Saúde cardiovascular ideal em idosos: prevalência e fatores associados

Abstract

The aging of the population is occurring at an increasingly accelerated pace and, as a result, spending on health services has increased considerably. Among the main causes of morbidity and mortality are Chronic Noncommunicable Diseases, with emphasis on cardiovascular diseases. The American Heart Association (AHA) created the concept of Ideal Cardiovascular Health (ideal CVH), which consists of evaluating seven health metrics, four of which are behavioral (not smoking, ideal body mass index, being physically active, healthy diet) and three factors biological (total cholesterol <200 mg/dl, untreated blood pressure <120/80 mmHg and untreated fasting glucose <100 mg/dL). The general objective of this study was to verify the prevalence and factors associated with ideal CVH in elderly people in the community. As specific objectives, we had: 1) to identify and describe studies that evaluated the prevalence of ideal CVH in the elderly through a systematic review; 2) estimate the prevalence of ideal CVH in the elderly; 3) analyze the factors associated with ideal CVH. For the systematic review, the electronic databases PubMed, Web of Science and Scopus were searched on 03/2022. For the last two objectives, it was carried out with 277 elderly people registered in the Family Health Strategy in the city of Matutina, MG. The elderly eligible according to the study criteria, after giving their consent to participate, answered a structured questionnaire applied in the form of an interview, in addition to undergoing an anthropometric assessment (weight and height) and blood pressure measurement, they underwent a laboratory test to measure cholesterol total and fasting blood glucose. According to the systematic review, the prevalence of ideal CVH, when considering the cutoff point  5 metrics, ranged from 57.10% to 0.32%. The original study carried out indicated a prevalence of 17.7% (n=49) for the same ideal CVH cutoff point. When the metrics are analyzed separately, the most difficult to achieve was diet (2.5%) and the metric with the best result was smoking (88.8%). Factors associated with higher ideal CVH were older age (β= 0.19; p < 0.001), fewer diseases (β= -0.21; p < 0.001), better self-perception of health status (β= -0, 24; p < 0.001), greater independence in basic activities of daily living (β= -0.16; p=0.03). Indirectly, the variables associated with better ideal CVH were lower depressive symptoms, mediated by self-rated health (β= -0.07); greater participation in advanced activities of daily living, mediated by depressive symptoms and self-rated health (β= 0.13). It is concluded that it is necessary to implement Public Policies that encourage the ideal maintenance of the seven metrics listed by the AHA. Additionally, the importance of the self-perceived health variable is highlighted, as it is a factor that is directly related to ideal CVH and to other factors, such as depressive symptoms and activities of daily living, which can be encouraged and stimulated through promotion actions of health.