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Conhecimen= to dos fatores de risco de Doenças Cardiovasculares por estudantes universitár= ios: evidências científicas

 = ;

Knowledge of risk factors for Cardiovascular Dise= ases by university students: scientific evidences

 

Braima Embaló[1] * Davide Carlos Joaquim[2] * Mama Saliu Culubali[3] * Virgínia Cláudia Carneiro Girão[4] * Daniel Freire de Sousa[5] * Ana Caroline Rocha de Melo Leite[6]

RESUMO:

Objetivo: Identificar e avaliar as evidências científicas em relação ao conh= ecimento de estudantes universitários sobre os fatores de risco de Doenças Cardiovasculares (DCV). Método: Trata-se de revisão integrativa, realizada em 2020, = nas bases de dados MEDLINE, CINAHL, PubMed, Scopus e Web of Science. Baseado na pergunta norteadora, foi feita a busca dos artigos, utilizando-se de= scritores “Estudantes”, “Universidades”, “Conhecimento”, “Doenças cardiovasculares” e= “Fatores de riscos” e seus correspondentes em inglês. Resultados: Dos 17 arti= gos incluídos, 6 estavam disponíveis no Scopus e todos estavam em língua ingles= a. Observou-se que estudantes tinham baixos níveis de conhecimento sobre os fatores de risco de DCV e não reconheciam a vulnerabilidade a elas= , além de não adotarem medidas preventivas e um estilo de vida saudável. As publicações sugeriram a necessidade de profissionais de saúde em ambientes educacionais, visando aprimorar o conhecimento relacionado à saúde, incorpo= rar práticas de estilo de vida saudáveis e desenvolver estratégias de redução d= os níveis de risco de DCV. Conclusão: O aprofundamento do conhecimento = e o olhar crítico sobre a literatura apontaram carência na produção de estudos brasileiros sobre a temática, despertando a necessidade de condução de mais pesquisas e revisões da literatura para fortalecimento da prática baseada em evidências.

Palavras-chave: Estudantes; Universidades; Doenças Cardiovasculares; Fatores de Risco; Conhecimento.

ABSTRACT

Objective: To identify and assess scienti= fic evidence regarding university students' knowledge about risk factors for Cardiovascular Diseases (CVD). Method: This is an integrative review, carried out in 2020, in the MEDLINE, CINAHL, PubMed, Scopus, and Web of Sci= ence databases. Based on the guiding question, the search for articles was made, using the descriptors “Students”, “Universities”, “Knowledge”, “Cardiovascu= lar Diseases”, and “Risk Factors” and their correspondents in English. <= strong>Results: Of the 17 articles included, six were available from Scopus, and all were in English. It was observed that students have a low level of knowledge about = risk factors for CVD and do not recognize their vulnerability to them, and not a= dopting preventive measures and a healthy lifestyle. Publications suggested the need for health professionals in educational settings to improve knowledge relat= ed to health, incorporate healthy lifestyle practices, and develop strategies = to reduce CVD risk levels. Conclusion: The deepening of knowledge and a critical look at the literature showed a lack = in producing Brazilian studies on the subject, arousing the need to conduct mo= re research and literature reviews to strengthen evidence-based practice.=

Keywords: Students; Universities; Cardiovascular Diseases; Risk Factors; Knowledge.

 

INTRODUÇÃO=

= No contexto atual, as D= oenças Crônicas Não Transmissíveis (DCNT), como as Doenças Cardiovasculares (DCV), diabetes, câncer e doenças crônicas respiratórias1, representam um= grave problema para a saúde pú­blica mundial, como consequência do elevado número= de óbitos e incapacitação2 = observado entre os países desenvolvidos e= subdesenvolvidos3. De fato, as DCNT são responsávei= s pela morte de 41 milhões de pessoas por ano, quantitativo correspondente a 71% do total de óbitos4. Em ter= mos etiopatogênicos, elas resultam da atuação de fatores genéticos, fisiológico= s, ambientais e estilo de vida4.

= Definidas como um grupo= de desordens que acometem o coração e a circulação arterial e venosa5,6, as quais incluem a doença arte= rial coronariana e cerebrovascular e aterosclerose aórtica7, as DCV representam a principal c= ausa de mor­te no mundo8. Rea= lmente, essa condição é responsável por 30% dos 50 milhões de óbitos registrados = mundialmente nas últimas décadas9. Sua etiologia, embora envolva fatores tidos como não modificáveis, como sexo, i= dade, história familiar e raça, compreende elementos modificáveis ou evitáveis, c= omo sedentarismo, obesidade, Hipertensão Arterial Sistêmica (HAS), Diabetes Mellitus (DM), dislipidemia, tabagismo, dieta inadequada e ingestão de álcool10,11.

= Embora acometa principalmente adultos acima de 60 anos6, além da ocorrência em indivíduos com idade inferior a 40 anos, geralmente associada a condições genéticas12, a literatura mostra o aumento da prevalência de fatores de risco de DCV ent= re adultos jovens, representados especialmente pela obesidade e sedentarismo13. Particularmente, o maior acomet= imento de faixas etárias mais jovens por DCV pode se relacionar à percepção de que essas doenças só ocorrem em indivíduos de maior idade14,15. Contribuem ainda para essa realidade as mudanças alimentares vivenciadas por esse público como consequência do processo de urbanização e fácil acesso a alimentos processa= dos16. 

= Diante desse novo cenár= io, estudantes universitários se destacam como um grupo vulnerável a DCV, especialmente se considerado o seu comportamento sedentário17,18, consumo de álcool e cigarro<= sup>19, estresse20 e alteração do hábito alimentar21. Corroborando com essa suposição, estudos relatam a presença de fatores de risco de DCV entre estudantes de diferentes cursos, como Medicina22, Enfermagem23, Nutrição e Fisioterapia24.

= Nesse sentido, a litera= tura ressalta que o ingresso na Universidade favorece o contato e desenvolviment= o de fatores de risco de DCV pelos estudantes, em particular aqueles que se veem obrigados a se distanciar da família e assumir a responsabilidade pela sua moradia, alimentação e condições financeiras23,25. Com o decorrer do curso, somam-se outros fatores, = como a carga horária extensa em sala de aula e estágio, adoção de consumo de alimentos industrializados pela escassez de tempo e dinheiro, limitado aces= so a alimentos saudáveis no ambiente universitário e reduzida disponibilidade e = tempo para a prática de exercício físico23,= 25,26.  

