Avaliação do risco cardiovascular por diferentes métodos no âmbito da atenção primária à saúde

Abstract

Due to the increasing rate of Cardiovascular Disease (CVD) in the world, it is essential to investigate the methods of evaluation of cardiovascular risk in primary care, in order to facilitate diagnosis through faster and more accessible tools. The aim of this study was to compare the cardiovascular risk of adult and elderly patients by using two different versions of the Framingham Risk Score. The study was cross-sectional and conducted with adults and elderly attended from 2002 to 2016 at nutritional clinic in the UFRN. The cardiovascular risk, heart age and profile of cardiometabolic markers (fasting glucose, systolic blood pressure, cholesterol and BMI) were evaluated. For the calculation of cardiovascular risk, the following data was used: age, sex, systolic blood pressure, use of antihypertensive medication, smoking, diabetes, total cholesterol and HDL (traditional method) or height and weight (simplified method). It was evaluated 62 individuals (male n = 17, female n = 45), age: 49.1 ± 12.1 years, BMI: 32.4 ± 7.3, blood pressure: 127.3 ± 15.7, glucose: 103.5 ± 41.0, attended from 2002 to 2016. Cardiovascular risk was classified as low (<10%), intermediate (10-20%) or high (> 20%). To check the differences between the traditional Framingham score (COL) versus simplified (BMI) for cardiovascular risk and heart age the t test was used for independent samples, with an accepted significance level of 5%. There was no statistically significant difference between the cardiovascular risk (p = 0.201) and heart age (p = 0.445) between the two methods. The assessment of cardiovascular risk in both methods showed the majority (63% and 58%) with low risk for traditional and simplified, respectively. We conclude that the simplified method was not statistically different from the traditional method, thus the simplified method can be used as an alternative for the assessment of cardiovascular risk in patients seen at primary level health care since it is fast, affordable, practical and reliable, and helps to identify the most likely individuals to develop CVD, which allows for the appropriate early treatment.