the effect of the dihydropyridine calcium channel antagonist, amlodipine,on blood pressure (BP) during resistance exercise performed at different intensities in hypertensives. Eleven hypertensives underwent 4 weeks of placebo and amlodipine (random doubleblinded crossover design). In each phase, they performed knee extension exercise until exhaustion following three protocols: one set at 100% of 1 RM (repetition maximum), three sets at 80% of 1 RM, and three sets at 40% of 1 RM. Intraarterial BP was measured before and during exercise. Amlodipine reduced maximal systolic/diastolic BP values achieved at all intensities (100% = 225 ± 6/141 ± 3 vs. 207 ± 6/130 ± 6 mmHg; 80% = 289 ± 8/178 ± 5 vs. 273 ± 10/169 ± 6 mmHg; 40% = 289 ± 10/176 ± 8 vs. 271 ± 11/154 ± 6 mmHg). Amlodipine blunted the increase in diastolic BP that occurred during the second and third sets of exercise at 40% of 1RM (+75 ± 6 vs. +61 ± 5 mmHg and +78 ± 7 vs. +64 ± 5 mmHg, respectively). Amlodipine was effective in reducing the absolute values of systolic and diastolic BP during resistance exercise and in preventing the progressive increase in diastolic BP that occurs over sets of lowintensity exercise. These results suggest that systemic vascular resistance is involved in BP increase during resistance exercise, and imply that hypertensives receiving amlodipine are at lower risk of increased BP during resistance exercise than nonmedicated patients. Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível na íntegra Papel preventivo do treinamento físico em parâmetros autonômicos, hemodinâmicos e metabólicos em ratos sobalto risco de desenvolvimento da síndrome metabólica. Preventive role of exercise training in autonomic, hemodynamic, and metabolic parameters in rats under high risk of metabolic syndrome development. MoraesSilva IC , Mostarda C , Moreira ED , Silva KA , dos Santos F , de Angelis K , Farah Vde M , Irigoyen MC . J Appl Physiol (1985). 2013 Mar 15;114(6):78691. doi: 10.1152/japplphysiol.00586.2012. Epub 2013 Jan 17. High fructose consumption contributes to metabolic syndrome incidence, whereas exercise training promotes several beneficial adaptations. In this study, we demonstrated the preventive role of exercise training in the metabolic syndrome derangements in a rat model. Wistar rats receiving fructose overload in drinking water (100 g/l) were concomitantly trained on a treadmill (FT) or kept sedentary (F) for 10 wk. Control rats treated with normal water were also submitted to exercise training (CT) or sedentarism (C). Metabolic evaluations consisted of the Lee index and glycemia and insulin tolerance test (kITT). Blood pressure (BP) was directly measured, whereas heart rate (HR) and BP variabilities were evaluated in time and frequency domains. Renal sympathetic nerve activity was also recorded. F rats presented significant alterations compared with all the other groups in insulin resistance (in mg · dl(1) · min(1): F: 3.4 ± 0.2; C: 4.7 ± 0.2; CT: 5.0 ± 0.5 FT: 4.6 ± 0.4), mean BP (in mmHG: F: 117 ± 2; C: 100 ± 2; CT: 98 ± 2; FT: 105 ± 2), and Lee index (in g/mm: F = 0.31 ± 0.001; C = 0.29 ± 0.001; CT = 0.27 ± 0.002; FT = 0.28 ± 0.002), confirming the metabolic syndrome diagnosis. Exercise training blunted all these derangements. Additionally, FS group presented autonomic dysfunction in relation to the others, as seen by an ≈ 50% decrease in baroreflex sensitivity and 24% in HR variability, and increases in sympathovagal balance (140%) and in renal sympathetic nerve activity (45%). These impairments were not observed in FT group, as well as in C and CT. Correlation analysis showed that both Lee index and kITT were associated with vagal impairment caused by fructose. Therefore, exercise training plays a preventive role in both autonomic and hemodynamic alterations related to the excessive fructose consumption. Artigos para o site\7 Preventive role of exercise training in autonomic,hemodynamic, and metabolic parameters in rats under high risk of metabolicsyndrome development.pdf Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível na íntegra Momento da ingestão de frutose: um importante regulador da adiposidade. Timing of fructose intake: an important regulator of adiposity. Morris M , Araujo IC , Pohlman RL , Marques MC , Rodwan NS , Farah VM . ClinExpPharmacol Physiol. 2012 Jan;39(1):5762. doi: 10.1111/j.14401681.2011.05636.x. 1. Overconsumption of fructose produces glucose intolerance, autonomic abnormalities and renal dysfunction and may be related to the worldwide epidemic of obesity and diabetes. 2. Experiments were conducted to determine whether the time period (light or dark) of fructose consumption influenced the pathological consequences. C57BL mice were given standard chow and assigned to one of three groups: (i) control (n = 10), which received water over a 24 h period; (ii) FL (n = 11), which received 10% fructose solution during the 12 h light period; and (iii) FD (n = 11), which received 10% fructose solution during the 12 h dark period. 3. There was a time related increase in body weight for all groups (P < 0.01, 2 vs 6 wks). There was a greater increase in body fat in the FL group compared with the control and FD groups. The changes in adiposity occurred even though the total caloric intake was not significantly different among the groups (approximately 18 kcal/day). Total fluid (water + fructose) consumption was greater in the FD and FL groups compared with control at 6 weeks. Significant increases were noted for plasma insulin and leptin at 8 weeks, with highest levels in the FL compared with FD group (P < 0.05). There were no significant changes in glucose, glucose tolerance, cholesterol, triglycerides or adiponectin. 4. The results of the present study suggest that there is a mismatch in caloric consumption, metabolism and adiposity as related to the lightdark cycle of fructose consumption. These findings have clinical implications in the control of bodyweight, abdominal fat accumulation and Type 2 diabetes. Artigos para o site\8 Timing of fructose intake an important regulator ofadiposity.pdf Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível na íntegra Efeitos do consumo de chá verde sobre alterações cardiometabólicas induzidas pelo diabetes experimental. The effects of green tea consumption on cardiometabolic alterations induced by experimental diabetes. Fiorino P , Evangelista FS , Santos F , Motter Magri FM , Delorenzi JC , Ginoza M , Farah V . Exp Diabetes Res. 2012;2012:309231. doi: 10.1155/2012/309231. Epub 2012 Feb 29. We evaluated cardiac autonomic modulation by heart rate (HRV), and arterial pressure variability (APV), and metabolic response in streptozotocin diabetic rats treated with green tea. Male Wistar