| Autor: |
Néri AKM; Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, CE, Brasil.; Serviço de Cardiologia, Hospital Universitário Walter Cantídio, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil., Xavier RMF; Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brasil., Matos SMA; Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brasil., Almeida MCC; Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brasil., Ladeira RM; Hospital João XXIII, Fundação Hospitalar do Estado de Minas Gerais, Secretaria Estadual de Saúde, Belo Horizonte, MG, Brasil., Lopes AA; Departamento de Medicina Interna/Nefrologia, Universidade Federal da Bahia, Salvador, BA, Brasil., Lino DOC; Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, CE, Brasil., Lázaro APP; Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, CE, Brasil., Cairutas RVBM; Serviço de Cardiologia, Hospital Universitário Walter Cantídio, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil., Silva Júnior JH; Serviço de Cardiologia, Hospital Universitário Walter Cantídio, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil., Lima JMO; Serviço de Cardiologia, Hospital Universitário Walter Cantídio, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil., Chaves MC; Serviço de Cardiologia, Hospital Universitário Walter Cantídio, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil., Silva RP; Serviço de Cardiologia, Hospital Universitário Walter Cantídio, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil., Silva Júnior GB; Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, CE, Brasil. |
| Abstrakt: |
The treatment of arterial hypertension (AH) contributes to the reduction of morbidity and mortality. Gender differences are likely to play a role, as non-treatment is associated with clinical and sociodemographic aspects. The aim of this study was to investigate the factors associated with non-treatment of AH and gender differences in hypertensive individuals from the ELSA-Brasil cohort. The study was conducted with 5,743 baseline hypertensive cohort participants. AH was considered if there was a previous diagnosis or if systolic blood pressure (SBP) was ≥140 and/or diastolic BP (DBP) was ≥90 mmHg. Sociodemographic and anthropometric data, lifestyle, comorbidities, and use of antihypertensive medications were evaluated through interviews and in-person measurements. Treatment with renin-angiotensin-aldosterone system inhibitors (RAASi) or other antihypertensive medications and non-treatment were evaluated with multivariate logistic regression. Non-treatment was observed in 32.8% of hypertensive individuals. Of the 67.7% treated individuals, 41.1% received RAASi. Non-treatment was associated with alcohol consumption in women (OR=1.41; 95%CI: 1.15-1.73; P=0.001), lowest schooling level in men (OR=1.70; 95%CI: 1.32-2.19; P<0.001), and younger age groups in men and women (strongest association in males aged 35-44 years: OR=4.58, 95%CI: 3.17-6.6, P<0.001). Among those using RAASi, a higher proportion of white, older individuals, and with more comorbidities was observed. The high percentage of non-treatment, even in this civil servant population, indicated the need to improve the treatment cascade for AH. Public health policies should consider giving special attention to gender roles in groups at higher risk of non-treatment to reduce inequities related to AH in Brazil. |
