Cardiovascular risk factors with an emphasis on hypertension in the Mura Indians from Amazonia.

BACKGROUND: The Brazilian indigenous population is currently undergoing a process of epidemiological transition regarding the occurrence of communicable diseases, malnutrition and non-communicable chronic diseases. Chronic non-infectious diseases are the most common causes of death worldwide, and hypertension is one of the main cardiovascular risk factors. Thus, the main objective of this paper was to evaluate the prevalence of cardiovascular risk factors, with an emphasis on hypertension, in the Mura Indians living in the municipality of Autazes in the northern Brazilian state of Amazonas. METHODS: This cross-sectional study was conducted among 455 natives (57.8% women, 42.2 ± 16.7 years) selected by simple random sampling. Sociodemographic variables, habits and lifestyles, anthropometric data, fasting glycaemia and lipid profiles were evaluated. Blood pressure was measured with a validated automatic device. Values of p ≤ 0.05 were considered significant. RESULTS: The prevalence of hypertension was 26.6%. The other cardiovascular risk factors were as follows: increased waist-hip ratio (85.1%); increased neck circumference (60.2%); increased waist circumference (48.6%); overweight (57.1%); physical inactivity (52.7%); use of alcoholic beverages (40.2%); high total cholesterol (27.5%); increased triglycerides (23.5%); smoking (20.4%); and diabetes mellitus (3.0%). In relation to non-hypertensive individuals, indigenous hypertensive individuals were (p ≤ 0.05) older and had a higher proportion of individuals living with partners and individuals who were retired, as well as a lower level of schooling and higher family income. The indigenous people living in urban areas had a higher prevalence of hypertension than did those living in rural areas. In relation to habits and lifestyles, hypertensive Indians had a lower prevalence of smoking, higher frequency of the use of animal fat during meal preparation, lower frequency of vegetable oil use and lower frequency of salt addition to already-prepared meals. An assessment of anthropometric variables and laboratory markers showed that the hypertensive indigenous individuals had higher values of body mass index, neck circumference, waist circumference, visceral fat, Conicity Index, and body fat than did the non-hypertensive individuals. CONCLUSION: The prevalence of hypertension and other important cardiovascular risk factors in the Mura Indians was high. This finding is probably due to the adoption of inappropriate habits and lifestyles.

[The control of hypertension in men and women: a comparative analysis]. / O controle da hipertensão arterial em mulheres e homens: uma análise comparative.

OBJECTIVE: To compare men and women who have hypertension with reference to the following: high blood pressure, biosocial variables, habits and life styles, mental disorders, and social support networks. METHOD: 290 hypertensive patients (women, 62.1%) were evaluated. The assessments involved the following: measuring blood pressure with an automatic measuring device, evaluating social status through the Social Support Scale, and the use of a Self-Report Questionnaire (SRQ-20) to identify common mental disorders. A value of p<0.05 was considered statistically significant. RESULTS: Women were found to be different to men (p<0.05) in the following areas having: better control of their blood pressure (64.4% vs 52.7%), less salary incomes, less diabetes, higher total cholesterol, higher body mass index and wider abdominal circumferences. They also had lower systolic blood pressure, lower levels of alcohol consumption and a greater prevalence for mental disorders. The social support assessment revealed that hypertensive women received less help with preparing meals but had more company from people which allowed them to engage in enjoyable activities. CONCLUSION: Women had more control over their blood pressure than men, despite the presence of negative biopsychosocial factors that may have influenced their adherence to the treatments.

Chronic and asymptomatic diseases influence the control of hypertension treatment in primary care.

