|LETTER TO EDITOR
|Year : 2017 | Volume
| Issue : 4 | Page : 60-61
Nutritional assessment of elderly cardiovascular patients
Vitorino Modesto dos Santos
Department of Internal Medicine of Armed Forces Hospital and Catholic University Medical Course, Brasília-DF, Brazil
|Date of Web Publication||22-Jan-2018|
Dr. Vitorino Modesto dos Santos
Armed Forces Hospital, Estrada Do Contorno Do Bosque S/N, Cruzeiro Novo, Brasília-Df
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
dos Santos VM. Nutritional assessment of elderly cardiovascular patients. Res Cardiovasc Med 2017;6:60-1
I read the recent cross-sectional study by Hosseini et al. about the mini nutritional assessment (MNA) of 225 hospitalized elderly patients with congestive heart failure (CHF) and mean age of 71.1 ± 7.35 years; there was a predominance of males. Objective and subjective functional, cognitive, and nutritional data were evaluated by the MNA; the objective was to compare with findings obtained among the elderly in nursing homes. The MNA includes 18 items to evaluate the nutritional risk as follows: malnourished <17 points, at risk of malnutrition 17–23.5 points, and normal nutritional status 24–30 points. Individuals; it is a phenomenon that can be prevented or controlled if the related factors are early identified. Malnutrition and its risk were observed in 90.7% of the total of the studied individuals, conditions that can be prevented or controlled if the related factors are early identified. Elderly patients usually have better nutritional status at home than if are hospitalized; the authors emphasized the nutritional intervention to reduce the hospitalization and costs. Malnutrition may be causally associated with CHF and can propitiate poor prognoses mainly among the group of elderly hospitalized individuals in low-income countries., The decrease of appetite and food intake is associated with low smell and taste senses. Actually, a Brazilian study including 16 inpatients, 62.5% males and mean age of 73.06 ± 5.8 years, described oral route as a good option for nutrition and should be individualized, with small palatable and frequent high-energy meals to ensure an adequate daily intake. Despite differences in anthropometric parameters, the malnourished patients ingested food to meet or exceed the recommended dietary allowances for energy and nutrients.
Brazilian authors also studied heart weight and heart weight/body weight coefficient (HW/BW × 100) in 210 autopsies of adults, with and without chronic malnutrition. Other study evaluated heart weight and heart weight/body weight coefficient (HW/BW × 100) in 210 autopsies of adults, with and without chronic malnutrition. Exclusion criteria included edema, obesity, CHF, liver or kidney diseases, and arterial hypertension. Malnutrition was characterized as a body mass index <18.5 kg/m 2. Significant differences were found in heart weight (267.3 ± 59.8 vs. 329.1 ± 50.4 g) and in HW/BW × 100 (0.64 ± 0.12 vs. 0.57 ± 0.09%); positive and significant correlation occurred between heart weight and body mass index and between heart weight and body weight. Malnourished people had lighter hearts, but a greater HW/BW coefficient than controls, suggesting preservation of the myocardium mass in relation to the body weight loss.
Worthy of note, obesity and arterial hypertension are frequent in school children and young Brazilian people; this It is a phenomenon that can enhance the risk of CHF in older population.,, this preventable phenomenon can enhance the risk of CHF in older population.,, Cross-sectional evaluations of overweight, obesity, and hypertension among 229 students with 5–15 years detected frequencies of 11.79%, 13,53%, and 13.53%, respectively., The majority of overweight and obese children had normal weight and height at birth; however, later on, the body mass index showed a significant correlation with high blood pressure., Young populations of developing countries should be instructed about how to modify the cardiovascular risk factors as soon as possible, undergoing adequate diets and good lifestyle habits since the very early infancy and maintaining them during all their life courses.,,
The articles herein commented emphasize obesity and hypertension as modifiable factors of CHF and highlight the role of malnutrition on the prognosis of elderly inpatients with CHF. This represents the main cause of hospitalization and death in elderly groups.,,,, Other concern that merits special attention is the increasing rate of obesity and hypertension among the younger population groups, which favors cardiovascular events in older population.,,
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Hosseini S, Keshavarz SA, Amin A, Bakshandeh H, Maleki M, Shahinfard A, et al.
Nutritional status assessment of the elderly patients with congestive heart failure by mini nutritional assessment test. Res Cardiovasc Med 2017;6:e31898.
Monteiro JP, Santos VM, Cunha SF, Cunha DF. Food intake of a typical Brazilian diet among hospitalized malnourished patients. Clin Nutr 2000;19:55-9.
Cunha DF, Cunha SF, Reis MA, Teixeira Vde P. Heart weight and heart weight/body weight coefficient in malnourished adults. Arq Bras Cardiol 2002;78:382-7.
Modesto dos Santos V, Aparecida Soares L, de Carvalho Santos S. Cardiovascular risk index and adequate nutrition. Rev Med Chil 2010;138:652-3.
Xavier MM, Xavier RM, Magalhães FO, Nunes AA, Santos VM. Factors associated to the prevalence of overweight in schoolchildren. Ped Mod 2009;45:105-8.
Xavier RM, Xavier MM, Cartafina RA, Magalhães FO, Nunes AA, Santos VM. Prevalence of arterial hypertension in students linked to the University of Uberaba (UNIUBE). Brasilia Med 2007;44:169-72.