Avaliação de fatores de risco relacionados com aterosclerose subclínica em mulheres hipertensas

Abstract

Atherosclerosis and its complications are the main cause of morbidity and mortality in the Western world. Increased carotid intima-media thickness is associated with cardiovascular risk,and it represents a marker of subclinical atherosclerosis, which can be detected early in asymptomatic individuals. The aim of this study was to identify clinical and nutritional variables associated with subclinical atherosclerosis in hypertensive women. Cross-sectional study involving a convenience sample composed by 116 hypertensive women aged between 40 and 65. Clinical data such systolic and diastolic blood pressure (BP), smoking history, physical activity, medication use were collected, a lipid profile, blood glucose and C-reactive protein (CRP) analysis was performed, the dietary assessment was obtained by dietary recall 24 hours and three days food record. Carotid intima-media thickness was performed by the high resolution ultrasound. Patients were divided into two groups according to the values of carotid IMT: IMT 0.9 mm or IMT > 0.9 mm. There was significant difference between the groups regarding age (50.84±6.62 vs 53.54±7.13; p=0.044), systolic BP(134.52±16.54 vs 142.98±21.47; p=0.020), pulse pressure (PP) (49.36±11.03 vs 60.15 ± 17.77; p<0.001), HDL-cholesterol (49.36±11.03 vs 60.15±17.77; p<0.001) and CRP(2.31±1.21 vs 3.05±1.34; p=0.016). There was no significant difference regarding to anthropometric parameters, except for the reactance (65.19±9.69 vs 61.44±7.88; p=0.036), measured by bioelectrical impedance analysis (BIA). Regarding the dietary pattern, only the monounsaturated fat intake was different between the groups 65.19±9.69 vs 61.44±7.88; p=0.036). There was no difference in smoking and physical activity. In the correlation analysis, we have found a correlation between carotid IMT and age (r = 0.25, p = 0.0067), SBP (r= 0.19, p = 0.0086); PP (r = 0.30, p = 0.0009), LDL (r = 0.19, p = 0.0434), and monounsaturated fat (r = -0.25, p = 0.0087), CRP (r = 0.31, p = 0.007) and HDL (r =- 0.33, p = 0.0004), but only HDL-cholesterol, hsCRP and pulse pressure were shown to be independent predictors of carotid IMT after made a multivariate analysis. Conclude that C reactive protein, HDL-cholesterol and pulse pressure are important predictors for subclinical atherosclerosis