Percepção da doença arterial obstrutiva periférica por pacientes classe I ou II de Fontaine de um programa de saúde da família / Perception of the peripheral arterial occlusive disease in Fontaine class I or II patients included in a family health program

CONTEXTO: A doença arterial obstrutiva periférica (DAOP) se destaca por deteriorar a qualidade de vida dos pacientes, quando associada a elevado risco de eventos cardiovasculares e cerebrovasculares. O diagnóstico clínico é sensível e específico, por meio do índice tornozelo-braquial (ITB), que, se precocemente detectado, otimiza o controle dos fatores de risco. OBJETIVO: Avaliar a percepção da DAOP em pacientes classe I ou II de Fontaine assistidos pela Estratégia de Saúde da Família em Pará de Minas (MG), analisando características socioeconômicas e determinantes da qualidade de vida. MÉTODOS: Após cálculo amostral estratificado por gênero e idade, um questionário elaborado para o estudo foi respondido por 123 indivíduos com diagnóstico de DAOP classe I ou II de Fontaine. Para as associações, utilizaram-se testes do c² e exato de Fisher (p<0,05). RESULTADOS: Dos indivíduos que responderam o questionário, 96 (78 por cento) eram do gênero feminino e tinham baixa escolaridade. Observou-se associação entre claudicação intermitente, o sintoma mais frequente da doença, e aperto nas pernas, câimbras, adormecimento dos pés, cansaço, inchaço e agulhadas. Não houve associação com tabagismo, hipertensão arterial sistêmica, diabetes e alteração do colesterol. Dos participantes, 76 (61,8 por cento) nunca ouviram falar da doença, apesar de serem portadores. Dor durante execução de tarefas dentro e fora de casa foi relatada por 48 (39 por cento) indivíduos. A prática de atividade física foi mais recomendada por médico clínico geral - mencionada por 18 (14,6 por cento) indivíduos - sendo que a caminhada, única atividade praticada em níveis recomendados, foi relatada por 102 (27,7 por cento). CONCLUSÃO: É necessário esclarecimento para essa população quanto ao tratamento clínico não-farmacológico para controle das manifestações crônicas irreversíveis. Ressalta-se a relevância da veiculação de informações sobre a evolução silenciosa e sintomatologia da doença.

BACKGROUND: The peripheral arterial occlusive disease (PAOD) is characterized by the deterioration in the quality of life of patients when associated with high risk of cardiovascular or cerebrovascular events. The clinical diagnosis is sensitive and specific, by means of the Ankle Brachial Pressure Index (ABPI), and, when there is early detection, the control of risk factors is optimized. OBJECTIVE: To assess the perception of PAOD in Fontaine class I or II patients by means of the Family Health Strategy in Pará de Minas (MG), Brazil, through an analysis of the socioeconomic characteristics and life quality determinants. METHODS: After the sample calculation, stratified by genre and age, a questionnaire elaborated for the purposes of this study was applied to 123 individuals who were diagnosed with Fontaine class I or II PAOD. Aiming at the associations, the c² and Fisher's exact tests were used (p<0.05). RESULTS: Among the participants who answered to the questionnaire, 96 (78 percent) were women and had low schooling. An association between intermittent claudication, the most common symptom, and the sensation of pressure on the legs, cramps, foot paresthesia, fatigue, swelling, and tingling was observed. There was no association with smoking, systemic arterial hypertension, diabetes and cholesterol alterations. Among the participants, 76 (61.8 percent) had never heard about the disease despite the fact that they had it. Pain during activities at home or elsewhere was reported by 48 individuals (39 percent). The practice of physical activities was more recommended by clinicians - mentioned by 18 (14.6 percent) individuals - and walking, the only activity that was practiced according to the recommended levels, was reported by 102 participants (27.7 percent)...

Oxidized low-density lipoprotein and ankle-brachial pressure index in patients with clinically evident peripheral arterial disease

OBJECTIVES: To investigate whether oxidized low-density lipoprotein is a suitable predictor of peripheral arterial disease severity. The role of oxidized low-density lipoprotein in the pathogenesis of atherosclerosis has already been investigated. Its relevance as a predictor of the appearance and worsening of coronary arterial disease is also well known. However, the same is not true regarding peripheral arterial disease. METHOD: Eighty-five consecutive patients with an ankle-brachial pressure index (ABPI) < 0.9 and the presence of either intermittent claudication or critical lower leg ischemia were included. The plasma level of IgG autoantibodies against oxidized low-density lipoprotein was evaluated through an enzyme-linked immunosorbent assay. The results were categorized into quartiles according to the ankle-brachial pressure index (a marker of peripheral arterial disease severity), and significant differences were investigated with the Kruskal-Wallis test. RESULTS: There was no significant difference between the quartiles for this population (p = 0.33). No correlation was found between the ankle-brachial pressure index and oxidized low-density lipoprotein levels in subjects with clinically evident peripheral arterial disease with a wide range of clinical manifestations. CONCLUSIONS: Oxidized low-density lipoprotein is not a good predictor of peripheral arterial disease severity.