[Cardiovascular risk profile and health self-evaluation in Brazil: a population-based study]

To estimate the prevalence and clustering of cardiovascular risk factors (hypertension, smoking, physical inactivity, excessive use of alcohol, inadequate diet, and central obesity) and investigate the association of these factors with health self-evaluation after adjustment for sociodemographic features and clinical diagnosis of diabetes and ischemic heart disease.

We studied 9 211 Brazilians with age between 30 and 69 years, residents of 16 state capitals, included in a cross-sectional population-based study carried out by the Ministry of Health (Inquérito Domiciliar sobre Comportamentos de Risco e Morbidade Referida de Doenças e Agravos Não Transmissíveis, 2002-2003). The response variable was the score of cardiovascular risk factor clustering, which ranged from zero to 3: no exposure or exposure to 1, 2, and 3 or more risk factors. Data were analyzed using multinomial logistic regression, having as reference the category of zero risk factors, with and without hypertension.

The prevalence of all risk factors except alcohol consumption was higher than 25%. The presence of two or more risk factors occurred in 47.49%; 17.91% of the participants presented zero risk factors. The clustering of risk factors was inversely associated with income and schooling and higher in the age group between 50 and 59 years, without significant differences between sexes. Health self-evaluation was worse in participants with more risk factors. The inclusion of hypertension in the score resulted in a worsening of the risk profile with increase in age and in a significant association with reported ischemic heart disease and diabetes.

The high prevalence of cardiovascular risk factors in Brazilian adults underscores the importance of policies aimed at reducing these factors. The association between worse self-perception of health and a higher number of cardiovascular risk factors calls attention to the importance, broadness and complexity of this subjective health marker in population surveys and suggests that self-perception of poor health is not sufficient to encourage healthy attitudes.