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

2019 ◽  
Vol 2019 ◽  
pp. 1-11
Author(s):  
Isabela Martins Oliveira ◽  
Yeda Aparecida de Oliveira Duarte ◽  
Dirce Maria Trevisan Zanetta

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.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M A Vieira ◽  
M Felisbino-Mendes ◽  
J G Velásquez-Meléndez

Abstract Background Hypertension is the main risk factor for cardiovascular diseases, contributing significantly to the increase in the number of deaths and disabilities worldwide. Moreover, hypertension control is a major action for NCDs prevention. Although pharmacological treatment has been shown effective, high rates of uncontrolled hypertension remain. The objective is to estimate the prevalence of uncontrolled arterial hypertension and the factors associated to this outcome in a representative adult Brazilian population under a pharmacological treatment. Methods This is a cross-sectional study conducted with 10,016 Brazilian adults over 18 years old who participated in the National Health Survey in Brazil carried-out in 2013. The sample comprised of residents from all Federative Units, Poisson multivariate regression was used to calculate the prevalence ratio (PR) and 95% confidence interval. Results 45% (95% CI: 44; 48) of hypertensive adults under drug treatment have uncontrolled blood pressure levels. Female gender [PR = 0.92; CI: 0.85; 0.99] and not having previous hospitalizations due to complications from hypertension or other causes [PR = 0.86; CI: 0.78; 0.94] were associated to low the prevalence of uncontrolled blood pressure. Participants aged 60 years old or more [PR = 1.31; CI:1.04; 1.64], who self-declared as black [PR = 1.19; CI: 1.04; 1.36], without health insurance [PR = 1.15; CI: 1.05; 1.27] and not attending the health service because of arterial hypertension [PR = 1.10; CI:1.01; 1.20)] presented higher prevalence of uncontrolled blood pressure. Conclusions The prevalence of uncontrolled hypertension among Brazilian adults was high among the male gender, black people, elderly, without previous hospitalizations, without health insurance and not regularly attending the health service. These results may alert the need for a reassessment of the assistance provided, in addition to raising awareness of a possible change in public policies in these groups. Key messages Evidence the magnitude of people who are at risk of hypertension even under pharmacological treatment. Highlight inequities related to the uncontrol of hypertension.


2019 ◽  
Vol 13 (44) ◽  
pp. 865-876
Author(s):  
Edglê Alves Ferreira ◽  
Deboráh Cristina Silva Queiroz Alves ◽  
Francisco José Braga Parnaíba ◽  
Neiza Davi da Silva ◽  
Suyanne Cavalcante Barreto ◽  
...  

Objetivou-se investigar os fatores determinantes à não adesão dos usuários idosos hipertensos quanto ao tratamento da hipertensão arterial sistêmica. Tratou-se de um estudo qualitativo, exploratório com abordagem descritiva. A coleta de dados ocorreu em agosto de 2017 através de um grupo focal com clientes idosos hipertensos que não aderiam ao tratamento da hipertensão arterial sistêmica. Foi visto a falta ou inexistência de medicamentos anti-hipertensivos na unidade de saúde, juntamente com o descuido do próprio cliente, configuram-se como os principais fatores que estavam diretamente relacionados a não adesão ao tratamento da hipertensão arterial sistêmica. Nesse sentido, há necessidade de ações de promoção da saúde que levem a prevenção e a busca destes clientes na para orientações e acompanhamento na Estratégia Saúde da Família, levando estes a um direcionamento adequado na redução e complicações decorrentes.    


Author(s):  
Muhamad Hasrol Mohd Ashri ◽  
Hazizi Abu Saad ◽  
Siti Nur ‘Asyura Adznam

