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Relatório de Estágio do Mestrado Integrado em Ciências Farmacêuticas apresentado à Faculdade de Farmácia Cardiovascular diseases are one of the major causes of deaths in adults in the western world. Elevated levels of certain blood lipids have been reported to be the principal cause of cardiovascular disease in developed countries. Hypercholesterolemia is a predominant risk factor for atherosclerosis and associated coronary and cerebrovascular diseases. Control of cholesterol levels through therapeutic drugs, notably statins, have significantly reduced the risk for developing atherosclerosis and associated cardiovascular diseases. However, adverse effects associated with therapeutic drugs warrant to find other alternative approaches for managing hypercholesterolemia, especially for those with borderline cholesterol levels. Food supplements have increasingly become attractive alternatives to prevent or treat hypercholesterolemia and reduce the risk for cardiovascular diseases. This review summarized some of the current food supplements with claims of hypocholesterolemic effects. The efficacy, mechanisms of action and potential side effects are reviewed for each of them. Some food supplements have already been a target of studies, and there are, for some of them, plenty of information, with positive outcomes in terms of their hypocholesterolemic effects. However,for the majority of these food supplements, additional clinical studies are required to establish the safety profiles and therapeutic dosages of certain probiotic bacteria as food supplements. As doenças cardiovasculares são uma das maiores causas de morte em adultos no mundo ocidental. Níveis elevados de certos lípidos no sangue têm sido reportados como a principal causa de doença cardiovascular em países desenvolvidos. A hipercolesterolemia é um fator de risco predominante para aterosclerose estando também associada a doenças coronárias e cerebrovasculares. O controlo dos níveis de colesterol através de farmacoterapêutica, nomeadamente, com estatinas, reduz o risco de desenvolvimento de aterosclerose e doenças cardiovasculares associadas. No entanto os efeitos adversos associados à terapêutica medicamentosa levam à necessidade de procurar novas abordagens para o controlo da hipercolesterolemia, nomeadamente para aqueles com níveis de colesterol perto dos valores de referência. Os suplementos alimentares têm vindo a tornar-se alternativas atrativas para prevenir ou tratar a hipercolesterolemia e reduzir o risco de doenças cardiovasculares. Esta monografia faz uma revisão de alguns suplementos alimentares atuais associados a um efeito hipocolesterolémico. A eficácia, mecanismos de ação e potenciais efeitos adversos são também analisados para cada um deles. Alguns suplementos alimentares têm já sido alvo de diversos estudos, existindo já bastante quantidade de informação para alguns destes suplementos, com conclusões positivas acerca dos seus efeitos hipocolesterolémicos. No entanto, para a maioria destes suplementos alimentares, estudos clínicos adicionais são necessários para estabelecer perfis de segurança e dosagens terapêuticas para um tratamento mais eficaz.

