CARDIOVASCULAR RISK ASSESSMENT IN CLIMACTERIC WOMEN ASSISTED IN PRIMARY HEALTH CARE
Contenido principal del artículo
Resumen
This study evaluated cardiovascular risk and associated factors in climacteric women through a quantitative, transversal, and analytical approach. Probabilistic sampling was selected from clusters and later by random selection. Variables were investigated by structured and pre-tested questionnaires that included sociodemographic characteristics, lifestyle habits, anthropometric measures, clinical-obstetric factors and through the Framingham Global Risk Score. The final sample included 874 women aged 40 to 65 years, assisted in primary health care of Montes Claros/MG, Brazil. Exploratory descriptive analysis of the data was performed, considering the frequency distribution of the study variables. Bivariate analyzes searched for associations between the independent variables and the risk for cardiovascular diseases, using the chi-square test, and the associated variables were selected for the multivariate analysis up to the level of 20% (p ≤ 0.20). In the adjusted analytical phase, Poisson regression with robust variance allowed obtaining the prevalence ratios (PR) and their respective 95% confidence intervals (95% CI), adopting the significance level of 5% (p < 0.05) for the final model. In this study, most climacteric women were at risk for cardiovascular disease, with an increased prevalence in postmenopausal women. The menopausal transition, associated with hormonal changes, unhealthy lifestyle habits, misinformation, in addition to clinical and obstetric factors, was shown to be harmful to cardiovascular health. These findings highlight the need to assess the main risk factors to institute preventive measures at this stage.
Detalles del artículo
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Copyright (c). Boletim de Coyuntura (BOCA)
Este obra está bajo una licencia de Creative Commons Reconocimiento 4.0 Internacional.
Citas
ALEXANDER, C. M. et al. “NCEP-Defined Metabolic Syndrome, Diabetes, and Prevalence of Coronary Heart Disease Among NHANES III Participants Age 50 Years and Older”. Diabetes, vol. 52, n. 5, 2003.
AMATO, M. C. et al. “Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk”. Diabetes Care, vol. 33, n. 4, 2010.
AZEVEDO, C. F. et al. “Calcium score and coronary CT angiography in cardiovascular risk stratification”. Arquivos Brasileiros de Cardiologia, vol. 98, n. 6, 2012.
BAGYURA, Z. et al. “Association between coronary atherosclerosis and visceral adiposity index”. Nutrition, Metabolism and Cardiovascular Diseases, vol. 30, n. 5, 2020.
BELGHAZI, J. et al. “Validation of four automatic devices for self-measurement of blood pressure according to the International Protocol of the European Society of Hypertension”. Vasc Health Risk Management, vol. 3, n. 4, 2007.
BRANT, L. C. C. et al. “Variations and particularities in cardiovascular disease mortality in Brazil and Brazilian states in 1990 and 2015: estimates from the Global Burden of Disease”. Revista Brasileira de Epidemiologia, vol. 20, n. 1, 2017.
BROTONS, C. et al. “Impact of using different SCORE tables for estimating cardiovascular risk”. Spanish Journal of Cardiology, vol. 67, 2014.
ERIKSSON, I. et al. “Self-rated health: Comparisons between three different measures. Results from a population study”. International Journal of Epidemiology, vol. 30, n. 2, 2001.
FLEMING, L. E. et al. “Earlier acts at menopause, work, and tobacco smoke exposure”. Menopause, vol. 15, n. 6, 2008.
FLY, L. et al. “Effectiveness-based guidelines for the prevention of cardiovascular disease in women-2011 update: a guideline from the American heart association”. Circulation Research, vol. 123, n.11, 2011.
GARCIA, G. T. et al. “Degree of agreement between Cardiovascular Risk Stratification Tools”. Brazilian Archives of Cardiology, vol. 108, n. 4, 2017.
GARCIA, M. et al. “Cardiovascular Disease in Women – Clinical Perspectives”. Circulation Research, vol. 118, n. 8, 2016.
GORENSTEIN, C.; ANDRADE, L. “Validation of a portuguese version of the Beck depression inventory and the state-trait anxiety inventory in brazilian subjects”. Brazilian Journal of Medical and Biological Research, vol. 29, n. 4, 1996.
