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Doctoral Thesis
DOI
https://doi.org/10.11606/T.17.2023.tde-15022024-100934
Document
Author
Full name
Tetzi Oliveira Brandão
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2023
Supervisor
Committee
Cavalli, Ricardo de Carvalho (President)
Batista, Rosângela Fernandes Lucena
Cardoso, Viviane Cunha
Nascimento, Maria Laura Costa do
Title in Portuguese
Avaliação dos marcadores biofísicos associados à hipertensão arterial em mulheres pertencentes à coorte de 1978/79 da cidade de Ribeirão Preto/SP
Keywords in Portuguese
Caso controle aninhado à coorte
Fatores de risco
Hipertensão
Marcadores biofísicos
Síndromes hipertensivas na gestação
Abstract in Portuguese
Introdução: Mulheres com distúrbios hipertensivos da gravidez (DHG), como hipertensão gestacional e pré-eclâmpsia (PE) apresentam mais repercussões cardiovasculares a longo prazo. Objetivos: Determinar a prevalência de hipertensão arterial em mulheres na quarta década de vida e identificar os fatores de risco relacionados ao histórico obstétricos e marcadores biofísicos associados à hipertensão arterial nessa população. Pacientes e Métodos: Trata-se de um estudo de caso controle de mulheres de 37 a 39 anos, pertencentes à coorte de nascimento de 1978/79 na cidade de Ribeirão Preto/SP. Foram analisados dados sociais e demográficos, presença de comorbidades, síndrome metabólica, antecedentes obstétricos, fatores hereditários, marcadores biométricos, biofísicos associados à pressão arterial. Resultados: Foram analisados dados de 929 mulheres, 925 tiveram a pressão mensurada de forma ambulatorial e 281 através da MAPA, dessas, 19,1% tinham hipertensão autodeclarada e 5,4 % tiveram hipertensão evidenciada pelas medidas ambulatoriais. O fator hereditário paterno estava relacionado ao risco de hipertensão arterial, sendo a hipertensão paterna (OR: 3,1; IC95%: 1,4-6,8) e a síndrome metabólica paterna (OR: 1,5; IC95 %: 1,1-2,2) os fatores significativos. O histórico pregresso obstétrico de duas gestações com presença de síndrome hipertensiva relatava mostrou um risco aumentado para o aparecimento de hipertensão futura (OR: 4,1; IC95%: 1,3-12,7). A presença de comorbidades mostrou associação com hipertensão, sendo a angina relatada (OR: 5,1; IC95%: 1,4-18,1), a hipercolesterolemia (OR: 3,3; IC95%: 1,5-7,0) e a Velocidade de Onda de Pulso (VOP) que evidencia o aumento da rigidez arterial (OR: 1,7; IC95%: 1,4-2,1), as variáveis encontradas com significância estatística. Conclusão: A prevalência de hipertensão mensurada nas pacientes foi de 5,4 %. O antecedente obstétrico de hipertensão e o histórico familiar paterno para hipertensão e síndrome metabólica evidenciaram aumento do risco de hipertensão atual nas pacientes do estudo. A presença de comorbidades atuais nas entrevistadas, como angina, hipercolesterolemia e maior rigidez arterial mostrou associação com hipertensão em nossa análise.
Title in English
Evolution of biophysical markers associated with hypertension in women belonging to the 1978/79 cohort from the city of Ribeirão Preto/SP
Keywords in English
Biophysical markers
Case-control nested cohort
Hypertension
Hypertensive syndromes in pregnancy
Risk factors
Abstract in English
Introduction: Women with hypertensive disorders of pregnancy (HDG), such as gestational hypertension and preeclampsia (PE), show an increased risk of developing cardiovascular disease (CVD). Objectives: To determine the prevalence of hypertension in women in the fourth decade of life and to identify risk factors related to obstetric history and biophysical markers associated with hypertension in this population. Patients and Methods: This is a case-control study of women, aged 37 to 39, belonging to the 1978/79 birth cohort in the city of Ribeirão Preto/SP. Social and demographic data, presence of comorbidities, metabolic syndrome, obstetric history, hereditary factors, and biometric and biophysical markers associated with blood pressure were analyzed. Results: Data from 929 women were analyzed, 925 had their blood pressure measured on an outpatient basis and 281 through ABPM, of which 19.1% had self-reported hypertension and 5.4% had hypertension, evidenced by outpatient measurements. The paternal hereditary factor was related to the risk of hypertension, with paternal hypertension (OR: 3.1; 95% CI: 1.4-6.8) and paternal metabolic syndrome (OR: 1.5; 95% CI: 1.1-2.2) being the significant factors. The previous obstetric history of two pregnancies with the presence of hypertensive syndrome reported showed an increased risk for the onset of future hypertension (OR: 4.1; 95%CI: 1.3-12.7). The presence of comorbidities showed an association with hypertension, reported angina (OR: 5.1; 95%CI: 1.4-18.1), hypercholesterolemia (OR: 3.3; 95%CI: 1.5-7.0), and Pulse Wave Velocity (PWV) that evidence increased arterial stiffness (OR: 1.7; 95%CI: 1.4-2.1), the variables found with statistical significance. Conclusion: The prevalence of hypertension measured in patients was 5.4%. Obstetric history of hypertension and paternal family history of hypertension and metabolic syndrome showed an increased risk of current hypertension in study patients. The presence of current comorbidities in the respondents, such as angina, hypercholesterolemia, and increased arterial stiffness showed an association with hypertension in our analysis.
 
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Publishing Date
2024-03-13
 
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