title: Prevalence, Awareness, Treatment and Influence of Socioeconomic Variables on Control of High Blood Pressure: Results of the ELSA-Brasil Study.
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.
authors.affiliation: Department of Epidemiology, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
authors.forename: Dóra
authors.initials: D
authors.lastname: Chor
authors.affiliation: Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Antonio Luiz
authors.initials: AL
authors.lastname: Pinho Ribeiro
authors.affiliation: Scientific Computing Program, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
authors.forename: Marilia
authors.initials: M
authors.lastname: Sá Carvalho
authors.affiliation: Postgraduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Bruce Bartholow
authors.initials: BB
authors.lastname: Duncan
authors.affiliation: School of Medicine, University of Sao Paulo, São Paulo, SP, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Andrade Lotufo
authors.affiliation: Scientific Computing Program, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
authors.forename: Aline
authors.initials: A
authors.lastname: Araújo Nobre
authors.affiliation: Institute of Collective Health, Federal University of Bahia, Salvador, BA, Brazil.
authors.forename: Estela Mota Lima Leão de
authors.initials: EM
authors.lastname: Aquino
authors.affiliation: Postgraduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Maria Inês
authors.initials: MI
authors.lastname: Schmidt
authors.affiliation: Laboratory of Health and Environment Education, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
authors.forename: Rosane Härter
authors.initials: RH
authors.lastname: Griep
authors.affiliation: Post Graduate Program of Collective Health, Federal University of Espírito Santo, Vitória, ES, Brazil.
authors.forename: Maria Del Carmen Bisi
authors.initials: Mdel C
authors.lastname: Molina
authors.affiliation: Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Sandhi Maria
authors.initials: SM
authors.lastname: Barreto
authors.affiliation: Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Valéria Maria de Azeredo
authors.initials: VM
authors.lastname: Passos
authors.affiliation: School of Medicine, University of Sao Paulo, São Paulo, SP, Brazil.
authors.forename: Isabela Judith Martins
authors.initials: IJ
authors.lastname: Benseñor
authors.affiliation: Institute of Collective Health, Federal University of Bahia, Salvador, BA, Brazil.
authors.forename: Sheila Maria Alvim
authors.initials: SM
authors.lastname: Matos
authors.affiliation: Department of Physiological Sciences, Federal University of Espirito Santo, Vitória, ES, Brazil.
authors.forename: José Geraldo
authors.initials: JG
authors.lastname: Mill
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001364:Awareness; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012959:Socioeconomic Factors
chemical_list: D000959:Antihypertensive Agents