Hypertension Prevalence, Treatment and Control in Older Adults in a Brazilian Capital City

Abstract Background: The diagnosis, treatment and control of arterial hypertension are fundamental for a reduction in cardiovascular outcomes, especially in the elderly. In Brazil, there are few studies that specifically identified these rates in the elderly population. Objective: To verify rates of prevalence, treatment and control of hypertension in elderly people living in the urban area of a Brazilian capital city. Methods: A cross-sectional, population-based, randomized, cluster-based study with 912 non-institutionalized elderly individuals (≥ 60 years), living in urban areas in the city of Goiania, Midwest Brazil. Predictor variables were: age, gender, socioeconomic and lifestyle aspects. Blood pressure measurements were performed at home; patients were considered as having arterial hypertension when SBP and/or DBP ≥ 140/90 mmHg or when using antihypertensive drugs (dependent variable). Rates of hypertension treatment and control were evaluated. Variable association analyses were performed by multivariate logistic regression and level of significance was set at 5%. Results: The prevalence of arterial hypertension was 74.9%, being higher (78.6%) in men (OR 1.4, 95% CI: 1.04-1.92); the treatment rate was 72.6%, with higher rates being observed in smokers (OR 2.06, 95% CI: 1.28-3.33). The rate of hypertension control was 50.8%,being higher in women (OR 1.57, 95% CI: 1.19-2.08). Conclusion: The prevalence rates were high. Treatment and control rates were low and associated with gender, age and lifestyle, indicating the need for early and individual interventions.

研究背景：动脉高血压（arterial hypertension）的诊断、治疗与控制是降低心血管不良结局的关键举措，尤其对于老年人群而言。在巴西，专门针对老年人群明确此类疾病相关指标的研究较为匮乏。研究目的：明确巴西首都某城市城区老年人群的高血压患病率、治疗率与控制率。研究方法：本研究为基于人群的横断面整群随机抽样研究，共纳入巴西中西部戈亚尼亚市城区912名非机构化老年受试者（年龄≥60岁）。本研究的预测变量包括年龄、性别、社会经济状况及生活方式相关因素。采用居家血压测量方式：当受试者收缩压（systolic blood pressure, SBP）和/或舒张压（diastolic blood pressure, DBP）≥140/90 mmHg，或正在服用降压药物时，判定为动脉高血压（作为因变量）。本研究对高血压的治疗率与控制率进行评估，采用多因素logistic回归开展变量关联分析，检验水准设定为5%。研究结果：动脉高血压患病率为74.9%，其中男性患病率更高（78.6%，比值比OR=1.4，95%置信区间CI：1.04~1.92）；高血压治疗率为72.6%，吸烟者的治疗率显著更高（OR=2.06，95%CI：1.28~3.33）；高血压控制率为50.8%，女性的控制率显著更高（OR=1.57，95%CI：1.19~2.08）。研究结论：本研究纳入人群的高血压患病率较高，而治疗率与控制率均偏低，且与性别、年龄及生活方式存在关联，提示亟需开展早期个体化干预措施。