rats were separated in groups: control, drinking tap water (C), green teatreated (GT) group, diabetic, drinking tap water (D), and diabetic, treated with green tea (DGT). Kidney mass was greater in D and DGT than in C and GT, but reduced in DGT compared to D. Green tea prevented the increase in creatinine clearance and reduced hyperglycemia in DGT compared to D. Arterial pressure was increased in GT and decreased in D compared to C. HRV was reduced in D compared with all groups. APV was decreased in D compared to C and recovery in DGT. Sympathetic modulation of APV was decreased in D compared with all groups. Green tea reduced hyperglycemia, prevented renal injury and autonomic dysfunction, suggesting reduced cardiovascular risk and target organ damage in diabetes Artigos para o site\9 The effects of green tea consumption on cardiometabolicalterations induced by experimental diabetes.pdf Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível na íntegra Correlatos da progressão da rigidez aórtica em pacientes com hipertensão resistente: importância das modificações na pressão arterial clínica e ambulatorial Correlates of aortic stiffness progression in patients with resistant hypertension: importance of clinic and ambulatory blood pressure changes. Roderjan CN, CardosoCRL, Ferreira MT, Muxfeldt ES, Salles GF. Journal of Hypertension: April 2015 – Volume 33 – Issue 4 – p 827835. doi: 10.1097/HJH.0000000000000491 Objectives: Correlates of serial aortic stiffness changes were scarcely evaluated. We aimed to evaluate them in patients with resistant hypertension, with particular attention to the importance of changes in clinic and ambulatory blood pressures (BP). Methods: In a prospective study, two carotid–femoral pulse wave velocity (cfPWV) measurements (three measures in each occasion) were performed with the Complior equipment in 442 resistant hypertensive patients over a mean followup of 4.6 years. Multivariable regressions assessed the independent correlates of changes in cfPWV. All analyses were further adjusted for baseline cfPWV and BP values, and for the time interval between measurements. Results : Carotid–femoral PWV had a median increase of 0.11 m/s per year (1.1% per year). Overall, 224 patients (51%) had an increase or persisted with high cfPWV, whereas 218 (49%) reduced or persisted with low values. On multivariable regressions, both changes in clinic SBP (partial correlation 0.34, P < 0.001) and in 24h SBP (partial correlation 0.40, P < 0.001) were correlates of changes in cfPWV. This means that the whitecoat effect, defined as the difference between clinic and daytime BPs, affected cfPWV changes (partial correlation 0.19, P < 0.001). The other independent correlates of aortic stiffness progression were older age, presence of diabetes, higher waist circumference and worse renal function. Conclusion: The exaggerated whitecoat effect, by acutely increasing clinic BPs during cfPWV examination, may partially obscure the beneficial effects of reducing ambulatory BP levels on aortic stiffness attenuation. Arterial stiffness measurements under ambulatory conditions may be needed to correctly assess aortic stiffness changes in resistant hypertensive patients. Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível na íntegra Correlatos da progressão da rigidez aórtica em pacientes com diabetes tipo 2: importância do controle glicêmico Correlates of Aortic Stiffness Progression in Patients With Type 2 Diabetes: Importance of Glycemic Control.The Rio de Janeiro Type2 Diabetes CohortStudy . Ferreira MT, Leite NC, Cardoso CLR, Salles GF. Diabetes Care, v. 38, p. dc142791, 2015. doi:10.2337/dc142791Diabetes Care February 12, 2015 Objective: The correlates of serial changes in aortic stiffness in patients with diabetes have never been investigated. We aimed to exam the importance of glycemic control on progression/regression of carotidfemoral pulse wave velocity (cfPWV) in type 2 diabetes. Research design and methods: In a prospective study, two cfPWV measurements were performed with the Complior equipment in 417 patients with type 2 diabetes over a mean followup of 4.2 years. Clinical laboratory data were obtained at baseline and throughout followup. Multivariable linear/logistic regressions assessed the independent correlates of changes in cfPWV. Results: Median cfPWV increase was 0.11 m/s/year (1.1% per year). Overall, 212 patients (51%) increased/persisted with high cfPWV, while 205 (49%) reduced/persisted with low cfPWV. Multivariate linear regression demonstrated direct associations between cfPWV changes and mean HbA during followup (partial correlation 0.14, P = 0.005). On logistic 1c regression, a mean HbA ≥7.5% (58 mmol/mol) was associated with twofold 1c higher odds of having increased/persistently high cfPWV during followup. Furthermore, the rate of HbA reduction relative to baseline levels was 1c inversely associated with cfPWV changes (partial correlation −0.11, P = 0.011) and associated with reduced risk of having increased/persistently high aortic stiffness (odds ratio 0.82 [95% CI 0.69–0.96]; P = 0.017). Other independent correlates of progression in aortic stiffness were increases in systolic blood pressure and heart rate between the two cfPWV measurements, older age, female sex, and presence of dyslipidemia and retinopathy. Conclusions: Better glycemic control, together with reductions in blood pressure and heart rate, were the most important correlates to attenuate/prevent progression of aortic stiffness in patients with type 2 diabetes. Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível na íntegra Efeitos do tratamento com pressão positiva contínua nas vias aéreassobre a pressão arterial clínica e ambulatorial em pacientes com apneia obstrutiva do sono e hipertensão resistente Effects of Continuous Positive Airway Pressure Treatment on Clinic and Ambulatory Blood Pressures in Patients With Obstructive Sleep Apnea and Resistant Hypertension A Randomized Controlled Trial Muxfeldt ES, Margallo V, Costa LMS, Guimarães G, Cavalcante AH, Azevedo JCM, Souza F, Cardoso CRL, Salles GF. Hypertension. 