Trends in the prevalence of systemic arterial hypertension and health care service use in Brazil over a decade (2008-2019)

Abstract The global burden and the prevalence of systemic arterial hypertension (SAH) have increased over the last two decades, especially in low- and middle-income countries, and are a concern to health authorities. This study analyzed the prevalence of SAH reported by Brazilian adults in 2008, 2013, and 2019, and individual disease control in 2013 and 2019. Data from the National Household Sample Survey (2008) and National Health Survey (2013-2019) were employed. We calculated the disease’s prevalence ratios using Poisson regression, adjusted for sociodemographic characteristics. Regarding health care and PHC organization indicators, we calculated proportions by gender, age group, ethnicity, and region. The results reveal persistent regional inequalities, with lower prevalence in the North and Northeast and higher prevalence in the Southeast and South. While the health care access and use indicators are positive, reflecting PHC improvements in recent years, we highlight the importance of adopting multifaceted SAH prevention and control strategies in the country.摘要 近二十年来，全球系统性动脉高血压（systemic arterial hypertension，SAH）的疾病负担与患病率持续攀升，在低收入及中等收入国家尤为显著，已引发卫生主管部门的广泛关注。本研究分析了2008年、2013年与2019年巴西成年人群报告的系统性动脉高血压患病率，以及2013年、2019年的个体疾病控制情况。研究采用全国住户抽样调查（National Household Sample Survey，2008年）及全国健康调查（National Health Survey，2013-2019年）的数据，通过泊松回归（Poisson regression）计算疾病患病率比，并针对社会人口统计学特征进行校正。针对医疗服务与初级卫生保健（Primary Health Care，PHC）组织相关指标，本研究按性别、年龄组、种族及地区划分，计算了各类占比。结果显示，巴西系统性动脉高血压患病率存在持续的区域不平等：北部与东北部地区患病率较低，东南部与南部地区则处于较高水平。尽管当前医疗服务可及性与利用指标呈积极向好态势，反映出近年初级卫生保健服务的改善，但本研究仍强调，在巴西推行多维度的系统性动脉高血压防控策略具有重要意义。