Background. Hypertension, diabetes and hypercholesterolemia are the most frequent and diagnosed chronic diseases in Argentina. They contribute largely to the burden of chronic disease and they are strongly influenced by a small number of risk factors. These risk factors are all modifiable at the population and individual level and offer major prospects for their prevention. We are interested in socioeconomic determinants of prevalence of those 3 specific diseases. Design and methods. We estimate 3-equation probit model, combined with 3 separate probit estimations and a probit-based Heckman correction considering possible sample selection bias. Estimations were carried out using secondary self-reported data coming from the 2013 Risk Factor National Survey. Results. We find a negative association between socioeconomic status and prevalence of hypertension, cholesterolemia and diabetes; main increases concentrate in the transition from low to high SES in hypertension and diabetes. In cholesterol, the major effect takes place when individual crosses from low to middle SES and then vanishes. Anyway, in Argentina SES exhibit and independent effect on chronic diseases apart from those based on habits and body weight. Conclusions. Public strategies to prevent chronic diseases must be specially targeted at women, poorest households and the least educated individuals in order to achieve efficacy. Also, as the probability of having a condition related to excessive blood pressure, high levels of cholesterol or glucose in the blood do not increase proportionally with age, so public campaigns promoting healthy diets, physical activity and medical checkups should be focused on young individuals to facilitate prophylaxis. Fil: Viego, Valentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Económicas y Sociales del Sur. Universidad Nacional del Sur. Departamento de Economía. Instituto de Investigaciones Económicas y Sociales del Sur; Argentina. Universidad Nacional del Sur. Departamento de Economía; Argentina Fil: Temporelli, Karina Luján. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Económicas y Sociales del Sur. Universidad Nacional del Sur. Departamento de Economía. Instituto de Investigaciones Económicas y Sociales del Sur; Argentina. Universidad Nacional del Sur. Departamento de Economía; Argentina

INTRODUCTION Lowering exposure to dyslipidemias is one of the biggest challenges in cardiovascular disease prevention. OBJECTIVES The aim of the study was to describe the prevalence of dyslipidemias and treatment of hypercholesterolemia in Poland, and to assess changes since the period of 2003-2005. PATIENTS AND METHODS Two cross-sectional surveys of the random samples of the Polish population were performed in the years 2003-2005 (WOBASZ) and 2013-2014 (WOBASZ II). Interviews were carried out according to a standard questionnaire. Blood lipid levels were determined in a single laboratory in frozen samples using the enzymatic colorimetric method. RESULTS The analysis included 14151 participants aged 20-74 years (WOBASZ) and 5947 participants aged 20-99 years (WOBASZ II). In the 2013-2014 survey, hypercholesterolemia was found in 70.3% of men and 64.3% of women. Isolated hypertriglyceridemia was found in 5.6% of men and 2.4% of women. Isolated low levels of high-density lipoprotein cholesterol (HDL-C) were found in 5.1% of men and in 7.3% of women. The prevalence of hypercholesterolemia did not change significantly with regards to the 2003-2005 survey. An increase in the prevalence of hypertriglyceridemia was found in men (relative ratio [RR], 1.26; 95% confidence interval [CI], 1.03-1.55), and an increase in the prevalence of low HDL-C levels was observed in both sexes (men: RR, 2.26; 95% CI, 1.77-2.88; women: RR, 1.94; 95% CI, 1.61-2.33). There was an increase in the proportion of persons receiving high- or moderate-intensity statin therapy. However, 60,6% of persons with hypercholesterolemia were not aware of their condition, and only 6% were treated and achieved the treatment target. CONCLUSIONS There is an urgent need for more effective strategies for the prevention and management of dyslipidemias.

