scholarly journals Control of Glucose, Blood Pressure, and Cholesterol among Adults with Diabetes: The Brazilian National Health Survey

2021 ◽  
Vol 10 (15) ◽  
pp. 3428
Author(s):  
Rodrigo Citton P. dos Reis ◽  
Bruce B. Duncan ◽  
Célia Landmann Szwarcwald ◽  
Deborah Carvalho Malta ◽  
Maria Inês Schmidt

ABC (glucose, blood pressure and LDL-cholesterol) goals are basic standards of diabetes care. We aimed to assess ABC control and related factors in a representative sample of Brazilian adults with diabetes. We analyzed 465 adults with known diabetes in the Brazilian National Health Survey. The targets used were <7% for glycated hemoglobin (A1C); <140/90 mmHg for blood pressure; and <100 mg/dL for LDL-C, with stricter targets for the latter two for those with high cardiovascular (CVD) risk. Individual goals were attained by 46% (95% CI, 40.3–51.6%) for A1C, 51.4% (95% CI, 45.7–57.1%) for blood pressure, and 40% (95% CI, 34.5–45.6%) for LDL-C. The achievement of all three goals was attained by 12.5% (95% CI, 8.9–16.2%). Those with high CVD risk attained blood pressure and LDL-C goals less frequently. A1C control improved with increasing age and worsened with greater duration of diabetes. Achievement of at least two ABC goals decreased with increasing BMI and greater duration of diabetes. In sum, about half of those with known diabetes achieved each ABC goal and only a small fraction achieved all three goals. Better access and adherence to treatment and strategies to personalize goals according to specific priorities are of the essence.

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Margozzini ◽  
A Passi ◽  
M Kruk ◽  
G Danaei

Abstract Background Chilean Health System has fully implemented Universal Health Coverage (UHC) for acute cardiovascular events since 2005. Age-adjusted cardiovascular mortality has decreased, but there is limited information about coverage and quality of chronic health care given to cardiovascular disease (CVD) survivors at the national level. Purpose To assess the prevalence and quality of care in Chilean adult CVD survivors. Methods Chilean National Health Survey 2016–2017 (ENS 2016–2017) is a random stratified multistage sample of non-institutionalized population over 14 years (n=6240). Age, education, gender, rural/urban and geographical area weighted prevalence of CVD survivors (self-reported medical diagnosis of myocardial infarction or cerebrovascular attack) were calculated. High quality of care was defined as meeting six criteria simultaneously: under 70mg% LDL- C level, statin use, aspirin use, blood pressure under 130/80 mmHg, HgA1C<7 or 8 (>74-year-old) and non-smoking. Quality of care was explored using multivariate linear and logistic regression adjusting by age, gender, education and year of diagnosis (before or after UHC). Results Weighted national prevalence of CVD survivors in over 20-year-old population was 6.1%. The sample size for the CVD survivor analyses was n=455. 28.7% of CVS had their first event before the year 2005 (n=141). Overall 27.9% had LDL-C under 70mg%, 37.8% used statins, 41.4% used aspirin, 37.8% had controlled blood pressure, 78.3% were non-smokers and 84.3% had good glycemic control. National “high quality of care” prevalence in CVD survivors was 0.3%, 0.4% and 0.1% for men and women respectively. LDL and Blood pressure control prevalence (meet both criteria simultaneously) was 4,4%. In the adjusted multivariate model age was associated to a higher number of quality criteria achievement. Conclusion The number of CVD survivors in Chile is a huge challenge for the health care system. Universal coverage does not guarantee the quality of chronic life long care. Specific surveillance in high-risk population is needed to assess the system's effectiveness and accountability. Acknowledgement/Funding ENS 2016-2017 was funded by the chilean Ministry of Health (MINSAL)


2019 ◽  
Vol 22 (12) ◽  
pp. 2147-2154 ◽  
Author(s):  
Ana Paula Alves de Souza ◽  
Paulo Rogério Melo Rodrigues ◽  
Ana Paula Muraro ◽  
Naiara Ferraz Moreira ◽  
Rosely Sichieri ◽  
...  