= Apesar da presença dess= es fatores de risco entre os universitários, estudos revelam um déficit no conhecimento desses fatores entre esses estudantes, o que pode interferir no seu estado de saúde. Nesse sentido, segundo os autores27, a avaliação dos níveis de conhecimento e identificação desses fatores de risco são fundamentais para a promoção da saúde no contexto das DCV, principalmente para a comunidade acadêmica que, muitas vezes, é referência para a sociedade.

= Assim, considerando-se o acima exposto, esse estudo teve como objetivo identificar e avaliar as evidências científicas em relação ao conhecimento de estudantes universitár= ios sobre os fatores de risco de DCV.  <= /o:p>

 

MÉTODOS

= Trata-se de uma revisão integrativa da literatura, a qual objetiva identificar, descrever, reunir e sintetizar resultados de estudos. Quando bem elaborada, possibilita a integração de pesquisas referentes a um determinado assunto, propiciando o desenvolvimento e direcionamento de outras investigações, auxiliando na tom= ada de decisão e permitindo a incorporação da evidência na prática clínica= 28.   

= Com base nos autores29, essa revisão foi elaborada em seis etapas, a saber: identificação do tema e objetivos da revisão integrativa; formulação da questão norteadora; busca na literatura e seleção criteriosa das pesquisas; categorização dos estudos encontrados e análise das publicações incluídas; interpretação dos resultad= os; relato da revisão e síntese do conhecimento evidenciado nas pesquisas.

= Para a formulação da pergunta norteadora, foi utilizada a estratégia PICO, a qual representa um acrônimo em inglês que significa “paciente, intervenção, comparação e resul= tados”. Esses quatros componentes são fundamentais para a questão da pesquisa e con= strução da pergunta norteadora, particularmente quando estuda um tema muito específ= ico29.

= Com base nessa estratég= ia, a presente revisão considerou “P” estudantes universitários, “I” e “C” não foram aplicados e “O” conhecimento sobre os fatores de riscos de doenças cardiovasculares. A fim de responder ao objetivo do estudo, foi definida a seguinte pergunta norteadora: “O que os estudantes universitários sabem sob= re os fatores de risco de doenças cardiovasculares?”. Para buscas dos artigos, foram utilizados os descritores controlados em português “Estudantes”, “Uni= versidades”, “Conhecimento”, “Doenças cardiovasculares” e “Fatores de riscos”, indexados= nos descritores em Ciências da Saúde (DeCS), e seus respectivos correspondentes= em inglês “Students”, “Universities”, “Knowledge”, “Ca= rdiovascular diseases” e “Risk factors”. Todas as palavras foram combinadas conjuntamente e associadas por meio do operador booleano “AND”.=

= A busca e análise dos artigos foram realizadas durante os meses de fevereiro e março de 2020, por meio da consulta do Portal de Periódico da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)/Ministério da Educação (MEC), usando as seguint= es bases de dados: Medical Literature Analysis and Retrieval System Online<= /i> (MEDLINE); Cumulative Index to Nursing and Allied Health Literature (CINAHL); National Library of Medicine (PubMed); Scopus – base multidisciplinar e Web of Science.

= Foram incluídos na revi= são artigos na íntegra, disponíveis gratuitamente, publicados nos últimos 10 anos (2010= a 2020) (esse recorte temporal se baseou na possibilidade de incluir um maior número de estudos que abordassem a temática), nos idiomas português, inglês= e espanhol. Foram excluídos artigos repetidos, editoriais, cartas ao editor, teses, dissertações, artigos de revisão, relatórios e artigos não relaciona= dos à temática ou não relevantes para essa revisão.

= Após a coleta, os dados foram organizados com b= ase no instrumento adaptado de Ursi30, constituído por um modelo específico de CheckList, dividido em nove domínios, cu= jo objetivo é facilitar a descrição e publicação dos dados presentes nos artig= os31. Esses foram primeiramente organizado= s de acordo com: título do artigo; autores, periódico e área de publicação; local onde a pesquisa foi conduzida e ano em que foi publicado e base de dados em= que foi indexado. Na sequência, foram verificados o objetivo, tipo de estudo e nível de evidência e, posteriormente, os resultados e conclusão.

= A análise da classifica= ção das evidências dos artigos foi fundamentada na proposta de Stillwell et al.= 32. Esses autores categorizam as evidências de pesquisa em sete níveis, nos quais o primeiro corresponde a melhor evidência externa, apresentando informações mais confiáveis, e o últ= imo compreende informações com um menor grau de confiabilidade.  

 

RESULTADOS=

= A partir da estratégia = de busca, foram encontrados 262 trabalhos, dos quais 191 tinham sido publicado= s nos últimos 10 anos. Desses, 93 estavam nos idiomas inglês, espanhol ou portugu= ês e, dentre eles, 71 tinham disponibilidade na íntegra. Após a leitura do tít= ulo e resumo, das 71 publicações, foram excluídas 42 por não se relacionaram ao objetivo da revisão. Dos 29 artigos lidos na íntegra, 9 foram excluídos por duplicidade e 3 por não responderem os critérios de inclusão. Assim, compus= eram a revisão 17 publicações (Figura 1).

=  

Figura 1= - Fluxogra= ma de identificação do processo de seleção dos estudos para compor a revisão integrativa. Redenção - CE, Brasil, 2020

=  

Fonte: Os autores

=  

= Do total de artigos incluídos, 5 estavam disponíveis no Scopus e todos estavam em língua inglesa. Quanto ao ano de publicação, 3 foram publicados em 2012, quantitativo igual ao observado nos= anos de 2015, 2017 e 2019. Em relação ao local de realização dos estudos, 3 foram conduzidos na Turquia, número igual ao constatado nos Estados Unidos da Amé= rica. Sobre a área de publicação, 11 estudos foram desenvolvidos na área da Medic= ina (Tabela 1).

 

Tabela 1<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-fareast-f= ont-family: "Times New Roman";color:black'> - Caracterização das publicações incluídas = na revisão, de acordo com = com o título, autores, ano, periódico, área, país e base de dados. Redenção - CE, Brasil, 2020.

Nº<= /b>

Título do Artigo

Autor e Ano

Periódico e Área=

País

Base de Dados

01<= /b>

Knowledge, attitude, = and practice on salt and assessment of dietary salt and fat intake among University of Sharjah Students

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Ismael et al. 2019

Journal Nutrients

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'> 

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Nutrição

Emirados Árabes Unidos

Scopus

02<= /b>

Cardiovascular risk factors among lower Silesian students of the Faculty of Medicine: knowled= ge and distribution<= /span>

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Kalka et al.