2015 Apr;65(4):73642. doi: 10.1161/HYPERTENSIONAHA.114.04852. Epub 2015 Jan 19. The effect of continuous positive airway pressure (CPAP) on blood pressures (BPs) in patients with resistant hypertension and obstructive sleep apnea is not established. We aimed to evaluate it in a randomized controlled clinical trial, with blinded assessment of outcomes. Four hundred thirtyfour resistant hypertensive patients were screened and 117 patients with moderate/severe obstructive sleep apnea, defined by an apnea–hypopnea index ≥15 per hour, were randomized to 6month CPAP treatment (57 patients) or no therapy (60 patients), while maintaining antihypertensive treatment. Clinic and 24hour ambulatory BPs were obtained before and after 6month treatment. Primary outcomes were changes in clinic and ambulatory BPs and in nocturnal BP fall patterns. Intentiontotreat and perprotocol (limited to those with uncontrolled ambulatory BPs) analyses were performed. Patients had mean (SD) 24hour BP of 129(16)/75(12) mm Hg, and 59% had uncontrolled ambulatory BPs. Mean apnea–hypopnea index was 41 per hour and 58.5% had severe obstructive sleep apnea. On intentiontotreat analysis, there was no significant difference in any BP change, neither in nocturnal BP fall, between CPAP and control groups. The best effect of CPAP was on nighttime systolic blood pressure in perprotocol analysis, with greater reduction of 4.7 mm Hg (95% confidence interval, −11.3 to +3.1 mm Hg; P = 0.24) and an increase in nocturnal BP fall of 2.2% (95% confidence interval, −1.6% to +5.8%; P = 0.25), in comparison with control group. In conclusion, CPAP treatment had no significant effect on clinic and ambulatory BPs in patients with resistant hypertension and moderate/severe obstructive sleep apnea, although a beneficial effect on nighttime systolic blood pressure and on nocturnal BP fall might exist in patients with uncontrolled ambulatory BP levels. Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível na íntegra Efeito do exercício físico e suplementação de potássio sobre a pressão arterial, metabolismo glicídico e albuminúria de ratos hipertensos. Effects of physical training and potassium supplementation on blood pressure, glucose metabolism and albuminuria of spontaneously hypertensive rats. Jodas EMMG , Voltera AF , Ginoza M , Junior OK, Santos NB, Cesaretti MLR J. Bras. Nefrol. vol.36 no.3 São Paulo July/Sept. 2014 http://dx.doi.org/10.5935/01012800.20140040 Introduction: It is still controversial whether there are synergistic effects among different nonpharmacological interventions used in the treatment of hypertension. Objetives: To evaluate the effect of aerobic exercise, oral supplementation of potassium and their combination on blood pressure, glucose metabolism, urinary albumin excretion and glomerular morphology in spontaneously hypertensive rats (SHR). Methods: SHR were divided into groups: Control Group (SHR; standard diet and sedentary, n = 10), Exercise Group (SHR + E; trained on a treadmill, standard diet, n = 10), Potassium Group (SHR + K; sedentary, potassium supplementation, n = 10) and Group Exercise + Potassium (SHR + E + K, exercise, potassium supplementation n = 10). Weekly, body weight (BW) and tail blood pressure (TAP) were measured. At the end of 16 weeks, a Oral Glucose Tolerance Test was performed. Albuminuria was determined in th th the baseline period, at 8 and at 16 week. After sacrifice, the analysis of glomerular sclerosis index and visceral fat weight was performed. Results: The TAP and BW did not change significantly. There was improvement in insulin sensitivity in SHR + E and SHR + K, but not in SHR + E + K. At week 16, albuminuria in all groups was significantly lower than the SHR control. The glomerular sclerosis index and visceral fat content were also significantly lower in all groups compared to control. Conclusion: An oral supplementation of potassium and exercise led to an improvement in glucose metabolism, in albuminuria and glomerular morphology, however, the overlap of the treatments did not show synergism. Artigos para o site\13 Effects of physical training and potassium supplementationon blood pressure, glucose metabolism and albuminuria of spontaneouslyhypertensive rats..pdf Título (português) Efeito da sobreposição de um modelo de obesidade neuroendócrina experimental e hipertensão arterial sobre a pressão arterial, peso corporal e parâmetros metabólicos e renais de ratos. Título (artigo submetido) Effects of the overlapping between an experimental model of neuroendocrine obesity with arterial hypertension under blood pressure, body weight and metabolic and renal parameters in rats. Autores Ferreira LBD, Cesaretti MLR, Voltera AF, Ginoza M, Kohlmann Junior O Periódico J. Bras. Nefrol. vol.33 no.3 São Paulo jul./set. 2011 http://dx.doi.org/10.1590/S010128002011000300010 Abstract Introdução: A elevação do índice de massa corporaleapresençadesíndromemetabólica se associam com diminuição da função renal e o aparecimento de doença renal terminal. Objetivo: Avaliar o efeito da sobreposição de um modelo de obesidade experimental e hipertensão arterial sobre a pressão arterial, peso corporal e parâmetros metabólicos e renais de ratos. Métodos: Foram estudados ratos machos das cepas Wistar e espontaneamente hipertensos (SHR). Os grupos MSG receberam glutamato monossódico no período neonatal (WST + MSG e SHR + MSG). Os animais controles receberam salina no período neonatal (WST e SHR). Após completarem três meses de vida, por 12 semanas foram pesados e tiveram a pressão arterial de cauda aferida semanalmente. A determinação de microalbuminúria foi realizada nas semanas 0, 4, 8 e 12. Ao final do período de acompanhamento, coletouse sangue para glicemia de jejum, creatinina e perfil lipídico. Os rins foram retirados, corados e o índice de esclerose glomerular foi calculado. Resultados: A administração de MSG produziu maior ganho percentual de peso corporal, elevação da glicemia de jejum e maior grau de lesão glomerular nos ratos WST MSG e SHR MSG quando comparados aos seus controles. Houve maior excreção urinária de albumina nos ratos do Grupo SHR + MSG quando comparados aos SHR. Não houve diferença estatística na pressão arterial de cauda, creatinina e parâmetros do metabolismo lipídico. Conclusões: A associação de obesidade neuroendócrina e a hipertensão arterial promoveram alterações morfológicas e funcionais no glomérulo mais severas do que aquelas observadas nos ratos somente hipertensos. Artigo disponível na íntegra Artigos para o site\14_Effects of the overlapping between an experimental model ofneuroendocrine obesity with arterial hypertension under blood pressure,body weight.pdf Título (português) Título (artigo submetido) Efeito da associação entre obesidade neuroendócrina e exócrina experimental sobre a pressão arterial de cauda e o metabolismo de glicose de ratos Wistar Effects of the association of experimental neuroendocrine and exocrine obesity on tail blood pressure and glucose metabolism in Wistar rats. Pastore AP, Cesaretti MLR, Ginoza M, Voltera AF, Kohlmann Junior O. Autores J. Bras. Nefrol. vol.32 no.2 São Paulo abr./jun. 2010 http://dx.doi.org/10.1590/S010128002010000200008 Periódico Objective: To study two different models of obesity, exocrine and endocrine, and its association on tail arterial pressure (TAP), body weight (BW), glucose metabolism and