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Blood pressure control in hypertensive patients in the "Hiperdia Program": a territory-based study
Clarita Silva de Souza1, Airton Tetelbom Stein2, Gisele Alsina Nader Bastos2
1Programa de Pós-Graduação em Ciências da Saúde: Cardiologia, Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brasil.
Insights
Blood pressure control in Brazil
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Systemic hypertension is a prevalent cardiovascular risk factor.
- Blood pressure control in Brazil's Hiperdia Program is suboptimal.
- Hypertension management requires continuous monitoring and intervention.
Purpose of the Study:
- To determine the epidemiological profile of patients in the Hiperdia Program.
- To evaluate blood pressure control rates among these patients.
- To identify factors associated with inadequate blood pressure management.
Main Methods:
- Cross-sectional study of 383 adult patients in Novo Hamburgo, Brazil.
- Stratified cluster random sampling from 15 Basic Health Units.
- Blood pressure measured using a calibrated aneroid device; statistical analysis via Poisson regression.
Main Results:
- Mean age 63 years; majority were females, social class C, low education, sedentary, with family history of hypertension.
- 31% had diabetes mellitus (DM); 54.3% adhered to treatment; only 33.7% achieved controlled blood pressure.
- Diabetes mellitus significantly correlated with poor blood pressure control (15.7% controlled).
Conclusions:
- Blood pressure control in the Hiperdia Program is unsatisfactory.
- Diabetic hypertensive patients exhibit the poorest blood pressure control.
- Improved strategies are needed for hypertension and diabetes management within public health programs.
Background:
Systemic hypertension is highly prevalent and an important risk factor for cardiovascular events. Blood pressure control in hypertensive patients enrolled in the Hiperdia Program, a program of the Single Health System for the follow-up and monitoring of hypertensive patients, is still far below the desired level.
Objective:
To describe the epidemiological profile and to assess blood pressure control of patients enrolled in Hiperdia, in the city of Novo Hamburgo (State of Rio Grande do Sul, Brazil).
Methods:
Cross-sectional study with a stratified cluster random sample, including 383 adults enrolled in the Hiperdia Program of the 15 Basic Health Units of the city of Porto Alegre, conducted between 2010 and 2011. Controlled blood pressure was defined as ≤ 140 mmHg × 90 mmHg. The hypertensive patients were interviewed and their blood pressure was measured using a calibrated aneroid device. Prevalence ratios (PR) with 95% confidence interval, Wald's χ(2) test, and simple and multiple Poisson regression were used in the statistical analysis.
Results:
The mean age was 63 ± 10 years, and most of the patients were females belonging to social class C, with a low level of education, a sedentary lifestyle, and family history positive for systemic hypertension. Diabetes mellitus (DM) was observed in 31%; adherence to the antihypertensive treatment in 54.3%; and 33.7% had their blood pressure controlled. DM was strongly associated with inadequate BP control, with only 15.7% of the diabetics showing BP considered as controlled.
Conclusion:
Even for hypertensive patients enrolled in the Hiperdia Program, BP control is not satisfactorily reached or sustained. Diabetic hypertensive patients show the most inappropriate BP control.
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