High prevalence of arterial hypertension in a Brazilian Northeast population of low education and income level, and its association with obesity and metabolic syndrome

OBJECTIVE: The objectives of this study are to estimate the prevalence of arterial hypertension (AH) in an adult population with a predominance of families with low education and income levels, in the hinterlands of Pernambuco, Brazil, and to analyze its association with other factors related to cardiovascular diseases (CVD). METHODS: A cross-sectional study in 2008/2009 was conducted with a sample of 198 subjects stratified by age, and representative of the urban adult population of the Canaã district of city of Triunfo, in the hinterlands of Pernambuco, Brazil. RESULTS: One hundred ninety eight individuals with average age of 57.7 years old (31 to 90 years-old), mainly women (65.6%), and with low income and education levels (81.3% with a monthly income of less than one minimum wage) were evaluated. Among these, 127 (64.1%) were identified as having AH, 54 (42.5%) of whom had no prior diagnosis. From those who were previously diagnosed, only 31.3% had good blood pressure control. Higher prevalence was observed in those individuals with lower incomes, higher body mass indexes (BMI), and those with metabolic syndrome (MS). CONCLUSION: These data demonstrated that there was a high prevalence of AH in the urban, low education and income levels adult population of Triunfo, strongly associated with lower income levels, elevated BMI, and the presence of MS; and a high prevalence of bad blood pressure control among the previously diagnosed cases. These results indicate that more effective interventions for early detection and adequate control of this disease and its comorbidities are necessary.

Prevalência de diabetes melito e fatores associados em população urbana adulta de baixa escolaridade e renda do sertão nordestino brasileiro / Prevalence of diabetes and associated factors in an urban adult population of low educational level and income from the Brazilian Northeast wilderness

INTRODUÇÃO: O diabetes melito (DM) constitui problema de saúde pública no Brasil. Este estudo teve por objetivo investigar a prevalência de DM, sua relação com características sociodemográficas e outros fatores de risco cardiovascular em uma população adulta do sertão de Pernambuco/Brasil. SUJEITOS E MÉTODOS: Foi conduzido em 2008/2009 estudo transversal na população adulta e urbana do Distrito de Canaã, município de Triunfo, sertão de Pernambuco/Brasil. Amostra representativa constituída por 198 indivíduos com idade média de 57,7 anos foi aleatoriamente selecionada, em que 80,0 por cento tinham apenas o ensino fundamental, e 81,3 por cento tinham renda mensal inferior a um salário-mínimo. RESULTADOS: Foi encontrada prevalência de 13,6 por cento de DM e de 7,6 por cento de disglicemia (6,6 por cento de glicemia de jejum alterada e 1,0 por cento de tolerância diminuída à glicose). Dos diabéticos, 24,0 por cento não tinham diagnóstico. Nos diabéticos, 87,5 por cento apresentavam síndrome metabólica (SM) e 68,0 por cento eram hipertensos. Houve associação positiva e significativa entre DM e IMC e entre DM e SM. CONCLUSÃO: Foi encontrada elevada prevalência de DM nessa população adulta urbana do sertão nordestino. Esses resultados assim como a sua associação com obesidade e síndrome metabólica indicam a necessidade de ações mais efetivas na prevenção dessas enfermidades.

BACKGROUND: Diabetes mellitus (DM) is a public health problem in Brazil. The objective of this study was to investigate the prevalence of DM and its relation with socio-demographic features and other cardiovascular risk factors in a adult population from the wilderness of Pernambuco, Brazil. SUBJECTS AND METHODS: In 2008/2009 a cross-sectional study in the adult urban population of Canãa district, city of Triunfo, in the wilderness of Pernambuco/Brazil was conducted. A representative sample of 198 individuals, with average age of 57.7 years, 80 percent with primary education and 81.3 percent with a monthly income of less than 1 minimum wage was randomly selected. RESULTS: A prevalence of diabetes of 13.6 percent and 7.6 percent of disglycemia (6.6 percent of impaired fasting glycemia, and 1.0 percent of impaired glucose tolerance) was found. Among those with diabetes, 24 percent had no prior diagnosis. Among diabetics, metabolic syndrome (MS) and arterial hypertension (AH) were diagnosed in 87.5 percent and 68 percent, respectively. Besides these, there was a positive and significant association between DM and BMI, and between DM and MS. CONCLUSION: These data demonstrate a high prevalence of DM in the adult urban population from the wilderness of Pernambuco/Brazil. These results as well as their association with obesity and MS, indicate that more effective interventions are necessary for the prevention of these diseases also outside principal urban centers.