L’augmentation de l’épaisseur intima-média carotidienne (EIMc) est associée aux facteurs de risque d’athérosclérose ainsi qu’à une augmentation du risque coronaire et cérébral chez l’adulte. L’EIMc a déjà été mesurée chez des enfants et adolescents présentant des affections associées à une augmentation du risque cardiovasculaire, les relations entre l’EIMc et les facteurs de risque traditionnels ou liés au style de vie ont cependant été peu étudiées chez des adolescents issus d’une population générale. Notre objectif a été d’étudier les facteurs déterminants de l’EIMc chez l’enfant et/ou l’adolescent.1: Nous avons réalisé une revue systématique de la littérature concernant la mesure de l’EIMc dans des populations pédiatriques présentant des facteurs de risque cardiovasculaire. 65 articles (67 études citées) ont été revus, publiés de 1986 à 2010, concernant des études cas-témoins réalisées chez des enfants et/ou adolescents présentant les affections suivantes: obésité, diabète de type 1, dyslipidémies, hypertension artérielle, insuffisance rénale chronique. Les études analysées ont inclus 3692 patients et 2623 témoins âgés en moyenne de 6.4 à 17.6 ans. Les méthodes de mesure de l’EIMc ont varié selon les études. Une augmentation significative de l’EIMc a été observée dans 22 études/26 chez les sujets obèses comparés aux témoins, dans 8 études/14 chez les patients diabétiques de type 1, 10 études/11 chez les patients dyslipidémiques, 7 études/8 chez les patients hypertendus et 8 études/8 chez les patients insuffisants rénaux. L’absence d’augmentation significative de l’EIMc dans certaines études chez les diabétiques a été expliquée par la courte durée d’évolution de la maladie (5.1 ans), le jeune âge des patients, le bon équilibre métabolique. Malgré l’hétérogénéité des méthodes de mesure, l’EIMc a été significativement augmentée dans 55/67 études citées confirmant la présence de modifications précoces de la paroi artérielle carotidienne dans les populations pédiatriques à risque cardiovasculaire accru.2:Objectif: Nous avons étudié chez des adolescents de la métropole lilloise les relations entre l’EIMc et les facteurs anthropométriques, biologiques et liés au style de vie (statut socioéconomique, activité physique, nutrition) pouvant influer sur le risque cardiovasculaire. Matériel et méthodes: Ce travail est une étude ancillaire de HELENA-CSS (Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study), laquelle analyse dans une population d’adolescents européens des données relatives à la santé, au style de vie et au statut nutritionnel. L’échantillon a été constitué de 319 adolescents (135 garçons et 184 filles) âgés de 12 à 17.5 ans. Les mesures de l’EIMc et du diamètre carotidien des deux côtés ont été effectuées en utilisant une sonde échographique linéaire de 7.5MHz, à l’aide d’un logiciel de détection semi-automatique des contours. Le poids, la taille, les tours de taille et de hanche, les plis cutanés, la pression artérielle ont été mesurées, et un prélèvement sanguin réalisé chez 29.8% des volontaires. Les rapports poids (kg)/taille (m) 2 (IMC), IMC z-score, tour de taille/tour de hanche, plis sous-scapulaire + suprailiaque/plis sous-scapulaire + suprailiaque + bicipital + tricipital (PT/∑4 plis) ont été calculés. Le stade pubertaire a été évalué selon la méthode de Tanner, le statut socioéconomique par le niveau maternel d’éducation et l’échelle de richesse de la famille FAS 4 (family affluent scale). Les concentrations sériques de cholestérol total, HDL et LDL, triglycérides, glucose, CRP-us, sICAM-1, sVCAM-1 et sE-sélectine ont été mesurées. Le fitness cardiorespiratoire a été mesuré indirectement par le test de course navette, et l’activité physique évaluée objectivement par l’intermédiaire d’un accéléromètre. / . Some studies suggested that lifestyle related factors such as physical activity, nutrition and socioeconomic status could influence the cardiovascular risk. An increased carotid intima-media thickness (cIMT) is associated with atherosclerosis risk factors and with an increased risk of coronary heart disease and stroke in adults. cIMT was measured before in children and adolescents with some diseases associated with an increased cardiovascular risk, but the relations between cIMT and the traditional risk factors or related to lifestyle were scarcely studied in adolescents from a general population. Our aim was to study the cIMT predictors in children and/or adolescents.1: We performed a literature systematic review about cIMT measurement in pediatric populations with cardiovascular risk factors. 