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Estudo do compromisso da função arterial por avaliação da velocidade da Onda de Pulso na hipertenção arterial e diabetes mellitus
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Introdução: A deterioração das grandes artérias elásticas contribui grandemente para a morbilidade e mortalidade cardiovascular em indivíduos hipertensos e diabéticos. A Velocidade da Onda de Pulso (VOP) é considerada um marcador precoce de rigidez arterial, tendo por diversas vezes sido estudada a sua correlação com factores de risco como a hipertensão arterial (HTA) e a diabetes mellitus (DM). Mais escassos são os dados de associação entre estes dois factores de risco e a sua repercussão conjunta ao nível da distensibilidade arterial. A influência de outras variáveis fisiológicas associadas à VOP tem sido pouco explorada. A correcta interpretação dos princípios biofísicos inerentes à função vascular posiciona a VOP na vanguarda dos estudos hemodinâmicos. Objectivos: Avaliar as repercussões vasculares da hipertensão arterial e Diabetes Mellitus, em doentes de risco cardiovascular, através da análise da velocidade da onda de pulso. Metodologia: Este estudo teve uma amostra total de 255 indivíduos que realizaram medição da VOP. Foram posteriormente divididos em grupos de normotensos, hipertensos e diabéticos hipertensos com diferentes valores tensionais. Os dados de anamnese e parâmetros fisiológicos como a pressão arterial, VOP, frequência cardíaca e índice de massa corporal foram recolhidos através de um formulário, tendo posteriormente sido estatisticamente processados. Resultados: A VOP revelou valores significativamente mais elevados nos grupos de indivíduos simultaneamente diabéticos e hipertensos comparativamente com os restantes grupos. O incremento da velocidade da onda de pulso atingiu, em média, mais 1.48 m/s (15,7%) nestes diabéticos. As variáveis idade, pressão arterial sistólica, pressão de pulso e frequência cardíaca revelaram-se preditores significativos da variância da VOP. Conclusões: A VOP constitui um importante instrumento de estratificação de risco cardiovascular, enquanto marcador precoce de compromisso arterial, com interesse clinicamente transversal. Outras variáveis fisiológicas correlacionadas com a VOP contribuem de formas distintas nos processos mecânicos da função arterial, devendo ser consideradas nos estudos da distensibilidade arterial.
Introduction: The deterioration of large elastic arteries contributes greatly to cardiovascular morbidity and mortality in hypertensive and diabetic patients. Pulse Wave Velocity (PWV) is considered an early marker of arterial stiffness, and its correlation with risk factors such as hypertension (HT) and diabetes mellitus (DM) has been studied several times. More scarce are the data about association between these risk factors and their joint impact on the level of arterial distensibility. The influence of other physiological variables associated with PWV has been poorly explored. The correct interpretation of the biophysical principles involved in vascular function as positioned PWV at the forefront of the hemodynamic studies. Aims: To evaluate the vascular effects of hypertension and diabetes mellitus in patients with cardiovascular risk, by analyzing the pulse wave velocity. Methodology: This study had a total sample of 255 subjects who underwent measurement of PWV. They were then divided into groups of normotensive, hypertensive and diabetic hypertensive patients with different blood pressure values. Data from history and physiological parameters as blood pressure, PWV, heart rate and body mass index were collected through a form, and then been statistically processed. Results: The PWV showed significantly higher values in the groups of diabetic hypertensive individuals when compared with other groups. The increase of pulse wave velocity was, on average, 1.48 m/s higher (15.7%) in diabetics. The variables age, systolic blood pressure, pulse pressure, and heart rate proved to be significant predictors of variance of PWV. Conclusions: PWV is an important tool for cardiovascular risk stratification, as early marker of arterial compromise, with transverse clinical interest. Other physiological variables correlated with PWV contribute in different ways in arterial mechanical function and should be considered in studies of arterial distensibility.
Introduction: The deterioration of large elastic arteries contributes greatly to cardiovascular morbidity and mortality in hypertensive and diabetic patients. Pulse Wave Velocity (PWV) is considered an early marker of arterial stiffness, and its correlation with risk factors such as hypertension (HT) and diabetes mellitus (DM) has been studied several times. More scarce are the data about association between these risk factors and their joint impact on the level of arterial distensibility. The influence of other physiological variables associated with PWV has been poorly explored. The correct interpretation of the biophysical principles involved in vascular function as positioned PWV at the forefront of the hemodynamic studies. Aims: To evaluate the vascular effects of hypertension and diabetes mellitus in patients with cardiovascular risk, by analyzing the pulse wave velocity. Methodology: This study had a total sample of 255 subjects who underwent measurement of PWV. They were then divided into groups of normotensive, hypertensive and diabetic hypertensive patients with different blood pressure values. Data from history and physiological parameters as blood pressure, PWV, heart rate and body mass index were collected through a form, and then been statistically processed. Results: The PWV showed significantly higher values in the groups of diabetic hypertensive individuals when compared with other groups. The increase of pulse wave velocity was, on average, 1.48 m/s higher (15.7%) in diabetics. The variables age, systolic blood pressure, pulse pressure, and heart rate proved to be significant predictors of variance of PWV. Conclusions: PWV is an important tool for cardiovascular risk stratification, as early marker of arterial compromise, with transverse clinical interest. Other physiological variables correlated with PWV contribute in different ways in arterial mechanical function and should be considered in studies of arterial distensibility.
Descrição
Tese de mestrado, Biofísica (Biofísica e Física Médica), Universidade de Lisboa, Faculdade de Ciências, 2009
Palavras-chave
Velocidade da Onda de Pulso Hipertensão arterial Diabetes Mellitus Mecânica dos biofluidos Função arterial Teses de mestrado - 2009