Background: Heart failure is a complex syndrome with multiple risk factors involved in its genesis, making its prevention and management difficult to achieve.

BackgroundThe diagnosis of chronic obstructive pulmonary disease (COPD) is often delayed until later stages of the disease. The purpose of the present study was to determine the prevalence of COPD among adults on treatment for systemic arterial hypertension independently of the presence of respiratory symptoms.MethodsThis cross-sectional study included adults aged ≥40 years with tobacco/occupational exposure and systemic arterial hypertension diagnosed at three Primary Health Care facilities in Goiania, Brazil. Patients were evaluated using a standardized respiratory questionnaire and spirometry. COPD prevalence was measured considering the value of forced vital capacity and/or forced expiratory volume in 1 second <0.70.ResultsOf a total of 570 subjects, 316 (55%) met inclusion criteria and were invited to participate. Two hundred and thirty-three (73.7%) patients with arterial hypertension reported at least one respiratory symptom, while 83 (26.3%) reported no respiratory symptoms; 41 (17.6%) patients with arterial hypertension and at least one respiratory symptom, and 10 (12%) patients with arterial hypertension but no respiratory symptoms were diagnosed with COPD (P=0.24). The prevalence of COPD in people with no previous COPD diagnosis was greater among those with no respiratory symptoms (100%) than among those with respiratory symptoms (56.1%) (P=0.01).ConclusionOur findings suggest that regardless of the presence of respiratory symptoms, individuals aged ≥40 years with tobacco/occupational exposure and arterial hypertension may benefit from spirometric evaluation.

BackgroundThe role of interleukins in the severity and clinical profile of chronic obstructive pulmonary disease (COPD) is not known, but evidence supports the contribution of systemic inflammation to disease pathophysiology. This study evaluated the relationship of serum biomarkers to the severity and clinical parameters of COPD.Methods and findingsSerum levels of high-sensitivity C-reactive protein, interleukin-6 (IL-6), and interleukin-8 (IL-8) were measured in 50 patients with stable COPD and in 16 controls. The levels of these biomarkers were compared with parameters of severity, such as the grading of flow obstruction using the recommendations of the Global initiative for chronic Obstructive Lung Disease, the BMI (body mass index), obstruction, dyspnea, exercise capacity (health index) index, the number of exacerbations within the last year, and peripheral oxygen saturation after the six-minute walk test, and with clinical parameters, such as bronchitis and non-bronchitis phenotypes, the number of associated comorbidities, and the smoking burden. COPD patients exhibited higher levels of IL-6 and IL-8 compared to the control group. Higher levels of IL-6 occurred in COPD groups with body mass index <21 kg/m2, with more than two exacerbations in the past year, with a higher smoking burden, and with bronchitis. The increase in serum IL-8 was found only in the group with the highest number of exacerbations within the previous year.ConclusionIncreased IL-6 was mainly associated with smoking burden, in patients who had smoked for more than 30 pack-years and exhibited a bronchitis phenotype. No direct association was observed for both IL-6 and IL-8 blood levels with the severity of COPD in ex-smokers.

Limitation in activities of daily living (ADL) caused by dyspnea is a common finding in patients with heart failure (HF), functional class III and IV. Specific assessment of ADL limitation could be used as a parameter of the disease progression and the therapy response. However, there is a shortage of instruments to assess ADL in this population. This study aimed to determine the applicability of the London Chest Activity of Daily Living (LCADL) and the Glittre ADL-test (T Glittre ), to evaluate functional limitations of individuals with HF functional class III and IV. Ten patients (57±9 years, 27.5±4.5kg/m 2 ) of both genders with a clinical diagnosis of HF functional class III and IV and left ventricle ejection fraction (LVEF) 34±7% participated in the study. Spirometry, body mass index (BMI), LCADL, six-minute walking test (6MWT), T Glittre , Medical Research Council Scale (MRC) and SF-36 were performed. The patients had an average score of the LCADL total from 27.7±12.1 (LCADL %total : 41.5±16.9) and time of T Glittre 6.3±4.8 minutes. A positive correlation was found between them (r = 0.88, p<0.05). LCADL %total correlated with 6MWT (r =-0.83), LVEF (r =-0.64), MRC (r =0.68) and Functional Capacity (functional capacity) of the SF-36 (r =-0.63) (p<0.05). T Glittre correlated with 6MWT (r =-0.90), LVEF (r =-0.66) and CF of the SF-36 (r =-0.69) (p<0.05). In conclusion, the LCADL scale and T Glittre have applicability in patients with HF class III and IV, demonstrating association with LVEF, distance on the 6MWT, degree of dyspnea and quality of life.