65 papers (67 cited studies) were reviewed, published from 1986 to 2010, about some case-control studies performed in children and/or adolescents with the following diseases: obesity, diabetes type 1, dyslipidemia, hypertension, chronic renal failure. The analyzed studies included 3692 patients and 2623 controls with mean ages from 6.4 to 17.6 years. The measurement methods varied according to the studies. A significant increased cIMT was observed in 22 studies/26 in obese children compared to controls, 8 studies/14 in diabetic type 1 patients, 10 studies/11 in dyslipidemic patients, 7 studies/8 in hypertensive patients and 8 studies/8 in chronic renal failure patients. The non significant increased cIMT in some studies in diabetic patients was explained by the short median duration of the disease, the young age of the patients or the good metabolic control of the disease. In spite of the heterogeneity of the measurement methods, the cIMT was significantly increased in 55/67 cited studies confirming the early carotid artery damages in pediatric populations with an increased cardiovascular risk.2: Aim: We studied in adolescents from Lille metropolis the relations between cIMT and the anthropometric, biologic and lifestyle factors that may influence the cardiovascular risk. Material and methods: This work is an ancillary study of HELENA-CSS (Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study), which analyzes in a population of European adolescents some data related to health, lifestyle and nutritional status. The sample comprised 319 adolescents (135 boys et 184 girls) aged from 12 to 17.5 years. The cIMT and carotid diameter measurements were performed on both sides, using a 7.5MHz linear probe, with the help of a semi-automatic edges detection soft. Weight, height, waist and hip circumferences, skinfolds, blood pressure were measured, and a blood sample was drawn in 29.8% of the adolescents. BMI, BMI z-score, waist/hip, subscapular + suprailiac skinfolds/ subscapular + suprailiac + bicipital + tricipital skinfolds (TSKF/∑4 skinfolds) were calculated. The pubertal stage was assessed according to the Tanner’s method, the socioeconomic status by the maternal education level and the family affluence scale (FAS 4).

Proefschrift Universiteit Maastricht. / Met bibliogr., lit. opg. - Met samenvatting in het Nederlands.

M.Tech.

<p>En trekant?– En kvalitativ studie om medias eventuella påverkan på ungdomars attityder till sexualitet, intimitet, relationer, manlighet och kvinnlighet. Högskolan i Halmstad. Simon Lindgren (2005) menar att vi allt mer tar till oss och tolkar vår verklighet genom media, den uttrycker liksom bidrar till formandet av våra attityder, tankar och livsstilar. Sexualitet, intima relationer, kvinnlighet och manlighet tänker och uttrycker vi inte helt individuellt. Utan samhället har normer och regler som formar vårt sexuella beteende och våra önskningar (Hedmius, 2000). Vårt syfte med studien är att lyfta fram om den kunskap som förmedlas via media till ungdomar påverkar dessa ungdomars tankar och attityder till sexualitet, intimitet, relationer, manlighet och kvinnlighet. Studiens frågeställning lyder: Finns det tydliga kopplingar mellan ungdomars tankar och attityder kring sexualitet, intima relationer, manlighet och kvinnlighet, och medias presentationer av sexualitet, intima relationer, manlighet och kvinnlighet? För att avgränsa studien har vi valt medieutbudet från Veckorevyn, Slitz, Tv3, Tv4 och kanal 5. Studiens empiriska material har samlats in via fyra fokusgrupper med ungdomar i artonårsåldern. Vi har bland andra valt Peter L. Berger och Thomas Luckmans (2003) socialisationsteori och Yvonne Hirdmans (2004) genuskontrakt som analysverktyg. Vårt resultat visar att medias presentationer av manlighet, kvinnlighet, sexualitet och intima relationer påverkar ungdomarna. Media som vi tagit del av upprätthåller ofta traditionella föreställningar, som bidrar till formandet av tankar och attityder kring sexualitet, manlighet och kvinnlighet. Dock påverkar nog även andra socialisationsagenter ungdomarna, så som familj, kompisar och skola.</p>