Alimentos contendo probióticos são conhecidos como funcionais e têm sido recomendados para indivíduos com hipercolesterolemia. Com o objetivo de avaliar seu efeito na modulação dos níveis de colesterol sérico, foi conduzido um estudo de 28 dias, utilizando-se 90 ratos machos Wistar, distribuídos entre os tratamentos: Padrão, com 30 animais e Controle, LDR (Leite Desnatado Reconstituído) e P (Probiótico), com 20 animais cada. O grupo Padrão recebeu a dieta AIN-93G durante todo o período experimental. Os demais grupos receberam a mesma dieta acrescida de 1% de colesterol e 0,1% de ácido cólico. Do 15º ao 28º dia, o grupo LDR recebeu 0,1mL/dia/animal de leite desnatado reconstituído a 10% de sólidos não gordurosos e o grupo P, recebeu 0,1mL/dia/animal de probiótico contendo 10(10) UFC/mL de Lactobacillus acidophilus NCFM. Avaliou-se o colesterol total, LDL-colesterol e HDL-colesterol e o peso do fígado, imediatamente após o término da administração do probiótico, onde os ratos tiveram o fígado retirado e o sangue coletado por punção cardíaca. A adição de colesterol e ácido cólico à dieta não elevou (p>0,05) os níveis de colesterol do grupo Controle, LDR e P em relação ao grupo Padrão, no entanto, promoveu aumento significativo de peso (p0,05) os níveis de colesterol sérico dos animais, uma vez que estes níveis se mantiveram normais durante todo o período experimental. Observou-se também que a administração de probiótico não impediu o acúmulo de gordura no fígado dos animais que receberam dieta rica em colesterol e ácido cólico.Probiotics are known as functional foods and have been recommended as dietary adjunct for individuals with high serum cholesterol levels. To evaluate probiotics effects on the modulation of serum cholesterol an experiment was carried out during 28 days, using 90 Wistar male rats, distributed in four treatments and individually housed, with initial average weight of 250±32g. The experimental groups were: Standard; Control; LDR and P. The Standard group received the AIN-93G diet during the whole experimental period. The other groups received for 28 days the AIN-93G diet added of 1% of cholesterol and 0,1% of cholic acid. Of the 15th to the 28th day (after an initial period of 14 days of hipercolesterolemia induction) the LDR group received the supplement of 0,1mL/day/animal of reconstituted skimmed milk at 10% of non fat solids and, the group P received 0,1mL/day/animal of a probiotic in the form of a concentrate of cells contends 10(10)UFC/mL of Lactobacillus acidophilus NCFM. Total cholesterol, high density lipoprotein (HDL) and low density lipoprotein (LDL) were evaluated at 28th days of experiment (immediately after the end of probiotic administration). The dietary increment of 1% of crystalline cholesterol and 0,1% of cholic acid did not promote hipercholesterolemia in the animals, evidenced by the non significant difference (p>0,05) of levels of total cholesterol, LDL-cholesterol and HDL-cholesterol among the groups Standard, Control, LDR and P after 14 days receiving hipercholesterolemic diet. However it provoked significant increase of the weight and alteration of normal coloration of liver (of red intense for red yellowish) due to fat accumulation in this organ, in the animals that received rich diet in cholesterol compared to the Standard group. Thus, rich diet in cholesterol and colic acid did not promote hipercholesterolemia in the animals, but it induced fat liver in the same. In consequence, the consumption of L. acidophilus did not alter (p>0,05) the levels of serum cholesterol of the animals, once these levels stayed normal during the whole experimental period. It was also observed that the probiotic administration did not impede the fat accumulation in the liver of the animals that received rich diet cholesterol and colic acid.

Este estudio caso-control analizó en los sujetos añosos el rol de los factores de riesgo coronario en el desarrollo del infarto agudo de miocardio (IAM), estableció la naturaleza de esta asociación y el grado de riesgo. Los datos fueron obtenidos en una investigación que incluyó 1060 casos y 1071 controles, realizada en 35 unidades coronarias de centros médicos de Argentina entre noviembre de 1991 y agosto de 1994. Nuestro análisis se basó en la información de los sujetos mayores de 65 años. Los casos fueron 427 pacientes con un primer IAM. Los controles fueron 396 sujetos sin evidencias clinicas de enfermedad cardiovascular, seleccionados en los mismos centros que los casos. Los Odds Ratios (OR) y su intervalo de confianza del 95% (IC 95%) se obtuvieron mediante un análisis de regresión logística, incluyendo variables como la edad, educación, clase social, tabaquismo, antecedente de diabetes o hipertensión arterial, índice de masa corporal e historia familiar de enfermedad coronaria. Los factores de riesgo relacionados independientemente con IAM fueron los siguientes: hipercolesterolemia (colesterol sérico > 240 mg/dl): OR=1.76 (IC 95%: 1.25-2.49), tabaquismo: OR=1.6 (IC 95%: 1.06-2.4), hipertensión arterial: OR=2.05 (IC 95%: 1.51-2.73), diabetes OR=1.71 (IC 95%: 1.12-2.70), historia de un familiar con enfermedad coronaria: