Fatores e comportamento de risco cardiovasculares em adultos residentes em Paiçandu-Paraná : efeitos de uma intervenção em saúde

• Autor(a) principal: Radovanovic, Cremilde Aparecida Trindade
• Data de Publicação: 2013
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Estadual de Maringá (RI-UEM)
• Texto Completo: http://repositorio.uem.br:8080/jspui/handle/1/2052
• topic: Doenças cardiovasculares; Fatores de risco; Hipertensão; Estudo de intervensão; Atividade física; Enfermagem; Hipertensos; Estudo de intervenção; Paiçandu; Paraná (Estado); Brasil.; Cardiovascular diseases; Risk factors; Hypertension; Intervention studies; Physical activity; Nursing; Paiçandu; Paraná (State); Brazil.; Ciências da Saúde; Medicina

For more than three decades non-transmissible chronic diseases have been responsible for the largest load of disease in Brazil. They are susceptible to prevention and they represent the most cost effective investment in the health system. Among those diseases the cardiovascular ones are now the major cause of death in the world, being hypertension an important arterial risk factor. Globally, the prevalence of arterial hypertension in adults from 25 years of age was estimated to be about 40%, in 2008, and in Brazil its prevalence was found to be between 22.3% and 43.9%. In agreement with the plan of strategic actions to face non-transmissible chronic diseases, the appropriate management of arterial hypertension requests articulating actions: the surveillance of hypertension, co-morbidities and its determinants; the integrality ofthe care and the promotion of health. For that, the accomplishment of this study is justified due to the high rate of morbi-mortality caused by non-transmissible chronic diseases in the country and in the world, to the increase of risk factors associated to the adult individual, and the absence of survey on the population in small municipal districts and the ignorance of the prevalence of risk factors in the population of Paiçandu, PR. The main objective of this study was to estimate the prevalence of factors and risk behaviors for cardiovascular diseases, to implement actions for the prevention and control of the cardiovascular diseases, and to evaluate the effectiveness of an intervention program in the reduction of the factors of cardiovascular risk in adults with arterial hypertension, residents in Paiçandu - PR. The study was divided into two stages: A cross-sectional, descriptive study of population base and a randomized clinical essay. In the cross-sectional research 415 adults were assessed, being the sedentary(77.77%) the greatest prevalence, followed by overweight (57.11%) and central obesity (49.63%). The increased prevalence of risk factors with increasing age was evident in relation to hypertension, diabetes mellitus, dyslipidemia, central obesity, overweight and inappropriate food habits. For the association of the arterial hypertension with other risk factors 408 individuals were appraised and the greatest prevalence was among women (24.64%). It was noticed that from 50 to 59 years of age, 40.38% of the hypertensive individuals possess five or more factors of cardiovascular risk. In the randomized clinical study 94 individuals pronounced themselves as hypertensive during the population research randomly divided into two groups, intervention group - IG (21) and control group - CG (21). The intervention was accomplished in 16 weeks and consisted of orientations on health and nutrition, and of physical exercises. In the first month the IG showed a drop of six participants. Of the 15 members who remained six accompanied the group for eight weeks, and nine for 16 weeks. Thus, we considered two distinct groups: those who participated until the end of test - IGa, and those who attended eight weeks - IGb. The CG finished with 15 members and presented a leakage of six participants. Comparison of blood pressure before and after the intervention showed that the IGb variation was statistically significantly for systolic blood pressure (143.3 ± 11.0 to 121.7 ± 14.6, p = 0.024). The IGa has significantly ecreased values to systolic blood pressure and diastolic blood pressure (132.2 ± 13.9 to 118.9 ± 8.7, p = 0.036 and 86.7 ± 9.4 to 77.8 ± 6.3, p = 0.041 respectively), whereas the control group showed no significant decrease in the systolic blood pressure and diastolic blood pressure. The biochemical variables showed changes in IGa for all variables, and the HDL showed a significant difference (50.4 ± 6.6 to 54.2 ± 7.8, p = 0.034) for this group. The IGb and CG showed changes in biochemical parameters, however, both without statistically significant differences. IGa presented a decrease in the values of all anthropometric variables, and revealed significant differences for hip circumference (108.9 ± 11.6 to 106.4 ± 12.1, p = 0.042) and waist/hip relation (1.00 ± 0.07 for 0.99 ± 0.07, p = 0.030). The IGb only showed decreased values on waist/hip relation (0.98 ± 0.06 to 0.97 ± 0.05). Body fat percentage (38.0 ± 6.4 to 37.9 ± 6.9) and hip circumference (105.3 ± 6.4 to 103.6 ± 5.7) presented decreased values in CG, but these last 3 cases showed no significant values decreasing. The comparison of the blood pressure before and after the intervention showed that the intervention group presented significant difference for systolic and diastolic blood pressure measurements. The survey on cardiovascular risk factors through the accomplishment of the population inquiry made possible to know the profile of health of this population and it allowed to identify the need of interventions in health, giving the opportunity to discuss subjects referring to chronic condition and the risk factors involved, besides participating in actions that promote the adoption of a healthier lifestyle. These proposed intervention can constitute an important tool for health professionals work, especially nurses, since health education permeates his daily life, and also because this professional plays a significant role in prevention and health promotion.