visceral fat content. Methods: Male Wistar rats were studied. The MSG group was composed by rats that received of MSG in neonatal period. At the 3rd month of life, part of these animals received cafeteria diet. Animals received saline control in the neonatal period. In the 12 weeks of study, body weight and blood pressure were measured twice a week. In the end of this period on, Oral Glucose Tolerance Test (OGTT) was performed and the Insulin Sensitivity Index (ISI) was calculated, also the left Relative Ventricular Weight (RLW) and Relative Epididimal Fat Weight (REFW) were obtained. Results: No changes on BW and TAP were verified. The obesity induced by MSG and CAF, individually, let to increases on insulin resistance (WST = 23,25 ± 9,31; CAF = 15,92 ± 9,10*; MSG = 13,41 ± 3,84* mg1mU1, p < 0,05 vs WST) and relative epididimal fat content (WST = 6,20 ± 0,57; CAF = 8,27 ± 1,53*; MSG = 8,23 ± 1,98* g/100 g, *p < 0,05) when these rats were compared to control rats. An enhanced effect upon these parameters was observed with the association of both obesity models (MSG+CAF = 9,34 ± 5,77 mg 1mU1, p < 0,05 vs MSG and CAF) and visceral fat content (MSG+CAF = 11,12 ± 3,85 g/100g, p < 0,05 vs MSG and CAF). Conclusion: The association of these two experimental models of obesity aggravates insulin resistance that probably is due at least in part to the increase of visceral fat content. Abstract Artigo disponível íntegra na Artigos para o site\15 Effects of the association of experimental neuroendocrineand exocrine obesity on tail blood pressure and glucose metabolism inwistar rats.pdf Título (português) Título (artigo submetido) Serino proteases como candidatas para o processamento proteolítico da enzima conversora da angiotensina I. Serine proteases as candidates for proteolytic processing of angiotensinI converting enzyme. Aragão DS, Andrade MCC, Ebihara F, Watanabe IKM, Magalhães DCBP, J uliano MA, Hirata IY, Casarini DE. Autores Int J BiolMacromol. 2015 Jan;72:6739. doi: 10.1016/j.ijbiomac.2014.09.017. Epub 2014 Sep 28. Periódico Somatic angiotensinI converting enzyme (sACE) is a broadly distributed peptidase which plays a role in blood pressure and electrolyte homeostasis by the conversion of angiotensin I into angiotensin II. Ndomain isoforms (nACE) with 65 and 90 kDa have been described in body fluids, tissues and mesangial cells (MC), and a 90 kDanACE has been described only in spontaneously hypertensive rats. The aim of this study was to investigate the existence of proteolytic enzymes that may act in the hydrolysis of sACE generating nACEs in MC. After the confirmation of the presence of ACE sheddases in Immortalized MC (IMC), we purified and characterized these enzymes using fluorogenic substrates specifically designed for ACE sheddases. Purified enzyme identified as a serine protease by Nterminal sequence was able to generate nACE. In the present study, we described for the first time the presence of ACE sheddases in IMC, identified as serine proteases able to hydrolyze sACE in vitro . Further investigations are necessary to elucidate the mechanisms responsible for the expression and regulation of ACE sheddases in MC and their roles in the generation of nACEs, especially the 90 kDa form possibly related to hypertension. Abstract Artigo disponível íntegra na Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível íntegra na Enzima conversora da angiotensina I Ndomínio expresso em células mesangiais imortalizadas, do túbulo proximal e do ducto coletor. Ndomain angiotensinI converting enzyme is expressed in immortalized mesangial, proximal tubule and collecting duct cells. Mei Wang PH , Andrade MC , Quinto BM , Di Marco G , Mortara RA , Vio CP , Casarini DE . Int J BiolMacromol. 2015 Jan;72:38090. doi: 10.1016/j.ijbiomac.2014.07.043. Epub 2014 Sep1. Somatic ACE (sACE) is found in glomerulus, proximal tubule and excreted in urine. We hypothesized that Ndomain ACE can also be found at these sites. ACE profile was analyzed in mesangial (IMC), proximal (LLCPK1), distal tubule (MDCK) and collecting duct (IMCD) cells. Cell lysate and culture medium were submitted to gel filtration chromatography, which separated two peaks with ACE activity from cells and medium, except from distal tubule. The first had a high molecular weight and the second, a lower one (65 kDa; Ndomain ACE). We focused on Ndomain ACE purification and characterization from LLCPK1. Total LLCPK1 Ndomain ACE purification was achieved by ionexchange chromatography, which presented only one peak with ACE activity, denominated ACE . ACE activity was int2A int2A influenced by pH, NaCl and temperature. The purified enzyme was inhibited by Captopril and hydrolyzed AngI, Ang17 and AcSDKP. Its ability to hydrolyze AcSDKP characterized it as an Ndomain ACE. ACE also int2A presented high amino acid sequence homology with the Nterminal part of sACE from mouse, rat, human and rabbit. The presence of secreted and intracellular Ndomain ACE and sACE in IMC, LLCPK1 and IMCD cells confirmed our studies along the nephron. We identified, purified and characterized Ndomain ACE from LLCPK1. Título (português) Sildenafil melhora o estresse oxidativo e a lesão do DNA nos rins estenóticos de camundongos com hipertensão renovascular. Título (artigo submetido) Sildenafil ameliorates oxidative stress and DNA damage in the stenotic kidneys in mice with renovascular hypertension Dias AT, Rodrigues BP, Porto ML, Gava AL, Balarini CM, Freitas FPS, Palomino Z, Casarini DE, Campagnaro BP, Pereira TMC, Meyrelles SS, Elisardo C Vasquez EC. Autores J Transl Med. 2014 Feb 6;12:35. doi: 10.1186/147958761235. Periódico Abstract Background: Oxidative stress and DNA damage have been implicated in the pathogenesis of renovascular hypertension induced by renal artery stenosis in the twokidney, oneclip (2K1C) Goldblatt model. Considering our previous report indicating that the chronic blockade of phosphodiesterase 5 with sildenafil (Viagra®) has marked beneficial effects on oxidative stress and DNA damage, we tested the hypothesis that sildenafil could also protect the stenotic kidneys of 2K1C hypertensive mice against oxidative stress and genotoxicity. Methods: The experiments were performed with C57BL6 mice subjected to renovascular hypertension by left renal artery clipping. Two weeks after clipping, the mice were treated with sildenafil (40 mg/kg/day for 2 weeks, 2K1Csildenafil group) or the vehicle (2K1C). These mice were compared with control mice not subjected to renal artery clipping (Sham). After hemodynamic measurements, the stenotic kidneys were assessed using flow cytometry to evaluate cell viability and the comet assay to evaluate DNA damage. Measurements of intracellular superoxide anions and hydrogen