Influência do uso do tabaco em população com múltiplas condições crônicas

Abstract

Smoking is a risk factor for the development of complications of chronic non communicable diseases and is classified as one potentiator and other similar conditions. Addressing tobacco use is cost-effective intervention at all levels of care, preventing diseases, reducing both complications as cardiovascular and overall mortality. For people at high cardiovascular risk (especially hypertension, diabetes and chronic kidney disease), with co-morbidities, smoking cessation may be the best intervention to be performed. In all interventions aimed at increasing the scope of tobacco cessation, should better understand the profile of smokers in detail, and thus draw effectively, strategic plans for individualized attention and better results. Aims: In users with multiple chronic conditions of high and very high cardiovascular risk, identify as tobacco use: 1. The psychosocial profile, clinical indicators, metabolic and associated comorbidities; 2. Associations of the profile according to the use of tobacco; 3. Evaluate temporally following a 12 month clinical indicators (especially cardiovascular outcomes and renal disease progression), according tobacco use. Methods: Cross-sectional study conducted in HIPERDIA Center Juiz de Fora Minas Gerais, Brazil, which manages patients with high cardiovascular risk, hypertension, diabetes mellitus and chronic kidney disease. Results: Of the 1558 participants, 12% were smokers; 41% former smokers and 47% had never smoked. In univariate analysis, current smoking was associated with sex, age, physical activity, alcohol consumption, depressive symptoms, overweight, and atherosclerosis. In multinomial analysis, several chronic diseases were associated with current or previous use of tobacco; chronic obstructive pulmonary disease and atherosclerosis were more prevalent among patients who were smokers. There were no statistically significant differences in the longitudinal evaluation of clinical outcomes or glomerular filtration rate, according to tobacco use. Conclusion: Smoking was so prevalent in the population studied as the general population. Smokers had poorer clinical profile compared to former smokers or those who never smoked. Support for smoking cessation can yield considerable benefits, combined with the reduction of care costs to health, especially in people with multiple chronic conditions and high cardiovascular risk.