A Avaliação do perfil de risco cardiovascular pelo escore de Framinghamem uma amostra da população adulta de Mateus Leme (MG)

Detalhes bibliográficos
Autor(a) principal: Cleiterson Rezende de Sa
Data de Publicação: 2009
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Repositório Institucional da UFMG
Texto Completo: http://hdl.handle.net/1843/ECJS-856GGJ
Resumo: Objective: To describe the main clinical features of the subjects of this study, to determine the prevalence of the modifiable risk factors (high blood pressure, diabetes mellitus, dyslipidemia, obesity, psychology stress, physical inactivity and smoking) and to estimate the cardiovascular risk, individual and collective, in an adult population sample of Mateus Leme (MG) - Brazil. Methods and Results: In this transversal study were assessed 231 participants aged 45 to 72years, 141 (61%) women and 90 (39%) men, from April, 28 to October, 17 of 2007. The protocol consisted of interview, anthropometric registers, physical examination, laboratorial exams, thorax x-rays and ECG. The cardiovascular risk was estimated by the Framingham Score(FS). The means of age ± SD were 58.40 ± 7.74 for women and 58.67 ± 7.67 for men. The median found was 4.0 risk factors / participant and 25 (10.8%) of them had known atherosclerotic CVD (stroke and/or CHD). Six risk factors were more prevalent among women: hypertension(p=0.025), diabetes (p=0.047), dyslipidemia (p=0.015), overweight and obesity (p=0.004), stress (p=0.004) and physical inactivity (p=0.002). Smoking was more prevalent among men (p<0.001). The BMI = 25 kg/m2 was identified in 122 (86.5%) women and in 63 (70%) men (p = 0.002). Likewise, a ratio of increased and/or very increased waist circumferencewas found in 136 (96.5%) women and in 63 (70%) men (p < 0.001). On the other hand, it was found similar proportions (0.686) for increased waist-hip ratio between female (86.5%) and male (88.9%) groups. In the primary estimate (in 10 years), involving 130 (63%) women and 76 (37%) men, the absolute total risk was 15.7 ± 9.52% (CI95% 14.6 - 16.7%) for the group, 13.59 ± 7.42% (12.31 - 14.88) for women and 18.87 ± 11.69% (16.00 - 21.34) for men (p=0.002). The absolute hard risk was 11.09 ± 8.36% (9.94 12.24) for the group, 8.89 ± 6.32% (7.80 - 9.99) for women and 14.84 ± 9.98% (12.56 - 17.12) for men (p<0.001). The relative risk was of 2.70 ± 1.46 in the group and similar (p=0.559) among women (2.69±1.55) and men (2.71±1.32). It was identified 66 (32%) high risk participants for primary prevention, being 33 (25.4%) women and 33 (43.4%) men (p=0.009). In the secondary estimate (in two years), involving 11 (44%) women and 14 (56%) men, the total risk was 9.44 ± 4.65% (7.52 11.36) in the group, 7.36 ± 4.93% (4.06 - 10.67) for women and 11.07 ± 3.83% (8,86 13,28) for men (p=0.085). However, robust evidences have shown that the Framingham risk function underestimate the predicted risk in high-risk population or with CV mortality rate rising. Efforts have been focused to adapt predictive equations fit to local population characteristics. Conclusion: It was found high prevalence of modifiable risk factors, mainly among women, resulting in a median of 4.0 risk factors / participant. In this study, the waist circumference was matching with BMI in the obesity diagnosis. The 10-year cardiovascular risk estimated was 15.47% for total CHD risk, 11.09% for hard risk and 2.7 for relative risk. It was identified 66 (32%) high-risk participants to primary prevention. However, adding 25 (10.8%) persons who had known atherosclerotic CVD, it was included 91 (39.4%) participants in the high- risk category for an intensive intervention. Although is possible that the actual risk may have been underestimated, the multiple CV risk assessment was regarded as a fundamental step in the risk stratification of the subjects of this study, becoming possible to identify the high risk condition. This valuable information guides the rational planning to intervention management. However, the results might have been more reliable with the risk equation adapted to Brazilian population characteristics.