En trekant?– En kvalitativ studie om medias eventuella påverkan på ungdomars attityder till sexualitet, intimitet, relationer, manlighet och kvinnlighet. Högskolan i Halmstad. Simon Lindgren (2005) menar att vi allt mer tar till oss och tolkar vår verklighet genom media, den uttrycker liksom bidrar till formandet av våra attityder, tankar och livsstilar. Sexualitet, intima relationer, kvinnlighet och manlighet tänker och uttrycker vi inte helt individuellt. Utan samhället har normer och regler som formar vårt sexuella beteende och våra önskningar (Hedmius, 2000). Vårt syfte med studien är att lyfta fram om den kunskap som förmedlas via media till ungdomar påverkar dessa ungdomars tankar och attityder till sexualitet, intimitet, relationer, manlighet och kvinnlighet. Studiens frågeställning lyder: Finns det tydliga kopplingar mellan ungdomars tankar och attityder kring sexualitet, intima relationer, manlighet och kvinnlighet, och medias presentationer av sexualitet, intima relationer, manlighet och kvinnlighet? För att avgränsa studien har vi valt medieutbudet från Veckorevyn, Slitz, Tv3, Tv4 och kanal 5. Studiens empiriska material har samlats in via fyra fokusgrupper med ungdomar i artonårsåldern. Vi har bland andra valt Peter L. Berger och Thomas Luckmans (2003) socialisationsteori och Yvonne Hirdmans (2004) genuskontrakt som analysverktyg. Vårt resultat visar att medias presentationer av manlighet, kvinnlighet, sexualitet och intima relationer påverkar ungdomarna. Media som vi tagit del av upprätthåller ofta traditionella föreställningar, som bidrar till formandet av tankar och attityder kring sexualitet, manlighet och kvinnlighet. Dock påverkar nog även andra socialisationsagenter ungdomarna, så som familj, kompisar och skola.

<p> Background: Vitamin D activity is important for the functioning of a broad range of body systems. Some of these, including the skeletal, immune, and cardiovascular systems, are particularly relevant in the management of HIV-infection; thus, and in consideration of evidence that factors associated with the scenario of HIV-infection can disrupt vitamin D metabolism, the assessment of vitamin D status in people living with HIV-infection may be particularly important. In this thesis, I address cardiovascular implications of vitamin D status in HIV-infection. More specifically, and based on a growing body of evidence implicating low vitamin D status in the development of cardiovascular disease (CVD), I hypothesized that in HIV-positive adults low 25-hydroxyvitamin D (25(0H)D) concentration would be associated with increased subclinical vascular disease as measured by carotid intima-medial thickness (IMT).</p> <p> Methods: Using regression analyses I cross-sectionally studied the relationship between 25(0H)D and carotid IMT in 283 participants of the Canadian HIV Vascular Study, a prospective study of CVD risk among HIV-positive Canadians.</p> <p> Results: The prevalence of vitamin D deficiency in the Canadian HIV Vascular study was surprisingly low. Plasma 25(0H)D by quartile was not associated with carotid IMT. However, in restricted cubic spline regression analyses designed to accommodate non-linearity there was evidence of an inverted U-shaped 25(0H)D-carotid IMT relationship. In exploratory regression models restricted to participants comprising the suboptimal range of vitamin D status, lower 25(0H)D concentration was statistically significantly associated with lower carotid IMT after adjustment for known CVD risk factors and other variables hypothesized to potentially confound a 25(0H)D-carotid IMT association.</p> <p> Main implication: While inference from these exploratory findings requires cautious interpretation, future investigations into the relationship between vitamin D status and vascular disease should consider the problem of non-linearity as a feature of primary analyses; otherwise, such studies might fail to detect a true association.</p> / Thesis / Master of Science (MSc)