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>2016

Adv Clin Exp Med

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> 

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Medicina

Sul e Sudoeste da Polônia

Scopus

03<= /b>

Knowledge, attitude, = and practice of Malaysian Public University students on risk factors for cardiovascular diseases

 

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Ibrahim et al. <= /o:p>

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2016

Journal of Applied Pharmaceutical Science

 

Medicina

Malásia

Scopus

04<= /b>

Prevalence of obesity= and hypertension among University students’ and their knowledge and attitude towards risk factors of Cardiovascular Disease (CVD) in Jeddah, Saudi Ara= bia

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Baig et al.

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2015

Pak J Med Sci

 

Medicina

Arábia Saudita

Scopus

05<= /b>

Diabetes Mellitus-rel= ated knowledge among University students in Ajman, United Arab Emirates

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Khan et al.

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2012

SQU Medical Journal

 

Medicina

Emirados Árabes Unidos

Scopus

06<= /b>

Awareness of cardiova= scular risk factors among University students in Turkey

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Güneş et al.

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2019

Primary Health Care Research & Development

 

Medicina

Turquia

PubMed

07<= /b>

Prevalence, risk awareness and health beliefs of behavioral risk factors for cardiovascular disease among University students in nine ASEAN countries

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Peltzer et al.

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>2018

BMC Public Health

 

Farmácia

Nove países da ASEAN*

PubMed

08<= /b>

Assessment of knowled= ge of critical cardiovascular risk indicators among college students: does s= tage of education matter?

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Sarpong et al. <= /o:p>

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2017

Int. J. Environ. Res. Public Health

Enfermagem

Estados Unidos da América

PubMed

09<= /b>

The perception and knowledge of cardiovascular risk factors among Medical students

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Reiner et al.

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>2012

Meoica'l Education- Croat Med J.

 

Medicina

Croácia

Medline

10<= /b>

Cardiovascular health risk behavior among Medical students in a teaching hospital

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Giri et al.

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2012

J Nepal Health Res Counc

 

Medicina

Nepal

 

Medline

11<= /b>

Awareness and knowled= ge of cardiovascular disease risk factors among Medical students<= /span>

Maksimovi= 63;

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>et al.

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2017

Wien Klin Wochenschr

 

Medicina

Sérvia

Medline

12<= /b>

An experiential cardiovascular health education program for African American college stud= ents

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Holland et al. 2014

The ABNF Journal

 

Medicina

Estados Unidos da América

Web of Science

13<= /b>

Cardiovascular disease risk factors and knowledge level in Nursing students

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Kaya et al.

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2019

Clin Exp Health Sci

 

Enfermagem

Turquia

Web of Science

14<= /b>

Factors predicting nutrition and physical activity behaviors due to cardiovascular disease i= n Tehran University students: application of health belief model=

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Najarkolaei et al.

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2015

Iran Red Crescent Med J

 

Medicina

Teerã

Web of Science

15<= /b>

Knowledge, attitude a= nd behaviour regarding dietary salt intake among Medical students in Angola<= o:p>

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Magalhães et al.

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>2015

Cardiovascular Journal of Africa <= /span>

 

Medicina

Angola

Web of Science

16<= /b>

University students’ knowledge levels about cardiovascular risk factors and assessment of their health behaviours in Turkey

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Kes et al.

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>2018

Journal of American College Health

 

Enfermagem

Turquia

 

CINAHL

17<= /b>

Cardiovascular risk factors among college students: knowledge, perception, and risk assessmen= t

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Tran et al.

<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2017

International Journal of Caring Sciences

 

Enfermagem

Estados Unidos da América

 

CINAHL

*ASEAN - Associação das Nações do Sudeste Asiático.

Fonte: Os autores

 

= Quanto aos objetivos dos estudos, eles envolver= am principalmente avaliar os conhecimentos, atitudes e práticas em relação aos fatores de risco de DCV por parte dos estudantes universitários. Outros objetivos mencionados corresponderam a: - estudar a prevalência de obesidad= e e hipertensão entre os universitários; - investigar os conhecimentos e prátic= as relacionados ao DM desses estudantes; - determinar a prevalência de fatores= de risco de DCV nesse público; - avaliar o impacto da educação médica no conhecimento e reconhecimento da importância da implementação de medidas preventivas contra DCV, segundo a percepção dos estudantes de Medicina; - conhecer os resultados da avaliação de risco de DCV entre universitários; - identificar os preditores importantes de nutrição e atividade física em rel= ação às DCV nesses estudantes (Tabela 2).

= No que se refere ao des= enho metodológico, 16 artigos eram estudos descritivos e, sobre o nível de evidência, todos as publicações apresentaram nível VI.


Tabela 2 - Cara= cterização das publicações incluídas nessa revisão, de acordo com o objetivo, tipo de estudo e nível de evidência. Redenção - CE, Brasil, 2020.

Nº<= /b>

Objetivo

Tipo de Estudo

Nível de Evidência

01<= /b>

Investigar os conhecimentos, atitudes e práti= cas relacionados à presença de sal na dieta de estudantes da UOSa e avaliar a ingestão alimentar de gordura total, saturada e trans, colester= ol e sódio

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Descritivo

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

02<= /b>

Avaliar o conhecimento dos estudantes de Medi= cina sobre os fatores de risco de DCVb e sua prevalência na populaç= ão estudada

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Descritivo

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

03<= /b>

Medir e avaliar os conhecimentos, atitudes e práticas de estudantes universitários em relação aos fatores de risco de = DCVb

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Descritivo

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

04<= /b>

Investigar a prevalência de obesidade e hipertensão entre estudantes universitários e seus conhecimentos e atitud= es em relação aos fatores de risco de DCVb

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Descritivo

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

05<= /b>

Avaliar os conhecimentos e práticas relaciona= dos ao DMc de estudantes universitários, incluindo as diferenças em relação ao gênero e histórico familiar

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Descritivo

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

06<= /b>

Determinar o nível de conscientização de estudantes universitários, especialmente calouros, em termos de fatores de risco de DCVb (elevado colesterol, estresse, hipertensão, tabagismo, obesidade, diabetes, inatividade física, história familiar de DCVb, dieta não saudável, exposição ao tabagismo passivo e baixo nível socioeconômico)

