Leptina, hipertensão arterial e obesidade: importância das ações de enfermagem

Abstract

The objective of this systematic review was to retrieve topics of relevance to the implications of leptin in modulating blood pressure and in the genesis, prevention and treatment of hypertension associated with obesity. Considering the hormone as a common link between the two pathological conditions, were identified actions to reduce the leptinemia, proposed and discussed in the literature. It was found that nursing lacks production of knowledge to subsidize the assistance to hypertensive obesity that present alterations in serum leptin. Were described signs and multifactorials symptoms dynamically interrelated and paradoxical in the manifestation of the clinical case studied, with effective management interventions in caring for those clients. Keywords: Leptin; Blood pressure/therapy; Obesity; Hypertension RESUMOO objetivo desta revisão sistemática foi o levantamento de tópicos de relevância sobre as implicações da leptina na modulação da pressão arterial e na gênese, prevenção e tratamento da hipertensão arterial associada à obesidade. Considerando o hormônio como um elo comum entre as duas condições patológicas, foram identificadas as ações para a redução da leptinemia, propostas e discutidas na literatura. Constatouse que a enfermagem carece de produção de conhecimento que subsidie a assistência ao hipertenso obeso com alterações nos níveis séricos de leptina. Foram descritos os sinais e sintomas multifatoriais que se interrelacionam de maneira dinâmica e paradoxal na manifestação do quadro clínico estudado, com ordenação de intervenções eficazes no cuidado a esses clientes. Descritores: Leptina; Pressão arterial/terapia; Obesidade; Hipertensão RESUMENEl objetivo de esta revisión sistemática fue el levantamiento de tópicos de relevancia sobre las implicaciones de la leptina en la modulación de la presión arterial y en la génesis, prevención y tratamiento de la hipertensión arterial asociada a la obesidad. Considerando a la hormona como un eslabón común entre las dos condiciones patológicas, fueron identificadas las acciones para la reducción de la leptinemia, propuestas y discutidas en la literatura. Se constató que la enfermería carece de producción de conocimiento que subsidie la asistencia al hipertenso obeso con alteraciones en los niveles séricos de leptina. Fueron descritas las señales y síntomas multifactoriales que se interrelacionan de manera dinámica y paradojal en la manifestación del cuadro clínico estudiado, con ordenación de intervenciones eficaces en el cuidado a esos clientes.

O papel educativo do enfermeiro na adesão ao tratamento da Hipertensão Arterial Sistêmica: revisão integrativa da literatura

“…O enfermeiro deve acompanhar o usuário do sistema de saúde ou realizar intervenções coletivas considerando o perfil da comunidade assistida. Para uma prevenção adequada, deve-se sempre enfocar a orientação sobre os riscos da doença 17 .…”

Nursing diagnoses in patients with morbid obesity

“…The prevention of risks to life and well-being of the obese patient should start from the pre-operative phase, with identification and guidance on the risk factors that may lead to compromised health of obese patients [26] .…”

Acupuntura e apetite de trabalhadores obesos de um hospital universitário

“…If higher than one for men and 0.85 for women, the risk for cardiovascular diseases is considered present (2) . Still without a defined primary cause, obesity involves multiple factors (3) and can be provoked by the increased intake of caloric foods or decreased physical exercise; it will definitely result in a calorie unbalance though, as more calories are consumed than spent.…”

“…Educative information on physiopathology and diet, physical exercise and lifestyle change orientations need to be part of these people's treatment, independently of the disease's severity. Then, community action is needed with a view to health promotion and prevention, clarifying the risks of obesity, besides acting in treatment, controlling signs of risk for other comorbidities and orienting the multiprofessional team and patients on other treatments that can be used (3) . Thus, nurses with a specialist degree in Acupuncture (8)(9) can contribute to the reduction of these symptoms, using this technique as yet another care strategy for individuals going through this process.…”

“…Besides its anxiolytic effects, this technique has also demonstrated its effectiveness in cholesterol control and reduction (13) . It is important to remember that anxiety strongly influences the appetite of overweight people, and that handling this problem is complex and demands multiprofessional care, including medication, nutritional, psychological and habit re-education treatments (3) . It is sometimes difficult to establish whether anxiety is the cause of the increased appetite that leads to obesity, or whether it precedes this emotional imbalance.…”