title: Balking blood pressure "control" by older persons of Bambuí, Minas Gerais State, Brazil: an ethno-epidemiological inquiry.
abstract: This ethno-epidemiological inquiry aims to comprehend hypertension-related experiences in the elderly population of Bambuí, in the State of Minas Gerais, Brazil. It combines ethnographic descriptions with statistical data. The subjective significance of factors associated with adequate arterial pressure control is explored. A baseline cohort of 26 people with hypertension, randomly selected from a total number of 1,494 residents over the age of 60, was interviewed utilizing signs, meanings and actions methodology. Multivariate analysis shows an association (p < 0.001) between female gender and monthly household income and treatment of hypertension and adequate blood pressure control. The number of doctor visits is associated with treatment but not with adequate blood pressure control. Conflicting cultural construction of "blood pressure problems" contributes to "non-adherence" to treatment. There is a fine line between blood pressure "control" and what is perceived as health professionals "controlling" patients' lives. Doctor-prescribed regimes are perceived as "prohibiting life's pleasures" and "controlling" personal liberty and free choice. Giving elderly people a voice regarding their social context can promote autonomy, well-being and happiness in later life.
authors.affiliation: Programa de Pós-Graduação em Saúde Coletiva, Universidade de Fortaleza, Fortaleza, Brasil. nations@unifor.br
authors.forename: Marilyn
authors.initials: M
authors.lastname: Nations
authors.forename: Josélia O A
authors.initials: JO
authors.lastname: Firmo
authors.forename: Maria Fernanda
authors.initials: MF
authors.lastname: Lima-Costa
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Uchôa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015924:Blood Pressure Monitors; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D066298:In Vitro Techniques; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012307:Risk Factors; D012959:Socioeconomic Factors