Relationship between alcohol drinking and arterial hypertension in indigenous people of the Mura ethnics, Brazil.

OBJECTIVE: To identify the consumption of alcoholic beverage and the relation with hypertension, their prevalence and associated factors, in indigenous Mura, Brazil. METHODS: A cross-sectional population-based study was conducted with 455 adult indigenous aged 18 years or more of Mura ethnics in Amazonia, Brazil. Interview was conducted and the alcohol intake was assessed by the Alcohol Use Disorders Identification Test. Blood pressure was measured in three measurements and the mean of the last two measurements was used. Physical examination included the following data: weight, height, waist and neck circumference, bioimpedance, and capillary measurement of glucose, triglycerides and cholesterol. Through multivariate Logistic regression in stepwise, the odds ratios for alcohol consumption and associated factors were identified. RESULTS: The prevalence of alcoholic beverage was 40.2%, with no significant difference for hypertension in those who drink (23.0%) and those who did not drink (29.0%). Referred hypertension in indigenous was associated to less use of alcoholic beverages (14.2% vs 24.3%, P = 0.009). After an adjusted analysis (Odds Ratio, 95% CI), there was a positive association between alcoholic drink intake and male sex (10.27, CI: 5.76-18.30), smoking (4.72, CI: 2.35-9.46) and live in rural areas (9.77, CI: 5.08-18.79). On the other hand, age (0.95, IC: 0.94-0.97), and absence of dyslipidemia (0.41, CI: 0.19-0.89) were associated to lower alcohol consumption. CONCLUSION: The prevalence of alcoholic beverage was high and associated with referred hypertension, but this association was not maintained after adjusted analysis. Changes to habits and inappropriate lifestyles in indigenous populations and living in urban areas may contribute to increase risk for cardiovascular diseases. Therefore, health policies should be implemented to meet the uniqueness of indigenous people.

Organização do cuidado às condições crônicas por equipes de Saúde da Família na Amazônia / Organization of health care for chronic conditions by Family Health teams in the Amazon

Este estudo tem por objetivo descrever a organização do cuidado especialmente direcionado a condições crônicas por equipes da Estratégia Saúde Família no estado do Amazonas e região Amazônica, Brasil. Trata-se de pesquisa avaliativa baseada em observação em unidades básicas de saúde e entrevistas com profissionais. Os resultados indicam alta rotatividade de profissionais, baixa disponibilidade de insumos indispensáveis ao atendimento; organização fragmentária do cuidado; limitado uso de protocolos, planejamento e programação baseados em critérios de risco e vulnerabilidade. A situação reflete-se em falta de longitunidalidade e integralidade do cuidado, pautado em demanda espontânea e voltado às queixas clínicas.

We describe health care organization, mainly as for chronic diseases, by Family Health Strategy teams in Amazonas State and Amazon region, Brazil. The assessing research grounds on basic health units' observation and on interviews with professionals. The results indicate high professionals' turnover, low availability of essential inputs to care; fragmented care organization; limited use of protocols, planning and scheduling based on risk and vulnerability criteria. The current condition is reflected in the lack of care longitudinal follow up and comprehensiveness, which relies on spontaneous demand and is addressed to clinical complaints.