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Rosa Weiss TellesAntonio Luiz Pinho RibeiroCristina Costa Duarte LannaGilda Aparecida FerreiraGabriel Assis Lopes do CarmoLuisa Lima Castro2019-08-14T10:08:43Z2019-08-14T10:08:43Z2016-06-20http://hdl.handle.net/1843/BUBD-AXNFAVINTRODUÇÃO: o risco de doença cardiovascular aterosclerótica no lúpus eritematoso sistêmico (LES) e na artrite reumatoide (AR) é maior que na população geral. Esse fato é parcialmente explicado pela maior prevalência de vários fatores de risco tradicionais para doença arterial coronariana (DAC) nos indivíduos afetados. No entanto, mesmo após ajustado para esses fatores, o risco cardiovascular continua maior nos indivíduos com LES ou AR, o que se justifica pela inflamação sistêmica presente nessas doenças e pelos efeitos adversos produzidos por alguns medicamentos usados no seu tratamento. Poucos estudos analisaram o controle e reconhecimento dos fatores de risco para DAC nos pacientes com LES ou AR. Esse trabalho será o primeiro a apresentar dados nacionais em relação ao reconhecimento e controle desses fatores de risco em indivíduos com LES ou AR e o primeiro trabalho no mundo, de conhecimento dos autores, a avaliar o reconhecimento do risco para DAC por pacientes com AR, assim como o controle de fatores de risco para DAC em pacientes com LES, considerando-se alcance de metas terapêuticas. OBJETIVO: avaliar a frequência, reconhecimento e controle dos fatores de risco para DAC em pacientes com LES ou AR. MÉTODOS: pacientes com diagnóstico de LES ou AR atendidos nos ambulatórios do Hospital das Clínicas da Universidade Federal de Minas Gerais (HC/UFMG) foram solicitados a responder questionário com perguntas relacionadas aos fatores de risco para DAC. Os registros dos prontuários dos pacientes participantes foram revistos para pesquisa desses fatores, tratamentos propostos e metas terapêuticas atingidas. Os dados obtidos dos prontuários foram confrontados com aqueles obtidos nos questionários. RESULTADOS E DISCUSSÃO: foram incluídos no estudo 137 pacientes com LES e 133 pacientes com AR, todos do sexo feminino. As pacientes com LES tiveram média (DP) de idade de 41,50 (11,89) anos e as pacientes com AR, 57,32 (12,92) anos. Entre as pacientes com LES, a frequência de hipertensão arterial sistêmica (HAS) foi 51,1%, das quais 85,7% reconheciam ser hipertensas, 71,4% apresentavam controle desejável e 24,3%, controle ideal da pressão arterial (PA). A frequência de dislipidemia foi 46,0%, das quais 68,3% reconheciam ser dislipidêmicas, 30,2% apresentavam controle do HDL, 55,6% apresentavam controle do triglicéride (TG), 69,8% apresentavam controle desejável do LDL e 17,5%, controle ideal do LDL. A frequência de diabete melito (DM) foi 11,7%, das quais 87,5% reconheciam ser diabéticas, 50,0% apresentavam controle desejável do DM e 37,5%, ideal. Entre as pacientes com AR, a frequência de HAS foi 66,2%, das quais 89,8% reconheciam ser hipertensas, 63,3% apresentavam controle desejável e 17,0%, controle ideal da PA. A frequência de dislipidemia foi 54,1%, das quais 68,1% reconheciam ser dislipidêmicos, 55,6% apresentavam controle do HDL, 56,9% tinham controle do TG, 59,4% apresentavam controle desejável do LDL e 34,7%, controle ideal do LDL. A frequência de DM foi 16,5%, das quais 90,9% reconheciam ser diabéticas, 40,9% apresentavam controle desejável do DM e 27,3% ideal. CONCLUSÃO: a frequência de HAS, DM e dislipidemia é alta nos pacientes em tratamento nos ambulatórios de LES e AR do HC/UFMG, quando se compara à população geral. A maioria das pacientes atingiram controle desejável da HAS ou dislipidemia e cerca de metade atingiu o controle do DM. As pacientes demonstraram ter um alto reconhecimento do estado de portador de determinado fator de risco.INTRODUCTION: risk of atherosclerotic cardiovascular disease in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) is greater than in the general population. This is partly explained by the higher prevalence of several traditional risk factors for coronary artery disease (CAD) in individuals with SLE and RA. However, even after risk factor adjustment, cardiovascular risk remains higher in these individuals, which is likely due to systemic