Avaliação do reconhecimento e controle de fatores de risco para doença arterial coronariana em pacientes com lúpus eritematoso sistêmico e artrite reumatoide

• Ano de defesa: 2016
• Autor(a) principal: Luisa Lima Castro
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: artrite reumatoide; lúpus eritematoso sistêmico; doença arterial coronariana; fatores de risco cardiovascular; Artrite reumatóide; Doença da artéria coronariana; Fatores de risco; Medicina; Lupus eritematoso sistêmico
• Link de acesso: http://hdl.handle.net/1843/BUBD-AXNFAV

INTRODUCTION: risk of atherosclerotic cardiovascular disease in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) is greater than in the general population. This is partly explained by the higher prevalence of several traditional risk factors for coronary artery disease (CAD) in individuals with SLE and RA. However, even after risk factor adjustment, cardiovascular risk remains higher in these individuals, which is likely due to systemic inflammation and adverse effects produced by some drugs used in their treatment. Few studies have analyzed the control and recognition of risk factors for CAD in patients with SLE or RA. To the best of our knowledge, this is the first study in Brazil to evaluate the recognition and control of traditional risk factors in SLE and RA. Moreover, it is the first in the world to assess the recognition of risk for CAD in patients with RA, as well as control of risk factors for CAD in patients with SLE, considering the range of therapeutic targets. OBJECTIVE: to evaluate the frequency, recognition and control of risk factors for CAD in patients with SLE or RA. METHODS: Patients with SLE or RA treated in outpatient clinics of the Hospital das Clinicas, Federal University of Minas Gerais (HC / UFMG) were asked to answer a questionnaire with questions related to risk factors for CAD. Medical records of participating were reviewed to assess these factors, proposed treatments and fulfilled therapeutic goals. Data obtained from medical records were compared with those obtained in the questionnaires. RESULTS AND DISCUSSION: The study included 137 women with SLE and 133 women with RA. Patients with SLE had mean (SD) age of 41.50 (11.89) years and patients with RA had mean (SD) age of 57.32 (12.92) years. Among SLE patients, the frequency of systemic arterial hypertension was 51.1% and 85.7% of affected patients recognized to be hypertensive. Between the hypertensive group, 71.4% had desirable control and 24.3% had optimal control of blood pressure. The frequency of dyslipidemia was 46.0% and 68.3% of affected patients considered themselves dyslipidemic. Between the dyslipidemic group, 30.2% had control of HDL, 55.6% had control of triglyceride (TG), 69.8% had desirable control of LDL and 17.5% had optimal control of LDL. The frequency of diabetes mellitus (DM) was 11.7%. Between the diabetic group, 87.5% acknowledged being diabetic, 50.0% had desirable control of DM and 37.5% had ideal control of DM. Among RA patients, the frequency of hypertension was 66.2% and 89.8% of affected patients recognized to be hypertensive. Between the hypertensive group, 63.3% had desirable control and 17.0% had optimal control of blood pressure. The frequency of dyslipidemia was 54.1% and 68.1% of patients considered themselves dyslipidemic. Among the dyslipidemic group, 55.6% had control of HDL, 56.9% had control of TG, 59.4% had desirable control of LDL and 34,7% had optimal control of LDL. The frequency of DM was 16.5% and 90.9% of the affected patients acknowledged being diabetic. Between the diabetic group, 40.9% had desirable control of DM and 27.3% had ideal control of DM. Conclusion: When compared to the general population, the frequency of hypertension, DM and dyslipidemia is high among SLE and RA patients undergoing treatment at HC / UFMG. Most patients achieved desirable control of hypertension or dyslipidemia and about half have reached the DM control. It was found that patients have a high recognition of the carrier status of a particular risk factor.