FERNANDA MARCIANO CONSOLIM COLOMBO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Effectiveness of Chlorthalidone Plus Amiloride for the Prevention of Hypertension: The PREVER-Prevention Randomized Clinical Trial(2016) FUCHS, Sandra Costa; POLI-DE-FIGUEIREDO, Carlos E.; FIGUEIREDO NETO, Jose A.; SCALA, Luiz Cesar N.; WHELTON, Paul K.; MOSELE, Francisca; MELLO, Renato Bandeira de; VILELA-MARTIN, Jose F.; MOREIRA, Leila B.; CHAVES, Hilton; GOMES, Marco Mota; SOUSA, Marcos R. de; SILVA, Ricardo Pereira e; CASTRO, Iran; CESARINO, Evandro Jose; JARDIM, Paulo Cesar; ALVES, Joao Guilherme; STEFFENS, Andre Avelino; BRANDAO, Andrea Araujo; CONSOLIM-COLOMBO, Fernanda M.; ALENCASTRO, Paulo Ricardo de; NETO, Abrahao Afiune; NOBREGA, Antonio C.; FRANCO, Roberto Silva; SOBRAL FILHO, Dario C.; BORDIGNON, Alexandro; NOBRE, Fernando; SCHLATTER, Rosane; GUS, Miguel; FUCHS, Felipe C.; BERWANGER, Otavio; FUCHS, Flavio D.Background-Prehypertension is associated with higher cardiovascular risk, target organ damage, and incidence of hypertension. The Prevention of Hypertension in Patients with PreHypertension (PREVER-Prevention) trial aimed to evaluate the efficacy and safety of a low-dose diuretic for the prevention of hypertension and end-organ damage. Methods and Results-This randomized, parallel, double-blind, placebo-controlled trial was conducted in 21 Brazilian academic medical centers. Participants with prehypertension who were aged 30 to 70 years and who did not reach optimal blood pressure after 3 months of lifestyle intervention were randomized to a chlorthalidone/amiloride combination pill or placebo and were evaluated every 3 months during 18 months of treatment. The primary outcome was incidence of hypertension. Development or worsening of microalbuminuria, new-onset diabetes mellitus, and reduction of left ventricular mass were secondary outcomes. Participant characteristics were evenly distributed by trial arms. The incidence of hypertension was significantly lower in 372 study participants allocated to diuretics compared with 358 allocated to placebo (hazard ratio 0.56, 95% CI 0.38-0.82), resulting in a cumulative incidence of 11.7% in the diuretic arm versus 19.5% in the placebo arm(P=0.004). Adverse events; levels of blood glucose, glycosylated hemoglobin, creatinine, and microalbuminuria; and incidence of diabetes mellitus were no different between the 2 arms. Left ventricular mass assessed through Sokolow-Lyon voltage and voltage-duration product decreased to a greater extent in participants allocated to diuretic therapy compared with placebo (P=0.02). Conclusions-A combination of low-dose chlorthalidone and amiloride effectively reduces the risk of incident hypertension and beneficially affects left ventricular mass in patients with prehypertension.
- Abnormalities of Anthropometric, Hemodynamic, and Autonomic Variables in Offspring of Hypertensive Parents(2016) MOTTA, Josiane M.; LEMOS, Tercio M.; CONSOLIM-COLOMBO, Fernanda M.; MOYSES, Rosa M. A.; GUSMAO, Marcelo A. N.; EGAN, Brent M.; LOPES, Heno F.Young adult offspring of hypertensive parents (pHTN circle plus) are a good model for assessing abnormalities of anthropometric, cardiometabolic, and autonomic variables prior to clinical hypertension. The objectives of this study were to determine whether these variables and autonomic responses to oral carbohydrates were altered in offspring of pHTN circle plus. Two hundred consecutive patients, including 100 pHTN circle plus, were evaluated, with 29 patients, including 14 pHTN circle plus, given a 70-gram carbohydrate load. The pHTN circle plus group had higher blood pressure, pulse pressure, abdominal circumference (AC), weight, body mass index, and basal metabolic rate than offspring of normotensive parents (pHTN empty set). At baseline, the low-frequency (LF, sympathetic) to high-frequency (HF, parasympathetic) ratio, assessed by spectral analysis of heart rate variability, was similar in both groups. After the carbohydrate load, the LF/HF ratio was greater in offspring of pHTN circle plus. pHTN circle plus individuals have abnormalities of anthropometric and hemodynamic variables at baseline and autonomic responses to oral carbohydrates before developing hypertension.
- Increase in cholinergic modulation with pyridostigmine induces anti-inflammatory cell recruitment soon after acute myocardial infarction in rats(2016) ROCHA, Juraci Aparecida; RIBEIRO, Susan Pereira; FRANCA, Cristiane Miranda; COELHO, Otavio; ALVES, Gisele; LACCHINI, Silvia; KALLAS, Esper Georges; IRIGOYEN, Maria Claudia; CONSOLIM-COLOMBO, Fernanda M.
- Visceral adiposity syndrome(2016) LOPES, Heno F.; CORREA-GIANNELLA, Maria Lucia; CONSOLIM-COLOMBO, Fernanda M.; EGAN, Brent M.The association of anthropometric (waist circumference) and hemodynamic (blood pressure) changes with abnormalities in glucose and lipid metabolism has been motivation for a lot of discussions in the last 30 years. Nowadays, blood pressure, body mass index/abdominal circumference, glycemia, triglyceridemia, and HDL-cholesterol concentrations are considered in the definition of Metabolic syndrome, referred as Visceral adiposity syndrome (VAS) in the present review. However, more than 250 years ago an association between visceral and mediastinal obesity with hypertension, gout, and obstructive apnea had already been recognized. Expansion of visceral adipose tissue secondary to chronic over-consumption of calories stimulates the recruitment of macrophages, which assume an inflammatory phenotype and produce cytokines that directly interfere with insulin signaling, resulting in insulin resistance. In turn, insulin resistance (IR) manifests itself in various tissues, contributing to the overall phenotype of VAS. For example, in white adipose tissue, IR results in lipolysis, increased free fatty acids release and worsening of inflammation, since fatty acids can bind to Toll-like receptors. In the liver, IR results in increased hepatic glucose production, contributing to hyperglycemia; in the vascular endothelium and kidney, IR results in vasoconstriction, sodium retention and, consequently, arterial hypertension. Other players have been recognized in the development of VAS, such as genetic predisposition, epigenetic factors associated with exposure to an unfavourable intrauterine environment and the gut microbiota. More recently, experimental and clinical studies have shown the autonomic nervous system participates in modulating visceral adipose tissue. The sympathetic nervous system is related to adipose tissue function and differentiation through beta(1), beta(2), beta(3), alpha(1), and alpha(2) adrenergic receptors. The relation is bidirectional: sympathetic denervation of adipose tissue blocks lipolysis to a variety of lipolytic stimuli and adipose tissue send inputs to the brain. An imbalance of sympathetic/parasympathetic and alpha(2) adrenergic/beta(3) receptor is related to visceral adipose tissue storage and insulin sensitivity. Thus, in addition to the well-known factors classically associated with VAS, abnormal autonomic activity also emerges as an important factor regulating white adipose tissue, which highlights complex role of adipose tissue in the VAS.
bookPart Monitorização ambulatorial e residencial da pressão arterial(2016) SANGALETI, Carine Teles; GIORGI, Dante Marcelo Artigas; CONSOLIM-COLOMBO, Fernanda M.