Bakgrund: Personer med demenssjukdom blir allt fler i världen och ett stort antal bor på äldreboenden. Att en persons kognitiva förmåga sviktar innebär inte att personen nödvändigtvis förlorar sin lust och behov av att uttrycka sexualitet och intimitet. Sjuksköterskor och vårdpersonal har ett ansvar att bevara och stötta personer med demenssjukdom och deras närstående i att tillgodose behov, samt främja rätten till autonomi, integritet, kärleksfulla relationer, minska stigma och diskriminering. Syfte: Syftet var att beskriva vårdpersonal och närståendes upplevelser och reflektioner av intima relationer hos personer med demenssjukdom på äldreboenden. Metod: Det här är en beskrivande litteraturstudie, baserad på 10 kvalitativa artiklar. Artiklarna har identifierats med hjälp av kvalitets- och relevans granskningsmallar och därefter sorterats in med hjälp av tematisk analys för att hitta fyra huvudteman. Huvudresultat: Resultatet visade att sexualitet och intimitet var viktigt för att bevara kontinuitet i relationer. Att respektera integritet och autonomi hos personer med demenssjukdom var lika viktigt för närstående som för vårdpersonal, trots att miljön på äldreboendet upplevdes som begränsande. Förmågan att bedöma validitet av samtycke, tillsammans med den negativa påverkan av stigma, tabun, kommunikationssvårigheter och bristande kunskap gällande äldres sexualitet, skapade komplexa utmaningar både för vårdpersonal och närstående när de skulle hantera förändringar i relationer samt uppkomsten av nya relationer.  Slutsats: Studien betonar vikten av intimitet och sexuell hälsa för personer med demenssjukdom, trots kognitiva utmaningar. Respekt för integritet och autonomi, variation i vårdpersonals attityder och utbildning, samt kampen mot etiska dilemman, stigma och kulturella normer är viktiga aspekter. Förändrade relationer vid demenssjukdom och behovet av förbättrad utbildning framhålls.

Motivation - Brain-derived neurotrophic factor (BDNF) is a protein complex, synthesised and secreted mainly by the central nervous system and is involved in neuronal maintenance. Research suggests that BDNF is implicated in various neurological and psychiatric diseases, while recent evidence suggests a role for the neurotrophin on the periphery as well. Indeed, the specific functional role of BDNF and its action mechanism in the cardiovascular system, especially in that of Africans, is yet to be determined. The cardiovascular health profile of black South Africans is a major concern as research has shown that this group suffers from an array of cardiovascular risk factors that may result in organ damage. Sub-clinical atherosclerosis or structural endothelial dysfunction contributes to ever-increasing morbidity and mortality in the world. However, no studies regarding the associations between BDNF and structural vascular disease have been undertaken relating to black African participants. Objectives - The objective of this study was to determine whether BDNF is associated with changes in ambulatory blood pressure (BP) and whether a relationship between BDNF and structural endothelial dysfunction exists in black African male and female participants, determined by cross sectional wall area (CSWA) and albumin:creatinine ratio (ACR). Methodology - The study included 172 black African teachers (82 males and 90 females) who were employed by the Kenneth Kaunda Education district of the North-West Province, South Africa. Ambulatory blood pressure recordings were obtained with the use of a Meditech CE120 CardioTens ® apparatus. Blood pressure readings were measured at 30 min intervals during the day and 60 min intervals during the night. Anthropometric measurements were performed in triplicate by registered level II