Uncontrolled blood pressure among hypertensive old people assisted in Primary Health Care

Abstract Objective To investigate the prevalence of uncontrolled blood pressure (BP) and associated factors in hypertensive old people assisted by the Family Health Strategy in a municipality in Piauí, Brazil. Method Cross-sectional study conducted with 384 hypertensive old people, selected by random sampling. A questionnaire included questions about sociodemographic aspects, health behaviors, the presence of comorbidities and treatment for hypertension. BP was measured using digital devices. To test the association between the independent variables (gender, age, education, alcohol consumption, smoking, presence of other diseases, adherence to drug treatment, and others factors) and uncontrolled BP, Poisson regressions with robust variance were performed in order to estimate the prevalence ratio (PR) and 95% confidence intervals (CI). Results The prevalence of uncontrolled BP was 61.7% and 51.8% had low adherence to antihypertensive medication. The prevalence of uncontrolled BP was higher among participants with low medication adherence (PR=2.41; 95% CI: 1.96-2.97) when compared to those with high adherence. Statistically significant associations were not maintained for the other variables. Conclusion The findings highlight the high prevalence of uncontrolled BP among hypertensive old people and the strong association between uncontrolled BP and low adherence to treatment. Efficient interventions for better control of hypertension continue to be necessary, as well as strategies for the adequate management of the disease in the scope of primary care, from prevention actions to appropriate treatment plans for each individual.【摘要】 目的：探讨巴西皮奥伊州某市政辖区内，接受家庭健康战略（Family Health Strategy）服务的老年高血压患者未控制血压（uncontrolled blood pressure，BP）的患病率及其相关影响因素。 方法：本研究为横断面研究，纳入经随机抽样选取的384名老年高血压患者。研究采用问卷调查收集受试者的社会人口学特征、健康行为、合并症患病情况及高血压治疗相关信息；使用电子设备测量血压。为分析自变量（性别、年龄、受教育程度、饮酒行为、吸烟情况、其他疾病患病情况、药物治疗依从性及其他相关因素）与未控制血压的关联，本研究采用稳健方差泊松回归分析，以估算患病率比（prevalence ratio，PR）及95%置信区间（95% confidence intervals，CI）。 结果：本研究中未控制血压的患病率为61.7%，51.8%的受试者存在降压药物治疗依从性低下的情况。与药物治疗依从性较高的受试者相比，依从性低下者的未控制血压患病率更高（PR=2.41；95%CI：1.96~2.97）；其余自变量与未控制血压未呈现统计学显著关联。 结论：本研究结果显示，纳入研究的老年高血压患者未控制血压患病率较高，且未控制血压与药物治疗依从性低下存在显著关联。当前仍需开展有效干预以更好地控制高血压病情，同时需在基层医疗卫生服务范畴内制定完善的疾病管理策略，涵盖预防措施与个体化适宜治疗方案。