OR=1.36 (IC 95%: 0.93-1.97) y de dos o más familiares: OR=2.63 (IC 95%: 1.21-5.71). Este estudio, confirma en los sujetos de edad avanzada la importancia de la hipercolesterolemia, del tabaquismo, la hipertesión arterial, la diabetes y la historia familiar de enfermedad coronaria como factores de riesgo de IAMThis case-control study, analized the role of coronary risk factors in acute myocardial infarction (AMI) in the elderly, and established the nature of this association and the degree of risk. Data were derived from an investigation (1060 cases and 1071 controls) conducted in 35 coronary care units from clinical centres in Argentina between November 1991 and August 1994. Our analysis was based on data collected from subjets over age 65. Cases were 427 patients with AMI and without history of ischaemic heart disease. Controls were 396 subjects identified in the same centres as the cases. Odds ratios (OR) estimates and their 95% confidence intervals (CI) were derived from multiple logistic regression equations including terms for age, education, social status, smoking status, history of diabetes or hypertension, body mass index and family history of coronary heart disease. The risk factors independently and strongly related to the risk of AMI were the following: hyperlipidemia (serum cholesterol > 240 mg/dl): OR=1.76 (95% CI: 1.25-2.49), smoking habits: OR=1.6 (95% CI: 1.06-2.4), hypertension: OR=2.05 (95% CI: 1.51-2.73), diabetes OR=1.71 (95% CI: 1.12-2.70), one relative with family history of coronary heart disease: OR=1.36 (95% CI: 0.93-1.97) and two or more relatives: OR=2.63 (95% CI: 1.21-5.71). This study confirms in the elderly the importance of hyperlipidemia, tobacco, hypertension, diabetes and family history of coronary heart disease as risks factors of AMI.

La obesidad es un problema creciente de salud pública, reconociéndose la importancia de su estudio en la población pediátrica y adulta joven para prevenir las complicaciones que esta puede generar. Objetivo: Determinar la prevalencia de obesidad e hipercolesterolemia en los alumnos de la Facultad de Medicina de la Universidad Peruana Cayetano Heredia. Materiales y métodos: Se realizó un estudio transversal analítico, evaluando 133 sujetos que acudieron al examen médico de la Universidad en febrero de 1998, seleccionados en forma aleatoria. Se definió sobrepeso como Índice de Masa Corporal (IMC) >25 y £30, obesidad como IMC >30 e hipercolesterolemia como colesterol total sérico >200 mg/dl. A cada sujeto de estudio se le determinó peso y talla y se le tomó una muestra de 5 cc de sangre en ayunas. Resultados: La prevalencia de obesidad fue 3.76% y 26.30% de sobrepeso. Se encontró 3.76% de sujetos con hipercolesterolemia. No se encontró asociación entre obesidad y edad o sexo. Las proporciones de sujetos con valores anormales de colesterol fueron: 3.76% de HDL-C, 13.53 % de LDL-C, 2.26% triglicéridos, 6.76% de LDL-C/HDL-C y 5.26% de CT/HDL-C. Conclusión: La obesidad es una patología relevante en este grupo poblacional. Se recomienda establecer programas de prevención de obesidad y modificación de estilos de vida en esta población adulta joven con la finalidad de poder reducir la prevalencia de sobrepeso y el riesgo posterior de enfermedades cardiovasculares. (Rev Med Hered 2001; 12: 78-84). Obesity represents an increasing public health problem, its recognized the importance of its study in pediatric population and young adults for to prevent the complications that this can generate. Objective: To determine the prevalence of obesity and hipercholesterolemia in students of the School of Medicine at Universidad Peruana Cayetano Heredia. Material and methods: An analytical cross sectional study was made, evaluating 133 randomized selected subjects that went to medical examination of the university in February 1998. Overweight was defined as Body Mass Index (IMC) >25 and £30, Obesity as IMC >30 and hypercholesterolemia as total cholesterol >200 mg/dl. In each subject weight and height was measured and a 5 cc sample of blood in fasting was taken. Results: The prevalence of obesity were 3.76% and 26.3% of overweight. Hypercholesterolemia were encountered in 3.76%. No association between obesity and age or sex was found. The proportion of abnormal values of cholesterol were:3.76% of HDL-C, 13.53% of LDL-C, 2.26% of triglycerides, 6.76% of LDL-C/HDL-C and 5.26% of CT/HDL-C. Conclusion: The obesity is a relevant pathology in this group. We recommend a prevention programs and changes in life style in this population. Its aim is to reduce the prevalence of overweight and further risk of cardiovascular diseases. (Rev Med Hered 2001; 12: 78-84 ).