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Descritivo

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

07<= /b>

Investigar a prevalência, consciência e crenç= as de saúde em relação aos fatores de risco de DCVb de universitá= rios em nove países da ASEANd

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Descritivo

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

08<= /b>

Estimar e comparar o nível de conscientização= de estudantes do 1º ano profissional do curso de Farmácia com universitários= do 2º semestre do referido curso sobre seus números (colesterol, pressão art= erial, glicose e IMCe)

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Descritivo

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

09<= /b>

Avaliar as percepções, conhecimentos e conscientização em relação aos fatores de risco de DCVb entre estudantes do curso de Medicina

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Descritivo

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

10<= /b>

Avaliar o comportamento em saúde e as percepç= ões de estudantes de medicina em relação a doenças cardiovasculares

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Descritivo

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

11<= /b>

Avaliar os conhecimentos e atitudes de estuda= ntes de Medicina com relação aos fatores de risco de DCVb e avaliar= o impacto da educação médica no conhecimento e reconhecimento da importânci= a da implementação de medidas preventivas dessas doenças para esses estudantes=

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Descritivo

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

12<= /b>

Investigar a aplicação de um teste culturalme= nte específico e de um currículo desenvolvido para universitários afro-americ= anos para aumentar a conscientização sobre o risco de DCVb

Descritivo e

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Misto

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

13<= /b>

Determinar o conhecimento dos fatores de risc= o de DCVb e a avaliação de risco entre os estudantes de Enfermagem<= o:p>

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Descritivo

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

14<= /b>

Identificar preditores importantes de nutriçã= o e atividade física em relação às DCVb de estudantes universitári= os de Teerã

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Descritivo

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

15<= /b>

Determinar a ingestão de sal e avaliar os conhecimentos, atitudes e comportamentos em relação a essa ingestão entre estudantes de Medicina

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Descritivo

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

16<= /b>

Avaliar os níveis de conhecimento de estudant= es universitários sobre fatores de risco de DCVb e seus comportamentos de saúde

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Descritivo

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

17<= /b>

Avaliar os conhecimentos e percepções dos estudantes universitários sobre fatores de risco de DCVb e identificar esses riscos

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>Descritivo

<= span style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo= nt-family: Arial'>VI

aUniversidade de Sharjah (UOS); bDoen= ças Cardiovasculares; cDiabetes Mellitus; dAssociação das Nações do Sudeste Asiático; eÍndice de Massa Corporal.

Fonte: Os autores

 

= No que diz respeito aos resultados observados n= os artigos, eles ressaltaram que, apesar das diferenças entre os universitário= s de distintas faculdades e tempo de curso, em geral, os estudantes apresentaram baixos níveis de conhecimento sobre os fatores de risco de DCV. Dentre esses fatores, foram citados inatividade física, dieta rica em gordura, tabagismo, obesidade, fatores genéticos, hipertensão= e DM tipo 2. Os estudos apontaram ainda a presença de fatores de risco entre = os estudantes, como sobrepeso, obesidade, hipertensão, excesso de ingestão de gorduras e sódio, falta de atividade física, ingestão de álcool e tabagismo= (Tabela 3).

= Algumas pesquisas constaram ainda que, apesar da consciência dos estudantes quanto aos fatores de risco de DCV, eles não se = viam em risco de desenvolver essas doenças, não adotavam medidas preventivas e n= ão tinham uma prática de estilo de vida saudável. Outros autores mostraram ain= da baixo nível de conhecimento sobre os indicadores de saúde entre os universitários, percepção de que o curso de Medicina era prejudicial à saúd= e e diferenças entre os sexos quanto às atitudes e práticas em saúde.

= Com relação à conclusão, os artigos, em geral, concluíram que os estudantes universitários tinham um nível insuficiente de consciência e conhecimento sobre os fatores de risco de DCV, bem como eleva= da prevalência desses fatores entre eles. Os estudos sugeriram ainda a necessi= dade da presença de profissionais de saúde em ambientes educacionais, a fim de aprimorar o conhecimento relacionado à saúde, incorporar práticas de estilo= de vida saudáveis e desenvolver estratégias de redução dos níveis de risco de = DCV entre os estudantes. 


Tabela 3 - Caracterização das publicações incluídas nessa revisão, de acordo com os resultados e conclusão. Redenção - CE, Brasil, 2020.=

Nº

Resultados

Conclusão

01

Entre os estudantes, os resultados indicaram = baixo escore de conhecimento com relação à presença de sal na dieta, assim como alta prevalência de sobrepeso (28%), obesidade (14%) e hipertensão estági= o 1 (31%) e 2 (20%). Observou-se uma elevada porcentagem de estudantes q= ue excederam a ingestão recomendada de gordura total (48%), saturada (90%) e trans (64%) e sódio (89%). Todos os estudantes não atenderam à ingestão adequada de potássio recomendada

Conhecimentos, atitudes e práticas relacionad= os ao consumo de sal entre estudantes revelaram a ingestão não recomendada de gordura total, saturada e trans e sódio. Esse resultado destaca a necessi= dade de desenvolver campanhas de conscientização específicas em relação à cult= ura de ingestão de sal e gordura e sua associação com a saúde

02

Os estudantes identificaram corretamente cinco fatores de risco de DCVa, dos quais os mais citados foram a fa= lta de atividade física e dieta rica em gordura, seguidos pelo tabagismo, obesidade, fatores genéticos e hipertensão. Os resultados mostraram que há uma consciência relativamente saudável por parte dos estudantes quanto aos fatores de risco de DCVa. Entretanto, não se observou uma correlação com um estilo de vida saudável

O estudo revelou um nível insuficiente de consciência quanto aos fatores de risco de DCVa entre estudant= es de Medicina

03

Entre os universitários de diferentes faculda= des, foram encontradas diferenças significativas em relação ao conhecimento dos fatores de risco de DCVa (HASb, DMc, sedentarismo, hereditariedade, estresse, tabagismo, dieta não saudável e falta de exercícios físicos), assim como diferenças de atitude e prática entre os sexos. Os dados indicaram que a prática de estilo de vida saudáv= el ​​não foi adequada entre os participantes

O estudo sugere que os estudantes devem aumen= tar a prática em saúde para prevenção de DCVa. Apesar do conhecime= nto elevado por parte dos estudantes, ele não condiz com as atitudes e prátic= as

04

Os resultados indicaram que 7,5% dos participantes eram hipertensos, 29,8% apresentavam sobrepeso, 10,7% eram moderadamente obesos e 7,9% eram severamente obesos. A maioria dos participantes estava ciente de que um estilo de vida saudável poderia imp= edir as DCVa, embora não o praticassem

Existe uma grande lacuna no conhecimento, ati= tude e prática entre a população jovem universitária saudita em relação aos fatores de risco de DCVa

 

05

Dos participantes, 25% apresentavam sobrepeso= ou obesidade e apenas 27% exercitavam-se regularmente. Sobre DMc, 70% dos estudantes sabiam que a doença se caracterizava pela presença de altos níveis de açúcar séricos e que o histórico familiar era um importan= te fator de risco. Mais da metade dos pesquisados vinculou a obesidade e inatividade física a fatores de risco para DMc. 

