Uncontrolled hypertension in older patients： markers and associated factors to masked and white-coat effect

Background Hypertension is the main risk factor for cardiovascular diseases, affecting more than half the elderly population. It is essential to know if they have proper control of hypertension. The aim of this study was to identify the associated factors to masked uncon- trolled hypertension and false uncontrolled hypertension in older patients. Methods Two-hundred seventy-three individuals （70.1±6.7 years-old） had blood pressure （BP） measured at the office and by ambulatory BP monitoring （ABPM）, with the definition of controlled group （C）, individuals with high office BP and adequate ABPM, called white-coat effect group （WCE）, uncontrolled （UC）, and subjects with ap- propriate office BP and elevated ABPM denominated masked effect group （ME）. Age, body mass index, diabetes, pulse pressure （PP） and BP dipping during sleep were evaluated （Kruskal-Wallis test and logistic regression models）. Results Age was higher in UC than in C and ME （P 〈 0.01）, and 24-h ABPM PP was lower in C （48± 7 mmHg） and WCE （51±6 mmHg） than in UC （67±12 mmHg） and ME （59±8 mmHg） （P 〈 0.01）. Sleep systolic BP dipping was lower in ME than in C （P = 0.03）. Female gender was associated with a greater chance of being of ME group, which showed a higher PP and lower BP dipping during sleep. Conclusions In older individuals, office BP measure- ments did not allow the detection of associated factors that would permit to differentiate WCE from UC group and C from ME group. ABPM favored the identification of a higher PP and a lower BP dipping during sleep in the masked effect and uncontrolled groups.

Springtime Monitoring of Passive Cool Roofs in Subtropical Climate

Passive strategies for acclimatization of buildings have been studied by several authors in many countries, especially the evaporative and radiant cooling techniques. Fiber cement tiles are very common in popular constructions due to their low cost. However, they have over twice of the value thermal transmittance indicated to this bioclimatic zone according to Brazilian guidelines. The objective is to present an alternative to reduce high temperatures on fiber cement tiles. In this paper, the monitoring of passive cooling of roofing during the spring season in a city with subtropical climate is described. Single and combined reflective and evaporative cooling systems were studied in different environmental conditions. Internal surface temperatures of tiles were monitored together with weather variables. Results show a decrease of about 6 ℃, 9 ℃, 10 ℃ and 11 ℃ as compared to the original tiles according to environment conditions and the combined passive cooling techniques. These results allow for the conclusion that the use of passive cooling techniques opens up new possibilities to attenuate the internal surface temperatures of tiles and to consequently decrease the roofing solar heat gain into buildings, thus, providing less air cooling energy consumption.