Uso de anti-hipertensivos e hipoglicemiantes por idosos, em Belo Horizonte, MG

Abstract

Introduction: Changes in the epidemiological profile, coupled with demographic transition, the improvement in quality of life and technological advances, are characteristics of the aging phenomenon of Brazilian population, where are predominant the cardiovascular diseases. Among the main risk factors are arterial hypertension (HA) and diabetes mellitus (DM). Elderly patients which these diseases tend to use more pharmaceuticals products and are more vulnerable to adverse effects. Objective: To describe and identify the treatments used for diabetic and hypertension elderly patients. To estimate the prevalence of the use of antihypertensives and hypoglycemic drugs and identify the factors associated with their use in these patients. Methods: A household survey among the elderly (aged 60 years or more), retired by INSS, inBelo Horizonte / MG, selected by simple random sampling. A total of 667 individuals were interviewed and selected those self-reported as diabetic or hypertensive. A descriptive analysis of the drugs used was performed, besides univariate and multivariate analysis to identify factors associated with these diseases and medicines were also used. Results: Among elderly hypertensive patients, 283 (89%) were on pharmacotherapy, 68.2% used diuretics, as recommended by the WHO, 37.8% used ACE inhibitors, 32.2% calcium channel blockers and 30.7% beta-blockers. The combination in fixed doses was observed in 19% of elderly in hypertensive drug therapy. Among diabetic patients, 22 (64.7%) were onpharmacotherapy, 45.5% used insulin and 77.3% hypoglycemic agents, especially metformin (64.7%) and glibenclamide (52.9%). Among the 89 diabetic hypertensive patients, 80 (90%) used antihypertensive drugs, especially ACE inhibitors (51.3%) and diuretics (42.5%); and 51(57.3%) of them used hypoglycemiants. It was observed among the elderly in antihypertensive therapy and / or hypoglycemic the use of combinations of fixed doses, also redundant or inappropriate drugs. The use of antihypertensive medications was significantly associated with greater number of physician visits in the year, the presence of diabetes and hypertension, other morbidities and the reported use of five or more drugs. The use of hypoglycemic drugs was associated with male gender, age, more advanced, more medical visits in the last year and the presence of hypertension and diabetes. Conclusion: There is a high irrational use of anti-hypertensive and hypoglycemiants in BeloHorizonte. The government must plan and implement health policies, enabling the rational use of drugs and an effective pharmaceutical care for the elderly with chronic diseases in the Belo Horizonte municipality.