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PLoS One. 2015 Jun 23;10(6):e0127382. doi: 10.1371/journal.pone.0127382. eCollection 2015.

Prevalence, Awareness, Treatment and Influence of Socioeconomic Variables on Control of High Blood Pressure: Results of the ELSA-Brasil Study.

Author information

1
Department of Epidemiology, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
2
Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
3
Scientific Computing Program, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
4
Postgraduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
5
School of Medicine, University of Sao Paulo, São Paulo, SP, Brazil.
6
Institute of Collective Health, Federal University of Bahia, Salvador, BA, Brazil.
7
Laboratory of Health and Environment Education, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
8
Post Graduate Program of Collective Health, Federal University of Espírito Santo, Vitória, ES, Brazil.
9
Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
10
Department of Physiological Sciences, Federal University of Espirito Santo, Vitória, ES, Brazil.

Abstract

High blood pressure (HBP) is the leading risk factor for years of life lost in Brazil. Factors associated with HBP awareness, treatment and control need to be understood better. Our aim is to estimate prevalence, awareness, and types of anti-hypertensive treatment and to investigate the association of HBP control with social position. Data of 15,103 (54% female) civil servants in six Brazilian state capitals collected at the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline (2008-2010) were used to estimate prevalence and cross-sectional association of HBP control with education, per capita family income and self-reported race, using multiple logistic regression. Blood pressure was measured by the oscillometric method. 35.8% were classified as presenting HBP; 76.8% of these used anti-hypertensive medication. Women were more aware than men (84.8% v. 75.8%) and more often using medication (83.1% v. 70.7%). Adjusted HBP prevalence was, in ascending order, Whites (30.3%), Browns (38.2%) and Blacks (49.3%). The therapeutic schemes most used were angiotensin-converting enzyme inhibitors, in isolation (12.4%) or combined with diuretics (13.3%). Among those in drug treatment, controlled blood pressure was more likely in the (postgraduate) higher education group than among participants with less than secondary school education (PR = 1.21; 95% CI: 1.14-1.28), and among Asian (PR = 1.21; 95% CI: 1.12-1.32) and 'Whites (PR = 1.19; 95% CI: 1.12-1.26) compared to Blacks. Socioeconomic and racial inequality-as measured by different indicators-are strongly associated with HBP control, beyond the expected influence of health services access.

PMID:
26102079
PMCID:
PMC4478044
DOI:
10.1371/journal.pone.0127382
[Indexed for MEDLINE]
Free PMC Article

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