Estudo da velocidade de onda de pulso e das pressões central e periférica, em idosos em área urbana no Brasil: resultados iniciais

Abstract

Introduction: There is now a great need for resource rationalization and improvement of results, and it is increasingly recognized the need and importance of studies for analysis and the adequacy of treatments, especially in chronic-degenerative pathologies because they are among the Leading causes of death in Brazil and worldwide. Recognition of the prevalence and significant impact of hypertension in the elderly, cardiovascular risk and quality of life is very important for health policy and public health strategy in developing countries. Objective: The present study was to establish reference PWV values in a large cohort of normotensive and hypertensive elderly persons of both sexes in an urban area in Brazil. Materials and Methods: Cross-sectional analysis of the first visit of 1192 elderly patients (> 60 years) who enrolled in the Study on the PWV in Elderly Individuals in an Urban Area of Brazil (in Portuguese: Estudo da Velocidade de Onda de Pulso em Idosos em área Urbana no Brasil – EVOPIU), with a 4-year follow-up. All patients were submitted to applanation tonometry with a SphygmoCor® XCEL device, model EM4C (AtCor Medical, Sydney, Australia). Patients were divided into three groups according to their respective pressure levels: Normotensive (N), with blood pressure (BP) < 140/90 mmHg and no antihypertensive drug use in the past 3 months; Controlled Hypertensive (CH), with BP < 140/90 mmHg, using antihypertensive drugs; and Hypertensive (H), with BP  140/90 mmHg. Carotid-femoral PWV (cf-PWV), central pressures and aortic augmentation indices (AIx75) were measured in the three groups. Results: The mean age overall was 69.2 (7.0) years. The cf-PWV values were as follows: overall: 9.3(3.1) m/s, N: 8.6(2.2) m/s; CH: 8.7(2.0) m/s, and H: 9.8(2.2) m/s (P < 0.005). The AIx75 values were as follows: overall = 33.3(14.4) %; N = 32.4(13.7) %; CH = 33.3(14.8) %; and H = 33.8(14.5) % (P > 0.05). Conclusion: The cf-PWV in elderly individuals from an urban area in Brazil showed differents values when compared with elderly patients from other South American and European countries. The different anthropometric measurements and methods used might explain these discrepancies. Pressure values exhibited a higher significance in the hypertensive group compared with the normotensive and controlled hypertensive groups. In the comparison of controlled hypertensive with normotensive patients, cf-PWV exhibited similar values, thus showing the potential of antihypertensive treatment to partially reverse artery stiffness.