Association between Cardiovascular Risk and Nutritional Status of Elderly

Introduction

In Brazil, the growth rate of the elderly population has been systematic and consistent. According to the National Sample Survey of Households - PNAD 2012, the country had a population of about 24 million people 60 years or older.

Objective

Check if there is association between cardiovascular risk and nutritional status of assisted elderly outpatients.

Methods

This is a cross-sectional study conducted at the Clinic in São Luís- MA, conducted on May 2015. The sample was for convenience and older had the inclusion criteria women aged over 60 years , diabetic, and not to include those who were unable to perform some of the procedures involved in the study as : measurement of anthropometric measurements and cognitive difficulties to answer the questions. Data collection was conducted through two questionnaires and conducting anthropometric measurements. For the measurement of weight, the elderly were placed in a previously calibrated anthropometric digital scale Welmy® brand for up to 150 kg and 100g precision, without shoes, properly supported on level ground in front walk to the scale scale with lateral distance of the feet, erect and stared straight ahead; the height was measured with fixed vertical anthropometer the balance with a maximum capacity of 220cm accuracy of 0.1 cm, with the elderly positioned standing with arms outstretched over the body, head raised and looking at a fixed point at eye [4]. For the nutritional status was used the Body Mass Index (BMI): derived from the ratio of the current body weight (kg) and the square of height (m), BMI classified according cutoff point, according to which BMI <23.00 kg/m² indicates underweight; ≥ 23,00 and <28.00 kg/m², eutrophic; ≥ 28.00 and <30.00 kg/m², overweight; and ≥ 30.00 kg/m², obesity [5]. Waist circumference was obtained by inelastic tape measure graduated Sanny® mark in centimeters, positioned between the iliac crest and the lower edge of the last rib. It was considered the average of two measurements in the standing position, with naked abdomen [6]; The accumulation of fat around the waist or abdominal obesity was classified as high risk of cardiovascular disease for women a DC ≥ 80.0 cm [7]. Hip circumference was obtained by inelastic tape measure graduated Sanny® mark in centimeters, where the measurement occurs at the level of the point of greatest circumference of the gluteal region. To assess the risk of cardiovascular and / or metabolic complications, waist-hip ratio was used, which was obtained by dividing the numerical value of the waist circumference at the hips, both in centimeters, the result classified according cutoff for women, at risk for CVD estimated values ≥ 0.85 cm [7]. For the organization of the data were performed encodings of all the variables of the collection instruments with double data entry in Microsoft Office Excel® program (2011). Completed validation by double entry, data were analyzed in STATA 12.0® program. The significance level was 5 %.

Results

The sample consisted of 33 elderly women with mean age 67.2 (± 4.68) years. The distribution between age groups showed a higher proportion of participants between 60 and 69 years (54.55%). The largest contingent of Brazilian elderly is also represented in this age group, about 28.6 % of the population [8] . Regarding marital status predominated married women [9], followed by widows (21.21%). Even with increased life expectancy of Brazilians, women have greater longevity to the men, which makes widowhood is commonly in the population of elderly. Besides the fact that women remains widowed after her husband's death, which among men marriage after widowhood is predominant [8].

When asked about their occupation the retired category and / or pensioner was the highest percentage (51,52 %), similar to that found by the National Sample Survey (PNAD), where elderly had 66.2 % of their income coming from retirement and / or pension [9].

Table 1: Demographic characteristics of elderly in outpatient care (n=33). São Luís - MA, 2015. 39.39% had a diagnosis of overweight, and when assessing the percentage of elderly overweight and obesity, this percentage significantly increased to 51.51 %, representing more than half of the sample. The diagnosis of low weight, was found in 30.30% of the elderly deserves special mention. According to Ferreira, 2014 [10] both the low-weight and obesity are associated with increased morbidity and mortality in the elderly. In research by Santos & Sichieri 2005 [11], it found that overweight was present 52.4 % in older women.

Increased abdominal fat measured by waist circumference in older women, is seen as a good indicator of coronary risk for this population [12]. 72.73% of the elderly were at risk of developing cardiovascular and metabolic complications. A similar result was found by Previato et al, 2014 [2], where high circumference 84% had the highest prevalence among the elderly.

Table 4 shows the association between waist circumference according to nutritional status.

Statistically significant association was observed (p<0.05) between cardiometabolic risk measured by waist circumference and body mass index variable, the diagnosis of overweight correlates with increased risk of cardiovascular complications (92.31 %). 100 % of obese elderly had risk presenting an increased waist circumference.

Conclusion

There was a high prevalence of obesity and risk of cardiovascular disease in the elderly population with significant association, following the global panorama of epidemiology current. Nutritional monitoring in conjunction with intervention strategies involving the various sectors of the community should. Minizar be considered for the losses arising from the nutritional status and its components, thus contributing to a better quality of life.