Four remote population samples (Yanomamo and Xingu Indians of Brazil and rural populations in Kenya and Papua New Guinea) had the lowest average blood pressures among all 52 populations studied in INTERSALT, an international cooperative investigation of electrolytes and blood pressure. Average systolic blood pressure was 103 versus 120 mm Hg in the remaining INTERSALT centers; diastolic blood pressure in these four population samples averaged 63 versus 74 mm Hg in the 48 other centers. There was little or no upward slope of blood pressure with age; hypertension was present in only 5% of the rural Kenyan sample and virtually absent in the other three centers. Also in marked contrast with the rest of the centers was level of daily salt intake, as estimated by 24-hour urinary sodium excretion. Median salt intake ranged from under 1 g to 3 g daily versus more than 9 g in the rest of INTERSALT populations. Average body weight was also low in these four centers, with no or low average alcohol intake, again unlike the other centers. The association within these four centers between the above variables and blood pressure was low, possibly reflecting their limited variability. While several other INTERSALT centers also had low average body weight or low prevalence of alcohol drinking, when this was accompanied by much higher salt intake (7-12 g salt or 120-210 mmol sodium daily), hypertension prevalence ranged from 8% to 19%. These findings confirm previous reports that in populations with a low salt intake, there is little or no hypertension or rise of blood pressure with age. While the contributory role of other characteristics of these populations must also be considered, the results are consistent with the view that a certain minimum salt intake is essential for rise in blood pressure with age in adults and a high frequency of hypertension in populations. {Hypertension 1989; 14:238-246)

The results indicate an unfavorable trend in the dietary patterns of this population, since three of the four patterns identified (cafeteria, traditional, and atherogenic) are significantly associated with risk factors for CVD.

Objective To investigate the efficacy of the H 1 antihistamine promethazine against early anaphylactic reactions to antivenom. Design Sequential randomised, double blind, placebo controlled trial. Setting Public hospital in a venom research institute, São Paulo, Brazil. Participants 101 patients requiring antivenom treatment after being bitten by bothrops snakes. Intervention Intramuscular injection of promethazine (25 mg for adults and 0.5/kg for children) or placebo given 15-20 min before starting intravenous infusion of antivenom. Main outcome measures Incidence and severity of anaphylactic reactions occurring within 24 hours after antivenom. Results Reactions occurred in 12 of 49 patients treated with promethazine (24%) and in 13 of 52 given placebo (25%); most were mild or moderate. Continuous sequential analysis indicated that the study could be interrupted at the 22nd untied pair, without preference for promethazine or placebo. Conclusion Prophylaxis with promethazine does not prevent early reactions. Patients should be observed carefully during antivenom infusion and the subsequent few hours.