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spelling A Avaliação do perfil de risco cardiovascular pelo escore de Framinghamem uma amostra da população adulta de Mateus Leme (MG)Prevenção primária ou secundáriaAvaliaçãoDoenças cardiovascularesEscore de riscoMedidaFatores de riscoDoenças cardiovasculares/prevenção e controleDoenças cardiovasculares/epidemiologiaFatores de riscoPrevenção primáriaPrevenção secundáriaObjective: To describe the main clinical features of the subjects of this study, to determine the prevalence of the modifiable risk factors (high blood pressure, diabetes mellitus, dyslipidemia, obesity, psychology stress, physical inactivity and smoking) and to estimate the cardiovascular risk, individual and collective, in an adult population sample of Mateus Leme (MG) - Brazil. Methods and Results: In this transversal study were assessed 231 participants aged 45 to 72years, 141 (61%) women and 90 (39%) men, from April, 28 to October, 17 of 2007. The protocol consisted of interview, anthropometric registers, physical examination, laboratorial exams, thorax x-rays and ECG. The cardiovascular risk was estimated by the Framingham Score(FS). The means of age ± SD were 58.40 ± 7.74 for women and 58.67 ± 7.67 for men. The median found was 4.0 risk factors / participant and 25 (10.8%) of them had known atherosclerotic CVD (stroke and/or CHD). Six risk factors were more prevalent among women: hypertension(p=0.025), diabetes (p=0.047), dyslipidemia (p=0.015), overweight and obesity (p=0.004), stress (p=0.004) and physical inactivity (p=0.002). Smoking was more prevalent among men (p<0.001). The BMI = 25 kg/m2 was identified in 122 (86.5%) women and in 63 (70%) men (p = 0.002). Likewise, a ratio of increased and/or very increased waist circumferencewas found in 136 (96.5%) women and in 63 (70%) men (p < 0.001). On the other hand, it was found similar proportions (0.686) for increased waist-hip ratio between female (86.5%) and male (88.9%) groups. In the primary estimate (in 10 years), involving 130 (63%) women and 76 (37%) men, the absolute total risk was 15.7 ± 9.52% (CI95% 14.6 - 16.7%) for the group, 13.59 ± 7.42% (12.31 - 14.88) for women and 18.87 ± 11.69% (16.00 - 21.34) for men (p=0.002). The absolute hard risk was 11.09 ± 8.36% (9.94 12.24) for the group, 8.89 ± 6.32% (7.80 - 9.99) for women and 14.84 ± 9.98% (12.56 - 17.12) for men (p<0.001). The relative risk was of 2.70 ± 1.46 in the group and similar (p=0.559) among women (2.69±1.55) and men (2.71±1.32). It was identified 66 (32%) high risk participants for primary prevention, being 33 (25.4%) women and 33 (43.4%) men (p=0.009). In the secondary estimate (in two years), involving 11 (44%) women and 14 (56%) men, the total risk was 9.44 ± 4.65% (7.52 11.36) in the group, 7.36 ± 4.93% (4.06 - 10.67) for women and 11.07 ± 3.83% (8,86 13,28) for men (p=0.085). However, robust evidences have shown that the Framingham risk function underestimate the predicted risk in high-risk population or with CV mortality rate rising. Efforts have been focused to adapt predictive equations fit to local population characteristics. Conclusion: It was found high prevalence of modifiable risk factors, mainly among women, resulting in a median of 4.0 risk factors / participant. In this study, the waist circumference was matching with BMI in the obesity diagnosis. The 10-year cardiovascular risk estimated was 15.47% for total CHD risk, 11.09% for hard risk and 2.7 for relative risk. It was identified 66 (32%) high-risk participants to primary prevention. However, adding 25 (10.8%) persons who had known atherosclerotic CVD, it was included 91 (39.4%) participants in the high- risk category for an intensive intervention. Although is possible that the actual risk may have been underestimated, the multiple CV risk assessment was regarded as a fundamental step in the risk stratification of the subjects of this study, becoming possible to identify the high risk condition. This