The current rapid growth of the economy has necessitated an assessment of health-related quality of life (HRQOL) and its associated factors among employees. Unfortunately, there are still limited data available in this area among the Malaysian working population in government sectors. The aim of this study was to evaluate the factors associated with HRQOL among government employees in Putrajaya, Malaysia. This cross-sectional study recruited 460 eligible government employees who worked in the area of Putrajaya through simple random sampling. The self-administered questionnaire was distributed to these participants to collect information on the SF-36 profile of scores, sociodemographic factors, lifestyle factors, and medical history. The results of this study signify that most of the participants were identified as having good HRQOL with the mean score of overall HRQOL was 72.42 ± 14.99. Multivariate analysis showed that being younger, receiving a better monthly personal income, a smaller household number, performing more physical activity, not having any chronic disease, and not using any long-term medication were significantly positively associated with overall HRQOL. The participants who did not have a family history of chronic disease were reported to be significantly associated with better mental component summary (MCS). Further, males were significantly positively associated with bodily pain (BP) and general health (GH) only, whereas better occupational status was limited to social functioning (SF). In conclusion, the results of this study provide motivation for future research and initiatives for improving the physical, emotional, and social well-being of government employees.


Author(s):  
Alyshia Gálvez

In the two decades since the North American Free Trade Agreement (NAFTA) went into effect, Mexico has seen an epidemic of diet-related illness. While globalization has been associated with an increase in chronic disease around the world, in Mexico, the speed and scope of the rise has been called a public health emergency. The shift in Mexican foodways is happening at a moment when the country’s ancestral cuisine is now more popular and appreciated around the world than ever. What does it mean for their health and well-being when many Mexicans eat fewer tortillas and more instant noodles, while global elites demand tacos made with handmade corn tortillas? This book examines the transformation of the Mexican food system since NAFTA and how it has made it harder for people to eat as they once did. The book contextualizes NAFTA within Mexico’s approach to economic development since the Revolution, noticing the role envisioned for rural and low-income people in the path to modernization. Examination of anti-poverty and public health policies in Mexico reveal how it has become easier for people to consume processed foods and beverages, even when to do so can be harmful to health. The book critiques Mexico’s strategy for addressing the public health crisis generated by rising rates of chronic disease for blaming the dietary habits of those whose lives have been upended by the economic and political shifts of NAFTA.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sahr Wali ◽  
Stefan Superina ◽  
Angela Mashford-Pringle ◽  
Heather Ross ◽  
Joseph A. Cafazzo

Abstract Background Indigenous populations have remained strong and resilient in maintaining their unique culture and values, despite centuries of colonial oppression. Unfortunately, a consequential result of facing years of adversity has led Indigenous populations to experience a disproportionate level of poorer health outcomes compared to non-Indigenous populations. Specifically, the rate of Indigenous chronic disease prevalence has significantly increased in the last decade. Many of the unique issues Indigenous populations experience are deeply rooted in their colonial history and the intergenerational traumas that has subsequently impacted their physical, mental, emotional and spiritual well-being. With this, to better improve Indigenous health outcomes, understanding the local context of their challenges is key. Studies have begun to use modes of community engagement to initiate Indigenous partnerships and design chronic disease-based interventions. However, with the lack of a methodological guideline regarding the appropriate level of community engagement to be used, there is concern that many interventions will continue to fall short in meeting community needs. Objective The objective of this study was to investigate the how various community engagement strategies have been used to design and/or implement interventions for Indigenous populations with chronic disease. Methods A scoping review guided by the methods outlined by Arksey and O’Malley was conducted. A comprehensive search was completed by two reviewers in five electronic databases using keywords related to community engagement, Indigenous health and chronic disease. Studies were reviewed using a descriptive-analytical narrative method and data was categorized into thematic groups reflective of the main findings. Results We identified 23 articles that met the criteria for this scoping review. The majority of the studies included the use a participatory research model and the procurement of study approval. However, despite the claimed use of participatory research methods, only 6 studies had involved community members to identify the area of priority and only five had utilized Indigenous interview styles to promote meaningful feedback. Adapting for the local cultural context and the inclusion of community outreach were identified as the key themes from this review. Conclusion Many studies have begun to adopt community engagement strategies to better meet the needs of Indigenous Peoples. With the lack of a clear guideline to approach Indigenous-based participatory research, we recommend that researchers focus on 1) building partnerships, 2) obtaining study approval and 3) adapting interventions to the local context.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A189-A190
Author(s):  
Miguel Meira e Cruz ◽  
Luana Seixas ◽  
Augusto Santos ◽  
João Garrido ◽  
Yuri Lopes ◽  
...  