AbstractObjectiveTo identify cut-off points for waist circumference (WC), waist-to-height ratio (WHtR) and BMI associated with hypertension in the Brazilian adult and elderly population.DesignCross-sectional study. The receiver-operating characteristic (ROC) curve was used to determine the cut-off points of WC, WHtR and BMI in the prediction of hypertension. Those who had systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg and those who reported use of antihypertensive medication were considered hypertensive.SettingBrazil.ParticipantsParticipants from the National Health Survey, the Brazilian household-based survey conducted in 2013, of both sexes and age ≥20 years.ResultsCut-off points for WC and WHtR increased with age in both sexes. WC cut-off limits ranged between 88·0 and 95·9 cm in men and between 85·0 and 93·2 cm in women. For WHtR, cut-off scores ranged from 0·51 to 0·58 for men and from 0·53 to 0·61 for women. Additionally, the area under the ROC curve (AUC) for all age and sex groups was greater than 0·60 while the lower limit of the AUC 95 % CI for both WC and WHtR was not less than 0·50. The performance of BMI was similar to that of indicators of fat location.ConclusionsAll analysed anthropometric indicators had similar performance in identifying hypertension in the Brazilian population.


2016 ◽  
Vol 134 (2) ◽  
pp. 163-170 ◽  
Author(s):  
Deborah Carvalho Malta ◽  
Nadir Baltazar dos Santos ◽  
Rosângela Durso Perillo ◽  
Célia Landmann Szwarcwald

ABSTRACT: CONTEXT AND OBJECTIVE: High blood pressure (hypertension) is the most frequent cause of morbidity and a major risk factor for cardiovascular complications. The aim here was to describe the prevalence of blood pressure greater than or equal to 140/90 mmHg in the adult Brazilian population and federal states, along with self-reported information about previous medical diagnoses of hypertension, use of medication and medical care for hypertension control. DESIGN AND SETTING: Cross-sectional study analyzing information from the National Health Survey of 2013, relating to Brazil and its federal states. METHODS: The sample size was estimated as 81,254 households and information was collected from 64,348 households. The survey consisted of interviews, physical and laboratory measurements. Systolic blood pressure was considered to be high when it was ≥ 140 mmHg and diastolic blood pressure, ≥ 90 mmHg. RESULTS: It was found that 22.8% of the population has blood pressure measurements ≥ 140/90 mmHg. The proportion was higher among men than among women: 25.8% versus 20.0%. The frequency increased with age, reaching 47.1% in individuals over 75 years and was highest in the southeast and south. 43.2% reported previous medical diagnoses of hypertension and, of these, 81.4% reported using medication for hypertension and 69.6%, going to the doctor within the past year for pressure monitoring, thus showing regular medical follow-up. CONCLUSION: These results are important for supporting measures for preventing and treating hypertension in Brazil, with the aim of achieving the World Health Organization's goal of reducing hypertension by 25% over the next decade.


2019 ◽  
Vol 29 (3) ◽  
pp. 304-312
Author(s):  
Fábia Cheyenne Gomes de Morais Fernandes ◽  
Emelynne Gabrielly De Oliveira Santos ◽  
Isabelle Ribeiro Barbosa

Introduction: The fertility pattern of Brazilian population has changed considerably in the last decades. Socioeconomic and cultural inequalities can influence the age of the first gestation, and the identification of these inequalities is a fundamental aspect of the monitoring and evaluation of women's health care policies. Objective: To analyze the age of women in their first gestation and the related factors in Brazil. Methods: A cross-sectional study using data from the National Health Survey 2013, analyzing women aged 18 to 49 years and their age in the first gestation, categorized by sociodemographic variables. Results: The North Region presented the highest percentage of pregnancy for the stratum of 10 to 14 years. The first pregnancy at the age of 15 to 19 years had the highest percentages for all regions, with a significant difference between the North and Southeast. The Southeast region obtained the highest percentage of the first pregnancy at the age of 30 to 39 years. The first pregnancy at the age of 15 to 19 years was significantly higher among the separated women; without instruction; and who live in rural areas. The first pregnancy of 10 to 14 was associated with the highest number of births that women will have throughout their lives, with a higher prevalence of 5 to 9 births. Conclusions: In Brazil, a large proportion of first pregnancies still occur in adolescence. The states of the northern region stand out with lower average ages in the first pregnancy, and this event is related to the worst socioeconomic conditions.


