Avalia????o da modula????o simp??tica e vagal, da press??o arterial e do perfil metab??lico de mulheres jovens usu??rias e n??o usu??rias de contraceptivo hormonal oral combinado

Detalhes bibliográficos
Ano de defesa: 2014
Autor(a) principal: Morais, T??rcio Lemos de lattes
Orientador(a): Consolim-Colombo, Fernanda Marciano lattes
Banca de defesa: Tinucci, Tais lattes, Angelis, K??tia de lattes
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Universidade Nove de Julho
Programa de Pós-Graduação: Programa de Mestrado em Medicina
Departamento: Sa??de
País: Brasil
Palavras-chave em Português:
Palavras-chave em Inglês:
Área do conhecimento CNPq:
Link de acesso: http://bibliotecatede.uninove.br/handle/tede/1144
Resumo: Evidence suggests the association of combined oral contraceptives (COC) with the development of hypertension, metabolic dysfunction and cardiovascular risk. The mechanisms involved in such association are not fully understood. It was demonstrated in previous studies by our group that there is an autonomic modulation imbalance before the development of hypertension in people with a positive family history of hypertension. This project evaluates the impact of combined oral contraceptives on anthropometric (BMI, abdominal circumference), hemodynamic (blood pressure, heart rate, cardiac outflow and total peripheral resistance), metabolic (serum glucose, total cholesterol and triglycerides) and autonomic (serum cathecolamines, heart rate variability) in normotensive and in hypertensive women (18 to 35 years of age) under combined oral contraceptives. We did not observe any significant change in blood pressure, hemodynamic and autonomic variables in the normotensive group under second and third generation of combined oral contraceptives. The same with hypertensive women under drospirenona (DRSP) and etinilestradiol (EE). Concerning the metabolic variables (against the control group), the normotensive women under combined oral contraceptives showed an increase in both means of total cholesterol (165.95 ?? 29.21 vs 189.11 ?? 28.96) and triglycerides (72.62 ?? 23.44 vs 110.07 ?? 40.60). Hypertensive women under DRSP+EE had also a significant increase in triglycerides when comparing basal (72.62 ?? 23.44 vs 110.07 ?? 40.60) with the later 6 month period( 72.62 ?? 23.44 vs 110.07 ?? 40.60). Moreover, in this same group of hypertensive women under Drospirenone-containing oral contraceptive, no change was found in potassium levels, the aldosterone-renin-angiotensin system or pharmacological interactions with anti-hypertensive drugs. Our conclusion is that second and third generation combined hormonal oral contraceptives causes no significant change in blood pressure or hemodynamic and autonomic variables. Also, DRSP+EE demonstrates a safe profile when used by young hypertensive women under anti-hypertensive drugs. No detectable variations in blood pressure and neuro-humoral activation, no hydro electrolyte imbalance and no metabolic change (except for a slight triglycerides augmentation) was encountered.