Apesar da exposição a diversas fontes de informação, o nível de conhecimento dos estudantes sobre o DMc= é inadequado. Recomenda-se o engajamento de profissionais de saúde em ambientes educacionais, a fim de aprimorar o conhecimento relacionado à s= aúde e incorporar práticas de estilo de vida saudáveis entre os estudantes

06

O estudo revelou que os estudantes são menos conscientes quanto aos fatores de risco de DCVa (colesterol al= to, estresse, hipertensão, tabagismo obesidade, diabetes, inatividade física e outros) do que as estudantes. Comparações entre os grupos de IMCd revelaram que os indivíduos obesos atribuíram menor importância aos fator= es de riscos de DCVa=

As observações indicaram que os níveis de consciência de fatores de risco de DCV precisam ser aprimorados entre os estudantes universitários. Portanto, é de extrema importância que os profissionais de saúde da atenção primária desenvolvam intervenções para a redução dos níveis de risco de DCVa

07

Em todos os nove países da ASEANe, houve prevalência de fatores de risco de DCVa entre os estudan= tes. Para os cinco fatores de risco considerados (tabagismo, dieta não saudáve= l, obesidade, inatividade física e uso nocivo de álcool), a conscientização = dos estudantes quanto ao envolvimento desses fatores em DCVa foi baixa. Entretanto, as estudantes apresentaram menor prevalência desses fatores e uma crença "mais saudável" quando comparado aos estudantes, exceto na prática de atividade física

A pesquisa constatou alta prevalência de fato= res de risco comportamentais de DCVa, limitada conscientização des= ses riscos e crenças de saúde negativas. Os resultados podem favorecer o desenvolvimento de estratégias de promoção da saúde entre estudantes universitários da ASEANe.

08

O nível de conhecimento dos estudantes quanto= aos quatro indicadores de saúde (colesterol, pressão arterial, glicemia e IMC= d) foi extremamente baixo. Entre os estudantes de Farmácia do 1º ano e calou= ros, foram observadas diferenças em termos de conhecimento sobre o colesterol total e a pressão arterial. Em ambos os grupos, menos de 50% dos estudantes conheciam seu IMCd, com um maior percentual constat= ado entre aqueles do 1º ano profissional. A porcentagem de respostas corretas para os outros três indicadores de saúde (colesterol, glicemia e IMC= d) foi baixa entre os estudantes

A pesquisa revelou um reduzido nível de conscientização de estudantes quanto aos seus indicadores de saúde. Mostr= ou ainda que dois ou mais anos de ensino superior e a escolha de uma carreira profissional de saúde fazem a diferença no nível de consciência dos estudantes quanto à saúde. Todavia, mais pesquisas são necessárias para e= ntender o baixo nível de conscientização dos indicadores críticos de saúde entre = os estudantes

09

Embora insuficientes, a percepção e conhecime= nto de alguns fatores de risco de DCVa (dislipidemia, hipertensão arterial e alterações metabólicas) foram significativamente melhores entr= e os estudantes de graduação em relação aos calouros. Ao final do curso de Medicina, muitos estudantes eram fumantes, apesar de conhecerem os efeitos nocivos do tabagismo. Eles apresentavam uma reduzida consciência quanto à contribuição da obesidade no desenvolvimento de DCVa

Os resultados sugerem uma necessidade urgente= de conscientizar os estudantes do curso de Medicina sobre a importância da obesidade e reduzida atividade física no desenvolvimento de DCVa

10

Diante da possibilidade de desenvolver DCVa, 85 (53%) estudantes mostraram-se preocupados, embora apenas 33 (38%) tive= ssem adotado práticas preventivas (atividade física e consumo regular de gordu= ra e sal). Do total de participantes, 101 (64%) acreditavam que a vida na escola de medicina tinha um efeito prejudicial à saúde<= /p>

O estudo mostrou uma alta prevalência de comportamentos de risco de DCVa entre os estudantes do curso de Medicina

11

Os estudantes mais avançados no curso de Medi= cina tinham maior conhecimento sobre os fatores de risco de DVCa (colesterol, síndrome metabólica e terapia hipolipemiante) do que aqueles= que estavam no início do curso. Apenas cerca de 20% dos estudantes conheciam todos os fatores de riscos incluídos na síndrome metabólica. Fatores, como inatividade física, obesidade, DMc tipo 2, tabagismo e hipertensão, não foram consideravelmente classificados como importantes condições de risco de DCVa

O estudo mostrou claramente que o conheciment= o de estudantes do curso de Medicina sobre os fatores de risco de DCVa devem ser aprimorados. Ainda, a educação médica deve fornecer conhecimentos básicos que possibilitem a prevenção eficaz dessas doenças<= o:p>

 

12

Em relação ao programa, o qual consistia em a= ulas semanais, durante as quais eram feitas atividades experimentais, autoavaliações, discussões e trabalhos de casa com estudantes afro-americanos, foi constatada sua eficácia. Foram identificados diversos benefícios da intervenção, como aumento no conhecimento sobre fatores de risco para DCVa e capacidade física, bem como melhores hábitos alimentares e maior conhecimento sobre as estratégias de gerenciamento do estresse

Oficinas experimentais com pequenos grupos po= dem ser eficazes para a compreensão dos riscos e estabelecimento de hábitos saudáveis para prevenção de DCVa entre os estudantes universitários afro-americanos

 

13

O nível de conhecimento dos estudantes sobre = os fatores de risco de DCVa (IMCd, pressão arterial, glicose séri= ca, colesterol e triglicerídeos) foi baixo. O percentual de participantes com sobrepeso e obesidade foi de 18,8%, para homens, e de 22,1%, para mulhere= s. Observou-se uma relação inversamente proporcional entre o maior nível de conhecimento sobre os fatores de risco de DCVa e a redução nos valores séricos de glicose e colesterol

