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：旨在调查巴西皮奥伊州某市镇接受家庭健康策略（Family Health Strategy）帮扶的老年高血压患者中，未控制血压（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，共纳入384名经随机抽样选取的老年高血压患者。调查问卷涵盖社会人口学特征、健康行为、合并症存在情况及高血压治疗相关问题。血压采用电子设备进行测量。为检验自变量（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因素）与未控制血压之间的关联，本研究采用稳健方差泊松回归进行分析，以估算患病率比（prevalence ratio，PR）及95%置信区间（confidence interval，CI）。
结果：老年高血压患者的未控制血压患病率为61.7%，另有51.8%的患者对抗高血压药物治疗依从性较低。与药物治疗依从性较高的患者相比，依从性较低的患者未控制血压的患病率更高（PR=2.41；95% CI：1.96-2.97）。其余变量未呈现具有统计学意义的关联。
结论：本研究结果凸显了老年高血压患者中未控制血压的高患病率，以及未控制血压与药物治疗低依从性之间的强关联。当前仍需开展可有效提升高血压控制水平的干预措施，同时也需在初级医疗保健范畴内制定针对该疾病的规范化管理策略，涵盖疾病预防措施与个体化适宜治疗方案。