Cintura hipertrigliceridêmica e risco cardiometabólico em mulheres hipertensas / Hypertriglyceridemic waist and cardiometabolic risk in hypertensive women

RESUMO

OBJETIVO: Avaliar a associação entre cintura hipertrigliceridêmica (CH) e fatores de risco cardiometabólicos em mulheres portadoras de hipertensão arterial. MÉTODOS: Foi realizado um estudo transversal em 218 pacientes acompanhadas pelo Programa do Sistema de Cadastramento e Acompanhamento de Hipertensos e Diabéticos (HiperDia), em duas unidades de saúde de São Luís, MA, Brasil. A variável dependente foi CH e as variáveis independentes foram sociodemográficas, estilo de vida, antropométricas e agravos à saúde. RESULTADOS: A CH esteve presente em 33% da amostra e foi predominante na idade > 60 anos (56,4%), não brancas (81,7%), com oito anos ou menos de estudo (57,3%) e pertencentes à classe C (49%). Observaram-se excesso de peso (68,8%) e hipercolesterolemia (68,8%). A CH associou-se a tabagismo (RP 2,08; p = 0,017), sobrepeso (RP 2,46; p = 0,010), obesidade (RP 4,13; p < 0,001), hipercolesterolemia (RP 1,87; p = 0,015), HDL (high density lipoproteins) colesterol alto (RP 3,41; p < 0,001) e glicemia de jejum > 100 mg/dL ou ser diabética (RP 1,86; p = 0,006). Após ajustamento, permaneceram associados o colesterol total (RP = 1,78; p = 0,012), HDL colesterol (RP 3,03; p < 0,001), IMC > 25 a < 30 kg/m² (RP = 2,60; p = 0,005) e IMC > 30 kg/m² (RP = 3,61; p < 0,001). CONCLUSÃO: Observou-se elevada prevalência de CH e sua associação com perfil lipídico alterado e excesso de peso corporal. A CH se mostrou um importante instrumento diagnóstico para o acompanhamento de hipertensas com risco metabólico, de fácil obtenção e menor custo, útil na prática clínica, em especial, na atenção básica do Sistema Único de Saúde (SUS).

ABSTRACT

OBJECTIVE: To evaluate the association between hypertriglyceridemic waist (HW) and cardiometabolic risk factors in women with hypertension. METHODS: A cross-sectional study was performed in 218 patients monitored by HiperDia (Enrollment and Monitoring Program for Hypertensive and Diabetic Individuals) in two health units in São Luis, MA, Brazil. The dependent variable was HW and the independent variables were sociodemographics, lifestyle, anthropometrics, and health problems. RESULTS: HW was present in 33% of the sample and was predominant in women aged > 60 years (56.4%), non-whites (81.7%), those with eight or fewer years of schooling (57.3%), and those belonging to socioeconomic class C (49%). Excess weight (68.8%) and hypercholesterolemia (68.8%) were observed. HW was associated with smoking (PR 2.08; p = 0.017), overweight (PR 2.46; p = 0.010), obesity (PR 4.13; p < 0.001), hypercholesterolemia (PR 1.87; p = 0.015), high levels of high-density lipoproteins (HDL) cholesterol (PR 3.41; p < 0.001), and fasting glycemia > 100 mg/dL or being diabetic (PR 1.86; p = 0.006). After adjustment, total cholesterol (PR = 1.78; p = 0.012), HDL-cholesterol (PR 3.03; p < 0.001), body mass index (BMI) > 25 to < 30 kg/m² (PR = 2.60; p = 0.005), and BMI > 30 kg/m² (PR = 3.61; p < 0.001) remained associated. CONCLUSION: A high prevalence of HW and its association with altered lipid profile and excess body weight was observed. HW showed to be an important diagnostic tool for the monitoring of hypertensive women with metabolic risk, which is low cost, easily accessible, and useful in clinical practice, especially in primary health care in the Brazilian Unified Health System (Sistema Único de Saúde - SUS).