GUEDES, T. A.; SILVA, F. S. “Gestão de saúde pública no brasil à luz da teoria da burocracia: escassez de médicos especialistas e desigualdade regional de acesso”. Boletim de Conjuntura (BOCA), vol. 13, n. 37, 2023.
GUNNING, M. N. et al. “The cardiovascular risk profile of middle age women previously diagnosed with preterm ovarian insufficiency: A case-control study”. Plos One, vol. 15, n. 3, 2020.
HARVEY, R. E. et al. “Women-specific factors to consider in risk, diagnosis and treatment of cardiovascular disease”. Womens Health, vol. 11, n. 2, 2015.
HUBERT, H. B. et al. “Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study”. Circulation Research, vol. 67, n.5, 1983.
KIM, M. J. et al. “Vasomotor and physical menopausal symptoms are associated with sleep quality”. Plos One, vol. 13, n. 2, 2018.
KUPPERMAN, H. S. et al. “Comparative clinical evaluation of estrogen preparations by the menopausal and amenorrheal índices”. The Journal of Clinical Endocrinology and Metabolism, vol. 13, n. 13, 1953.
LLOYD-JONES, D. M. et al. “Use of Risk Assessment Tools to Guide Decision Making in the Primary Prevention of Atherosclerotic Cardiovascular Disease: A Special Report From the American Heart Association and American College of Cardiology”. Journal of the American College of Cardiology, vol. 73, n. 24, 2019.
MALTA, D. C. et al. “Risk and protection factors for chronic diseases by telephone survey in Brazilian capitals, Vigitel 2014”. Revista Brasileira de Epidemiologia, vol. 18, n. 2, 2015.
MELO, J. B. et al. “Cardiovascular Risk in Climacteric Women with Coronary Artery Disease”. International Journal of Cardiovascular Sciences, vol. 13, 2018.
MIRANDA, G. M. D. et al. “The Brazilian population aging: current and future social challenges and consequences”. Brazilian Journal of Geriatrics and Gerontology, vol. 19, n. 3, 2016.
NORRIS, C. M. et al. “State of the Science in Women's Cardiovascular Disease: A Canadian Perspective on the Influence of Sex and Gender”. Journal of the American Heart Association, vol. 9, n. 4, 2020.
PRECOMA, D. B. et al. “Updated Cardiovascular Prevention Guideline of the Brazilian Society of Cardiology – 2019”. Arquivos Brasileiros de Cardiologia, vol. 113, n. 4, 2019.
SAEED, A. et al. “Prevention of Cardiovascular Disease in Women”. Methodist DeBakey Cardiovascular Journal, vol. 13, n. 4, 2017.
SANTOS-VIEIRA, R. et al. “Risk factors for the development of cardiovascular disease in women”. Investigación y Educación en Enfermería, vol. 35, n. 1, 2017.
SCHOENAKER, D. A. et al. “Socioeconomic position, lifestyle factors and acts at natural menopause: a systematic review and meta-analyses of studies across six continentes”. International Journal Epidemiology, vol. 43, n. 5, 2014.
SILVEIRA, I. L. et al. “Prevalence of climacteric symptoms in rural and urban women in Rio Grande do Norte, Brazil”. Brazilian Journal of Gynecology and Obstetrics, vol. 29, n. 8, 2007.
SOBRAC - Brazilian Association of Climacteric. Menopause Guide. São Paulo: North American Menopause, 2013.
WEDGE, J. A. Manual of the Portuguese version of the Beck Scales. São Paulo: Psychologist's House, 2001.
WHO - World Health Organization. “World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions”. Lancet Globe Health, vol.7, n.10, 2019.
WHO - World Health Organization. Obesity: preventing and managing the global epidemic. Geneva: WHO, 1998.
WHO - World Health Organization. Obesity: preventing and managing the global epidemic. Geneva: WHO, 2000.
WILSON, P. W. F. et al. “Prediction of coronary heart disease using risk factor categories”. Circulation Research, vol. 67, n. 18, 1998.
YANG, L. et al. “China Kadoorie Biobank Study Collaborative Group. Menopause Characteristics, Total Reproductive Years, and Risk of Cardiovascular Disease Among Chinese Women”. Circulation: Cardiovascular Quality Outcomes, vol. 10, n. 11, 2017.
ZHU, D. et al. “Acts at natural menopause and risk of incident cardiovascular disease: A pooled analysis of 15 studies”. The Lancet Public Health, vol. 4, 2019.