A pesquisa mostrou um conhecimento reduzido d= os fatores de risco de DCVa entre estudantes do curso de Enfermag= em, além da presença desses fatores de risco

 

14

Verificou-se que os estudantes do sexo femini= no tinham uma nutrição mais adequada. Observou-se uma associação positiva en= tre o conhecimento, a gravidade percebida de DCVa e autoeficácia c= om a prática de atividade física, assim como uma relação negativa entre esse comportamento e as barreiras percebidas (medo de estranhos, mau tempo e muitas tarefas escolares)

O estudo indicou que os contrastes entre as crenças em saúde podem prever o comportamento de risco de estudantes universitários frente a doenças cardíacas. No entanto, são necessárias ma= is pesquisas para verificar os preditores de comportamentos de alto risco ne= sses estudantes

15

Entre os estudantes, constatou-se uma ingesta= de sal superior ao limite máximo recomendado internacionalmente, embora foss= em conscientes de suas consequências. Menos da metade dos participantes rela= tou ter ciência de sua alta ingestão de sódio. Quanto ao potássio, a ingestão média pelos estudantes foi inferior ao valor recomendado. Em relação a ou= tros fatores de risco de DCVa clássicos, foi observada alta prevalê= ncia de inatividade física e ingestão de álcool, bem como baixa prevalência de hipertensão, diabetes e obesidade

O estudo indicou uma alta ingestão de sal ent= re estudantes do curso de Medicina e uma percepção inadequada quanto ao seu nível de ingestão, bem como atitude e comportamento insuficientes em rela= ção ao seu controle.  Diante desse cenário, faz-se necessária a educação nutricional para aprimorar os conhecimentos e hábitos alimentares desses estudantes

 

16

Entre os estudantes, foram constatados baixos níveis de conhecimento sobre fatores de risco de DCVa (tabagis= mo, álcool, dieta não saudável, inatividade física, IMCd e estress= e). Dos participantes, 46,1% eram fumantes, 31,9% consumiam álcool, 20,8% tin= ham sobrepeso, 1,6% eram obesos e 26,1% tinham doenças crônicas. Os resultados mostraram que os estudantes não tinham comportamentos saudáveis, como prá= tica de exercício físico, nutrição adequada e controle do estresse<= /span>

As avaliações dos níveis de conhecimento mostraram que os estudantes não possuíam conhecimento adequado e que exis= tia uma relação positiva e significativa entre comportamentos positivos de sa= úde e níveis de conhecimento sobre fatores de riscos de DCVa. Nesse sentido, pode-se sugerir que estudos e triagem em doenças crônicas e consultas médicas regulares podem prevenir essas doenças

17

 Os participantes conheciam os fatores de risco de DCVa (diabetes, sobrepeso/ obesidade, hipertensão, hiperlipidemia, tabagismo), mas não se viam em risco de desenvolvê-las. Quando avaliados os fatores de riscos de DCVa, constatou-se que mais de 50% dos estudantes tinham um ou mais desses fato= res

O alto nível de conhecimento dos fatores de r= isco de DCVa não foi suficiente para reduzir os riscos dessas doenç= as entre os estudantes. Dessa forma, alterar a percepção desses fatores pode desempenhar um papel maior na redução dos riscos dessas doenças a longo p= razo

 

aDoenças Cardiovasculares; bHipertens= ão Arterial Sistêmica; cDiabetes Mellitus; dÍndice de Ma= ssa Corporal; eAssociação das Nações do Sudeste Asiático.  

Fonte: Os autores

 

DISCUSSÃO<= /span>

= As estatísticas apresentadas pela literatura revelam que as DCV representam uma das principais causas de morte no contexto mundial. Em vista disso, a relevância de estudar os fatores de risco cardiovasculares em universitário= s se baseia na conjuntura de que esse público, pelas transformações físicas, emo= cionais e sociais, busca pela independência e vivência de novas experiências, associadas a uma elevada carga de estresse proporcionada pelo ambiente universitário, torna-se vulnerável a comportamentos de risco, mesmo diante = do acesso a informações19. =

= Assim, compreender esses fatores pode prevenir, manter ou restabelecer a saúde des= sa população e evitar impactos socioeconômicos33, visto que esses elementos podem ser modificáveis de acordo com o ambiente e tempo de exposi= ção34.

= Na presente revisão, foram avaliadas as produções que abordaram a prevalência, conhecimento, atitudes e práticas em relação aos fatores de risco de DCV em estudantes universitários. A constatação desses aspectos em adultos jovens possibilita identificar o nível de suscetibilidade desses indivíduos a essas doenças. Portanto, a compilação dos estudos ajudará a identificar as lacuna= s no conhecimento, o que poderá melhorar as práticas e políticas direcionadas à promoção e prevenção das DCV entre os universitários.

Quando avaliado o quantitativo de trabalhos incluíd= os nessa revisão, de acordo com a base de dados, o destaque para o Scopus pode= ser concebido por ser ele a maior base de dados, contendo resumos de publicações revisadas por pares, da Editora Elsevier35. Quanto ao idioma dos artigos aqui inseridos, o fato de todos estarem em lín= gua inglesa pode ser justificado por ser ela uma das estratégias aplicadas para= a internacionalização científica36 ou pelo fato de possíveis bases de dados que incluem artigos no idioma portugu= ês não terem sido incluídos na revisão.

No que se refere ao maior número de estudos publica= dos em diferentes anos, esse resultado pode sugerir a relevância e interesse da temática aqui retratada em distintos momentos do tempo. Quanto ao local da realização dos estudos incluídos nessa revisão, o destaque para a Turquia, = além dos EUA, foi um dado inesperado, já que a China tem se destacado pelo incen= tivo ao desenvolvimento de pesquisas37. O destaque dos EUA pode ser justificado pela possibilidade desse país desen= volver mais pesquisas nessa área como consequência dos hábitos alimentares, estilo= de vida e acometimento da população por doenças cardiovasculares, uma vez que é considerado como um dos líderes globais em ciência e tecnologia38.  

