Parâmetros centrais e medida periférica da pressão arterial como preditores de desfechos cardiovasculares e associação com qualidade de vida

Abstract

Introduction: this doctoral thesis is composed of two articles that originated from “Central parameters and peripheral blood pressure measure as predictors of cardiovascular outcomes and association with quality of life”. Goals: evaluate the PWV and peripheral PA measure with quality of life (QoL) in a cardiovascular high-risk population and correlate the central parameters and peripheral blood pressure measure with cardiovascular outcomes at infarcted patients’ segment, in an attempt to make the Brazilian data more robust and strengthen the pulse wave velocity (PWV) common use. Method: the population of this study was composed of individuals with acute myocardial infarction diagnosis (AMI) admitted at Heart’s Hospital of Alagoas (HCAL) between June 2016 and May 2017. The overall outline was longitudinal, prospective, following-up 12 months, besides the association with healthy quality in a specific risk group, being a transversal study. A questionary of epidemiological data was applied, as well as the implantation of Short Form Health Survey 36 (SF-36) and QoL, lately a non-invasive evaluation of central and peripheral parameters were processed using the Mobil-O-Graph® device. Results: between the 144 cataloged individuals, 66 fulfilled the necessary criteria for inclusion in the study. Correlating the PWV general score of SF-36, it could be observed the significant correlation (R=-0,350; p=0,005), that is, while the PWV increases, the QoL reduces moderately. Concerning the peripheral arterial systolic pressure measure, was observed that has no significant correlation in none of the measures realized (r=-0,0431; p=0,7396). It was observed a significant difference between the proportions obtained of PWV categorization concerning the systemic hypertension (p=0,008) and previous cardiovascular disease (p=0,004) and concerning death (p=0,042). It was verified a significant difference between pressure systolic central related to systemic arterial hypertension (p=0,013), previous cardiovascular disease (p=0,027), chronic renal failure (p=0,001) and death (p < 0,000). Related to peripheral arterial systolic pressure, a difference in the death outcome (p=0,006). Related to measures realized during the index event duration and one year after the clinical segment, a significant difference between the averages with an increase of all the central parameters and peripheral blood pressure measure. Conclusions: the study results suggest that a PWV elevated measure is correlated to a QoL worsening. It can be verified that with the aging and increase of all of the evaluated parameters, being able to suggest a significant association between PWV and with some classical risk factors as systemic hypertension, previous cardiovascular disease, and chronic renal insufficiency. Also, a significant association between PWV, central arterial systolic pressure and peripheral arterial systolic pressure with fatal outcomes (death) can be observed.