valuable information guides the rational planning to intervention management. However, the results might have been more reliable with the risk equation adapted to Brazilian population characteristics.Objetivo: Descrever as características clínicas dos sujeitos deste estudo, determinar a prevalência dos fatores de risco modificáveis (hipertensão arterial sistêmica, diabetes melito, dislipidemia, obesidade, estresse psicológico, sedentarismo e tabagismo) e estimar o risco cardiovascular, individual e coletivo, em uma amostra da população adulta de Mateus Leme (MG). Métodos e Resultados: Neste estudo transversal foram avaliados 231 participantes entre 45 e 72 anos, 141 (61%) mulheres e 90 (39%) homens, no período de 28 de abril a 17 de outubro de 2007. O protocolo constituiu de entrevista, registros antropométricos, exame físico, exames laboratoriais, raios-x de tórax e ECG. O risco cardiovascular foi estimado pelo Escore de Framingham (EF). As médias de idade ± DP foram de 58,40 ± 7,74 para mulheres e de 58,67 ± 7,67 para homens. A mediana encontrada foi de 4,0 fatores de risco / participante, sendo ainda identificada a presença de DCV ateromatosa (doença cerebrovascular e/ou coronariopatia) em 25 (10,8%) integrantes desse grupo. Seis fatores de risco foram mais prevalentes entre as mulheres: hipertensão (p=0,025), diabetes (p=0,047), dislipidemia (p=0,015), sobrepeso e obesidade (p=0,004), estresse (p=0,004) e sedentarismo (p=0,002). O tabagismo foi mais prevalente entre os homens (p<0,001). O IMC = 25 kg/m2 foi observado em 122 (86,5%) mulheres e em 63 (70%) homens (p = 0,002). De modo concordante, foi encontrada uma proporção de circunferência abdominal aumentada e/ou muito aumentada em 136 (96,5%) mulheres e em 63 (70%) homens (p < 0,001). Por outro lado, foram encontradas proporções semelhantes (0,686) para a relação cintura-quadril aumentada entre os grupos feminino (86,5%) e masculino (88,9%). Na estimativa primária (em 10 anos), envolvendo 130 (63%) mulheres e 76(37%) homens, o risco absoluto total foi de 15,47 ± 9,52% (IC95% 14,16 - 16,77%) para o grupo, 13,59 ± 7,42% (12,31 - 14,88) para as mulheres e 18,87 ± 11,69% (16,00 - 21,34) para os homens (p=0,002). O risco absoluto hard foi de 11,09 ± 8,36% (9,94 - 12,24) para o grupo, 8,89 ± 6,32% (7,80 - 9,99) para as mulheres e 14,84 ± 9,98% (12,56 - 17,12) para os homens (p<0,001). O risco relativo foi de 2,70 ± 1,46 no grupo e semelhante (p=0,559) entre mulheres (2,69 ± 1,55) e homens (2,71 ± 1,32). Foram identificados 66 (32%) participantes de alto risco para prevenção primária, sendo 33 (25,4%) mulheres e 33 (43,4%) homens(p=0,009). Na estimativa secundária (em 2 anos), envolvendo 11 (44%) mulheres e 14 (56%) homens, o risco total foi de 9,44 ± 4,65% (7,52 11,36) para o grupo, sendo de 7,36 ± 4,93% (4,06 - 10,67) para as mulheres e 11,07 ± 3,83% (8,86 13,28) para os homens (p=0,085).Entretanto, evidências consistentes mostram que a função de risco tende a subestimar o risco predito em populações com alta incidência de DCV ou com a taxa de mortalidade CV em ascensão. Existe uma concentração de esforços direcionados para o ajuste das equações preditivas às características da população onde é aplicada.Conclusão: Foram encontradas prevalências elevadas de fatores de Risco modificáveis, predominantemente entre as mulheres, resultando em uma mediana de 4,0 fatores de risco / participante. Neste estudo, a circunferência abdominal foi mais concordante com o IMC no diagnóstico da obesidade. O risco cardiovascular estimado em 10 anos foi de 15,47% para DAC total, 11,09% para eventos maiores (hard) e 2,7 para risco relativo. Foram identificados 66 (32%) participantes de alto risco no grupo da prevenção primária. Entretanto, incluindo os 25(10,8%) integrantes como DCV ateromatosa conhecida, a categoria de alto risco, que deve ser alvo de uma intervenção criteriosa, foi ampliada para 91 (39,4,%) pessoas. A despeito da possibilidade do risco real ter sido subestimado, a