Zinco na urina e o uso de medicamentos anti-hipertensivos em pacientes com insuficiência cardíaca

Abstract

Introduction: The use of antihypertensive drugs to treat heart failure (HF) can affect zinc metabolism and lead to zinc deficiency. Objective: To evaluate urinary zinc excretion and its relationship with the use of antihypertensive drugs in patients with HF. Method: The study included 54 adult and elderly patients, of both sexes, diagnosed with HF. Socio-demographic, clinical and nutritional data were collected. Urinary zinc was determined by inductively coupled plasma mass spectrometry (ICP-MS). Dietary zinc intake was assessed by 24-hour recalls, the data were analyzed using Virtual Nutri Plus 2.0® software and compared with the recommended values of the EAR. To verify the distribution of data, the Kolmogorov-Smirnov test was used and for association of variables between groups, Kruskall Wallis, Chi-square or Fisher's tests were used, when appropriate. Results: Patients were divided into three groups according to the number of antihypertensive drugs used, namely: two (n = 12), three (n = 24) and four or more (n = 18). A higher frequency of males was observed (70%), in functional class I / II (93%) and a reduced left ventricular ejection fraction (LVEF) (56%). In addition, there was a higher frequency of non-ischemic HF (57%) and the presence of arterial hypertension (67%). Diuretics were used by 87% of the sample. A median zinc intake of 7.06mg / day (4.85 - 10.23) and urinary zinc values with a median of 366.83 µg / 24h (229.38 - 542.38) were found, with no statistical difference between groups (all p> 0.05). It was observed that 80% of the total sample had zincuria below 600 µg / 24h. Conclusion: The patients showed diet zinc lower than recommended. Zincuria was an uncommon finding in our patients and regardless of the number of antihypertensive drugs used.