Hipertensão Arterial Avaliada no Sistemas Público e Privado de Saúde Brasileiro
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Data
2023-05-31
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Universidade Federal de Goiás
Resumo
Arterial hypertension (AH) control rates in Brazil and Latin
America are low, approximately 20%. This is a serious problem, as it is the
risk factor that is the main cause of death worldwide. On the other hand,
rates of 60,6% are found in patients with AH treated by cardiologists and in
private service. Objective: To compare socio-demographic characteristics,
body mass index (BMI), use of antihypertensive drugs (AH), blood pressure
(BP) between patients with followed in public (SRPU) and private (SRPR)
reference services; and their control rates an uncontrolled AH phenotype.
Methodology: This is a national multicenter cross-sectional study that
evaluated treated hypertensive patients followed up in two SRPUs and in two
SRPR under the same coordination and conduct guidance. Gender, age,
BMI, classes an the number of AH uses, and mean values of systolic (SBP)
and diastolic (DBP) blood pressure by office measurement and HBPM were
evaluated Uncontrolled AH phenotypes (uncontrolled white coat
Hypertension, uncontrolled masked hypertension and uncontrolled Sustained
Hypertension) and BP control rates were also evaluated. Descriptive
statistics and Chi-square tests or unpaired t-test we used for comparisons. A
significance level of p <0.05 was considered. Results: A total of 2.956
patients were evaluated, 60,5% of whom were followed up at the SRPR.
There was a predominance of females (58,9%), more evident in the SRPU
(65,7%) than in the SRPR(54,5%). Only 21,7% of the sample were eutrophic.
The prevalence of obesity in the SRPU was 42% and of SRPR 34,4% higher
in the SRPU (p<0.001) and of overweight in the SRPR 37,5% and in the
SRPR 43%; higher in the SRPR (p< 0.001);. The mean number of
antihypertensive drugs used was 2.01.3 for the total sample, being 1.40.7
for SRPR and 2.91.5 for SRPU (p<0.001).Mean SBP and DBP values were
higher in the SRPU (134 20.8 and 82 13.0). Uncontrolled AH rates were
67,8% in SRPU and 47,6% SRPR (p<0.001) by office measurement and
60,4% in SRPU and 35,3% en SRPR (p<0.001) by HBPM. Conclusions:
Hypertensive patients are mostly female, have a higher prevalence of obesity
in the SRPU and use a greater number of AH drugs, maintaining higher
mean values of SBP and DBP, either in the office measurement or by HBPM,
than in the SRPR. BP control rates are worse in SRPU, on average 15.3
mmhg and 12,1 mmhg in systolic and diastolic pressure respectively higher
than in SRPR by office measurement. Higher prevalence of uncontrolled
sustained hypertension (HSNC) and uncontrolled white coat (HABNC) in the
SRPU were found.
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Citação
AMORIM, KECIA C.F. O. Hipertensão Arterial Avaliada no Sistemas Público e Privado de Saúde Brasileiro. 2023. 93 f. Dissertação (Mestrado em Ciências da Saúde) - Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, 2023.