In addition to the socioeconomic asymmetries, the hospitalization length and the mortality rate adjusted for age were greater in patients in the public health system.

Women without cardiopathy showed serum levels of glucose, triglycerides and HDL-cholesterol lower than men's. In both sexes, the means are lower in the comparison with eutrophic and overweight, and only the triglycerides average of women with overweight and obesity showed significant statistic difference.

SummaryBackground: In developed countries, heart failure with preserved ejection fraction (HFpEF) is more prevalent than heart failure with reduced ejection fraction (HFrEF) in the community. However, it has not been completely established if this fact is also observed within our community.

From health plan companies to international insurance companies: changes in the accumulation regime and repercussions on the healthcare system in Brazil

SummaryBackground: Metabolic syndrome (MS) is characterized by a collection of risk factors that are associated with elevated rates of cardiovascular events and the risk of developing heart failure (HF). In our field, the association of MS in stable chronic HF patients has not been established.

Original Article M a i l i n g A d d r e s s : L e a n d r o R e i s T a v a r e s• R u a O t á v i o C a r n e i r o , 1 1 0 / 2 0 1 -2 4 2 3 0 -1 9 1 -N i t e r ó i , R J -B r a z i l E-mail: lreistavares@uol.com. OBJECTIVETo compare the perceptions of heart failure (HF) diagnosis and management between clinical cardiologists (CC) and family doctors (FD) in the city of Niterói. METHODSA qualitative questionnaire, validated by the EURO-HF study, was submitted to 54 FD and 62 CC. These professionals supplied the following information: HF diagnosis; availability of complementary tests; which tests were used more often; names, dosages and adverse effects of the medications prescribed; and which pharmaceuticals reduced mortality. RESULTSFD and CC reported that the most common signs and symptoms identifi ed by HF patients were: dyspnea, edema and fatigue (96.3% vs. 100%, 74% vs. 58% and 22.2% vs. 67.7%). The HF classifi cation method used most often by FD was mild/moderate/severe (53.8%) while the CC used the NYHA method (72.7%) more often. CC request echocardiograms more often than FD (p < 0.001). CC differentiate HF with preserved systolic function from HF with systolic dysfunction more often than FD (p < 0.001). CC use beta-blockers (p < 0.001), angiotensin-converting enzyme inhibitors (p < 0.001) and spironolactone (p < 0.001) more often than FD. The angiotensin-converting enzyme (ACE) inhibitor dosages used by CC are greater than those used by FD (p < 0.001) and the spironolactone dosages used by CC are closer to those recommended in medical literature. CONCLUSIONCC use a more intensive investigative diagnosis and medications that are more effective in reducing morbidity and mortality rates for HF patients. KEY WORDSHeart failure, diagnosis, management.

COVID-19-related in-hospital mortality has been reported at 30.7–47.3% in Brazil, however studies assessing exclusively private hospitals are lacking. This is important because of significant differences existing between the Brazilian private and public healthcare systems. We aimed to determine the COVID-19-related in-hospital mortality and associated risk factors in a Brazilian private network from March/2020 to March/2021. Data were extracted from institutional database and analyzed using Cox regression model. Length of hospitalization and death-related factors were modeled based on available independent variables. In total, 38,937 COVID-19 patients were hospitalized of whom 3058 (7.8%) died. Admission to the intensive care unit occurred in 62.5% of cases, and 11.5% and 3.8% required mechanical ventilation (MV) and renal replacement therapy (RRT), respectively. In the adjusted model, age ≥ 61 years-old, comorbidities, and the need for MV and/or RRT were significantly associated with increased mortality (p < 0.05). Obesity and hypertension were associated with the need for MV and RRT (p < 0.05).

Monotherapy with trandolapril is more effective than that with captopril to control blood pressure during exercise in hypertensive patients.