ObjectiveTo estimate the prevalence of a set of risk factors for non-transmissible chronic diseases and compare it to that found 15-16 years ago in a similar survey. Methods A cross-sectional household survey was carried out comprising a random sample of people aged 15-59 years in the city of São Paulo between 2001 and 2002. The total of 2,103 people answered a questionnaire and had their blood pressure, weight, height, waist and hip circumferences measured. For a third of these participants, their total cholesterol, HDL-cholesterol, triglycerides and glucose levels were determined. ResultsThe total age-adjusted prevalences in the study age group were as follows: smoking, 22.6%; uncontrolled blood pressure, 24.3%; obesity, 13.7%; increased waist circumference, 19.7%; total cholesterol ≥240 mg/dL, 8.1%; HDL-cholesterol <40 mg/ dL, 27.1%; triglycerides ≥200 mg/dL, 14.4%; and blood glucose ≥110 mg/dL, 6.8%. Smoking, uncontrolled blood pressure, high total cholesterol, low HDL-cholesterol and high triglycerides were significantly more prevalent in men than women. ConclusionsThe prevalences of a set of risk factors for chronic diseases showed men to have a poorer condition than women. In comparison to the previous survey, the prevalence of uncontrolled blood pressure remained unchanged but the prevalence of smoking has significantly lowered. methodology, most of them were conducted separately and at different points in time (Volta Redonda, 7 1979-1980 Fortaleza, 19 1985; Araraquara, 10 1987; Piracicaba, 1 1988; Cotia, 15 1990 Cotia, 15 -1991 Ilha do Governador, 8 1991-1992 Pelotas, 6,17 1992 and Passo Fundo, 21 1995; Catanduva, 4 1998), making it difficult to identify geographical differences and temporal changes. Few exceptions are the studies on diabetes in Brazilian capitals 13 and on obesity trends in urban and rural areas. 16 Porto Alegre is perhaps the only Brazilian city where the prevalence of hypertension was measured at two points in time, in the 70's and in the 90's. were later excluded because they were found to be pregnant or puerperal women.The final sample was then composed of 2,103 people who answered a questionnaire applied by trained nurse interviewers, and had their blood pressure, weight, height, waist and hip circumferences measured twice. Most (70.9%) interviews were performed on weekends (42.7% on Saturdays and 28.2% on Sundays), and 29.1% were equally distributed on the other five weekdays. A 10% randomly selected subsample of interviews had their integrity checked by telephone, and showed no discrepancies.About a third of participants (759), randomly selected, answered a quantitative nutrition questionnaire and 700 had a fasting venous blood sample collected at home; as 59 (7.8%) refused to have their blood drawn. In order to minimize the interference of overeating on weekends, blood collection was not carried out on Sundays and was avoided on Mondays. Blood samples were processed for determinations of plasma glucose and serum total cholesterol, HDL-cholesterol and trig...

Resumo ObjetivoDescrever o perfil de utilização de medicamentos por idosos residentes em áreas de diferentes níveis socioeconômicos de um centro urbano do Nordeste do Brasil. Métodos Inquérito domiciliar entre idosos (60 anos ou mais) da cidade de Fortaleza, Ceará, selecionados por amostragem sistemática em múltiplos estágios e estratificada por nível socioeconômico (melhor = área central; intermediário = área intermediária; pior = área periférica). Estatística descritiva foi apresentada pelas percentagens dos respectivos totais para variáveis categóricas e médias (± desvio-padrão) para variável contínua. Realizou-se análise multivariada para identificação de fatores associados a uso de medicamentos prescritos; não-prescritos e inadequados. Resultados A maioria dos idosos (80,3% na área central) usava pelo menos um medicamento prescrito. Mais de um terço (37,4%) na área periférica usava pelo menos um não-prescrito, e quase 20% pelo menos um inadequado. O uso de medicamentos prescritos foi associado à idade avançada (razão de chances -RR=1,7; IC 95%: 1,1-2,8); sexo masculino (RR=0,5; IC 95%: 0,3-0,7); visitas a serviços de saúde (RR=2,5; IC 95%: 1,9-3,1); doenças crônicas (RR=4,0; IC 95%: 2,5-6,2); e nível socioeconômico (RR=2,0; IC 95%: 1,5-2,6). O uso de medicamentos não prescritos foi associado a comprometimento funcional (RR=1,5; IC 95%: 1,1-2,2) e nível socioeconômico (RR=0,6; IC 95%: 0,5-0,8). O uso de medicamentos inadequados foi associado principalmente a sexo masculino (RR=0,4; IC 95%: 0,2-0,8); doenças crônicas (RR=2,0; IC 95%: 1,2-3,3), e nível socioeconômico (RR=0,7; IC 95%: 0,5-0,9). Conclusões As proporções de idosos usando medicamentos prescritos, não-prescritos e inadequados foram significativas, havendo desigualdades particularmente entre aqueles de diferentes níveis socioeconômicos. Os resultados apontam para a necessidade de programas para otimizar o acesso e racionalizar o uso de medicamentos entre idosos no Brasil. Abstract ObjectiveTo identify medication use patterns among elderly people residing in areas with different socioeconomic status in the city of Fortaleza, Brazil.