Avaliação do risco cardiovascular em mulheres climatéricas assistidas na Estratégia Saúde da Família

Abstract

This study assessed cardiovascular risk and associated factors in climacteric women through a quantitative, transversal and analytical approach. Probabilist sampling was selected frm clusters and later by random selection. Variables were investigated by structured and pre-tested questionnaires that included sociodemographic characteristics, lifestyle habits, anthropometric measures, clinical-obstetric factors and through the Framingham Global Risk Score. The final sample included 874 women aged 40 to 65 years who were assisted in the Family Health Strategy in the city of Montes Claros, Minas Gerais, Brazil. Exploratory despriptive analysis of the data was performed, with frequency distribution of the study variables. Then, bivariate analyzes searched for associations between the independent variables and the risk for cardiovascular diseases, using the chi-square test, and the associated variables were selected for the multivariate analysis up to the level of 20% (p ≤ 0.20). In the adjusted analytical phase, Poisson regression with robust variance allowed obtaining the prevalenve ratios (PR) and their respective 95% confidence intervaks (95% CI), adopting, for the final model, the significance level of 5% (p<0.05). Not having a partner in the marital situation (PR=1,13;CI=1,02-1,26;p=0,020), not working outside the home (PR=1,16;CI=1,03-1,31;p=0,014), having schooling until elementary school (PR=1,20;CI=1,07-1,34;p=0,001), smoking (PR=1,28;CI=1,11-1,49;p=0,001), being hypertensive (PR=1,65;CI=1,45-1,88;p<0,001), having metabolic syndrome (PR=1,65;CI=1,45- 1,88;p<0,001), being postmenopausal (PR=1,30;CI=1,16-1,44;p<0,001) and having an altered waist-hip ratio (PR=1,22;CI=1,06-1,41;p=0,005). Good perception of health status (PR=0,86;CI=0,76-0,97;p=0,019) was considered a protective factor. In this study, most climacteric women presented a risk for cardiovascular disease, with increased prevalence in postmenopausal women. The menopausal transition, associated with hormonal changes, unhealthy lifestyle habits, misinformation, as well as clinical and obstetric factors, proved to be harmful to cardiovascular health. These findings warn of the need to assess the main risk factors to institute preventive measures in this phase, wich can be done through risk calculators in application format, practical and accessible from any location and easy to handle.