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

Dóra Chor, Antonio Luiz Pinho Ribeiro, Marilia Sá Carvalho, Bruce Bartholow Duncan, Paulo Andrade Lotufo, Aline Araújo Nobre, Estela Mota Lima Leão de Aquino, Maria Inês Schmidt, Rosane Härter Griep, Maria Del Carmen Bisi Molina, Sandhi Maria Barreto, Valéria Maria de Azeredo Passos, Isabela Judith Martins Benseñor, Sheila Maria Alvim Matos and José Geraldo Mill

PLOS ONE, 2015, vol. 10, issue 6, 1-14

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.

Date: 2015
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0127382

DOI: 10.1371/journal.pone.0127382

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