W niniejszej pracy omówiono zasady postępowania w dyslipidemii u chorych na cukrzycę typu 2. Istotną rolę odgrywa obniżenie stężenia cholesterolu frakcji LDL, należy jednak dążyć do normalizacji całego profilu lipidowego. Modyfikacja stylu życia i ścisłe wyrównanie glikemii, a także kontrola stężenia lipidów i dostosowywanie dawek leków w celu uzyskania stężeń docelowych mają istotne znaczenie w uzyskaniu dobrego efektu terapeutycznego. In this paper we described the practical guidelines of diagnosis and treatment of diabetic dyslipidemia. The primary treatment goal is to decrease LDL-cholesterol concentration, however, normalization of the whole lipid profile is recommended. Life style modification, strict glycemic control, as well as serum lipids control and adjusting drugs dose to obtain goal levels is important in achieving good therapeutic effect.

Alimentos contendo probióticos são conhecidos como funcionais e têm sido recomendados para indivíduos com hipercolesterolemia. Com o objetivo de avaliar seu efeito na modulação dos níveis de colesterol sérico, foi conduzido um estudo de 28 dias, utilizando-se 90 ratos machos Wistar, distribuídos entre os tratamentos: Padrão, com 30 animais e Controle, LDR (Leite Desnatado Reconstituído) e P (Probiótico), com 20 animais cada. O grupo Padrão recebeu a dieta AIN-93G durante todo o período experimental. Os demais grupos receberam a mesma dieta acrescida de 1% de colesterol e 0,1% de ácido cólico. Do 15º ao 28º dia, o grupo LDR recebeu 0,1mL/dia/animal de leite desnatado reconstituído a 10% de sólidos não gordurosos e o grupo P, recebeu 0,1mL/dia/animal de probiótico contendo 10(10) UFC/mL de Lactobacillus acidophilus NCFM. Avaliou-se o colesterol total, LDL-colesterol e HDL-colesterol e o peso do fígado, imediatamente após o término da administração do probiótico, onde os ratos tiveram o fígado retirado e o sangue coletado por punção cardíaca. A adição de colesterol e ácido cólico à dieta não elevou (p>0,05) os níveis de colesterol do grupo Controle, LDR e P em relação ao grupo Padrão, no entanto, promoveu aumento significativo de peso (p0,05) os níveis de colesterol sérico dos animais, uma vez que estes níveis se mantiveram normais durante todo o período experimental. Observou-se também que a administração de probiótico não impediu o acúmulo de gordura no fígado dos animais que receberam dieta rica em colesterol e ácido cólico. Probiotics are known as functional foods and have been recommended as dietary adjunct for individuals with high serum cholesterol levels. To evaluate probiotics effects on the modulation of serum cholesterol an experiment was carried out during 28 days, using 90 Wistar male rats, distributed in four treatments and individually housed, with initial average weight of 250±32g. The experimental groups were: Standard; Control; LDR and P. The Standard group received the AIN-93G diet during the whole experimental period. The other groups received for 28 days the AIN-93G diet added of 1% of cholesterol and 0,1% of cholic acid. Of the 15th to the 28th day (after an initial period of 14 days of hipercolesterolemia induction) the LDR group received the supplement of 0,1mL/day/animal of reconstituted skimmed milk at 10% of non fat solids and, the group P received 0,1mL/day/animal of a probiotic in the form of a concentrate of cells contends 10(10)UFC/mL of Lactobacillus acidophilus NCFM. Total cholesterol, high density lipoprotein (HDL) and low density lipoprotein (LDL) were evaluated at 28th days of experiment (immediately after the end of probiotic administration). The dietary increment of 1% of crystalline cholesterol and 0,1% of cholic acid did not promote hipercholesterolemia in the animals, evidenced by the non significant difference (p>0,05) of levels of total cholesterol, LDL-cholesterol and HDL-cholesterol among the groups Standard, Control, LDR and P after 14 days receiving hipercholesterolemic diet. However it provoked significant increase of the weight and alteration of normal coloration of liver (of red intense for red yellowish) due to fat accumulation in this organ, in the animals that received rich diet in cholesterol compared to the Standard group. Thus, rich diet in cholesterol and colic acid did not promote hipercholesterolemia in the animals, but it induced fat liver in the same. In consequence, the consumption of L. acidophilus did not alter (p>0,05) the levels of serum cholesterol of the animals, once these levels stayed normal during the whole experimental period. It was also observed that the probiotic administration did not impede the fat accumulation in the liver of the animals that received rich diet cholesterol and colic acid.

