Rigidez arterial e seus determinantes em amostra de população negra de Angola e do Brasil

• Autor(a) principal: Magalhães, Pedro
• Data de Publicação: 2012
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
• Texto Completo: http://repositorio.ufes.br/handle/10/8050
• topic: pulse wave velocity; arterial stiffness; Africans; blood pressure; cardiovascular risk; velocidade da onda de pulso; rigidez arterial; negros; pressão arterial; risco cardiovascular; Fisiologia; 612

Higher values of aortic stiffness measured by carotid-femoral pulse wave velocity (PWV) have been observed in black subjects compared to caucasians. Environmental expositions to cardiovascular risk factors according to geographic regions of residence can vary in these two groups, beyond genetic ancestry. Arterial stiffness and its determinant factors have not been compared between Africans and black populations living outside Africa. Also, studies to establish reference values of PWV in Africans are still scarce. Therefore, the aims of this study were to compare arterial stiffness and its determinants in black populations living in Africa and Brazil and to determine PWV reference values for Africans. Methods: Cross sectional investigations of cardiovascular risk factors were performed in a representative sample (N = 1,661) of the general population of Vitória, Brazil, and in a sample (N = 615) of civil servants (all blacks) from Agostinho Neto University in Luanda, Angola. Carotid-femoral PVW was determined in the two studies by using the same methods (Complior device). Data were compared between the sub-sample (n = 133) of black individuals of the Vitória study with the whole group studied in Angola. Data are reported as means ± standard deviations and comparisons were performed with the Student t-test or ANOVA or ANCOVA after adjusting for confounders. PWV predictors were determined by multiple regression analysis. Statistical significance was set at p<0.05. Results: Data are reported for 615 and 133 subjects with similar age studied in Luanda and Vitoria, respectively (44.5 ± 10.6 years; 22-72 years vs 42.7 ± 10.6 years; 25-64 years; P=0.068). Similar values of systolic blood pressure (SBP) was observed in the two samples (Luanda: 134.7 ± 24.9 vs Vitorial: 134.2 ± 21.7 mmHg, P = 0.796) whereas diastolic and mean blood pressure (MBP, DBP) were lower (P<0.01) in Luanda (DBP: 82.6 ± 14 vs 90.1 ± 15.1 mmHg; MBP: 100 ± 16.9 vs 104.8 ± 16.8 vs mmHg). Pulse pressure was higher in Luanda (52.1 ± 14.9 vs 44 ± 11.2 mmHg, P <0.001). PWV was higher in the Brazilian group (10.4 ± 2.3 vs 9.6 ± 2 m/s, P <0.001) and this difference remained after adjusting for age and MBP (Brazil: 10.2 ± 1.7 vs Angola: 9.6± 1.7 m/s, P <0.001). Univariate analysis in the whole sample showed that PWV correlated with age, blood pressure, waist-to-hip ratio, total cholesterol, uric acid, heart rate, glucose and gender. In the multivariate analysis, however, only age and blood pressure were strong and independent PWV predictors (R2 = 38.1%) with small additional influence of gender and plasma glucose to PWV variability in Luanda and Vitoria groups, (R2 = 2.2 and 3%, respectively. Age- and gender-specific PWV reference values of PWV were obtained from percentiles curves in normotensive, non-diabetic and non-obese abstract xii subjects studied in Luanda. Conclusions: Our results suggest higher arterial stiffness in black individuals living in Brazil. Aside from a small influence of plasma glucose levels in the Vitoria study, predictors of PWV seem to be similar in the two studied black populations.