avaliação múltipla do risco CV total foi consideradauma etapa fundamental para a estratificação de risco nos sujeitos do estudo, permitindo a identificação da condição de alto risco. Essas informações valiosas constituem a base para o planejamento racional das metas na intervenção para a redução do risco CV. Porém, osresultados poderiam ter sido mais fidedignos com a equação de risco adaptada para as características da população brasileira.Universidade Federal de Minas GeraisUFMGMaria da Consolacao Vieira MoreiraCarlos Faria Santos AmaralCarlos Faria Santos AmaralEmilia SakuraiRobespierre Queiroz da Costa RibeiroCleiterson Rezende de Sa2019-08-10T06:13:26Z2019-08-10T06:13:26Z2009-08-25info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttp://hdl.handle.net/1843/ECJS-856GGJinfo:eu-repo/semantics/openAccessporreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMG2019-11-14T07:41:22Zoai:repositorio.ufmg.br:1843/ECJS-856GGJRepositório InstitucionalPUBhttps://repositorio.ufmg.br/oairepositorio@ufmg.bropendoar:2019-11-14T07:41:22Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
dc.title.none.fl_str_mv A Avaliação do perfil de risco cardiovascular pelo escore de Framinghamem uma amostra da população adulta de Mateus Leme (MG)
title A Avaliação do perfil de risco cardiovascular pelo escore de Framinghamem uma amostra da população adulta de Mateus Leme (MG)
spellingShingle A Avaliação do perfil de risco cardiovascular pelo escore de Framinghamem uma amostra da população adulta de Mateus Leme (MG)
Cleiterson Rezende de Sa
Prevenção primária ou secundária
Avaliação
Doenças cardiovasculares
Escore de risco
Medida
Fatores de risco
Doenças cardiovasculares/prevenção e controle
Doenças cardiovasculares/epidemiologia
Fatores de risco
Prevenção primária
Prevenção secundária
title_short A Avaliação do perfil de risco cardiovascular pelo escore de Framinghamem uma amostra da população adulta de Mateus Leme (MG)
title_full A Avaliação do perfil de risco cardiovascular pelo escore de Framinghamem uma amostra da população adulta de Mateus Leme (MG)
title_fullStr A Avaliação do perfil de risco cardiovascular pelo escore de Framinghamem uma amostra da população adulta de Mateus Leme (MG)
title_full_unstemmed A Avaliação do perfil de risco cardiovascular pelo escore de Framinghamem uma amostra da população adulta de Mateus Leme (MG)
title_sort A Avaliação do perfil de risco cardiovascular pelo escore de Framinghamem uma amostra da população adulta de Mateus Leme (MG)
author Cleiterson Rezende de Sa
author_facet Cleiterson Rezende de Sa
author_role author
dc.contributor.none.fl_str_mv Maria da Consolacao Vieira Moreira
Carlos Faria Santos Amaral
Carlos Faria Santos Amaral
Emilia Sakurai
Robespierre Queiroz da Costa Ribeiro
dc.contributor.author.fl_str_mv Cleiterson Rezende de Sa
dc.subject.por.fl_str_mv Prevenção primária ou secundária
Avaliação
Doenças cardiovasculares
Escore de risco
Medida
Fatores de risco
Doenças cardiovasculares/prevenção e controle
Doenças cardiovasculares/epidemiologia
Fatores de risco
Prevenção primária
Prevenção secundária
topic Prevenção primária ou secundária
Avaliação
Doenças cardiovasculares
Escore de risco
Medida
Fatores de risco
Doenças cardiovasculares/prevenção e controle
Doenças cardiovasculares/epidemiologia
Fatores de risco
Prevenção primária
Prevenção secundária
description Objective: To describe the main clinical features of the subjects of this study, to determine the prevalence of the modifiable risk factors (high blood pressure, diabetes mellitus, dyslipidemia, obesity, psychology stress, physical inactivity and smoking) and to estimate the cardiovascular risk, individual and collective, in an adult population sample of Mateus Leme (MG) - Brazil. Methods and Results: In this transversal study were assessed 231 participants aged 45 to 72years, 141 (61%) women and 90 (39%) men, from April, 28 to October, 17 of 2007. The protocol consisted of interview, anthropometric registers, physical