IJCS | Volume 32, Nº5, September/October 2019

519 Cabral Cardiovascular risk and metabolic syndrome Int J Cardiovasc Sci. 2019;32(5):517-526 Original Article 20%, respectively, for coronary heart disease, based on sex, age, HDL and LDL cholesterol levels, systolic and diastolic blood pressure, diabetes and smoking. 17 An informed consent form, containing detailed information about the study, and assuring confidentiality and protection from harm or complications, was signed by each participant or their tutors. The study was submitted and approved by the ethics committee of Piauí Federal University. Statistical analysis We conducted a descriptive, analytical study. Categorical data were expressed as relative (%) and absolute (n) frequency, and 95% confidence interval. Distribution of quantitative variables was tested for normality using the Kolmogorov-Smirnov test. Continuous variables with normal distribution were presented as dispersion measures (mean and standard deviation) and measures of central tendency (minimum and maximum values). The null hypothesis (H0) was that the data had a normal distribution, whereas the alternative hypothesis (H1) was that data did not have a normal distribution (Kolmogorov test). Student’s t-test was used for comparisons of the means of data with normal distribution, and the non-parametric Mann-Whitney U test used for data without normal distribution (rejecting the null hypothesis). To verifywhether the variables were independent (i.e., unrelated), we used the chi-square test of independence and the Fisher’s exact test (when more than 25% of the expected frequency was lower than 5 or if any of the expected frequencies was lower than 1). The odds ratio was used to test the strength of the association between two variables. The level of significance was set at 0.05. Data were organized and analyzed using the IBM Statistical Package for the Social Sciences software, version 20.0. 18 Results A total of 298 individuals participated in the study, 176 (59.1%) were women. Most men (57.38%) were aged between 18 and 40 years, and most women (55.11%) between 40 and 60 years. Most participants (65.4%) self- reported “Pardo”. Regarding school attainment, 46% completed elementary school, 75.9% were single, living with family members, and 36.2% of them gained < 1 minimum wage (Table 1). The frequency of MS was 5.4%, 41.3% and 46% according to the WHO, NCEP and IDF criteria, respectively. A higher frequency of MS was seen among women according to these three definitions, although a statistically significant difference between men and women was seen with the NCEP criteria only (p = 0.0094) (Table 2). Schizotypal disorders and persistent delusional disorders were themost prevalent conditions (50%; 60.7% in men), followed by mood disorders (39.3%; 50.0% in women). No cases of behavioral syndromes, disorders of adult personality and behavior, intellectual disabilities, or psychological developmental disorders were found. A higher frequency of MS was observed in patients with schizotypal disorders and persistent delusional disorders - 50%, 47.2% and 48.2% according to WHO, NCEP and IDF criteria, respectively (Table 3). In addition, regarding the 10-year risk for coronary diseases, most patients (81.9%) showed a low cardiovascular risk, 13.8% and intermediate risk, and 4.4% a high risk. Therefore, an intermediate or a high cardiovascular risk was seen in 18.12% of the sample, 75.07% among women. The factors used for the Framingham score calculation are described in Table 4. All variables were significantly associated with cardiovascular risk, except for smoking. Significant association between the variables was found in the analysis of the relationship of the intermediate/high risk for coronary disease with MS (p < 0,01). Analysis of the data revealed that the chance of individuals with MS, according to the WHO criteria, being at an intermediate or high risk for cardiovascular disease was 12.22 times greater than those without MS, and 8.01 and 6.23 times greater based on NCEP and IDF criteria for MS, respectively (Table 5). Discussion Although many studies have investigated MS or cardiovascular risk in psychiatric patients, 19-21 this is the first study to evaluate the classification of cardiovascular risk and its association with MS in MD patients at secondary health care in Brazil. The present study confirmed data in the literature showing an association between MDs and social indicators, such as a higher frequency of female