Avaliação da prevalência de sarcopenia em idosos com hipertensão arterial assistidos na atenção primária à saúde

Abstract

As a result of the reduction of the fertility rate and improvements in the health sector, there is now a clear demographic transition characterized by an increase in the number of elderly people in the population. This phenomenon increases the prevalence of chronic diseases and geriatric syndromes common to the senility process, especially Systemic Arterial Hypertension (SAH) and sarcopenia. These conditions interrelate, favoring the occurrence of unfavorable outcomes in the health of the elderly . Thus, the present study aims to verify the prevalence of sarcopenia in elderly people with SAH assisted in the Primary Health Care Units (UAPS). It is a quantitative, descriptive and cross-sectional study developed in three UAPS located in the city of Fortaleza, Ceará, from April to August 2018. The sample was composed of 135 elderly individuals and the following inclusion criteria were considered: individuals aged 60 years or older with a diagnosis of SAH and enrolled in the UAPS. As an exclusion criterion, the cognitive impairment observed by a low score in the Mental State Mini-Exam (MMSE) was adopted. Data were collected in three stages: questioning of socioeconomic and clinical data, evaluation of anthropometric parameters and evaluation of sarcopenia. The data were pooled and analyzed statistically through Statistical Package for Social Sciences - SPSS version 22.0. The analysis was based on the pertinent literature on the subject matter, using the simple, relative, mean and standard deviation frequencies for descriptive statistical analysis, the independent T-test was used to compare the means between the independent variables and the outcome variables and the independent chi-square test. Regarding the parameters defining sarcopenia, 60% of the women and 73.3% of the men presented a low handgrip strength, in relation to the evaluation of muscle mass, 78.1% of the women and 96, 7% of the men demonstrated a Skeletal Muscle Mass Index (SMI) higher than the established cutoff point, and, regarding the physical performance analysis, 50.4% of the elderly had a satisfactory walking speed. Thus, according to the operational classification for the syndrome, 25.9% of the elderly presented a picture of probable sarcopenia, 28.9% of sarcopenia and 8.9% of severe sarcopenia. It was also found that there is an association between probable sarcopenia and walking speed (p = 0.001), handgrip strength (p = 0.015) and physical activity practice (p = 0.046) between sarcopenia and Diabetes Mellitus (p = 0.006), walking speed (p = 0.000) and handgrip strength (p = 0.000) and finally between severe sarcopenia and the following variables: SMI (p = 0.000), falls (p = 0.008), walking speed (p = 0.002) and handgrip strength (p = 0.034). It is concluded that the evaluation of the hypertensive elderly with respect to these parameters is essential for directing actions that aim at the prevention of health problems, considering the context of integral attention to the elderly person.