examination, laboratorial exams, thorax x-rays and ECG. The cardiovascular risk was estimated by the Framingham Score(FS). The means of age ± SD were 58.40 ± 7.74 for women and 58.67 ± 7.67 for men. The median found was 4.0 risk factors / participant and 25 (10.8%) of them had known atherosclerotic CVD (stroke and/or CHD). Six risk factors were more prevalent among women: hypertension(p=0.025), diabetes (p=0.047), dyslipidemia (p=0.015), overweight and obesity (p=0.004), stress (p=0.004) and physical inactivity (p=0.002). Smoking was more prevalent among men (p<0.001). The BMI = 25 kg/m2 was identified in 122 (86.5%) women and in 63 (70%) men (p = 0.002). Likewise, a ratio of increased and/or very increased waist circumferencewas found in 136 (96.5%) women and in 63 (70%) men (p < 0.001). On the other hand, it was found similar proportions (0.686) for increased waist-hip ratio between female (86.5%) and male (88.9%) groups. In the primary estimate (in 10 years), involving 130 (63%) women and 76 (37%) men, the absolute total risk was 15.7 ± 9.52% (CI95% 14.6 - 16.7%) for the group, 13.59 ± 7.42% (12.31 - 14.88) for women and 18.87 ± 11.69% (16.00 - 21.34) for men (p=0.002). The absolute hard risk was 11.09 ± 8.36% (9.94 12.24) for the group, 8.89 ± 6.32% (7.80 - 9.99) for women and 14.84 ± 9.98% (12.56 - 17.12) for men (p<0.001). The relative risk was of 2.70 ± 1.46 in the group and similar (p=0.559) among women (2.69±1.55) and men (2.71±1.32). It was identified 66 (32%) high risk participants for primary prevention, being 33 (25.4%) women and 33 (43.4%) men (p=0.009). In the secondary estimate (in two years), involving 11 (44%) women and 14 (56%) men, the total risk was 9.44 ± 4.65% (7.52 11.36) in the group, 7.36 ± 4.93% (4.06 - 10.67) for women and 11.07 ± 3.83% (8,86 13,28) for men (p=0.085). However, robust evidences have shown that the Framingham risk function underestimate the predicted risk in high-risk population or with CV mortality rate rising. Efforts have been focused to adapt predictive equations fit to local population characteristics. Conclusion: It was found high prevalence of modifiable risk factors, mainly among women, resulting in a median of 4.0 risk factors / participant. In this study, the waist circumference was matching with BMI in the obesity diagnosis. The 10-year cardiovascular risk estimated was 15.47% for total CHD risk, 11.09% for hard risk and 2.7 for relative risk. It was identified 66 (32%) high-risk participants to primary prevention. However, adding 25 (10.8%) persons who had known atherosclerotic CVD, it was included 91 (39.4%) participants in the high- risk category for an intensive intervention. Although is possible that the actual risk may have been underestimated, the multiple CV risk assessment was regarded as a fundamental step in the risk stratification of the subjects of this study, becoming possible to identify the high risk condition. This valuable information guides the rational planning to intervention management. However, the results might have been more reliable with the risk equation adapted to Brazilian population characteristics.
publishDate 2009
dc.date.none.fl_str_mv 2009-08-25
2019-08-10T06:13:26Z
2019-08-10T06:13:26Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/1843/ECJS-856GGJ
url http://hdl.handle.net/1843/ECJS-856GGJ
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade Federal de Minas Gerais
UFMG
publisher.none.fl_str_mv Universidade Federal de Minas Gerais
UFMG
dc.source.none.fl_str_mv reponame:Repositório Institucional da UFMG
instname:Universidade Federal de Minas Gerais (UFMG)
instacron:UFMG
instname_str Universidade Federal de Minas Gerais (UFMG)
instacron_str UFMG
institution UFMG
reponame_str Repositório Institucional da UFMG
collection Repositório Institucional da UFMG
repository.name.fl_str_mv Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)
repository.mail.fl_str_mv repositorio@ufmg.br
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