Hypertension in Brazil.
BACKGROUND
Mean values for prevalence of hypertension in 18 selected populations, varied between 15.7% (BP > or = 95 mm Hg) and 27.7% (BP > or = 90 mm Hg). In three Mall surveys in Salvador (n = 5093 volunteers), prevalence mean value was 33.7% (JNC VI criteria), being influenced by age (5.5 to 17.8% and 41.0 to 54.9% for the 25-34 and 55-59 year old age groups, respectively) and socioeconomic class (24.7 and 39.6% for the highest and lowest social class, respectively, OR = 0.50 (0.26-0.95, P = 0.023). The national prevalence by the Ministry of Health is 20%.
Mortality as a consequence of morbidity has increased, with stroke being a leading cause of death (11.3% of total deaths, 10.1% of all deaths in the 20-59 year-old age group, and 33.9% of cardiovascular deaths in Brazilian Capitals, 1994)Cardiovascular risk factors: At comparable age groups, prevalence of other major cardiovascular risk factors are: smoking approximately 27%, total cholesterol > or =200 mg/dl approximately 32.5%, glucose intolerance approximately 8.0%, diabetes approximately 7.5%, BMI 25-29 approximately 29.1%, BMI > or = 30 approximately 9.6%, and physical inactivity approximately 92%. AWARENESS, TREATMENT, AND CONTROL: Data are very scarce. In the total Mall population (n = 4613) in Salvador, a high blood pressure was present in 24.4% of those who either denied hypertension or ignored blood pressure. Of those who reported to be hypertensives, only 34.5% had their blood pressure <140/90 mm Hg. In a national inquiry including 2519 physicians, 88% would start treatment with drug monotherapy, diuretics (53%), and angiotensin-converting enzyme inhibitor (ACEI) (24%). If blood pressure control is not achieved, 55% will combine with another drug (diuretic + ACEI (46%) or + beta-blocker (24%)), and 33% will increase the dosage. Nonpharmacological treatment would be prescribed for every patient by 17% of the physicians, while 62% would prescribe it for 25% of their patients. Adhesion is better for pharmacological (60%) than for nonpharmacological treatment (8%).


CONCLUSIONS
Three Consensus Documents (the most recent in 1998), the creation of the Department of Hypertension Leagues, the Fighting Hypertension National Day, the Confederation of Hypertensive Patients Associations, and the very recent launch of the National Plan for Reorganization of Hypertension and Diabetes Care are some measures being taken in a joint effort of the Ministry of Health and the Brazilian Societies of Cardiology, Hypertension and Nephrology, to strengthen and improve the fight against hypertension.
Guimarães
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AC
Post-Graduate School, University of Bahia School of Medicine, and Bahian League of Hypertension and Atherosclerosis, Bahia, Brazil.
D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D015994:Incidence; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors