Prevalência de Síndrome metabólica em indivíduos hipertensos cadastrados em uma Unidade de Saúde da Família, Corumbá - MS

Abstract

Arterial Hypertension represents an independent, linear and continuous risk factor to cardiovascular diseases. However, what is often observed in the clinical practice is the combination of this one with other metabolic risk factors. The united presence of arterial hypertension, abdominal obesity, dyslipidemia, decreased glucose tolerance and insulin resistance characterize the Metabolic Syndrome (MS). The objective of this study was to estimate the prevalence of the Metabolic Syndrome in arterial hypertension profile individuals. There was made a cross-sectional study with 295 hypertensive patients, with ages equal or higher than 18, registered in Family Health Unit Fernando Moutinho, at Corumbá city, MS. The data collection took place from November of 2008 to March, 2009. In order to diagnose Metabolic Syndrome, it was used the criteria proposed by National Cholesterol Education Program – Third Adult Treatment Panel (NCEP- ATP III) and by International Diabetes Federation (IDF). Anthropometric and clinical-biochemical data was obtained through physical exams, biological material collection and/or access to hypertensive’s medical records, respectively. In order to verify the association between variables, the Chi-Square Test was applied (with the calculation of the prevalence reason). The prevalence of the MS was calculated with its respective confidence interval of 95%. The concordance analysis between the diagnosis methods IDF and NCEP ATP-III was realized through the determination of the kappa coefficient. The results showed that 66,4% of the individuals were female, with average age of 59,3 years. From the total hypertensive patients that took part of the study, 252 (85,4%) and 209 (70,9%) were diagnosticated as carrier of the MS according to the IDF and NCEP-ATP III criteria, respectively. The Metabolic Syndrome occurred more frequently in women, even in the IDF (93,4%) as in the NCEP-ATP III (85,8%) criteria. In the total group, there was a moderated concordance between both criteria (K=0,549, p<0,001), however it was better for the female gender (K=0,44, p<0,001), in comparison to the male gender (K=0,32, p<0,001). Following the NCEP-ATP III criteria, 3,3% of the hypertensive patients with MS did not show it by the IDF definition. From the diagnosed as having MS by the IDF one, 19,8% did not fulfill the NCEP-ATP III criteria. The study allowed to conclude that: 1. With the IDF criteria, a higher MS prevalence was found among the hypertensives in relation to the one found with the NCEP-ATP III; 2. The prevalence of MS was higher among women, no matter which criteria was used; 3. The concordance between both definitions was considered moderated.