Prevalência e fatores associados à hipertensão arterial em idosos de municípios da Amazônia Legal, MT

Impact of the Health Gym Program on mortality from Systemic Arterial Hypertension in Pernambuco state, Brazil

The aim of this paper was to analyze the impact of the Health Gym Program (HGP) on the Systemic Arterial Hypertension mortality rate in Pernambuco state, Brazil. This public policy impact analysis used a quasi-experimental approach which consisted of the application of Propensity Score Matching in the years 2010 and 2017. Socioeconomic, demographic, and epidemiological data of 89 municipalities that implemented HGP (treated) and 54 that did not (controls) were collected from the Brazilian Health Data Department, Brazilian Institute of Geography and Statistics, and other databases. The impact of HGP on hypertension mortality rate was estimated through a logit model using the Kernel algorithm. Treated municipalities presented a decrease of 12.8% in global hypertension mortality rate, 12.5% in brown-skinned people and 13.1% in those over 80 years of age. The balancing test attests to the robustness of the estimated model to explain the impact of the program on mortality due to hypertension. The implementation of the program proved to be effective in decreasing the mortality rate in the treated municipalities, indicating that it seems to contribute to controlling the progress of chronic non-communicable diseases.

Falha no diagnóstico e no tratamento medicamentoso da hipertensão arterial em idosos brasileiros – Estudo FIBRA

Resumo O objetivo deste estudo foi investigar prevalências de falhas no diagnóstico, no uso de anti-hipertensivos e na eficácia do tratamento medicamentoso da hipertensão, e a associação destes parâmetros com variáveis sociodemográficas, de saúde e acesso ao serviço de saúde em idosos não institucionalizados. O estudo foi descritivo, transversal, com 3478 idosos, analisados separadamente em regiões Norte/Nordeste e Sul/Sudeste. Utilizou-se a regressão múltipla de Poisson para estimar razões de prevalência brutas e ajustadas pelo tipo de serviço de saúde utilizado. Do total, 29,6% dos idosos apresentaram falhas no diagnóstico, 4,6% no uso de anti-hipertensivos e 65,3% na eficácia medicamentosa. A falha no diagnóstico associou-se ao sexo masculino, menos morbidades, ter um companheiro, raça/cor branca, ter acesso ao convênio ou serviço privado de saúde, possuir renda pessoal inferior/média e ainda trabalhar. A falha no uso de anti-hipertensivos esteve associada à renda pessoal inferior/média e trabalhar. As falhas no manejo da hipertensão são prevalentes em idosos não institucionalizados. Há necessidade de ações que minimizem os impactos negativos destas insuficiências em saúde, em um país com diferenças sociais, econômicas e étnicas.

Prevalence of Systemic Arterial Hypertension Diagnosed, Undiagnosed, and Uncontrolled in Elderly Population: SABE Study

Systemic arterial hypertension is the most prevalent chronic noncommunicable disease among older people. This study aimed to estimate the prevalence of hypertension in the elderly and to analyze factors associated with diagnosed, undiagnosed, and uncontrolled hypertension. This is a cross-sectional study of data from the SABE study-Health, Well-Being, and Aging Survey-a multiple-cohort study, obtained in 2010, composed of a probabilistic sample representative of the population of the São Paulo city aged ≥60 years. Hypertension was self-reported or defined by increased blood pressure. Multinomial regression assessed factors associated with diagnosis and lack of diagnosis of hypertension (reference: no hypertension), and logistic regression assessed factors associated with uncontrolled hypertension (reference: controlled). The prevalence of hypertension was 79.5%, and in 51% of individuals with the condition, hypertension was uncontrolled. Undiagnosed hypertension was associated with nonwhite skin color (OR: 1.89, CI: 1.11-3.19), being uninsured (OR: 1.77, CI: 1.04-3.03), overweight (OR: 2.38, CI: 1.09-5.19), higher education (OR: 0.46, CI: 0.22-1.94), and ≥1 chronic disease (OR: 0.28; CI: 0.13-0.58). Diagnosed hypertension was associated with age between 70 and 79 years (OR: 2.02, CI: 1.34-3.05), age ≥80 (OR: 2.73, CI: 1.72-4.31), nonwhite skin color (OR: 1.48, CI: 1.01-2.18), being uninsured (OR: 1.70, CI: 1.18-2.47), at least one medical consultation in the last year (OR: 1.86, CI: 1.06-3.25), obesity (OR: 2.50, CI: 1.61-3.88), and ≥1 chronic disease (OR: 2.81, CI: 1.94-4.08). Among those with hypertension, being uncontrolled was associated with widowhood (OR: 1.73, CI: 1.23-2.43), being uninsured (OR: 1.38, CI: 1.02-1.87), and female gender (OR: 0.61, CI: 0.43-0.87). The prevalence of hypertension was high in this population, and its diagnosis and control were associated with socioeconomic, demographic, and healthcare access factors.

High Blood Pressure and Self-Reported Systemic Hypertension in Elderly Enrolled in the Family Health Strategy Program

OBJECTIVE

This study aimed to determine the prevalence of high blood pressure (HBP), self-reported hypertension, and associated factors among in elderly enrolled in the Family Health Strategy (FHS) Program.

METHOD

This is a cross-sectional study with in elderly enrolled in the FHS Program of Campina Grande/Paraíba/Brazil. This study determined the prevalence of HBP and self-reported hypertension and their associations with demographic, socioeconomic variables, lifestyle, and number of self-reported morbidities. Three blood pressure measurements were performed, and the average value was used for analysis. To control possible confounding factors, data were modeled by the method of linear models generalized with Poisson log modeling to determine prevalence ratios and confidence intervals. The SPSS 22.0 statistical application was used, and 5% significance level was adopted.

RESULTS

High prevalence of HBP (80.9%) was observed, which was associated with the number of self-reported morbidities, both in the univariate and multivariate analyses. High prevalence of self-reported hypertension (66.4%) was also observed. In the final model, positive association between hypertension and demographic and socioeconomic variables and lifestyle was verified.

DISCUSSION

Monitor hypertension should be a priority action given its association with genetic, social and behavioral conditions presented by individuals.

Estado nutricional e prevalência de doenças crônicas em idosos de um município do interior do Rio Grande do Sul

OBJETIVO: Verificar os fatores de risco que interferem no estado nutricional dos idosos socialmente ativos de um município do interior do Estado do Rio Grande do Sul. MÉTODOS: Estudo do tipo transversal, do qual participaram voluntariamente 284 idosos. Foi aplicado questionário individual estruturado contendo questões relativas aos hábitos alimentares e foram coletados os dados antropométricos (peso, altura, circunferência da cintura). RESULTADOS: 60,3% dos homens e 62,5% das mulheres estavam com sobrepeso. Com base na avaliação da circunferência da cintura, verificou-se um risco muito aumentado para o desenvolvimento de doenças cardiovasculares em 98,5% dos homens e 92,5% das mulheres. A maioria das mulheres (56,9%) informou usar algum medicamento contínuo, enquanto que entre os homens (52,5%), a maioria respondeu não consumir nenhum medicamento. Não se observou diferença significativa entre os diferentes estados nutricionais e os hábitos alimentares investigados. Entre os casados, o sobrepeso foi encontrado em 47,1% dos homens e em 35,6% das mulheres. CONCLUSÃO: A maioria da população idosa estudada apresentou sobrepeso e circunferência da cintura elevada entre homens e mulheres. Não se observou associação entre o estado nutricional e o número de refeições, ingestão de água, consumo diário de frutas e verduras, tipo de leite ingerido, consumo semanal de carnes, doces, frituras e leguminosas.