Prevalência de hipertensão arterial sistêmica em adultos da área urbana e rural e fatores de riscos associados

Abstract

Introduction: Systemic Arterial Hypertension (SAH) is one of the main public health problems causing high morbidity and mortality worldwide. SAH is a multifactor clinical condition characterized by elevated and sustained levels of high Blood Pressure (BP). Despite SAH being an important changeable risk factor for Cardiovascular Diseases (CD), it is highly prevalent (in Brazil, a prevalence of 19,8% is estimated in rural populations, and of 21,7% in urban populations). Prevalence of SAH differs between the populations and is modulated by risk factors. Workers, both rural and urban are exposed to risk factors (behavioral, environmental and economic) of SAH. Subpopulations with lack of access to diagnosis, treatment and monitoring of the disease, factors that might increase their morbidity and mortality. Despite the high morbidity and mortality of SAH, heterogeneity of prevalence and of the risk factors associated with this condition in many subpopulations has yet to be portrayed. Objectives: Define and compare the prevalence of Systemic Arterial Hypertension between urban and rural adults, as well as risk factors associated with. Materials and methods: This study is clinical, observational and transversal, evaluating and comparing subjects that live in urban and rural area. Data was collected through structured interview in a questionnaire, screening, ambulatory and specialized blood pressure monitoring, anthropometric evaluation, additional laboratorial tests. Statistic approach was descriptive and analytical. Results: Population in the study was of 400 workers, 200 of them from the rural area (AR) and 200 from the urban area (AU), 77 (19.3%) women and 323 (80.8%) men. The average age was 39.3±13.7 (47.4±13.7 in AR and 31.3±7.6 in AU). The overall prevalence of hypertension was 28.8% [40.5% in AR and 17.0% in AU, p <0.001, OR 3.32 (2.09-5.29)]. The risk factors associated with high blood pressure were: socioeconomic class (p=0.002), marital status (p=0.002), educational level (p <0.001), high IMC (p<0.001), history of HAS (p=0.049), (p<0.001), waist circumference (p<0.001), total cholesterol (p<0.001), HDL (p=0.048), LDL (p<0.001), triglycerides (p<0.001) and ECG (p<0.001). In the urban area the variables associated with SAH were: age (p <0,001), waist circumference (p<0.001), high IMC (p<0.001), total cholesterol (p=0.001), triglycerides (p<0.001), and Altered ECG (p <0.001). In the rural area: age (p<0.001), IMC (p<0.001), total cholesterol (p<0.001), LDL (p<0.001), triglycerides (p<0.001) and altered ECG (p<0.001). Conclusion: Prevalence of HAS was higher in the rural population when compared to the urban population, risk factors associated with the rural population might explain the increased prevalence. Lack of diagnose is present in rural and urban areas. Needs for better follow-up among patients was demonstrated by blood pressure alterations in anti-hypertensive drug users.