Wstęp Obecność nadwagi i otyłości istotnie zwiększa ryzyko wystąpienia incydentów sercowo-naczyniowych. Celem badania było określenie wpływu interakcji wskaźników antropometrycznych (wskaźnik masy ciała — BMI i stosunek obwodu talii do obwodu bioder — WHR) na wartość ciśnienia tętniczego oraz ocena zależności pomiędzy dystrybucją tkanki tłuszczowej, paleniem tytoniu a wysokością ciśnienia tętniczego. Materiał i metody Pracę zrealizowano w ramach projektu EPOGH (European Project on Genes in Hypertension). Badaniem objęto 206 osób między 18 a 60 rż. z rejonu Niepołomic, k. Krakowa. Każdy z uczestników badania wypełnił standardowy kwestionariusz EPOGH. U wszystkich dokonano pomiarów antropometrycznych, biochemicznych (stężenie cholesterolu całkowitego i cholesterolu frakcji TG, LDL, HDL) oraz przeprowadzono ambulatoryjną, całodobową rejestrację ciśnienia tętniczego (ABPM). Kryterium klasyfikacji badanych do czterech grup stanowiły: poziom BMI (< 25,0 i ≥ 25,0 kg/m2) oraz wartość wskaźnika WHR (< Me i ≥ Me; Me = 0,84). Analizy statystycznej dokonano przy użyciu pakietu Statistica 6.0 PL. Wyniki Badani charakteryzujący się wyższym wskaźnikiem WHR byli starsi, reprezentowali płeć męską, w wywiadzie częściej podawali palenie tytoniu. Standaryzowana analiza wykazała wpływ BMI i WHR na wysokość skurczowego ciśnienia tętniczego, zarówno w ciągu dnia jak i nocy. Badani charakteryzujący się BMI ≥ 25,0 kg/m2 i WHR ≥ Me wykazywali istotnie wyższe wartości ciśnienia tętniczego niż osoby o prawidłowej masie ciała (BMI < 25,0 kg/m2 i WHR < Me) — w odniesieniu zarówno do skurczowego i rozkurczowego ciśnienia w ciągu dnia i nocy. Analiza interakcji wykazała znamienny statystycznie, kumulacyjny efekt oddziaływania BMI i WHR na wysokość ciśnienia skurczowego w nocy. W trójczynnikowej analizie interakcji — BMI, WHR, palenie tytoniu a wysokość ciśnienia tętniczego — nie odnotowano znamienności statystycznej. Stwierdzono jednak wyższe wartości ciśnienia w nocy u osób palących, z nadwagą, wykazujących androidalny rozkład tkanki tłuszczowej. Wnioski Badanie potwierdziło istotny, niezależny efekt oddziaływania interakcji wskaźników antropometrycznych: BMI i WHR na wysokość nocnego ciśnienia skurczowego. Palenie tytoniu nasilało niekorzystny wpływ otyłości brzusznej na wysokość ciśnienia tętniczego. Background Overweight and obesity markedly increase the risk of cardiovascular events. The purpose of the study was to identify the effect of interactions between the anthropometric parameters (body mass index — BMI and waist/hip ratio — WHR) on blood pressure values and to assess the relationship between adipose tissue distribution, smoking and blood pressure values. Material and methods The study was conducted as part of the EPOGH Project (European Project on Genes in Hypertension). The study population consisted of 206 subjects ranging in age from 18 to 60 years inhabiting the area of Niepolomice close to Krakow. Each study participant completed a standard EPOGH questionnaire. From all subjects we obtained anthropometric (BMI and WHR) and biochemical measurements (total cholesterol, TG, LDL and HDL cholesterol), and 24hr ambulatory blood pressure monitoring. Entry criteria to four study groups were BMI (< 25,0 and ≥ 25,0 kg/m2) and WHR (< Me and ≥ Me; Me = 0,84). Statistical analysis was done using the Statistica 6.0 PL. Results Subjects with higher WHR were older, male