OBJECTIVE: To identify the association between blood pressure control and the following variables: a) bio-social and lifestyle characteristics of hypertensive patients; and b) factors related to the antihypertensive treatment. METHODS: This is an exploratory study with 290 people with hypertension from primary care. We used a specific instrument, self-administered, with 21 questions on factors that can hinder treatment, divided into four dimensions: medication, socioeconomic, institutional and personal beliefs. We adopted a significance level of p <0.05. RESULTS: The control of blood pressure was associated (p <0.05) with female gender, Caucasian ethnicity, primary/secondary education, not drinking alcohol, higher income and regular physical activity. Regarding the factors that can hinder treatment, there was association of hypertension control with only two questions: "feel nothing" and "have to do treatment for life". CONCLUSION: Sociodemographic variables and beliefs concerning the absence of symptoms and chronicity of the disease influenced the control of hypertension and should be considered in the adherence process to the treatment. OBJETIVO: Identificar a associação entre o controle da pressão arterial e as seguintes variáveis: a) características biossociais e hábitos de vida dos hipertensos; e b) fatores relacionados ao tratamento anti-hipertensivo. MÉTODOS: Realizou-se estudo exploratório com 290 hipertensos da atenção primária. Utilizou-se de instrumento específico, autoaplicável, com 21 questões sobre fatores que podem dificultar o tratamento, divididas em quatro domínios: medicamentos, socioeconômico, institucional e crenças pessoais. Adotou-se nível de significância de p < 0,05. RESULTADOS: O controle da pressão arterial se associou (p < 0,05) com sexo feminino, etnia branca, ensino fundamental/médio, não ingerir bebida alcoólica, maior renda e atividade física regular. Quanto aos fatores que podem dificultar o tratamento, houve associação do controle com apenas duas questões: "não sentir nada" e "ter que fazer tratamento para vida toda". CONCLUSÃO: Variáveis sociodemográficas e crenças relativas à ausência de sintomatologia e cronicidade da doença influenciaram o controle dos hipertensos e devem ser consideradas no processo de adesão ao tratamento.

Hypertensive patients with and without kidney disease: assessment of risk factors. / Hipertensos com e sem doença renal: avaliação de fatores de risco.

Objective To compare hypertensive patients with and without chronic kidney disease and identify factors associated with their clinical condition and antihypertensive treatment. Method This was a cross-sectional study conducted with patients hospitalized in a general medical ward at a university hospital in the city of São Paulo, Brazil. Data were collected from medical records. Significance was set at p<0.05. Results Of the 386 patients studied, 59.3% presented hypertension and, of these, 37.5% presented chronic kidney disease. The data showed an independent association between chronic kidney disease and prior history of diabetes (OR 1.86; CI 1.02-3.41), congestive heart failure (OR 3.42; CI 1.36-9.03) and living with a partner (OR 1.99; CI 1.09-3.69). Regarding antihypertensive treatment, there was a difference (p<0.05) between hypertensive patients with and without chronic kidney disease in terms of administering healthcare treatment (93.2% versus 77.7%); ongoing use of antihypertensive drugs, (79.1% versus 66.4%); higher number of antihypertensive drugs; the use of beta-adrenergic blockers (34.9%versus 19.6%), calcium channel blockers (29.1%versus 11.2%), loop diuretics (30.2%versus 10.5%) and vasodilators (9.3%versus 2.1%). Conclusion The hypertensive patients with chronic kidney disease presented a more compromised clinical profile; however, the attitudes of these patients toward antihypertensive treatment were more positive than those without chronic kidney disease.

[Hypertension prevalence among indigenous populations in Brazil: a systematic review with meta-analysis]. / Prevalência de hipertensão arterial em indígenas do Brasil: uma revisão sistemática com meta-análise.

OBJECTIVE: Evaluating the evidence of hypertension prevalence among indigenous populations in Brazil through a systematic review and meta-analysis. METHODS: A search was performed by two reviewers, with no restriction of date or language in the databases of PubMed, LILACS, SciELO, Virtual Health Library and Capes Journal Portal. Also, a meta-regression model was designed in which the last collection year of each study was used as a moderating variable. RESULTS: 23 articles were included in the review. No hypertension was found in indigenous populations in 10 studies, and its prevalence was increasing and varied, reaching levels of up to 29.7%. Combined hypertension prevalence in Indigenous from the period of 1970 to 2014 was 6.2% (95% CI, 3.1% - 10.3%). In the regression, the value of the odds ratio was 1.12 (95% CI, 1.07 - 1.18; p <0.0001), indicating a 12% increase every year in the probability of an indigenous person presenting hypertension. CONCLUSION: There has been a constant increase in prevalence despite the absence of hypertension in about half of the studies, probably due to changes in cultural, economic and lifestyle habits, resulting from indigenous interaction with non-indigenous society.

