RESUMO
Age is an important risk factor for cardiovascular disease in the general population and in dialysis patients. The aim of this study is to investigate the influence of age on the cardiovascular status of asymptomatic predialysis patients with chronic kidney disease (CKD). Echocardiography and carotid ultrasound were performed in 61 patients with CKD stages 4-5, who were divided by age into two groups: group 1 (≥65 years, n = 31) and group 2 (<65 years, n = 30). Data were compared with those of control group (≥65 years, n = 20). Group 1 patients had significantly higher left ventricular mass index (LVMI), (P <0.001), worse LV diastolic function (lower E/A ratio: P<0.05, E' velocities: P< 0.001, E'/A' ratio: P <0.001, and a higher ratio E/E': P <0.05) and a higher prevalence of aortic (P <0.01) and mitral calcification (P <0.001) compared to group 2 patients. Elderly patients also had significantly increased intima-media thickness (IMT, P <0.001) and a greater prevalence of carotid plaques (P <0.05) and calcifications (P <0.001) than younger patients. Multiple regression analysis showed that IMT, LVMI, and E/A ratio were independent variables associated with aging (R2 = 0.605). We concluded that older CKD patients demonstrated more profound structural and functional abnormalities of the myocardium, as well as more prominent vascular changes compared to younger CKD patients. The changes in IMT, LVMI, and E/A ratio are independently associated with aging of CKD patients.
Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Espessura Intima-Media Carotídea , Ecocardiografia Doppler , Insuficiência Renal Crônica/complicações , Adulto , Fatores Etários , Idoso , Doenças Assintomáticas , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Insuficiência Renal Crônica/diagnóstico , Fatores de RiscoRESUMO
BACKGROUND: Arterial hypertension (AH) is the most common cardiovascular disease risk factor, affecting between 30 and 50% of the adult population in developed countries. A steady increase of the prevalence of AH by about 60% is expected by year 2025. METHODS: Serbian Society of Hypertension conducted a prevalence study from February to May 2012 on a sample of 3878 adult respondents. The study included 2066 women (53.3%) and 1812 men (46.7%). Average age was 48.89â±â17.48 years. Most participants resided in urban areas (2956 people, 76.2%), whereas 922 resided in rural areas (23.8%). RESULTS: The prevalence of AH in Serbia is 42.7%. Hypertension is more frequently diagnosed among women (53.3%), than among men (46.7%). One thousand, four hundred and twelve respondents were previously diagnosed and treated for hypertension. The estimated awareness of the presence of AH was 42.99% (i.e. 40.00% among male and 45.41% among female participants). Out of all diagnosed cases of hypertension, 390 persons (27.7%) have well regulated blood pressure values, whereas 1022 persons (72.3%) do not have their blood pressure under control. CONCLUSION: Serbia belongs to countries with a high prevalence of AH. A poor control of AH may be explained in view of socioeconomic problems. High prevalence of AH may indicate a remarkably high cardiovascular disease mortality in Serbia.