and more frequently reported smoking. Standardized analysis showed that BMI and WHR affected systolic blood pressure both day and night. Subjects with BMI ≥ 25,0 kg/m2 and WHR 3 Me had significantly higher blood pressure values as compared with subjects with normal body mass (BMI < < 25,0 kg/m2 and WHR < Me) both with respect to systolic and diastolic blood pressure in the daytime and nighttime. Analysis of interaction showed a significant cumulative effect of BMI and WHR on systolic blood pressure at night. Triple-factorial analysis of interactions — BMI, WHR, smoking versus blood pressure value — did not show statistical significance. However, smokers with abdominal overweight had higher blood pressure values at night. Conclusions The present study confirmed the significant independent effect of interactions between the anthropometric parameters: BMI and WHR on systolic blood pressure at night. Smoking potentiated the unfavorable effect of overweight and abdominal adipose tissue distribution on blood pressure value.

Cuarenta y nueve (49) pacientes con hipercolesterolemia tipo II fueron enrolados en un estudio prospectivo y comparativo a fin de evaluar el efecto terapéutico y la tolerabilidad de 10 mg de Policosanol y Simvastatina sobre el colesterol total, el LDL-Colesterol, HDL-Colesterol, triglicéridos y los índices colesterol total/HDL-Colesterol y LDL-Colesterol/HDL-Colesterol. Previo al tratamiento, los pacientes siguieron una dieta estándar para reducción de colesterol durante 4 semanas. Ambos productos redujeron los niveles de colesterol total (Simvastatina 20% y Policosanol 21%), el LDL-Colesterol (Simvastatina 24% y Policosanol 30%). Los niveles de triglicéridos se redujeron en 24% en el grupo que recibió Simvastatina y 10% en el grupo que recibió Policosanol. En ambos grupos se observó una elevación de los niveles de HDL-Colesterol sin alcanzar éste significación estadística. Los índices colesterol total/HDL-Colesterol y LDL-Colesterol/HDL-Colesterol descendieron de manera importante con ambos tratamientos. Ambas drogas fueron bien toleradas, ningún paciente salió del estudio a causa de efectos adversos, se observó una tendencia en el grupo que recibió Policosanol a mejorar los niveles de Aspartalo-aminotransferasa previamente alterados Forty nine (49) patients with type II Hipercholesterolemia were enrolled in a comparative and prospective study about the therapeutic effect of 10 mg of Policosanol and Simvastatin on the total-Cholesterol, LDL-Cholesterol, HDL-Cholesterol, Triglycerides and the ratios: total cholesterol/HDL-Cholesterol, LDL-Cholesterol/HDL-Cholesterol. Before the treatment the patients were advised to follow a standard cholesterol lowering diet for 4 weeks. Both products reduce the level of total cholesterol (Simvastatin 20% and Policosanol 21%), Low-density lipoprotein cholesterol (LDL-cholesterol), (Simvastatin 24% and Policosanol 30%). Triglyceride level was reduced in 24% in the Simvastatin group and 10% in the Policosanol group. In both groups were observed and elevation in the HDL-cholesterol level without statistic significance. Total cholesterol/HDL cholesterol and LDL-cholesterol/HDL-cholesterol ratios were significantly lowered by the both therapies. Both drugs were well tolerated, no patients were withdraw from the trial because of adverse experiences, was see a tendency in the policosanol group to improve the Aspartate aminotrasnferase previously disturbed