2018 ◽  
Vol 19 (3) ◽  
Author(s):  
SIMARLY M. SOARES ◽  
SIMONE GELMINI ◽  
SILVÂNIA S. S. BRANDÃO ◽  
JUNE M. C. SILVA

ABSTRACT Purpose: To identify the influence of physical and psychosocial stress and health-related factors on the occurrence of work-related accidents, based on the National Health Survey (NHS) conducted in Brazil in 2013, through the execution of a retest in the Brazilian context, according to the model elaborated by Rommel, Varnaccia, Lahmann, Kottner, and Kroll (2016). Originality/value: Brazil has a high rate of workplace accidents. This retest, applied to the Brazilian context based on the German model of Rommel et al. (2016), allows obtaining information concerning the factors that may increase the chances of workplace accidents. Design/methodology/approach: Study with secondary data collected from the National Health Survey (Fiocruz, 2013). The model of Rommel et al. (2016) was used with the set of four blocks of variable factors. Logistic regression explored the physical, psychosocial, and health-related stress factors that may be more likely to occur in the workplace. Findings: 2.8% of the individuals have been involved in some work accident. Model 5 is the most explanatory of occupational accidents and factors such as high school level of education (OR = 2.082), full-time work (OR = 4.814), having three or more jobs (OR = 2.593), exposure to radiation, asthma (OR = 4.880), and alcohol consumption (OR = 4.620), according to each block typified, which most significantly increase the chances for the occurrence of work accidents. Managers and legislators should observe the factors that increase the chances of an accident occurring in order to develop prevention policies or actions.


2020 ◽  
Vol 22 (6) ◽  
pp. 1041-1049
Author(s):  
Giovanna Valentino ◽  
Camila Hernández ◽  
Rodrigo Tagle ◽  
Lorena Orellana ◽  
Marcela Adasme ◽  
...  

Author(s):  
Pedro Ángel Latorre-Román ◽  
Juan Manuel Carmona-Torres ◽  
Ana Isabel Cobo-Cuenca ◽  
José Alberto Laredo-Aguilera

Background. Many studies have shown a relationship between physical functioning and health status in older people. Aim. The purpose of this study was to analyze the temporal trends of physical activity (PA), ability to walk, weight status, self-perceived health, and disease or chronic health problems in people over 65 years from 2009 to 2017, using the European Health Survey in Spain and the National Health Survey in Spain. Methods. This study included 13,049 older people: 6026 (2330 men and 3696 women; age (mean, SD (Standard Deviation)) = 75.61 ± 7.11 years old) in 2009 and 7023 (2850 men and 4173 women; age (mean, SD) = 76.01 ± 7.57 years old) in 2017. Results. In 2017, older people exhibited lower values of moderate PA (p < 0.001), a lower number of hours of walking per week (p < 0.001), and worse self-perceived health status (p < 0.001) compared to 2009. These differences are maintained when comparing the sexes. Compliance with PA recommendations was 27.9% and 6.1% (chi-squared = 352.991, p < 0.001) in 2009 and 2017, respectively. There were no significant differences in weight status between older people in 2009 and 2017. In 2017, older people had significantly high percentages of disease or chronic health problems (p < 0.05), number of diseases (p < 0.001), severe difficulty walking 500 m without assistance (p < 0.05), and severe difficulty going up or down 12 stairs. Conclusions. From 2009 to 2017, Spanish older people worsened their PA levels and perception of their health status, and they increased their disease levels, which could be associated with the worsening of ability to walk in 2017.


Sign in / Sign up

Export Citation Format

Share Document