Toneti Adrielle Naiara, Freitas Dayana, Magnabosco Patrícia, Toneti Bruna Francielle, Lana Daniel Martinez, de Godoy Simone, Marchi-Alves Leila Maria
University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, SP, Brazil.
Federal University of Uberlândia, Uberlândia, MG, Brazil.
J Vasc Nurs. 2016 Mar;34(1):17-23. doi: 10.1016/j.jvn.2015.10.001.
Arterial hypertension is associated with a high prevalence of vascular alterations. The use of noninvasive procedures to assess peripheral arterial diseases in the ranking of cardiovascular risks has been increasingly valued in clinical practice and should be adopted in nursing.
To identify the cardiovascular risk of hypertensive and normotensive individuals through the use of different noninvasive procedures to assess the vascular function and integrity: ankle-brachial index, pulse pressure, and delta brachial-brachial and delta ankle-brachial indexes.
Quantitative, descriptive, and cross-sectional study undertaken at a health service in a Brazilian city. The research variables were age, sex, blood pressure, abdominal circumference, body mass index, ankle-brachial index, pulse pressure, and delta brachial-brachial and delta ankle-brachial indexes.
Fifty-four (43.1%) normotensive and 69 (56.9%) hypertensive individuals participated in the study. Alterations were identified in ankle-brachial index, corresponding to mild and moderate arterial obstruction, among hypertensive individuals only (7.2%), with higher pulse pressure indices (P < 0.0001). The assessment of the correlation between the ankle-brachial index and pulse pressure showed no correlation in the normotensive group and a statistically significant correlation among hypertensive patients (Pearson's coefficient = -0.45, P < 0.0001, r(2) = 0.21). A statistically significant difference (P < 0.05) was found in the analysis of the mean delta brachial-brachial (6.2 ± 0.71 mm Hg for normotensive and 10.16 ± 1.45 mm Hg for hypertensive individuals) and delta ankle-brachial index (0.06 ± 0.01 for normotensive and 0.11 ± 0.01 for hypertensive individuals).
The use of the proposed cardiovascular risk predictors shows more frequent alterations among hypertensive than normotensive individuals.
动脉高血压与血管改变的高患病率相关。在心血管风险分级中，使用非侵入性程序评估外周动脉疾病在临床实践中越来越受到重视，护理工作中也应采用。
通过使用不同的非侵入性程序评估血管功能和完整性，即踝臂指数、脉压以及肱动脉-肱动脉差值和踝臂-肱动脉差值指数，来确定高血压和血压正常个体的心血管风险。
在巴西一个城市的一家卫生服务机构进行了定量、描述性横断面研究。研究变量包括年龄、性别、血压、腹围、体重指数、踝臂指数、脉压以及肱动脉-肱动脉差值和踝臂-肱动脉差值指数。
54名（43.1%）血压正常者和69名（56.9%）高血压患者参与了研究。仅在高血压个体中发现踝臂指数有改变，对应轻度和中度动脉阻塞（7.2%），脉压指数更高（P<0.0001）。踝臂指数与脉压之间的相关性评估显示，血压正常组无相关性，高血压患者中有统计学显著相关性（Pearson系数=-0.45，P<0.0001，r²=0.21）。在分析肱动脉-肱动脉平均差值（血压正常者为6.2±0.71mmHg，高血压个体为10.16±1.45mmHg）和踝臂-肱动脉差值指数（血压正常者为0.06±0.01，高血压个体为0.11±0.01）时发现有统计学显著差异（P<0.05）。
使用所提出的心血管风险预测指标显示高血压个体比血压正常个体有更频繁的改变。
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