RESUMO
Background: SARS-CoV-2 pandemic has modified the cardiovascular care of ambulatory patients. The aim of this survey was to study changes in lifestyle habits, treatment adherence, and mental health status in patients with cardiometabolic disease, but no clinical evidence of COVID-19. Methods: A cross-sectional survey was conducted in ambulatory patients with cardiometabolic disease using paper/digital surveys. Variables investigated included socioeconomic status, physical activity, diet, tobacco use, alcohol intake, treatment discontinuation, and psychological symptoms. Results: A total of 4,216 patients (50.9% males, mean age 60.3 ± 15.3 years old) from 13 Spanish-speaking Latin American countries were enrolled. Among the study population, 46.4% of patients did not have contact with a healthcare provider, 31.5% reported access barriers to treatments and 17% discontinued some medication. Multivariate analysis showed that non-adherence to treatment was more prevalent in the secondary prevention group: peripheral vascular disease (OR 1.55, CI 1.08-2.24; p = 0.018), heart failure (OR 1.36, CI 1.05-1.75; p = 0.017), and coronary artery disease (OR 1.29 CI 1.04-1.60; p = 0.018). No physical activity was reported by 38% of patients. Only 15% of patients met minimum recommendations of physical activity (more than 150 minutes/week) and vegetable and fruit intake. Low/very low income (45.5%) was associated with a lower level of physical activity (p < 0.0001), less fruit and vegetables intake (p < 0.0001), more tobacco use (p < 0.001) and perception of depression (p < 0.001). Low educational level was also associated with the perception of depression (OR 1.46, CI 1.26-1.70; p < 0.01). Conclusions: Patients with cardiometabolic disease but without clinical evidence of COVID-19 showed significant medication non-adherence, especially in secondary prevention patients. Deterioration in lifestyle habits and appearance of depressive symptoms during the pandemic were frequent and related to socioeconomic status.
Assuntos
COVID-19 , Doenças Cardiovasculares/terapia , Depressão/psicologia , Diabetes Mellitus/terapia , Dieta , Dislipidemias/terapia , Exercício Físico , Cooperação e Adesão ao Tratamento/estatística & dados numéricos , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Arritmias Cardíacas/terapia , Fatores de Risco Cardiometabólico , Fumar Cigarros/epidemiologia , Doença da Artéria Coronariana/terapia , Escolaridade , Feminino , Acessibilidade aos Serviços de Saúde , Insuficiência Cardíaca/terapia , Humanos , Hipertensão/terapia , América Latina/epidemiologia , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Doenças Vasculares Periféricas/terapia , SARS-CoV-2 , Prevenção Secundária , Classe Social , Inquéritos e QuestionáriosRESUMO
La hipertrofia ventricular izquierda (HVI) en la hipertensión arterial es un proceso compensatorio de adaptación al estrés parietal aumentado que, sin embargo, genera cardiopatía. Se revisa la prevalencia de esta patología, aspectos moleculares que genera la hipertrofia, cómo se diagnostica y cuáles son sus determinantes. También se expone el concepto de hipertrofia ventricular izquierda inapropiada y cómo es la función ventricular en el corazón HVI, su pronóstico y el fenómeno de regresión de ella, considerando medidas no farmacológicas y farmacológicas. Finalmente se explica cómo está la reserva coronaria en esta patología.