anthropometrists according to standardised procedures. A high-resolution ultrasound scan with carotid intima-media thickness (CIMT) images from at least two optimal angles of the left and right common carotid artery were obtained using a SonoSite Micromaxx ultrasound system. The lumen diameter between the near and far wall of the lumen-intima interface and the averages of both the left and right common carotid arteries were calculated. Subsequently, the carotid cross-sectional wall area (CSWA) was calculated. Participants, who fasted overnight, provided eight-hour blood and urine samples to determine serum BDNF and metabolic markers, for example, hyperglycaemia (HbA1c) and gamma glutamyl transferase (GGT). Urinary albumin and creatinine levels were determined by means of a turbidimetric method with the use of a Unicel DXC 800 analyser from Beckman and Coulter (Germany) and expressed as a ratio between albumin and creatinine (ACR). BDNF median split x Gender interaction effects for structural ED justified stratification of BDNF into low and high (≤ / > 1.37 ng/ml) gender groups. Results and Conclusion - On average, male participants were overweight (BMI 25-30kg/m2) and abused more alcohol.21 African men revealed a vulnerable cardiometabolic profile with values exceeding cut–points (European Society of Hypertension). These men demonstrated increased acute and chronic glucose (HbA1c) levels indicating a pre-diabetic state; as well as a disturbed lipid profile with lower HdL and increased triglycerides. Overall BDNF levels were lower than reference ranges (6.97 – 42.6 ng/ml). The men revealed mean lower BDNF levels, ambulatory BP values exceeding guideline cut-points (ambulatory SBP > 130mmHg; DBP > 80mmHg) as well as a hypertensive state compared to their female counterparts. Pertaining to structural endothelial dysfunction, the mean ACR value in men exceeded normal laboratory values (< 3.5mg/mmol). The African women displayed an obese state with low grade inflammation (CRP, 12.27 ± 11.67mg/l). A single two-way ANCOVA interaction on main effects (BDNF median split x Gender) demonstrated significant interaction for CIMTf [F (1,164); 3.99, p=0.05] and cholesterol [F (1,164); 4.12, p=0.05]. Therefore, a median split approach was followed which stratified gender groups into lower (≤ 1.37 ng/ml) and higher BDNF levels (>1.37 ng/ml). The low BDNF men revealed higher cholesterol than the high BDNF group, independent of BMI and age. Only the low BDNF women indicated significantly higher values for structural vascular markers (p< 0.05) than the high BDNF female group. In conclusion, we accept our hypothesis, as hypertrophic remodelling of the carotid artery was associated with lower BDNF levels. This may imply attenuated or possibly down-regulated BDNF levels acting as a compensatory mechanism for the mean higher BP levels. In women, metabolic risk and hypertrophic remodelling were evident within higher circulating levels of BDNF, underpinning different underlying mechanisms for impaired neurotrophin health in men and women. Novel findings of BDNF revealed the impact of central neural regulation on the circulatory system, which may contribute to cardiometabolic risk in Africans. / MSc (Physiology), North-West University, Potchefstroom Campus, 2014

Motivation - Brain-derived neurotrophic factor (BDNF) is a protein complex, synthesised and secreted mainly by the central nervous system and is involved in neuronal maintenance. Research suggests that BDNF is implicated in various neurological and psychiatric diseases, while recent evidence suggests a role for the neurotrophin on the periphery as well. Indeed, the specific functional role of BDNF and its action mechanism in the cardiovascular system, especially in that of Africans, is yet to be determined. The cardiovascular health profile of black South Africans is a major concern as research has shown that this group suffers from an array of cardiovascular risk factors that may result in organ damage. Sub-clinical atherosclerosis or structural endothelial dysfunction contributes to ever-increasing morbidity and mortality