= Sobre a área de publicação dos artigos, o grande quantitativo de trabalhos disponibilizados em periódicos da área médica, embora evidencie a importânc= ia da temática para a Medicina, sugere uma deficiência na integração entre as diferentes áreas da saúde, o que vai de encontro ao ditado pela literatura.= De acordo com os autores39,= o trabalho em saúde deve envolver ações interdisciplinares, multidisciplinare= s e transdisciplinares.    <= /span>

= Com relação à grande parte das publicações apresentarem, como desenho metodológ= ico, o estudo descritivo, embora descreva dados que foram verificados, registrad= os, analisados, classificados e interpretados, sem a interferência do pesquisad= or e com uso de técnicas padronizadas de coleta de dados40, não busca avaliar uma possível associação entre a cau= sa da doença e seu efeito41= . Sobre o predomínio de estudos com nível= VI de evidência, esse achado sugere que as publicações não apresentam fortes evidências, o que pode prejudicar sua aplicabilidade clínica32.         

= Quando analisados os objetivos dos artigos incluídos, a maior quantidade de publicações que avaliaram os conhecimentos, atitudes e práticas em relação = aos fatores de risco de DCV de estudantes universitários superou as expectativas dessa revisão por não terem se limitado ao conhecimento desses fatores. Esse resultado é importante no sentido de que intervenções voltadas à promoção e prevenção de DCV, de cunho individual ou coletivo, são melhores efetuadas se embasadas no conhecimento das atitudes e práticas do público a que se desti= nam42. 

= O mesmo pode ser dito em relação aos estudos aqui retratados, os quais se propuseram a apresentar a prevalência de fatores de risco ou da própria DCV entre os universitários, os resultados da avaliação desse risco e a análise= do impacto da educação sobre o conhecimento e reconhecimento da importância da implementação de medidas preventivas contra DCV. Realmente, conhecer esses diferentes aspectos pode interferir nas ações destinadas à prevenção, manutenção e restabelecimento da saúde de universitários diante dessas doen= ças.

= No que diz respeito aos resultados apresentados pelas pesquisas incluídas na revisão, o fato de que, em geral, os estudantes apresentaram baixos níveis = de conhecimento sobre os fatores de risco de DCV= , foi surpreendente, especialmente se considerado que esse fenômeno ocorreu entre estudantes de diferentes faculdades e tempo de curso. Ressaltando ainda o imprevisto desse achado, sabe-se que esses estudantes apresentavam inúmeros comportamentos de risco para essas doenças e que a Universidade representa = um importante meio de disseminação das informações sobre esses fatores de risc= o a muitos jovens43.

= Contudo, esse dado pode resultar da fo= rma como a mídia e o consumismo da sociedade atual vinculam esses fatores de ri= sco ao prazer, especialmente em propagandas de fast food, além de que se admite= que a atuação dos fatores de risco comportamentais sobre a saúde é geralmente manifestada em idades mais avançadas4= 4. Esse dado também pode decorrer do nível de escolaridade dos pais, especialm= ente da mãe, pelo papel que essa assume no cuidado com os filhos45. Realmente, em pesquisa d= os autores46, os autores observaram que os estudantes, cujas mães tinham 5 a 11 anos de estudo, apresentaram maior possibilidade de ter um fator de risco a mais em comparação àqueles, cujas = mães tinham escolaridade maior ou igual a 12 anos.

= Dessa forma, independentemente da caus= a da desinformação, a sua consequência pode não diminuir a incidência de DVC ent= re os estudantes universitários, além de favorecer a elevação dos custos para = os setores públicos e privados47. 

= No que se refere aos fatores de risco = de DCV, a literatura classifica-os em fatores de riscos modificáveis (ambientais e comportamentais), como o tabagismo, alcoolismo, colesterol sérico elevado, hipertensão arterial sistêmica, inatividade físi= ca, estresse e condições secundárias (DM, obesidade, uso de anticoncepcional e obesidade abdominal), e fatores de risco não modificáveis (genéticos e biológicos), representados pela hereditariedade, sexo e idade avançada= 44.

= Especificamente, os fatores de risco de DCV relatados nos estudos aqui incluídos foram inúme= ros e compreenderam tanto os modificáveis quanto os não modificáveis, com um quantitativo maior entre os primeiros. Esses fatores foram também observados por outros autores44,48,= os quais destacaram o sedentarismo. Esse, conjuntamente com a hipertensão arterial, tabagismo, hiperglicemia e sobrepeso/obesidade, figura como um dos fatores de risco de DCV globalmente conhecidos49.   =

= Nessa revisão, o tabagismo foi o fator de risco modificável mais citado pelos estudantes, o que pode estar associado à elevada prática desse hábito entre= os universitários50 e/ou ao= fato de ser ele um dos principais fatores de risco cardiovascular modificável51. Segundo a literatura, o tabagis= mo é responsável por inúmeras e diversas doenças crônicas e por metade de todas = as mortes evitáveis50. A el= e é atribuída a elevação do estresse oxidativo, do processo inflamatório e da disfunção endotelial e plaquetária, fenômenos que podem causar dano ao organismo51.  

= No tocante ao resultado apresentado pelos artigos de que, apesar de terem a consciência quanto aos fatores de risco de DCV, os estudantes não acreditav= am em sua vulnerabilidade a essas doenças, o que pode ser compreendido se admi= tido que a idade acima de 45 anos para homens e 55 anos para mulheres é tida com= o um fator de susceptibilidade a DCV52. Para a não adoção de medidas preventivas pelos estudantes, esse resultado p= ode se associar à própria crença de que não são susceptíveis a DCV e/ou falta d= e tempo53. Quanto à ausência de prática de= um estilo saudável, apesar da consciência quanto aos fatores de risco, ela pode ser explicada por problemas na administração do tempo, necessidade de obter= um bom desempenho53, comprometimento dos hábitos alimentares e horários de refeições e adoção de= um estilo de vida mais sedentário54. 

= Em relação ao baixo nível de conhecimento sobre os indicadores de saúde entre = os universitários, esse achado é preocupante por sugerir que esses estudantes desconhecem a realidade vivenciada por eles, o que pode comprometer a aplic= ação de políticas e estratégias voltadas a uma boa atuação e desempenho do siste= ma de saúde, bem como do monitoramento dessas doenças nessa população. 

= No que se refere à percepção dos estudantes universitários de que o curso de Medicina era prejudicial à saúde, esse resultado corrobora com os autores55, os quais relataram que o desafi= o das escolas de Medicina é proporcionar ambientes acadêmicos que não comprometam= a saúde e estimulem o progresso nos estudos. Especificamente, o estresse crôn= ico vivenciado por esses estudantes pode aumentar o risco de doenças cardiometabólicas e neurodegenerativas, além de causar declínio cognitivo e efeitos adversos no hipocampo55.

