Evaluation of Cardiovascular Risk in Hypertensive Individuals Attending a Primary Health Care Center

Abstract Background: Cardiovascular risk (CVR) stratification has traditionally been used as a strategy for the prevention of cardiovascular diseases in asymptomatic people. Objective: To identify the CVR in hypertensive patients attending a primary health care center, using the Framingham risk score, and to evaluate possible associations and correlations with sociodemographic, clinical and laboratory variables not included in this score. This cross-sectional study was conducted with hypertensive patients treated in a primary health care center in Brazil (n = 166). Methods: Data collection, administration of questionnaires, anthropometric measurements and laboratory tests were performed from July to August 2013. Multiple linear regression was used in the analysis. A two-tailed p-value < 0.05 was considered significant. Results: High CVR was independently associated with male sex (B = 8.73; 95%CI: 6.27: 11.19), high serum levels of total cholesterol (B = 0.05; IC95%: 0.02: 0.08), number of drugs used (B = 0.55; 95%Ci: 0.12: 0.98) and a low glomerular filtration rate (GFR) (B = -0.11; 95%CI: -0.18 : -0.03). Conclusion: The results of this study reinforce the importance of continuous and longitudinal care practices directed to hypertensive patients aiming at early detection of risk factors and appropriate intervention to improve the prognosis of this population.

摘要
背景：心血管风险（Cardiovascular Risk, CVR）分层历来是无症状人群心血管疾病预防的常用策略。
目的：采用弗雷明汉风险评分（Framingham Risk Score）评估巴西某初级卫生保健中心就诊的高血压患者的心血管风险，并探讨该评分未纳入的社会人口学、临床及实验室变量与心血管风险的潜在关联与相关性。本横断面研究纳入了巴西某初级卫生保健中心接受治疗的高血压患者共166例。
方法：数据采集、问卷调查、人体测量学检测及实验室检验于2013年7月至8月间完成。分析采用多重线性回归方法，以双侧P值<0.05作为显著性判定标准。
结果：较高的心血管风险与男性性别（B=8.73；95%CI：6.27~11.19）、血清总胆固醇水平升高（B=0.05；95%CI：0.02~0.08）、用药数量（B=0.55；95%CI：0.12~0.98）以及低肾小球滤过率（glomerular filtration rate, GFR）（B=-0.11；95%CI：-0.18~-0.03）呈独立相关关系。
结论：本研究结果进一步证实，针对高血压患者实施持续纵向照护实践，以早期识别风险因素并采取适宜干预措施改善该人群预后，具有重要临床意义。