peroxide levels as well as nitric oxide bioavailability were also obtained. Results: Sildenafil treatment significantly reduced mean arterial pressure (15%), heart rate (8%), intrarenal angiotensin II (50%) and renal atrophy (36%). In addition, it caused a remarkable decrease of reactive oxygen species production. On the other hand, sildenafil increased nitric oxide levels relative to those in the nontreated 2K1C mice. Sildenafil treatment also significantly reduced the high level of kidney DNA damage that is a characteristic of renovascular hypertensive mice. Conclusions: Our data reveal that sildenafil has a protective effect on the stenotic kidneys of 2K1C mice, suggesting a new use of phosphodiesterase 5 inhibitors for protection against the DNA damage observed in the hypoperfused kidneys of individuals with renovascular hypertension. Further translational research is necessary to delineate the mechanisms involved in the prevention of renal stenosis in the clinical setting. Artigo disponível íntegra Artigos para o site\18 Sildenafil ameliorates oxidative stress and DNA damage instenotic kidneys in mice with renovascular hypertension.pdf na Título (português) Título (artigo submetido) Relação entre os fatores de risco cardiovascular e a ecogenicidade e o padrão do complexo íntimamédia carotídeo em homens. Relationship between cardiovascular risk factors and the echogenicity and pattern of the carotid intimamedia complex in men. Autores Sarmento PLFA, Plavnik FL, Scaciota A, Lima JO, Miranda RB, AjzenSA Sao Paulo Med. J. vol.132 no.2 São Paulo 2014. http://dx.doi.org/10.1590/15163180.2014.1322490 Periódico Abstract Context and objective: The thickness of the carotid intimamedia complex (CIMC) is considered to be a marker of early atherosclerosis, but visual and echogenic changes to the CIMC can also be noted. The objective here was to evaluate the relationship between cardiovascular risk factors and the echogenicity of the CIMC and identify those most associated with an "abnormal" CIMC. Design and setting :Crosssectional study in the ultrasound sector of the Department of Diagnostic Imaging, Universidade Federal de São Paulo. Methods :Eighty men were evaluated. Measurements of arterial blood pressure, waist circumference (WC), lipid profile, fasting glucose, uric acid and highsensitivity Creactive protein were obtained. The thickness of the CIMC was measured by means of Bmode ultrasound, and the intimamedia grayscale mean (IMGSM) and standard deviation (IMSD) were calculated. 2 Results: The following were discriminating variables: fasting glucose (r = 2 2 0.036; P = 0.013), uric acid (r = 0.08; P = 0.03), IMSD (r = 0.43; P < 2 2 0.001), IMGSM (r = 0.35; P < 0.001) and thickness of the CIMC (r = 0.29; P < 0.001). IMGSM showed significant correlations with WC (r = 0.22; P = 0.005), fasting glucose (r = 0.24; P = 0.002) and highdensity lipoprotein cholesterol (HDLC) (r = 0.27; P = 0.0007). Conclusion :IMGSM showed correlations with WC, fasting glucose and HDLC. However, uric acid and IMSD presented the greatest discriminating impact. These results suggest that visual changes in CIMC may help identify patients with potential cardiovascular risk, independently of the thickness of the CIMC. Artigo disponível íntegra Artigos para o site\19 Relationship between cardiovascular risk factors and theechogenicity and pattern of the carotid intimamedia complex in men.pdf na Título (português) Título (artigo submetido) Autores Efeitos de diferentes graus de sensibilidade a insulina na função endotelial de pacientes obesos. Effects of Different Degrees of Insulin Sensitivity on Endothelial Function in Obese Patients. Galvão R, Plavnik FL, Ribeiro FF, Ajzen SA, Christofalo DMJ, KohlmannJr O. Arq Bras Cardiol. 2012 Jan;98(1):4551. Epub 2011 Dec 13. Periódico Background: Obesity derived from intraabdominal fat deposition tends to increase hormonal and cytokine production, thus worsening insulin sensitivity and leading to endothelial dysfunction. Hyperinsulinemia is considered an independent risk factor for ischemic heart disease and cause of endothelial dysfunction in healthy individuals. Objective: To assess the impact of different degrees of insulin resistance, measured by HOMAIR (Homeostasis Model Assessment of Insulin Resistance), on endothelial function in obese, nondiabetic patients without prior history of cardiovascular events and different metabolic syndrome components. Methods: Forty obese individuals were submitted to anthropometric measurements, BP measurements at office and ABPM and laboratory tests, in addition to noninvasive ultrasound assessment of endothelial function. Patients were divided into 3 groups according to the level of insulin resistance: patients with HOMAIR values from 0.590 to 1.082 were assigned to Group 1 (n=13), from 1.083 to 1.410 to Group 2 (n=14) and from 1.610 to 2.510 to Group 3 (n=13). Results: We found a significant difference in flowmediated dilation in group 3 compared to group 1 (9.2±7.0 vs 18.0±7.5 %, p=0.006). There was a negative correlation between endothelial function and insulin, HOMAIR and triglycerides. Conclusion: Our data suggest that mild changes in insulin resistance levels assessed by HOMAIR may have an impact on vasodilatatory endothelial function in uncomplicated obese individuals with different cardiovascular risk factors. Abstract Artigo disponível íntegra na Artigos para o site\20 Effects of different degrees of insulin sensitivity onendothelial function in obese patients.pdf Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível íntegra na Associação da espessura da íntimamédia da carótida e fatores de risco cardiovascular em mulheres antes e após a cirurgia bariátrica Association of carotid intimamedia thickness and cardiovascular risk factors in women pre and postbariatric surgery. Sarmento PL , Plavnik FL , Zanella MT , Pinto PE , Miranda RB , Ajzen SA ObesSurg. 2009 Mar;19(3):33944. doi: 10.1007/s1169500897835. Epub 2008 Dec 13. Background : Obesity is associated with cardiovascular risk factors (CVRFs), such as hypertension, hypertriglyceridemia, and low levels of highdensity cholesterol (HDLC). In obese patients with a body mass index (BMI) of >or=40 kg/m2 or 3540 kg/m2 associated with CVRFs, weight loss may be achieved more effectively by bariatric surgery on reducing several CVRFs. Carotid intimamedia thickness (CIMT) is an indicator of early atherosclerosis, and may be correlated with CVRFs. Our objective was to correlate CIMT with CVRFs before (baseline data) and after surgery, and to observe whether weight loss is followed by a regression of CIMT. Methods: Eighteen women who had undergone bariatric surgery participated in this study. Assessments were carried out on the baseline date, and 3, 6, and 12 months after surgery. Some of the CVRFs analyzed were: total cholesterol (TC) levels, HDLC, triglycerides to HDLC ratio (TG/HDLC) and fasting plasma glucose. CIMT was measured by Bmode ultrasound. Results: A positive correlation was found between CIMT and age and triglyceride level (p=0.002 and p=0.02, respectively). Six months after surgery, we found a significant reduction in CIMT (p<0.05), which was significantly correlated with TG level and systolic pressure (p<0.05). Conclusion : The weight loss achieved with bariatric surgery resulted in regression of CIMT. This regression could be observed 6 months following surgery, with an additional benefit at 12 months. Also, this finding was correlated with a reduction in triglyceride levels and systolic blood pressure. ..