in the world. However, no studies regarding the associations between BDNF and structural vascular disease have been undertaken relating to black African participants. Objectives - The objective of this study was to determine whether BDNF is associated with changes in ambulatory blood pressure (BP) and whether a relationship between BDNF and structural endothelial dysfunction exists in black African male and female participants, determined by cross sectional wall area (CSWA) and albumin:creatinine ratio (ACR). Methodology - The study included 172 black African teachers (82 males and 90 females) who were employed by the Kenneth Kaunda Education district of the North-West Province, South Africa. Ambulatory blood pressure recordings were obtained with the use of a Meditech CE120 CardioTens ® apparatus. Blood pressure readings were measured at 30 min intervals during the day and 60 min intervals during the night. Anthropometric measurements were performed in triplicate by registered level II anthropometrists according to standardised procedures. A high-resolution ultrasound scan with carotid intima-media thickness (CIMT) images from at least two optimal angles of the left and right common carotid artery were obtained using a SonoSite Micromaxx ultrasound system. The lumen diameter between the near and far wall of the lumen-intima interface and the averages of both the left and right common carotid arteries were calculated. Subsequently, the carotid cross-sectional wall area (CSWA) was calculated. Participants, who fasted overnight, provided eight-hour blood and urine samples to determine serum BDNF and metabolic markers, for example, hyperglycaemia (HbA1c) and gamma glutamyl transferase (GGT). Urinary albumin and creatinine levels were determined by means of a turbidimetric method with the use of a Unicel DXC 800 analyser from Beckman and Coulter (Germany) and expressed as a ratio between albumin and creatinine (ACR). BDNF median split x Gender interaction effects for structural ED justified stratification of BDNF into low and high (≤ / > 1.37 ng/ml) gender groups. Results and Conclusion - On average, male participants were overweight (BMI 25-30kg/m2) and abused more alcohol.21 African men revealed a vulnerable cardiometabolic profile with values exceeding cut–points (European Society of Hypertension). These men demonstrated increased acute and chronic glucose (HbA1c) levels indicating a pre-diabetic state; as well as a disturbed lipid profile with lower HdL and increased triglycerides. Overall BDNF levels were lower than reference ranges (6.97 – 42.6 ng/ml). The men revealed mean lower BDNF levels, ambulatory BP values exceeding guideline cut-points (ambulatory SBP > 130mmHg; DBP > 80mmHg) as well as a hypertensive state compared to their female counterparts. Pertaining to structural endothelial dysfunction, the mean ACR value in men exceeded normal laboratory values (< 3.5mg/mmol). The African women displayed an obese state with low grade inflammation (CRP, 12.27 ± 11.67mg/l). A single two-way ANCOVA interaction on main effects (BDNF median split x Gender) demonstrated significant interaction for CIMTf [F (1,164); 3.99, p=0.05] and cholesterol [F (1,164); 4.12, p=0.05]. Therefore, a median split approach was followed which stratified gender groups into lower (≤ 1.37 ng/ml) and higher BDNF levels (>1.37 ng/ml). The low BDNF men revealed higher cholesterol than the high BDNF group, independent of BMI and age. Only the low BDNF women indicated significantly higher values for structural vascular markers (p< 0.05) than the high BDNF female group. In conclusion, we accept our hypothesis, as hypertrophic remodelling of the carotid artery was associated with lower BDNF levels. This may imply attenuated or possibly down-regulated BDNF levels acting as a compensatory mechanism for the mean higher BP levels. In women, metabolic risk and hypertrophic remodelling were evident within higher circulating levels of BDNF, underpinning different underlying mechanisms for impaired neurotrophin health in men and women. Novel findings of BDNF revealed the impact of central neural regulation on the circulatory system, which may contribute to cardiometabolic risk in Africans. / MSc (Physiology), North-West University, Potchefstroom Campus, 2014

