Risco cardiovascular em uma população de obesos

Abstract

Os riscos cardiovasculares associados à obesidade crescem com o índice de massa corporal (IMC). Este estudo teve por objetivos verificar a correlação entre IMC e a prevalência de fatores de risco cardiovascular em uma população de obesos do Hospital das Clínicas da Faculdade de Medicina da USP (HC-FMUSP), e verificar a agregação de fatores de risco em quartis de acordo com o IMC. Foram estudados 474 indivíduos obesos (86,9% do sexo feminino e 13,1% do sexo masculino). Dividimos esta população em quartis de acordo com o IMC e avaliamos a presença de hipertensão arterial, diabetes mellitus e dislipidemia em cada quartil. Estratificamos os pacientes de cada quartil em alto, moderado e baixo risco cardiovascular pelos critérios do National Cholesterol Education Program (NCEP). Fizeram parte do primeiro quartil aqueles com IMC de 30 a 33,99kg/m², e do segundo, terceiro e último quartil, respectivamente aqueles com IMC igual a 34 a 37,19kg/m²,37,2 a 41,77kg/m² e 41,78 a 79,8kg/m². Houve nítido aumento de hipertensão, diabetes e hipertrigliceridemia com o aumento do IMC, o que não foi observado com os níveis de colesterol. A proporção de indivíduos com risco moderado e alto cresceu com o aumento do IMC. Em nossa população de obesos observou-se aumento do risco cardiovascular com o aumento do IMC.

Translated abstract

According to the literature cardiovascular risks have a direct relationship with body mass index (BMI). The aim of our study was to verify the relationship between BMI and prevalence of cardiovascular risk factors in a sample of obese patients searching for treatment in our hospital, and to verify if there was greater aggregation of risk factors into the quarters with greater BMI. 474 obese subjects were studied (86.9% female and 13.1% male). They were divided in quarters according to BMI and the presence of hypertension, diabetes mellitus and dyslipidemia was accessed. The patients were also classified in high, moderate and low risk groups according to criteria of the National Cholesterol Education Program (NCEP). The first quarter was formed by patients with BMI 30-33.99kg/m², and the second, third and last quarter respectively by BMI 34-37.19kg/m², 37.2-41.77kg/m² and 41.78-79.8kg/m2. There was a marked increase in the prevalence of hypertension, diabetes mellitus and triglycerides levels as the BMI increased, but there wasn't relationship with levels of cholesterol. The prevalence of patients with moderate and high risk increased with the increase in BMI. In our sample of obese patients there was an increase in the prevalence of cardiovascular risk factors in the population of greater BMI.