Epidemiologic Study of Antihypertensive Terapeutic and its Effects on Lipoproteic Metabolism

FundaÃÃo de Amparo à Pesquisa do Estado do Cearà === The identification of patients with arterial hypertension, and the attitudes and practices related to individual cases of the condition, are fundamental to its control and to the prevention of associated complications. The dyslipidemia and hyperte...

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Bibliographic Details
Main Author: Renà Duarte Martins
Other Authors: Maria Goretti Rodrigues de Queiroz
Format: Others
Language:Portuguese
Published: Universidade Federal do Cearà 2002
Subjects:
Online Access:http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=347
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Summary:FundaÃÃo de Amparo à Pesquisa do Estado do Cearà === The identification of patients with arterial hypertension, and the attitudes and practices related to individual cases of the condition, are fundamental to its control and to the prevention of associated complications. The dyslipidemia and hypertension are common and powerful risk factors for cardiovascular disease (CVD) and often coexist in the same individual. The diuretics and beta blockers affect the lipid profile and they can act synergistically, with dyslipidemia and hypertension, in terms of increased risk for CVD. We investigated the influence of hypertension and its treatment on circulating lipids. One hundred and sixty-nine individuals with aged between 32-87 years were studied. According to the results the population was predominantly women (72,6%), and the subjects had a mean blood pressure of 144,23  14,86 (mean  SD) for systolic pressure, and 90,45  9,91 for diastolic pressure. Hydrochlorothiazide (HCTZ), captopril (CPT) and propranolol (PPL) were the most prescribed drugs. Monotherapy was used in 33,53% of the patients, and CPT was the most prescribed drug. In association therapy (66,47%) the most used drug was HCTZ, specially in prescriptions associated to CPT. Propranolol was used proportionally more by women (p=0,01) and verapamil more by men (p=0,009), and the control of hypertension was significantly (p=0,04) more frequent in individuals being treated with monotherapy than in the subjects being treated with combination therapy. Patients taking HCTZ had significant effects in theirs lipid serum concentrations while that ones taking CPT and/or PPL have no expressive effects. The main associations which lead to lipid serum alterations were HCTZ+CPT and HCTZ+PPL. Theses results suggest that any therapy with includes HCTZ as an hypertensive drug, must be associated to a lipid monitoring process === A identificaÃÃo de pacientes com hipertensÃo arterial, as atitudes e as prÃticas face aos casos individuais sÃo determinantes para o controle da doenÃa e prevenÃÃo e para prevenÃÃo das complicaÃÃes associadas. Dislipidemia e hipertensÃo sÃo comuns e poderosos fatores de risco para doenÃas cardiovasculares e freqÃentemente coexistem num mesmo indivÃduo. Os diurÃticos e beta bloqueadores elevam o perfil lipÃdico e podem agir sinergicamente, com dislipidemia e hipertensÃo, na elevaÃÃo dos riscos para doenÃas cardÃacas. NÃs investigamos a influÃncia da hipertensÃo e seu tratamento sobre os lipÃdios circulantes. Foram estudados 169 indivÃduos, com idades entre 32 â 87 anos. De acordo com os resultados obtidos, a maioria da populaÃÃo foi composta por mulheres (72,6%), e a mÃdia de pressÃo era 144,23  14,86 (mÃdia  DP) para pressÃo sistÃlica e 90,45  9,91 para pressÃo diastÃlica. Hidroclorotiazida (HCTZ), captopril (CPT) e propranolol (PPL) foram as drogas mais prescritas. Monoterapia foi utilizada por 33,53% dos pacientes, e captopril foi a droga mais prescrita. Em associaÃÃo (66,47%) a droga mais prescrita foi HCTZ, principalmente associada com CPT. Propranolol foi predominantemente utilizada no sexo feminino (p= 0,01) e verapamil no sexo masculino (p=0,009), sendo que o controle da hipertensÃo foi significativamente (p=0,04) mais freqÃente nos indivÃduos tratados com monoterapia do que naqueles em uso de associaÃÃo. Pacientes em uso de hidroclorotiazida tiveram efeitos significantes sobre as concentraÃÃes sÃricas de lipÃdios, enquanto aqueles em uso de CPT e/ou PPL nÃo apresentaram efeitos expressivos. As principais associaÃÃes que elevaram lipÃdeos sÃricos foram HCTZ+CPT e HCTZ+PPL. Estes resultados sugerem que quando a terapÃutica antihipertensiva envolver o uso de HCTZ, a monitorizaÃÃo do perfil lipÃdico se faz necessÃria.