FATORES ASSOCIADOS A HOSPITALIZAÇÃO POR LESÃO DE ÓRGÃO-ALVO EM DOENTES SEGUIDOS EM CONSULTA DEDICADA À HIPERTENSÃO ARTERIAL SISTÉMICA: UM ESTUDO CASO-CONTROLO
DOI:
https://doi.org/10.58043/rphrc.54Palavras-chave:
pressão arterial, hipertensão, enfarte do miocárdio, acidente vascular cerebral, hospitalizaçãoResumo
Para identificar fatores associados à hospitalização por lesão de órgão alvo (HLOA) em doentes seguidos em consulta especializada em hipertensão arterial sistémica (HAS), elaboramos um estudo retrospetivo do tipo caso-controlo. Analisamos o perfil das medições automáticas da pressão arterial (PA) realizadas em consultório. Extraímos dados em termos de causas de HAS, fatores de risco vascular e terapêutica anti-hipertensiva instituída. Identificamos 42 casos que necessitaram de pelo menos uma HLOA entre 2010 e 2020. Os principais motivos de HLOA foram enfarte cerebral (19 casos; 45,2%) e enfarte agudo do miocárdio (14 casos; 35,7%). A média das idades de ocorrência da HLOA foi 63,8 (desvio-padrão [DP] 12,9) anos, sendo de 73,0 (DP 39,0) anos para o enfarte cerebral e de 65,0 (DP 51,0) anos para o enfarte agudo do miocárdio. Três doentes (7,1%) apresentaram uma segunda HLOA. Selecionamos 84 controlos sem HLOA seguidos na mesma consulta emparelhados com os casos pelo sexo e pelo ano de nascimento. Os grupos eram distintos em termos de média da PA sistólica (com HLOA 158,6 versus sem HLOA 145,9 mmHg; p < 0,001), DP da PA sistólica (18,4 versus 14,5 mmHg; p = 0,002), coeficiente de variabilidade (CV) da PA sistólica (0,12 versus 0,10; p = 0,033), média da PA diastólica (83,5 versus 76,7 mmHg; p = 0,002) e DP da PA diastólica (10,9 versus 8,8 mmHg; p = 0,003) mas não do CV da PA diastólica (0,13 versus 0,12; p = 0,113). Na análise multivariada, associaram-se a HLOA: PA sistólica ≥ 160 mmHg em 10% ou mais das medições (razão de chances ajustada [RCA] 3,0; p = 0,034), PA diastólica ≥ 100 mmHg em 10% ou mais das medições (RCA 3,8; p = 0,006), presença de 2 ou mais comorbilidades (entre diabetes mellitus, tabagismo presente ou pregresso, dislipidemia ou fibrilhação auricular) (RCA 3,1; p = 0,016) e doença renal crónica (RCA 2,7; p = 0,027).
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Direitos de Autor (c) 2023 Mariana Bilreiro, Luís Marote Correia, Ana Sofia Silva, Maria da Luz Brasão
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição 4.0.
