RESUMO
Patients with prehypertension suffer endothelial dysfunction and are at increased cardiovascular risk. Ankle-brachial index (ABI) constitutes an efficient tool for diagnosing peripheral arterial disease; but also an ABI<0.9 is an independent and positive predictor of endothelial dysfunction and is associated with increased cardiovascular risk and mortality. THE AIM: of this study was testing whether ABI was decreased in prehypertensive patients when compared with normotensive subjects. METHODS: We included 70 prehypertensive patients older than 19 years, in whom the ABI was registered with a 5 megahertz Doppler (Summit Doppler L250, Life Dop., USA). The highest ankle systolic pressure was divided by the highest brachial systolic pressure. We also included 70 normotensive subjects in whom the ABI was registered in the same way. The measurements were performed by the same physician who was blinded about the study. Statistical analysis was performed with odds ratio and student t-test. RESULTS: The ABI values in normotensive subjects were 1.023±0.21, whereas prehypertensive patients significantly had lower ABI (0.90±0.14p=0.00012). We found ABI <0.9 in 30 prehypertensive patients (42.85%) and 13 normotensive patients (18.5%). The odds ratio of ABI <0.90 in prehypertensive patients was 3.288 (IC95 1.5-7.0, p=0.0023). A regression analysis failed to show any independent association between ABI values and any other clinical parameter. CONCLUSIONS: Prehypertensive patients had lower ABI and higher prevalence of peripheral artery disease when compared with normotensive subjects; this fact increases their cardiovascular risk. ABI must be included in global evaluation of prehypertensive subjects.
Assuntos
Índice Tornozelo-Braço/métodos , Pressão Sanguínea/fisiologia , Doença Arterial Periférica/complicações , Pré-Hipertensão/etiologia , Adulto , Feminino , Humanos , Masculino , México/epidemiologia , Razão de Chances , Doença Arterial Periférica/diagnóstico , Doença Arterial Periférica/fisiopatologia , Pré-Hipertensão/epidemiologia , Pré-Hipertensão/fisiopatologia , Prevalência , Fatores de Risco , Adulto JovemRESUMO
Hyperuricemia leads to insulin resistance, whereas insulin resistance decreases renal excretion of uric acid, both mechanisms link elevated serum uric acid with metabolic syndrome. The aim of this study is to evaluate the probability for the development of metabolic syndrome in low-income young adults with hyperuricaemia. METHODS: We evaluated 103 patients less than 40 years of age, from a low-income population, and without history of cardiovascular disease, in all of them the presence of metabolic syndrome was assessed in accordance with the International Diabetes Federation criteria. In all patients, fasting serum uric acid levels were measured; hyperuricaemia was defined as serum uric acid values 6.5 mg/dl in men and 5.1 mg/dl in women. Statistical analysis was performed with odds ratio. RESULTS: 83 of our patients (80.5%) suffered metabolic syndrome, the odds ratio for the presence of metabolic syndrome in patients with hyperuricaemia was 5.1 (p=0.002, I.C 1.8- 14.5). When patients were evaluated by gender a significantly association between hyperuricaemia and metabolic syndrome was found in women (odds ratio 3.6, p=0.048, C.I. 1.0-12.9), and men (odds ratio 10.2, p= 0.015, IC 1.5-13.2). When uric acid was correlated with the components of metabolic syndrome, we only found a positive correlation with waist circumference (r=0.483). CONCLUSION: Our results showed a significant association between hyperuricemia and metabolic syndrome in low-income young adults in Mexico. DR is associated with estimated risk of CVD in type 2 diabetic patients.