Orientadores: Wilson Nadruz Junior, Maria Cecilia Jayme Bueno Gallani / Tese (doutorado) - Universidade Estadual de Campinas. Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-15T21:45:10Z (GMT). No. of bitstreams: 1 Sae_MariaCarolinaSalmoraFerreira_D.pdf: 794464 bytes, checksum: da3a843585885666b5cc119a59820102 (MD5) Previous issue date: 2010 / Resumo: O consumo elevado de sódio vem sendo amplamente estudado ao longo dos anos com o intuito de avaliar sua contribuição para o desenvolvimento de hipertensão arterial e aumento do risco cardiovascular. No entanto, pouco se sabe sobre o impacto do consumo de sódio sobre a estrutura e hemodinâmica das artérias carótidas. Desta forma, este estudo buscou investigar os efeitos do consumo de sódio sobre parâmetros estruturais e hemodinâmicos nas artérias carótidas de indivíduos hipertensos. A amostra foi composta por cento e trinta e quatro pacientes (n=134), selecionados aleatoriamente, atendidos no ambulatório de Hipertensão Arterial do Hospital de Clínicas da Universidade Estadual de Campinas - UNICAMP. O consumo diário de sódio (CDS) foi estimado pelos métodos de auto-relato: recordatório de 24 horas; consumo de sódio per capita e um questionário de freqüência alimentar - QFASó. Foram ainda obtidos dados clínicos e laboratoriais e realizado o exame ultra-sonográfico de carótidas. Os sujeitos tiveram um CDS de 5520 ± 286mg/dia. A análise univariada mostrou que o consumo diário de sódio se correlacionou com o diâmetro sistólico e diastólico da artéria carótida comum (r=0.36 e r=0.34, ambos p <0.001), tensão circunferencial de pico e média (r=0.44 e r=0.39, ambos p <0.001), Modelo de elasticidade de Young (r=0.40, p <0.001), espessura de íntima-média (r=0.19, p <0.05) e com o índice de resistência da artéria carótida interna (r=0.20, p <0.05). A análise multivariada mostrou que o consumo diário de sódio foi associado com o diâmetro da artéria carótida comum, a tensão circunferencial da parede e o modelo de elasticidade de Young. Estes dados sugerem que o consumo de sódio é um preditor independente de menor elasticidade, aumento do diâmetro da artéria e maior carga hemodinâmica local nas artérias carótidas de hipertensos / Abstract:High sodium consumption and its effect on hypertension has been widely studied over the years in an attempt to more clearly assesses its contribution for high blood pressure levels and progression of cardiovascular disease. However, little is known about the impact of dietary sodium on the structure and hemodynamics of carotid arteries. We investigated the effects of sodium intake on carotid structural and hemodynamic parameters of hypertensive subjects. The study sample was compound by one hundred third four subjects (n=134) who attended a hypertensive outpatient clinic in State University of Campinas teaching hospital, were randomly selected. Daily sodium intake was estimated by 24 hour recall, discretionary sodium and a food frequency questionnaire. Clinical history, carotid ultrasound and hemodynamic, inflammatory and metabolic parameters were also obtained. The studied sample had a daily sodium intake of 5520±286mg/day. Univariate analysis showed that daily sodium intake correlated with common carotid artery systolic and diastolic diameter (r=0.36 and r=0.34; both p<0.001), peak and mean circumferential tension (r=0.44 and r=39; both p<0.001), Young's Elastic Modulus (r=0.40, p<0.001), intima-media thickness (r=0.19, p<0.05) and with internal carotid artery resistive index (r=0.20; p<0.05). Multivariate analyses showed that daily sodium intake was associated with common carotid artery diameter, circumferential wall tension and Young's Elastic Modulus. These data suggest that sodium intake is an independent predictor of reduced elasticity, increased luminal diameter and higher local hemodynamic load in carotid arteries of hypertensive subjects / Doutorado / Ciencias Basicas / Doutor em Clínica Médica