Avaliação dos efeitos a curto prazo de programas de conscientização e de terapia com pravastatina em indivíduos de alto risco para doença cardiovascular provenientes de consultórios particulares Translated title: The evaluation of short term effects of awareness programs and pravastatin therapy on subjects from private clinics at high risk for cardiovascular disease

Abstract

OBJETIVO: Avaliar a eficácia de programas de conscientização (PC) sobre o controle de fatores de risco (FR) para doença cardiovascular (DCV). MÉTODOS: Pacientes hipercolesterolêmicos de alto risco para DCV foram divididos em 2 grupos durante 16 semanas. O grupo A (n=417, 54,3±10,0 anos, 55% homens) recebeu orientação verbal e escrita sobre controle de FR, e o grupo B (n=180, 54,4±10,9 anos, 45% homens) apenas orientação verbal. Todos os participantes receberam 10mg/dia de pravastatina por 12 semanas. Avaliaram-se o peso, pressão arterial, o colesterol total (CT) e frações, triglicérides, índices I e II de Castelli (CT/HDL-C e LDL-C/HDL-C) e escores de Framingham. RESULTADOS: No basal, A diferiu de B no HDL-C (40,0±11,0 vs 43,0±11,0mg/dl, p=0,013) e no índice I (8,2±3,0 vs 7,6±2,3, p=0,008). Após 16 semanas as variações % foram maiores em A do que B no CT (-28,0 vs -25,0, p<0,05), LDL-C (-29,0 vs -27,6, p<0,05), HDL-C (+13,7 vs. + 10,8, p<0,05) e índice I (-39,0 vs -33,0; p<0,05). A pravastatina potencializou os efeitos da dieta sobre os lípides. CONCLUSÃO: O PC parece ser mais eficaz a curto prazo, em reduzir os FR para DCV do que a orientação apenas verbal.

Translated abstract

PURPOSE: To evaluate short-term efficacy of awareness programs (AP) in reducing coronary heart disease risk factors (CHDRF). METHODS: High risk hypercholesterolemic patients were divided in 2 groups during 16 weeks. Group A (n=417, 54.3±10.0 years, 55% males) received verbal and written orientation on CHDRF control, and group B (n=180, 54.4±10.9 years, 45% males) received only verbal orientation. All participants received pravastatin 10mg q.d. for 12 weeks. The evolution of body weight, arterial pressure, lipid profile, Castelli's I and II indexes (TC/HDL and LDL/HDL), and Framingham scores were evaluated. RESULTS: At baseline, A had a lower HDL-C (40.0±11.0 vs 43.0±11.0mg/dl, p=0.013) and a higher index I (8.2±3.0 vs 7.6±2.3, p=0.008) than B. After 16 weeks, A had greater change than B in TC (-28.0 vs -25.0, p<0.05), LDL-C (-29.0 vs -27.6, p<0.05), HDL-C levels (+13.7 vs +10.8, p<0.05) and in the Castelli's Index (-39.0 vs -33.0; p<0.05). In both groups pravastatin use potentialized the effects of diet on the lipid profile. CONCLUSION: The AP seemed to be more effective than verbal orientation alone in CHDRF reduction at short-term.