Menopausa e fatores de risco associados a doença cardiovascular : um estudo de coorte longitudinal

AUTOR(ES)
DATA DE PUBLICAÇÃO

2005

RESUMO

Objectives: to understand epidemiological, anthropometric and behavioral characteristics of climacteric women, evaluate variations in blood pressure, lipid profile and fasting plasma glucose level in the first, second and third years of follow-up, using baseline values as reference. To have knowledge of factors associated with variations in blood pressure, lipid profile measurements and fasting plasma glucose. Methods: a co-hort longitudinal study was conducted on patients aged between 45 and 65 years, with a follow-up of three years, at the Climacteric Outpatient Facility in the Celso Pierro Hospital of the Catholic University School of Medicine from March 01, 2000 to March 11, 2003. Independent variables were age, color, menopausal status, length of menopause; body mass index and fat distribution profile. Lifestyle and habits: regular exercise, smoking, diet and alcoholism; use and length of hormone therapy use and use of other medications, as well as a personal and family history of cardiovascular risk. The risk factors associated with cardiovascular disease and mean variations were defined as dependent variables: systolic and diastolic pressure, total and fractionated cholesterol, triglycerides, predictive ratios of cardiovascular risk and fasting plasma glucose. Numerical values of blood pressure measurements and laboratory results of plasma levels performed at the first visit (T0) and those obtained after one (T1), two (T2) and three years (T3) of follow-up were considered. Statistical analysis was performed with measures of rates, means, mean variations and standard deviations. The t tests (two-tailed) and Pearson?s chi-square with a significance level of 0.05 were used for the mean values. Finally, we performed multiple analysis using a logistic regression model and a stepwise selecting process with odds ratio calculation and 95% confidence interval. Results: more than two-thirds of women were overweight (35.7%) and obese (33.2%) with android profile (89.0%). They were white (66.1%), postmenopausal (63.3%) and sedentary (64.9%). One-fifth of women were smokers (16.1%) and 3.4% were alcoholics. Half of participants reported having an inadequate diet (48.8%) and receiving hormone therapy (60.8%). More than 40.0% of women were hypertensive and total cholesterol/HDL cholesterol ratio was higher than 4.0. One-third of women had hypercholesterolemia, hypertriglyceridemia and an LDL/HDL cholesterol ratio higher than 3.5. Only 5.3% of women had diabetes. There was no significant variation in mean systolic and diastolic blood pressure. However, there was a significant reduction in mean total and fractionated cholesterol, triglycerides, total cholesterol/HDL cholesterol ratio, LDL/HDL ratio, fasting plasma glucose and increased mean HDL cholesterol when mean variations of the third year were compared to those of baseline values. Exercise and inadequate diet, non-use of hormone therapy, smoking habit and family history of arterial hypertension and cardiovascular diesease; non-white color and the use of hypotensive agent were characteristics associated with increased mean variations of total and fractionated cholesterol, triglycerides and fasting plasma glucose and no increase in mean variations of HDL cholesterol. Conclusion: in this female population, a high percentage of risk factors associated with cardiovascular disease was observed. Variations in lipid profile and fasting plasma glucose were primarily associated with a sedentary lifestyle and inadequate diet, non-use of hormone therapy and a personal history of diabetes as protective factor

ASSUNTO(S)

terapia hormonal glicemia pressão arterial lipidios

ACESSO AO ARTIGO

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