\CURRICULUMFRIDA\Artigos publicados\Sarmento PL Obes Surgery 2009.pdf Título (português) Título (artigo submetido) A deficiência de vitamina D está associada com resistência à insulina em mulheres na prémenopausa. Vitamin d deficiency is associated with insulin resistance independent of intracellular calcium, dietary calcium and serum levels of parathormone, calcitriol and calcium in premenopausal women. Autores Periódico Da Silva Ferreira T , Martins Rocha T , Simas Torres Klein MR , Sanjuliani AF Nutr Hosp. 2015 Apr 1;31(n04):14911498. Abstract Background: There is evidence that vitamin D deficiency is associated with increased risk of cardiovascular disease. However, it is not known if this association is independent of dietary calcium, intracellular calcium and serum levels of parathormone, calcitriol and calcium. Objectives: To investigate the independent relationship of vitamin D deficiency with insulin resistance, lipid profile, inflammatory status, blood pressure and endothelial function. Method : Crosssectional study conducted with 73 healthy Brazilian premenopausal women aged 18 50 years. All participants were evaluated for: 25 hydroxyvitamin D serum levels, anthropometric parameters, body composition, calcium metabolism, insulin resistance, lipoprotein profile, inflammatory status, blood pressure and endothelial function. Endothelial function was assessed by reactive hyperemia index using EndoPAT 2000®. Women were stratified in two groups: with vitamin D deficiency (25 hydroxyvitamin D <; 20 ng/ml; n=12) and without vitamin D deficiency (25 hydroxyvitamin D ≥ 20 ng/ml; n=61). Results and discussion : Participants with vitamin D deficiency compared with those without deficiency of this vitamin had significantly higher levels of glucose (88.25 ± 3.24 vs. 80.15 ± 1.13 mg/dl), greater HOMAIR (6.43 ± 0.73 vs. 4.42 ± 0.25) and lower reactive hyperemia index (1.68 ± 0.1 vs. 2.17 ± 0.1). After adjustments for confounding factors including age, body mass index, waist circumference, dietary calcium, intracellular calcium and serum levels of parathormone, calcitriol and calcium differences between groups remained significant, regarding glucose and HOMAIR. Conclusions : The findings of the present study suggest that vitamin D deficiency is associated with insulin resistance independent of dietary calcium, intracellular calcium and serum levels of parathormone, calcitriol and calcium in healthy premenopausal women. Artigo Artigos para o site\22 Vitamin D deficiency is associated with insulin disponível na resistanceindependent of intracellular calcium, dietary calcium íntegra and.pdf Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível íntegra na Efeitos da perda ponderal induzida por dieta hipocalórica rica em cálcio sobre biomarcadores inflamatórios da fibrinólise e da função endotelial em obesos Effects of weight loss from a highcalcium energyreduced diet on biomarkers of inflammatory stress, fibrinolysis, and endothelial function in obese subjects. Torres MR , Sanjuliani AF . Nutrition. 2013 Jan;29(1):14351. doi: 10.1016/j.nut.2012.05.012. Epub 2012 Sep 23. Objective: Obesity is characterized by chronic subclinical inflammation, which is critical to endothelial dysfunction. Weight loss, induced by lifestyle interventions, is associated with a decline in biomarkers of inflammation and endothelial dysfunction. There is little evidence that high dietary calcium intake may reduce inflammation and improve endothelial function. The purpose of this study was to evaluate the effects of weight loss from a highcalcium energyreduced diet on biomarkers of inflammation, fibrinolysis, and endothelial function in obese individuals. Methods : In this randomized clinical trial, we analyzed the data from 35 obese adults who lost at least 3% of initial body weight, during a period of 16 wk of energy restriction (800 Kcal/d). Individuals were randomized into the following dietary regimens: (1) a high calcium diet (HCD; 12001300 mg/d) or (2) a lowcalcium diet (LCD; <500 mg/d). Results : After 16 wk of intervention subjects on HCD compared with those on LCD exhibited greater reduction in waist circumference and waisttohip ratio. Participants on HCD presented a significant reduction in all biomarkers of endothelial dysfunction evaluated in the study (intracellular adhesion molecule1, vascular cell adhesion molecule 1, and ESelectin), whereas subjects on LCD showed a significant decrease in intracellular adhesion molecule1 and ESelectin. Biomarkers of inflammation and fibrinolysis were reduced in both diets, although without reaching statistical significance. The reduction in all markers of inflammation, fibrinolysis, and endothelial dysfunction was similar in both diets. Conclusion : The findings of this study suggest that increased calcium intake during weight loss has no benefits with respect to biomarkers of inflammation, fibrinolysis, and endothelial function Artigos para o site\23 Effects of weight loss from a highcalcium energyreduceddiet on biomarkers of inflammatory stress, fibrinolysis, and endothelialfunction in obeses subjects.pdf Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível na íntegra A ingestão de cálcio dietético está associada com adiposidade, perfil metabólico, estado inflamatório e pressão arterial em mulheres saudáveis na prémenopausa. Dietary calcium intake is associated with adiposity, metabolic profile, in flammatory state and blood pressure, but not with erythrocyte intracellular calcium and endothelial function in healthy premenopausal women. da Silva Ferreira T , Torres MR , Sanjuliani AF . Br J Nutr. 2013 Sep 28;110(6):107988. doi: 10.1017/S0007114513000111. Epub 2013 Feb 15. Recent studies have suggested that dietary Ca may have beneficial effects on adiposity, insulin resistance, dyslipidaemia and blood pressure (BP). One potential mechanism underlying these benefits involves modifications in intracellular Ca concentration ([Ca2+]i). The