Pressão arterial ambulatorial e a associação com a disfunção diastólica em pacientes atendidos em uma unidade de saúde

Abstract

Cardiovascular diseases are the leading cause of death in the world and are responsible for a high frequency of hospitalizations, with high socioeconomic costs. Systemic arterial hypertension is the most common among cardiovascular diseases and affects more than one third of adults worldwide. Another very prevalent problem in the population, especially among hypertensive patients, are abnormalities in diastolic filling and left ventricular relaxation characterized by diastolic dysfunction. The combination of echocardiographic parameters and Ambulatory Blood Pressure Monitoring (ABPM) as a prognostic assessment tool was evaluated, with the aim of describing the association between diastolic dysfunction and changes in circadian blood pressure. The present study evaluated 217 patients treated at a health unit in Vitória da Conquista/Bahia, (Instituto de Cardiologia e Arritmia do Sudoeste da Bahia) between January 2019 and December 2020, and who had an echocardiogram and ABPM exam in their medical records. Diastolic dysfunction showed a positive and independent association only with age, with the highest prevalence in patients over 40 years of age. It was observed that patients with diastolic dysfunction had more abnormalities on ABPM, with higher systolic loads, diastolic load during sleep, maximum pulse pressures (wakefulness and sleep) and minimum pulse pressure, and abnormal nocturnal dipping. Thus, diastolic dysfunction is highly prevalent and is a predictor of morbidity and mortality, and has been shown to be more prevalent in patients with abnormal 24- hour ABPM measurements with abnormal nocturnal dipping more prevalent in patients with diastolic dysfunction. In addition, age was a factor that showed a greater association with the presence of diastolic dysfunction.