Desigualdades sociodemográficas na prevalência de conhecimento, tratamento e controle da Hipertensão Arterial no Brasil

Abstract

Background: Arterial Hypertension (AH) is the main risk factor for cardiovascular diseases, contributing significantly to the increase in the number of deaths and disabilities in Brazil and worldwide. Previous studies have distinguished the prevalence of awareness, treatment and control of hypertension, and the results are worrisome. In Brazil, similar studies were conducted in local and specific populations, hindering the possibility to generalized their results to the Brazilian population. In addition, they show great variability and inaccuracy of the data. Objectives: To estimate the prevalence of arterial hypertension awareness, treatment and control in the Brazilian adult population and the sociodemographic factors associated with these outcomes. Methodology: Cross-sectional, descriptive and analytical study that used data from the Brazilian adult population, which responded to the National Health Survey (PNS), in 2013. The total prevalence of awareness, treatment and control of hypertension in the Brazilian adult population was estimated and according to sociodemographic characteristics (sex, age group, race / color, education, marital status, area of residence and region) and access, using the variable health insurance. The 95% confidence intervals (95%CI) of the estimates were calculated. Poisson regression was used to estimate the prevalence ratios. To obtain population estimates, the PNS complex sample design was considered. Results: The prevalence of hypertension in the Brazilian population was 32.3% (95% CI: 31.7 - 33.1), with approximately 60.8% (95% CI 59.5 - 62.1) of awareness, 90.6% (95% CI 89.5 - 91.6) of these used anti-hypertensive medications and considering those in treatment, 54.4% (95% CI 52.6 - 56.2) showed controlled of AH. Prevalence of these outcomes was lower in men, in those who live in rural areas of the country, living with a partner and without health insurance. Female gender was positively associated with all outcomes. Older individuals were associated with higher prevalence of awareness and treatment, but the prevalence of control did decrease. Individuals who self-declared as black were associated with lower prevalence of control, while those who self-declared as brown were associated with lower prevalence of treatment and control. Conclusions: Higher prevalence of awareness, treatment and control of AH were observed in population subgroups with a history of better access to health such as women, health insurance, higher education and residents in urban areas; lower prevalence of treatment and control was observed in groups with unfavorable sociodemographic conditions such as race / black and brown and older individuals.