present study aimed to evaluate the associations ofdietary Ca with adiposity, erythrocyte [Ca2+]i, metabolic profile,BP, inflammatory state and endothelial function inhealthy premenopausal women. In the present crosssectional study, seventysix women aged 18–50 years were submitted to the evaluation of dietary intake, anthropometric parameters, body composition, erythrocyte[Ca2+]i, biochemical variables, endothelial function and BP. A FFQ was used to assess usual dietary intake.Endothelial function was evaluated by serum concentrations of adhesion molecules and by the peripheral arterial tonometry (PAT) method, using EndoPAT 2000®. Participants were allocated into two groups according to Caintake: lowCa group (LCG; n 32; < 600 mg/d) and highCa group (HCG; n 44; ≥ 600 mg/d). Women in the LCG compared with those in the HCG exhibited, after adjustments for potential confounders, higher values of BMI, waist circumference, waist:height ratio, percentage of body fat, insulin, homeostasis model assessment of insulin resistance, leptin, diastolic and mean BP; and lower levels of HDLcholesterol, adiponectin and vascular cell adhesion molecule 1. Endothelial function assessed by PAT and [Ca2+]i was similar in both groups. Subjects in the HCG had lower OR for prevalent overweight, obesity, abdominal obesity, insulin resistance, HDLcholesterol < 600 mg/l and systolic BP >120 mmHg. The findings of the present study suggest that high Ca intake is inverselyassociated with some cardiovascular risk factors. Artigos para o site\24 Dietary calcium intake is associated with adiposity,metabolic profile, inflammatory state and blood pressure, but not witherytrocyte intracellular calcium and.pdf Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível íntegra na Hiperhomocisteinemia moderada provoca disfunção do sistema autonômico cardiovascular e estresse oxidativo hepático em ratos. Moderate hyperhomocysteinemia provokes dysfunction of cardiovascular autonomic system and liver oxidative stress in rats Mendes RH , Mostarda C , Candido GO , MoraesSilva IC , D'Almeida V , BellóKlein A , Irigoyen MC , Rigatto K . AutonNeurosci. 2014 Feb;180:437. doi: 10.1016/j.autneu.2013.10.006. Epub 2013 Oct 26. Hyperhomocysteinemia (HHcy) is associated with cardiovascular disease, atherosclerosis and reactive oxygen species generation. Thus, our aim was to investigate whether there was an association between HHcy, bloodpressure, autonomic control and liver oxidative stress. Male Wistar rats were divided into 2 groups and treated for 8weeks: one group (control, CO) received tap water, while the other group (methionine, ME) was given a 100mg/kg of methionine in water by gavage. Two catheters were implanted into the femoral artery and vein to record arterial pressure (AP) and heart rate (HR) and drug administration. Signals were recorded by a data acquisition system. Baroreflex sensitivity was evaluated by HR responses to AP changes induced by vasoactive drugs. HR variability and AP variability were performed by spectral analysis in time and frequency domains to evaluate the contribution of the sympathetic and parasympathetic modulation. Lipid peroxidation and antioxidant enzyme activities were evaluated by measuring superoxide dismutase, catalase and glutathione peroxidase in liver homogenates. The ME group presented a significant increase in systolic arterial pressure (118±9 vs 135±6mmHg), diastolic arterial pressure (81±6 vs. 92±4) and mean arterial pressure (95±7 vs. 106±6). In addition, pulse interval variability presented a significant decrease (41%), while the low frequency component of AP was significantly increased (delta P=6.24mmHg(2)) in the ME group. We also found a positive association between lipid peroxidation and cardiac sympathetic modulation, sympathetic and vagal modulation ratio and systolic pressure variability. Collectively, these findings showed that HHcy induced dysfunction of cardiovascular autonomic system and liver oxidative stress. Artigos para o site\25 Moderate hyperhomocysteinemia provokes dysfunction ofcardiovascular autonomic system and liver oxidative stress in rats.pdf Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível íntegra na O peptídeo mimético 4F da apolipoproteína AI atenua lesão renal, lesão cardíaca e disfunção endotelial na sepse Apolipoprotein AI mimetic peptide 4F attenuates kidney injury, heart injury, andendothelial dysfunction in sepsis. Moreira RS , Irigoyen M , Sanches TR , Volpini RA , Camara NO , Malheiros DM , Shimizu MH , Seguro AC , Andrade L . Am J PhysiolRegulIntegr Comp Physiol . 2014 Sep 1;307(5):R51424. doi: 10.1152/ajpregu.00445.2013. Epub 2014 Jun 11. Kidney injury, heart injury, and cytokineinduced vascular hyperpermeability are associated with high rates of morbidity and mortality in sepsis. Although the mechanism remains unknown, apolipoprotein AI (apoAI) mimetic peptide 4F reduces inflammation and protects HDL levels, which are reduced in sepsis. We hypothesized that 4F also protects kidneys and hearts in a rat model of cecal ligation and puncture (CLP). We divided Wistar rats into groups: shamoperated (control), CLP, and CLP+4F (10 mg/kg body wtip, 6 h after CLP). At 24 h postCLP, we evaluated cardiac function, mean arterial pressure (MAP), heart rate (HR), baroreflex sensitivity, total cholesterol, LDL, HDL, serum cytokines, and inulin clearance. We performed immunoblotting for protein regulators of vascular permeability (Slit2 and Robo4) and endothelial nitric oxide synthase (eNOS) in kidney tissue. We evaluated heartmitochondria with electron microscopy. Although there was no difference in MAP, the HR was significantly higher in CLP rats than in control and CLP+4F rats. In CLP+4F rats, baroreflex sensitivity and cardiac function were completely protected from the effects of CLP, as was glomerular filtration; heart mitochondria morphology was improved; sepsisinduced changes in serum cholesterol, LDL, HDL, and apoAI were less common; all cytokines were lower than in CLP rats; and expression of Slit2, Robo4, and eNOS was completely restored. Administration of 4F inhibits inflammatory responses and strengthens the vascular barrier, protecting kidneys and hearts in an HDLdependent manner. To determine the extent of the protective effect of 4F, further studies are needed. Título (português) Título (artigo submetido) Autores Comprometimento cardíaco avaliado por ecocardiografiatransesofágica e medidas invasivas em ratos submetidos denervaçãosinoaórtica. Cardiac impairment evaluated by transesophageal echocardiography and inva sive measurements in rats undergoing sinoaortic denervation. Sirvente RA , Irigoyen MC , Souza LE , Mostarda C , La Fuente RN , Candido GO , Souza PR , Medeiros A , MadyC , Salemi