Estudo da reatividade microvascular em pacientes hipertensos com adiposidade corporal elevada

Abstract

Several anthropometric indices have been proposed to determine the association between overweight and cardiovascular risk factors. The objective of this study was to evaluate the relationship between body adiposity and microvascular reactivity in hypertensive patients under antihypertensive therapy. A cross-sectional study was carried out on treated hypertensive patients (n = 81) aged 40 to 70 years, both sexes, submitted to anthropometric evaluation and blood collection to evaluate biochemical tests (glycemia, uric acid, lipid profile, C-Reactive protein, Homeostatic Model Assessment - Insulin Resistance, with subsequent calculation of adiposity indices such as conicity index (CI), body adiposity index (BAI), visceral adiposity index (VAI) and waist-height ratio (WHeR). In addition to these evaluations, the patients underwent vascular tests including microvascular reactivity analysis, pulse wave velocity (PWV) measurement and assessment of central hemodynamic parameters (by Sphygmocor and Arteriograph). The participants were divided according to fat percentage (%F) obtained by electrical bioimpedance. The area under the curve (AUC) of cutaneous perfusion was lower in the upper tertile (97 ± 57% vs 67 ± 36%, p = 0.027). The %F showed a significant correlation with WHeR (r = 0.77, p <0.001), VAI (r = 0.41, p = 0.018), CI (r = 0.60, p <0.001) and VAI (0.65, p <0.001) in men, and only with WHeR (r = 0.55, p <0.001) and BAI (r = 0.60, p <0.001) in women. By linear regression, AUC perfusion change showed independent association with %F (β = - 3.15, p = 0.04) in women and with glycemia (β = -1.15, p = 0.02) in men. There was no difference in PWV measurements. In conclusion, the anthropometric indexes of adiposity were more associated with the %F in men. The higher body adiposity was associated with lower microvascular reactivity, which was more evident in women. There was no difference in arterial stiffness, which may have been influenced by antihypertensive treatment.