Abstract Introduction Only few studies looked for a possible association of cardiovascular disorders (CVD), in comorbid insomnia with obstructive sleep apnea (COMISA) even though this is a relevant topic in order to prevent one of the major causes of morbimortality. The present study aimed to investigate the association of insomnia symptoms in patients at risk for obstructive sleep apnea in terms of prevalence and clinical interactions and to evaluate the risk of CVD in patients with a risk for COMISA. Methods This is a cross-sectional study. All medical records with data such as age, sex, height, weight and BMI, time to sleep, time to wake up, total sleep time, the Epworth Sleepiness Scale (ESS), STOP-BANG Questionnaires were studied. Insomnia and comorbidities were also investigated, and the patientsanswered yes or no to systemic arterial hypertension, diabetes, CVD. Results 685 patients were enrolled on the present study. We observed that the mild, moderate, and high risk for COMISA presented progressively increasing levels for the frequency of hypertension, diabetes, and CVD. A binary logistic regression was performed to assess whether risk for COMISA could be a predictor for CVD, and it was found that the model containing risk for COMISA was statistically significant: [x2(1)=5.273;p<0.021, R2 Negelkerke=0.014]. Risk for COMISA presented itself as a significant predictor for CVD (OR=1.672; 95% CI=1.079–2.592). Conclusion There was an increased frequency of associated comorbidities such as CVD, systemic arterial hypertension, and diabetes, according to the mild, moderate, or high risk. These findings highlight the need for a cardiometabolic evaluation in patients with this comorbid condition which may impact prognosis and therapeutic success. Support (if any):


2019 ◽  
Vol 27 ◽  
pp. e37193
Author(s):  
Anna Luisa de Oliveira Salles ◽  
Carlos Eduardo Peres Sampaio ◽  
Leonardo Dos Santos Pereira ◽  
Nickson Scarpine Malheiros ◽  
Renan Araújo Gonçalves

Objetivo: identificar os recursos utilizados pelo enfermeiro da estratégia saúde da família (ESF) para estimular a adesão do paciente ao tratamento da Hipertensão Arterial Sistêmica. Método: abordagem qualitativa. O projeto foi aprovado por Comitê de Ética em Pesquisa. A coleta de dados ocorreu no período de abril a agosto de 2017, por meio de entrevista semiestruturada com 10 enfermeiros atuantes em unidades de ESF localizadas no Estado do Rio de Janeiro. Os depoimentos dos sujeitos foram submetidos à análise de conteúdo de Bardin. Resultados: os enfermeiros realizam consultas de enfermagem garantindo a adesão dos participantes em atividades educativas de grupo, como palestras e orientações de enfermagem. Conclusão: o sistema utilizado na adesão ao tratamento é similar entre as unidades de ESF mantendo um padrão preconizado pela literatura.ABSTRACTObjective: to identify the resources used by Family Health Strategy (FHS) nurses to encourage patient adherence to treatment for Systemic Arterial Hypertension. Method: qualitative approach. The project was approved by the research ethics committee. Data were collected between April and August 2017, through semi-structured interviews of 10 nurses working in FHS units in Rio de Janeiro state. The transcriptions underwent Bardin content analysis. Results: the nurses held nursing appointments thus fostering participants’ adherence in group educational activities, such as talks and nursing guidance sessions. Conclusion: the treatment adherence system used is similar among FHS units, maintaining a pattern recommended by the literature.RESUMENObjetivo: identificar los recursos utilizados por el enfermero de la estrategia de salud familiar (ESF) para estimular la adhesión del paciente al tratamiento de la hipertensión. Método: enfoque cualitativo. El proyecto fue aprobado por el Comité de Ética en Investigación. La recolección de datos ocurrió en el período entre abril y agosto de 2017, por medio de entrevista semiestructurada junto a 10 enfermeros que trabajan en unidades de ESF ubicadas en el estado de Río de Janeiro. Las declaraciones fueron sometidas al análisis de contenido de Bardin. Resultados: los enfermeros realizan consultas de enfermería garantizando la adhesión de los participantes en actividades educativas de grupo, como charlas y orientaciones de enfermería. Conclusión: el sistema utilizado en la adhesión al tratamiento es similar entre las unidades de ESF manteniendo un patrón preconizado por la literatura.


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