inflammation and adverse effects produced by some drugs used in their treatment. Few studies have analyzed the control and recognition of risk factors for CAD in patients with SLE or RA. To the best of our knowledge, this is the first study in Brazil to evaluate the recognition and control of traditional risk factors in SLE and RA. Moreover, it is the first in the world to assess the recognition of risk for CAD in patients with RA, as well as control of risk factors for CAD in patients with SLE, considering the range of therapeutic targets. OBJECTIVE: to evaluate the frequency, recognition and control of risk factors for CAD in patients with SLE or RA. METHODS: Patients with SLE or RA treated in outpatient clinics of the Hospital das Clinicas, Federal University of Minas Gerais (HC / UFMG) were asked to answer a questionnaire with questions related to risk factors for CAD. Medical records of participating were reviewed to assess these factors, proposed treatments and fulfilled therapeutic goals. Data obtained from medical records were compared with those obtained in the questionnaires. RESULTS AND DISCUSSION: The study included 137 women with SLE and 133 women with RA. Patients with SLE had mean (SD) age of 41.50 (11.89) years and patients with RA had mean (SD) age of 57.32 (12.92) years. Among SLE patients, the frequency of systemic arterial hypertension was 51.1% and 85.7% of affected patients recognized to be hypertensive. Between the hypertensive group, 71.4% had desirable control and 24.3% had optimal control of blood pressure. The frequency of dyslipidemia was 46.0% and 68.3% of affected patients considered themselves dyslipidemic. Between the dyslipidemic group, 30.2% had control of HDL, 55.6% had control of triglyceride (TG), 69.8% had desirable control of LDL and 17.5% had optimal control of LDL. The frequency of diabetes mellitus (DM) was 11.7%. Between the diabetic group, 87.5% acknowledged being diabetic, 50.0% had desirable control of DM and 37.5% had ideal control of DM. Among RA patients, the frequency of hypertension was 66.2% and 89.8% of affected patients recognized to be hypertensive. Between the hypertensive group, 63.3% had desirable control and 17.0% had optimal control of blood pressure. The frequency of dyslipidemia was 54.1% and 68.1% of patients considered themselves dyslipidemic. Among the dyslipidemic group, 55.6% had control of HDL, 56.9% had control of TG, 59.4% had desirable control of LDL and 34,7% had optimal control of LDL. The frequency of DM was 16.5% and 90.9% of the affected patients acknowledged being diabetic. Between the diabetic group, 40.9% had desirable control of DM and 27.3% had ideal control of DM. Conclusion: When compared to the general population, the frequency of hypertension, DM and dyslipidemia is high among SLE and RA patients undergoing treatment at HC / UFMG. Most patients achieved desirable control of hypertension or dyslipidemia and about half have reached the DM control. It was found that patients have a high recognition of the carrier status of a particular risk factor.Universidade Federal de Minas GeraisUFMGArtrite reumatóideDoença da artéria coronarianaFatores de riscoMedicinaLupus eritematoso sistêmicoartrite reumatoidelúpus eritematoso sistêmicodoença arterial coronarianafatores de risco cardiovascularAvaliação do reconhecimento e controle de fatores de risco para doença arterial coronariana em pacientes com lúpus eritematoso sistêmico e artrite reumatoideinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessporreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGORIGINALdissertacao_luisa.pdfapplication/pdf1124717https://repositorio.ufmg.br/bitstream/1843/BUBD-AXNFAV/1/dissertacao_luisa.pdf78f243b19b76eca2a3c5a51cb7395f92MD51TEXTdissertacao_luisa.pdf.txtdissertacao_luisa.pdf.txtExtracted texttext/plain143040https://repositorio.ufmg.br/bitstream/1843/BUBD-AXNFAV/2/dissertacao_luisa.pdf.txte650862b651a3c1b203fe5bcc61aed00MD521843/BUBD-AXNFAV2019-11-14 10:37:40.591oai:repositorio.ufmg.br:1843/BUBD-AXNFAVRepositório InstitucionalPUBhttps://repositorio.ufmg.br/oaiopendoar:2019-11-14T13:37:40Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
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