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Does it make sense to use questionnaires to assess the cardiovascular risk of hypertensive patients?
Session:
Posters (Sessão 3 - Écran 5) - Risco Cardiovascular 1 - Lípidos e Hipertensão Arterial
Speaker:
Adriana Rei Pacheco
Congress:
CPC 2022
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
27.2 Hypertension – Epidemiology, Prognosis, Outcome
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Adriana Rei Pacheco; Pedro Carvalho; Lisa Marques; Diana Carvalho; Simão Carvalho; Mesquita Bastos; Ana Briosa
Abstract
<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">Obstructive Sleep Apnea (OSA), sedentary lifestyle and cognitive impairment are related to arterial hypertension.</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">For 3 months, patients undergoing Arterial Blood Pressure Monitoring (ABPM) were submitted to 3 <span style="background-color:white"><span style="color:#202124">questionnaire</span></span>s: International Physical Activity Questionnaire (</span>iPAQ), STOP-Bang and Montreal Cognitive Assessment (MoCA), relating to the assessment of, respectively, level of physical activity, risk of OSA and cognitive impairment.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">80 patients were included. Exclusion criteria: <18 years, pregnancy, secondary hypertension,</span> <span style="font-size:12.0pt">illiteracy and diagnosed OSA. 45 were men (56.3%), mean age 63 ± 14 years, body mass index (BMI) 27.6±4 kg/m<sup>2</sup>. 24-hour ABPM: systolic blood pressure 127.2mmHg, diastolic blood pressure 75.3mmHg, systolic blood pressure dipping (SBPd) 10.2mmHg. MOCA score: 22.3±4.9 points. SAOS score: low risk 16 patients (20.1%), high risk 62 patients (79.9%). Exercise score: 48 active (60%), 10 moderate (12.5%), 9 sedentary. BMI: 24 normal weight (30%), 35 overweight (43.8%), 21 obesity (26.3%).</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">In T-student analysis, the age of the population with normal MoCA score vs low score was significantly different, respectively, 60.2±12 vs 68.1±15, p<0.05.</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">In cross tabs analysis for non-parametric variables comparing OSA high vs low risk, exercise was significantly lower on high-risk group (T student 4.5, p<0.05). The other variables with significance observed were those included in the score (age, BMI, neck perimeter).</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">Table 1 shows Pearson correlation with significance in relation to MoCA score: age (</span><em><span style="font-size:10.5pt"><span style="background-color:white"><span style="font-family:"Arial",sans-serif"><span style="color:#202122">ρ</span></span></span></span></em><span style="font-size:12.0pt"> -0.420, p<0.001), SBPdip (</span><em><span style="font-size:10.5pt"><span style="background-color:white"><span style="font-family:"Arial",sans-serif"><span style="color:#202122">ρ</span></span></span></span></em><span style="font-size:12.0pt"> 0.342, p<0.01), exercise (</span><em><span style="font-size:10.5pt"><span style="background-color:white"><span style="font-family:"Arial",sans-serif"><span style="color:#202122">ρ</span></span></span></span></em><span style="font-size:12.0pt"> 0.415, p<0.01); and Pearson correlation with significance in relation to OSA risk: obesity (</span><em><span style="font-size:10.5pt"><span style="background-color:white"><span style="font-family:"Arial",sans-serif"><span style="color:#202122">ρ</span></span></span></span></em><span style="font-size:12.0pt"> 0.227, p<0.05), exercise (</span><em><span style="font-size:10.5pt"><span style="background-color:white"><span style="font-family:"Arial",sans-serif"><span style="color:#202122">ρ</span></span></span></span></em><span style="font-size:12.0pt"> -0.254, p<0.05).</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">The presence of this features (high risk of OSA, lower score in MoCA and lower physical activity) simultaneously is associated with a higher prevalence of resistant hypertension (</span><em><span style="font-size:10.5pt"><span style="background-color:white"><span style="font-family:"Arial",sans-serif"><span style="color:#202122">ρ</span></span></span></span></em><span style="font-size:12.0pt"> 0.256, p<0.05).</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">Conclusion: Cognitive impairment is associated with arterial hypertension, on top of age and other risk factors. Systolic blood pressure dipping, a physiological answer, seems to be associated with a better score on MoCA. </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">Exercise seems to benefit mental cognitive status and is associated with a lower OSA risk. Resistant hypertension seems to be associated with worse performance in all of the tests. Approaching the risk factors described may improve prognosis. </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">With the results of these study, the authors decided to implement these surveys in the daily practice of the service.</span></span></span></p>
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