Acurácia de indicadores antropométricos como preditores de hipertensão arterial sistêmica em mulheres

Abstract

Systemic arterial hypertension (SAH) is one of the main risk factors for developing cardiovascular disease, the leading cause of death worldwide. It is estimated that in Brazil hypertension affects 21.4% of the population. The magnitude of the problem is bigger among woman, where about 24.2% are affected by the problem. Although 90% of cases of hypertension present idiopathic etiology, the influence of obesity on the development of this condition is already well established. For this reason, anthropometric indicators related to body fat have been suggested to assist in screening individuals in hypertension risk. Due to differences in body composition and predisposition to diseases among populations, it is necessary to validated and even set specific cutoff points that optimize the accuracy of anthropometric predictors of SAH. To contribute to the discussion of this problem, this dissertation presents two chapters, a literature review and an original article. The original article aimed to evaluate the accuracy of anthropometric indicators as a resource for screening women with high blood pressure. This is a cross-sectional study involving a probabilistic sample of 3,143 women (20-49 years) in the state of Alagoas. Anthropometric, demographic, socioeconomic, health information and gauged to blood pressure data were collected. The anthropometric indicators evaluated were: body mass index, waist circumference, waist-hip ratio, waist-height ratio (WHtR), body fat percentage and conicity index. The ROC curve analysis showed that all assessed anthropometric indicators were considered effective in the identification of high blood pressure (AUC > 0.5). The ratio height-waist (WHtR) showed discriminatory power for high blood pressure statistically superior to the other parameters (AUC = 0.72; p <0.05); and its cutoff point considered more accurate was 0.54 (sensitivity = 67%; specificity = 66%). These findings demonstrate that hypertension risk screening among women should preferably be performed by WHtR > 0.54.