VM . Periódico PLoS One. 2014 May 14;9(5):e87935. doi: 10.1371/journal.pone.0087935. eCollection 2014. Abstract Background : Sympathetic hyperactivity may be related to left ventricular (LV) dysfunction and baro and chemoreflex impairment in hypertension. However, cardiac function, regarding the association of hypertension and baroreflex dysfunction, has not been previously evaluated by transesophageal echocardiography (TEE) using intracardiac echocardiographic catheter. Methods and results : We evaluated exercise tests, baroreflex sensitivity and cardiovascular autonomic control, cardiac function, and biventricular invasive pressures in rats 10 weeks after sinoaortic denervation (SAD). The rats (n = 32) were divided into 4 groups: 16 Wistar (W) with (n = 8) or without SAD (n = 8) and 16 spontaneously hypertensive rats (SHR) with (n = 8) or without SAD (SHRSAD) (n = 8). Blood pressure (BP) and heart rate (HR) did not change between the groups with or without SAD; however, compared to W, SHR groups had higher BP levels and BP variability was increased. Exercise testing showed that SHR had better functional capacity compared to SAD and SHRSAD. Echocardiography showed left ventricular (LV) concentric hypertrophy; segmental systolic and diastolic biventricular dysfunction; indirect signals of pulmonary arterial hypertension, mostly evident in SHRSAD. The enddiastolic right ventricular (RV) pressure increased in all groups compared to W, and the enddiastolic LV pressure increased in SHR and SHRSAD groups compared to W, and in SHRSAD compared to SAD. Conclusions: Our results suggest that baroreflex dysfunction impairs cardiac function, and increases pulmonary artery pressure, supporting a role for baroreflex dysfunction in the pathogenesis of hypertensivecardiac disease. Moreover, TEE is a useful and feasible noninvasive technique that allows the assessment ofcardiac function, particularly RV indices in this model of cardiac disease. Artigos para o site\27 ‐ Cardiac impairment evaluated by transesophagealechocardiography and invasive measurements in rats undergoing sinoaorticdenervation.pdf Artigo disponível na íntegra Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível íntegra na Exercício aquático é tão eficaz quanto o treinamento no solo na redução da pressão arterial em mulheres hipertensas na pósmenopausa Aquatic exercise is as effective as dry land training to blood pressure reduction inpostmenopausal hypertensive women. Arca EA , Martinelli B , Martin LC , Waisberg CB , Franco RJ . Physiother Res Int. 2014 Jun;19(2):938. doi: 10.1002/pri.1565. Epub 2013 Sep 10. Background and purpose : The evidence of the benefits from regular physical activity to hypertensives is based on dry land training studies. Therefore, the aim of this study is to compare the effect of aquatic exercise with dry land training on hypertensive women. Methods : This is a randomized controlled study with 52 postmenopausal hypertensive women. The patients were randomly allocated in three groups: water aerobic training group (n = 19), dry land aerobic training group (n = 19) and a nonintervention control group (n = 14). The training protocol was performed by 12 weeks. Results: There were no differences among the three groups concerning basal blood pressure (BP) and biochemical variables. In water group, there was a statistically significant reduction of systolic BP from 136 ± 16 mm Hg at zero week to 124 ± 18 mm Hg at 11th week and 124 ± 15 mm Hg at 12th week. In dry land traininggroup, there was a statistically significant reduction of systolic BP from 138 ± 15 mm Hg at zero week to 125 ± 10 mm Hg at 7th week, 127 ± 10 mm Hg at 10th week and 126 ± 9 mm Hg at 12th week. The control group presented no change in any of the assessed variables. No changes were carried out in any antihypertensive medications during study. Discussion: This is a randomized controlled study that demonstrates the antihypertensive efficacy of aerobicaquatic exercise. Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível íntegra na Água corporal total e falha no controle da pressão arterial pela medicação em pacientes submetidos a hemodiálise Total body water and failure to control blood pressure by medication in hemodialysis patients. Santi Xavier P , Perez Vogt B , Cuadrado Martin L , Vaninni F , Araújo Antunes A , Ponce D , Costa Teixeira Caramori J , Dos Santos E Silva Martin R , da Silva Franco RJ , Barretti P . Nephron Extra. 2014 Jul 3;4(2):95100. doi: 10.1159/000363322. eCollection 2014. Background: Volume overload is the main factor responsible for the pathogenesis of hypertension in dialysispatients. Few studies have evaluated the interpretation of the parameters obtained by bioelectrical impedance (BIA) to manage these patients. The aim of this study was to assess the best cutoff level of volume overload obtained by BIA able to predict the absence of hypertension control in hemodialysis patients. Methods: Volume overload was calculated as the difference between total body water (TBW) measured by bioimpedance and TBW estimated by the Watson formula in chronic stable hemodialysis patients. Inadequatecontrol of blood pressure (BP) was defined as the mean of measurements obtained before five hemodialysissessions ≥140 × 90 mm Hg. The best cutoff level of volume overload assessed by BIA able to predict the absence of BP control in patients on chronic hemodialysis was determined by the receiver operating characteristic (ROC) curve using the Youden method. Results : We included 205 patients, 53% male, aged 56 ± 14.5 years. The largest area under the ROC curve was found for predialysis volume overload (0.660, 95% CI 0.5560.765, p = 0.004). The ROC curve of postdialysis volume overload also reaches statistical significance. The best cutoff point was found for predialysis volume overload ≥1.4 liters with a sensitivity of 69% and a specificity of 67%. Conclusion : The association of TBW and inadequate BP control highlights the importance of volume management in hemodialysis patients. Predialysis volume overload of 1.4 liters was the parameter that best discriminated the presence of inadequate BP control. Artigos para o site\29 Total body water and failure to control blood pressure bymedication in hemodialysis patients.pdf Título (português) Título (artigo submetido) Autores Periódico Abstract Artigo disponível íntegra na Comportamento cognitivo na doença renal crônica Cognitive impairment in chronic kidney disease. StringuettaBelik F, Martin LC, Franco RJS. J. Bras. Nefrol. vol.36 no.2 São Paulo Apr./June 2014 http://dx.doi.org/10.5935/01012800.20140018 EDITORIAL Artigos para o site\30 Cognitive impairment in chronic kidney disease.pdf
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