RESUMO
The treatment of arterial hypertension (AH) contributes to the reduction of morbidity and mortality. Gender differences are likely to play a role, as non-treatment is associated with clinical and sociodemographic aspects. The aim of this study was to investigate the factors associated with non-treatment of AH and gender differences in hypertensive individuals from the ELSA-Brasil cohort. The study was conducted with 5,743 baseline hypertensive cohort participants. AH was considered if there was a previous diagnosis or if systolic blood pressure (SBP) was ≥140 and/or diastolic BP (DBP) was ≥90 mmHg. Sociodemographic and anthropometric data, lifestyle, comorbidities, and use of antihypertensive medications were evaluated through interviews and in-person measurements. Treatment with renin-angiotensin-aldosterone system inhibitors (RAASi) or other antihypertensive medications and non-treatment were evaluated with multivariate logistic regression. Non-treatment was observed in 32.8% of hypertensive individuals. Of the 67.7% treated individuals, 41.1% received RAASi. Non-treatment was associated with alcohol consumption in women (OR=1.41; 95%CI: 1.15-1.73; P=0.001), lowest schooling level in men (OR=1.70; 95%CI: 1.32-2.19; P<0.001), and younger age groups in men and women (strongest association in males aged 35-44 years: OR=4.58, 95%CI: 3.17-6.6, P<0.001). Among those using RAASi, a higher proportion of white, older individuals, and with more comorbidities was observed. The high percentage of non-treatment, even in this civil servant population, indicated the need to improve the treatment cascade for AH. Public health policies should consider giving special attention to gender roles in groups at higher risk of non-treatment to reduce inequities related to AH in Brazil.
RESUMO
Purpose - To evaluate the reliability of the blood pressure measurements in an arterial hypertension study. Methods - It was evaluated 502 nurse workers of a public hospital. After careful training and selection of the observers, for the quality control at the field work, it was analyzed the correlation between the 1st and 2st measuments, final digit preference and mean systolic (SBP) and diastolic pressure(DBP). 5% of the sample had their measures compared with those checked by an expert. Results - There was a great confiability intraobserver (96.2% in the SBP and 93.4% in the DBP). The final digit distribution was almost identical. At the 5% sample, there was a strong correlation between them (96. 0% in the SBP and 93.9% in the DBP). Conclusion - This methodology is feasible in national studies and confers validity to the results
Objetivo - Avaliar a confiabilidade das medidas de pressão arterial sanguínea em um estudo sobre hipertensão arterial (HA). Métodos - Foram examinadas 502 trabalhadoras de enfermagem em hospital de Salvador. Após cuidadoso processo de treinamento e seleção para controle de qualidade do trabalho de campo, os valores aferidos foram analisados, quanto à correlação entre as medidas e à distribuição dos dígitos terminais e das médias de pressão arterial sistólica (PAS) e diastólica (PAD). Comparou-se amostra de 5% das medidas com as efetuadas, de modo cego, na mesma ocasião, por supervisora médica. Resultados - Observou-se grande confiabilidade intra-observadora (96,2% na PAS e 93,4% na PAD). A distribuição entre os dígitos terminais foi praticamente eqüitativa. Na amostra, houve grande correlação entre as medidas (96,0% na PAS e 93,9% na PAD). Conclusão - As estratégias adotadas para a uniformização das medidas foram satisfatórias, garantindo a confiabilidade dos resultados e factíveis em estudos nacionais