Envelhecimento celular aumenta risco de ataque cardíaco e morte prematura

Telómeros vão ficando mais curtos com a idade e com determinados estilos de vida

 Cada célula do corpo possui cromossomas que têm nas suas extremidades os chamados telómeros. Estes desempenham a função de manter a estabilidade estrutural do cromossoma. Com o passar do tempo e dependendo também dos estilos de vida, os telómeros vão ficando mais curtos. Há muito que os investigadores consideram que essa redução aumenta o risco de ataque cardíaco e morte prematura.

 Um estudo realizado na Dinamarca, e que envolveu 20 mil pessoas, demonstra que existe efectivamente uma relação directa. A investigação forneceu também aos médicos uma forma de avaliar a saúde celular de cada pessoa. O artigo está publicado na «Arteriosclerosis, Thrombosis and Vascular Biology». 

 “O risco de ataque cardíaco ou morte prematura está presente sempre que os telómeros ficam mais curtos devido ao estilo de vida (tabagismo, sedentarismo, obesidade, entre outros) ou a idade avançada”, explica Borge Nordestgaard, professor clínico de epidemiologia genética da Faculdade de Ciências da Saúde e de Medicina da Universidade de Copenhaga e médico-chefe do Hospital Universitário de Copenhaga.

 O recente «Estudo Geral da População de Copenhaga» envolveu aproximadamente 20 mil pessoas, algumas das quais foram acompanhadas durante 19 anos. A conclusão, dizem os investigadores, “foi clara”: se o “comprimento dos telómeros é curto, o risco de ataque cardíaco e morte prematura aumenta em 50 e 25 por cento, respectivamente”.

“Sabíamos já que o fumo e a obesidade aumentam o risco de doença cardíaca. Comprovamos agora, como se especulava, que o aumento do risco está directamente relacionado ao encurtamento dos telómeros de protecção - podemos dizer que o tabagismo e a obesidade envelhecem o corpo a nível celular, do mesmo modo que o passar do tempo”, explica Borge Nordestgaard.

2012-02-17
Fonte: http://www.cienciahoje.pt/index.php?oid=53104&op=all
Artigo Original

Reduced Dietary Salt for the Prevention of Cardiovascular Disease: A Meta-Analysis of Randomized Controlled Trials (Cochrane Review)

Background Although meta-analyses of randomized controlled trials (RCTs) of salt reduction report a reduction in the level of blood pressure (BP), the effect of reduced dietary salt on cardiovascular disease (CVD) events remains unclear.

Methods We searched for RCTs with follow-up of at least 6 months that compared dietary salt reduction (restricted salt dietary intervention or advice to reduce salt intake) to control/no intervention in adults, and reported mortality or CVD morbidity data. Outcomes were pooled at end of trial or longest follow-up point.

Results Seven studies were identified: three in normotensives, two in hypertensives, one in a mixed population of normo- and hypertensives and one in heart failure. Salt reduction was associated with reductions in urinary salt excretion of between 27 and 39 mmol/24 h and reductions in systolic BP between 1 and 4 mm Hg. Relative risks (RRs) for all-cause mortality in normotensives (longest follow-up—RR: 0.90, 95% confidence interval (CI): 0.58–1.40, 79 deaths) and hypertensives (longest follow-up RR 0.96, 0.83–1.11, 565 deaths) showed no strong evidence of any effect of salt reduction CVD morbidity in people with normal BP (longest follow-up: RR 0.71, 0.42–1.20, 200 events) and raised BP at baseline (end of trial: RR 0.84, 0.57–1.23, 93 events) also showed no strong evidence of benefit. Salt restriction increased the risk of all-cause mortality in those with heart failure (end of trial RR 2.59, 1.04–6.44, 21 deaths).We found no information on participant's health-related quality of life.

Conclusions Despite collating more event data than previous systematic reviews of RCTs (665 deaths in some 6,250 participants) there is still insufficient power to exclude clinically important effects of reduced dietary salt on mortality or CVD morbidity. Our estimates of benefits from dietary salt restriction are consistent with the predicted small effects on clinical events attributable to the small BP reduction achieved.

A more detailed review has been published and will be updated in the Cochrane Database of Systematic Reviews [Taylor RS, Ashton KE, Moxham T, Hooper L, Ebrahim S. Reduced dietary salt for the prevention of cardiovascular disease. Cochrane Database of Systematic Reviews (CDSR) 2011, Issue 7 (see www.thecochranelibrary.com for information). This is a version of a Cochrane review, which is available in The Cochrane Library. Cochrane systematic reviews are regularly updated to include new research, and in response to feedback from readers. The results of a Cochrane review can be interpreted differently, depending on people's perspectives and circumstances. Please consider the conclusions presented carefully. They are the opinions of review authors, and are not necessarily shared by The Cochrane Collaboration.

Rod S. Taylor, Kate E. Ashton, Tiffany Moxham, Lee Hooper and Shah Ebrahim

From more: http://www.nature.com/ajh/journal/vaop/ncurrent/full/ajh2011115a.html