Increased cardiovascular risk and role of metabolic syndrome in hypertensive elderly
Aumento del riesgo cardiovascular y el papel del síndrome metabólico en personas hipertensas de la tercera edad
Risco cardiovascular aumentado e o papel da síndrome metabólica em idosos hipertensos
Manoela Vieira Gomes da Costa; Luciano Ramos de Lima; Izabel Cristina Rodrigues da Silva; Tania Cristina Morais Santa Barbara Rehem; Silvana Schwerz Funghetto; Marina Morato Stival
Abstract
Objective: To evaluate metabolic syndrome and cardiovascular risk for hypertensive elderly patients treated in primary care.
Methods: A cross-sectional study carried out with 154 hypertensive elderly from a Basic Health Unit in the Federal District. A structured instrument investigated the profile of the elderly. For classifying the metabolic syndrome, the criteria proposed by the National Cholesterol Education Program - Treatment Panel for Adults III were considered. For cardiovascular risk analysis, the Framingham risk score was used. Statistical and inferential analysis was performed using ANOVA, chi-square test and Fisher's exact test, in addition to Odds Ratio and its 95% confidence interval to estimate cardiovascular risk among the groups.
Results: 64.9% of the hypertensive elderly were obese. Metabolic syndrome was evidenced in 70.8%. It was noted that 27.2% had low, 46.8% moderate, and 26.0% high cardiovascular risk, and that being a woman and of advanced aged negatively influenced the risk. Older adults with metabolic syndrome showed 7.19 times more likelihood to have high cardiovascular risk.
Final considerations and implications for the practice: The hypertensive elderly patients had high metabolic syndrome prevalence, which significantly increased cardiovascular risk. This result allows for a better planning of nursing care by the nurses in primary health care.
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Resumo
Objetivo: avaliar a síndrome metabólica e o risco cardiovascular de idosos hipertensos atendidos na atenção primária.
Métodos: estudo transversal realizado com 154 idosos hipertensos de uma Unidade Básica de Saúde do Distrito Federal. Um instrumento estruturado investigou o perfil dos idosos. Para a classificação da síndrome metabólica, consideraram-se os critérios propostos pela National Cholesterol Education Program – Adult Treatment Panel III. Para análise do risco cardiovascular, utilizou-se o escore de risco de Framingham. Foi realizada análise estatística e inferencial com a utilização da ANOVA, teste qui-quadrado e exato de Fisher, além da odds ratio e seu intervalo de confiança de 95% para estimar o risco cardiovascular entre os grupos.
Resultados: 64,9% dos idosos hipertensos eram obesos. Síndrome metabólica foi evidenciada em 70,8%. Observou-se que 27,2% apresentaram baixo, 46,8% moderado e 26,0% elevado risco cardiovascular, sendo que o sexo feminino e a idade avançada influenciaram negativamente o risco. Idosos com síndrome metabólica apresentaram 7,19 vezes mais chances de terem elevado risco cardiovascular.
Considerações finais e implicações para a prática: os idosos hipertensos apresentaram uma elevada prevalência de síndrome metabólica que aumentou significativamente o risco cardiovascular. Este resultado possibilita um melhor planejamento da assistência de enfermagem pelo enfermeiro da atenção primária à saúde.
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Referências
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Submetido em:
09/03/2020
Aceito em:
22/05/2020
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