= Esse dado pode ser ainda entendido se admitido que estudantes de Medicina apresentam, em geral, um estilo de vida inadequado marcado pelo sedentarism= o, hábitos alimentares inadequados, limitado tempo para o lazer e alta carga de trabalho, assim como elevada frequência de realização de provas e expectati= va de si mesmos, isolamento social, competição com amigos e excesso de conteúd= o a ser estudado56,57.   

= Com respeito às diferenças entre os sexos quanto às atitudes e práticas em saúde dos estudantes universitários observados pelas pesquisas aqui abordadas, es= se resultado parece refletir os estereótipos relacionados ao sexo, especialmen= te expressando a imagem do homem como aquele que é mais forte, que não cuida d= e si nem do outro e que não busca os serviços de saúde. Em contrapartida, a mulh= er é aquela que é naturalmente cuidadora e que requer mais atenção pelas particularidades do organismo feminino58. Esse dado é preocupante, já que os homens parecem ser mais vulneráveis a enfermidades crônicas e graves, além de terem uma morte mais precoce59,60.  

 

CONCLUSÕES

= Pode-se concluir que o reduzido conhecimento sobre= os fatores de risco de doenças cardiovasculares apresentado por estudantes universitários de diferentes instituições de ensino e tempo de curso, assoc= iado ao não reconhecimento de vulnerabilidade a essas enfermidades e não adoção = de medidas preventivas e de estilo de vida saudável, ressalta a urgência da elaboração e aplicação de estratégias voltadas à promoção da saúde. 

= Os dados dessa revisão possibilit= aram aprofundar o conhecimento e o olhar crítico acerca do que é produzido pela literatura nacional e internacional sobre a temática aqui retratada. Nesse âmbito, poucos foram os estudos brasileiros incluídos, o que desperta para a necessidade de condução de mais pesquisas relacionadas ao conhecimento dos fatores de risco de doenças cardiovasculares entre os estudantes universitários, proporcionando a elaboração de novas revisões da literatura= e fortalecendo a prática baseada em evidências. 

 

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= 56.      Steiner-Hofbauer V, Holzinger A= . How to Cope with the Challenges of Medical Education? Stress, Depression, and Coping in Undergraduate Medical Students. Acad Psychiatry. 2020;44(4):380‑7. DOI: 10.1007/s40596-020-01193-1

= 57.      Thomas E, M G. Prevalence and Determinants of Overweight and Obesity among Medical Students. Nsatl J Phys= iol Pharm Pharmacol. 2020;10(1):1. DOI: 10.5455/njppp.2020.10.1035506112019

= 58.      Bertolini DNP, Simonetti JP. Th= e male genre and health care: the experience of men at a health center. Esc Anna N= ery - Rev Enferm. 2014;18(4):722‑7. DOI: 10.5935/1414-8145.20140103<= /o:p>

= 59.      Balbino CM, Silvino ZR, Santos = JS dos, Joaquim FL, Souza CJ de, Santos LM dos, et al. Os motivos que impedem a adesão masculina aos programas de atenção a saúde do homem. Res Soc Dev. 2020;9(7):e389974230. DOI: 10.33448/rsd-v9i7.4230

= 60.      Bruno PS, Zanini MTB, Soratto M= T, Feltrin JO. Saúde do homem: limites e possibilidades. Enferm Bras [En ligne= ]. 2011 [cité le 10 janvier 2021];10(5):274‑9. Disponible: http://www.portalatlanticaeditora.com.br/index.php/enfermagembrasil/article= /view/3874<= /span>

 

         Autor correspondente

       Ana Caroline Rocha de Melo Leite,<= br>        Universidade da Integra= ção Internacional da  Lusofonia Afro-Brasiliera - Campus das Auroras - Rua José Franco de Oliveira, s/n,        CEP – 62.790-970 – Redenção-= Ceará, fone
       (85) 99168-0679 e e-mail:         acarolmelo@unilab.edu.br

 

 

 

Submissão: 2021-05-25

Aprovado: 2021-09-26

 


[1]= Enfermeiro pela Universidade da Integração Internacional da Lusofonia Afro-Brasileira – UNILAB. Redenção - CE, Brasil. ORCID https://orcid.org/0000-0002-7787-1889

[2]= Enfermeiro pela Universidade da Integração Internacional da Lusofonia Afro-Brasileira – UNILAB. Doutorando do Programa de Pós-graduação em Ciências Morfofuncionais da Universidade Feder= al do Ceará – UFC. Mestre pelo Programa de Pós-Graduação em Enfermagem da UNIL= AB. Redenção - CE, Brasil. ORCID https://orcid.org/0000-0003= -0245-3110

[3]= Enfermeiro pela Universidade da Integração Internacional da Lusofonia Afro-Brasileira – UNILAB. Redenção - CE, Brasil. ORCID https://orcid.org/0000-0002-8079-866X

[4]= Médica Veterinária pela Universidade Estadual do Ceará – UECE. Doutora em Farmacologia pela Universidade Federal do Ceará – UFC. Mestre em Ciências Veterinárias pela U= ECE. Docente do Departamento de Morfologia da UFC. Fortaleza, Ceará – Brasil. ORCID https://orcid.org/0000-0002-0676-8585<= /o:p>

[5]= Farmacêutico pela Universidade Federal do Cea= rá – UFC. Doutor em Biotecnologi= a em Saúde pela Rede Nordeste de Biotecnologia – RENORBIO. Docente dos Cursos de= Enfermagem e Farmácia da Universidade da Integração Internacional da Lusofonia Afro-Brasileira – UNILAB. Redenção - CE, Brasil. ORCID https://orcid.org/0000-0002= -2333-5343

[6]= Odontóloga = pela Universidade Federal do Ceará – UFC. Doutora em Ciências Médicas pela UFC. Mestre em Farmacologia pela UFC. Doce= nte dos Cursos de Enfermagem e Farmácia da Universi= dade da Integração Internacional da Lusofonia Afro-Brasileira – UNILAB. Redenção - CE, Brasil. ORCID https://orcid.org/0000-0002-9007-7970 =

 

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                =

https://doi.org/10.31011/reaid-2021-v.95-n.36-art.1122  Rev Enferm A= tual In Derme  v. 95, n. 36, 2021  = e-021136                 1

 

 

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