OBJETIVO: Descrever o perfil lipídico e a prevalência de hipercolesterolemia em escolares de 7 a 14 anos de idade do município de Campinas, SP, Brasil. MÉTODOS: Foram determinados os níveis de colesterol sérico, frações, razões e triglicerídeos, conforme idade e sexo numa amostra populacional de 1.600 escolares. Considerou-se hipercolesterolemia leve para 170 mg/dl ou = 200 mg/dl. RESULTADOS: Os escolares apresentaram média de 160 mg/dl de colesterol, 49 mg/dl de HDL-colesterol, 96 mg/dl de LDL-colesterol, 16 mg/dl de VLDL-colesterol, 79 mg/dl de triglicerídeos, 3,5 para a razão colesterol/HDL-colesterol e 2,1 para a razão LDL-colesterol/HDL-colesterol. De um modo geral, as meninas apresentaram valores maiores para o colesterol e triglicerídeos do que os meninos. A prevalência de hipercolesterolemia foi de 35,0%, dividida em 15,7% leve, 9,8% moderada e 9,5% grave. O sexo feminino apresentou maior prevalência de hipercolesterolemia do que o masculino. CONCLUSÕES: Os resultados apontam para a emergência da hipercolesterolemia como problema de saúde pública no Brasil. OBJECTIVE: To describe the lipid profile and the prevalence of hypercholestrolemia among schoolchildren aged 7 to 14 years in Campinas, São Paulo State, Brazil. METHODS: Plasma cholesterol levels, fractions, ratios and triglycerides were determined according to age and gender in a total of 1,600 schoolchildren. Hypercholestrolemia was considered borderline for 170 mg/dl or = 200 mg/dl. RESULTS: Schoolchildren presented a cholesterol mean of 160 mg/dl, HDL-cholesterol mean of 49 mg/dl, LDL-cholesterol mean of 96 mg/dl, VLDL-cholesterol mean of 16 mg/dl, triglycerides mean of 79 mg/dl, cholesterol/HDL-cholesterol mean of 3.5 and LDL-cholesterol/HDL-cholesterol mean of 2.1. In general, females had higher cholesterol and triglycerides values than males. The prevalence of hypercholesterolemia was 35.0%: 15.6% was borderline high, 9.8% moderate and 9.5% severe. Females presented higher prevalence of hypercholesterolemia than males. CONCLUSIONS: The results pointed to the emergence of hypercholesterolemia as a public health problem in Brazil.

INTRODUCTION About 90% of Polish adults with hypercholesterolemia are not aware of their disease or are not treated. OBJECTIVES The aim of the study was to evaluate hypercholesterolemia control in general practice and to assess the implications of introducing the nationwide Program of Cardiovascular Disease Prevention (PCVDP). PATIENTS AND METHODS Sixty-six primary care clinics were scheduled to participate in the study. In half of them, PCVDP was implemented (active clinics), the remaining 33 constituted the control group. Study participants were selected from a group of persons aged 35-55 years with medical records established before January 1, 2005. Patients with coronary heart disease, stroke, or peripheral atherosclerosis were excluded. In a random sample of patients scheduled for the study, medical records were reviewed followed by an interview, physical examination, and blood lipid tests. RESULTS The availability of data on total cholesterol (TC) levels increased from 19.2% to 40.5% in patients from the active clinics and did not change in the control group. Hypercholesterolemia treatment was reported more often in the active clinics than in the control group (4.4% and 3.3%, respectively, P