[Arterial hypertension and associated factors in patients submitted to myocardial revascularization]. / Hipertensão arterial e fatores associados em pessoas submetidas à cirurgia de revascularização do miocárdio.

OBJECTIVE To identify the prevalence of arterial hypertension and associated factors in patients submitted to myocardial revascularization. METHOD Cross-sectional study using the database of a hospital in São Paulo (SP, Brazil) containing 3010 patients with coronary artery disease submitted to myocardial revascularization. A multiple logistic regression was performed to identify variables independently associated with hypertension (statistical significance: p<0.05). RESULTS Prevalence of hypertension was 82.8%. After the variables were adjusted, the associated factors were as follows: age, odds ratio (OR): OR=1.01; 95% confidence interval (CI): CI:1.00-1.02; female gender: (OR=1.77;CI:1.39-2.25); brown-skin race: (OR=1.53;CI:1.07-2.19); obesity: (OR=1.53;CI:1.13-2.06); diabetes: (OR=1.90;CI:1.52-2.39); dyslipidemia: (OR=1.51;CI:1.23-1.85); and creatinine>1.3: (OR=1.37;CI:1.09-1.72). CONCLUSION A high prevalence of arterial hypertension and association with both non-modifiable and modifiable factors was observed.

[Adherence to anti-hypertensive treatment within a chronic disease management 
program: a longitudinal, retrospective study]. / Adesão ao tratamento de hipertensos em um programa de gestão de doenças crônicas: estudo longitudinal retrospectivo.

OBJECTIVE: This study assessed pharmacological treatment adherence using the Morisky-Green Test and identified related variables. METHOD: A longitudinal and retrospective study examined 283 patients with hypertension (62.5% women, 73.4 [10.9] years old) who were being monitored by a chronic disease management program for 17 months between 2011 and 2012. Nurses performed all the actions of the program, which consisted of advice via telephone and periodic home visits based on the risk stratification of the patients. RESULTS: A significant increase in treatment adherence (25.1% vs. 85.5%) and a decrease in blood pressure were observed (p<0.05). Patients with hypertension and chronic renal failure as well as those treated using angiotensin-converting enzyme inhibitors were the most adherent (p<0.05). Patients with hypertension who received angiotensin receptor blockers were less adherent (p<0.05). CONCLUSIONS: Strategies such as nurse-performed chronic disease management can increase adherence to anti-hypertensive treatment and therefore contribute to the control of blood pressure, minimizing the morbidity profiles of patients with hypertension.

Adherence to antihypertensive drug treatment in Brazil: a systematic review and meta-analysis. / Adesão ao tratamento medicamentoso anti-hipertensivo no Brasil: revisão sistemática e meta-análise.

This article aims to evaluate the adherence to antihypertensive treatment prevalence in the Brazilian population based on peer-reviewed studies which used instruments exclusively designed and/or adapted for this purpose. A systematic review with meta-analysis based on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search was carried out in the BDENF, SciELO, Cuiden, PsycINFOe, CINAHL, Embase, LILACS, and MEDLINE databases, as well as the AgeLine, Google Scholar and ScienceDirect academic search engines. The protocol was registered with PROSPERO (CRD42021292689). Random effects models were used for a meta-analysis of the prevalence obtained from individual studies. A total of 104 studies were included in the meta-analysis on antihypertensive treatment in the Brazilian population, totaling 38,299 patients. The most used instrument was the four-item Morisky-Green Test (49.5%). The adherence prevalence estimated by the meta-analysis was 44.4% (95%CI: 39.12%-49.94%, I2 = 91.17, p < 0.001), showing high heterogeneity. The adherence to antihypertensive treatment prevalence found in national studies was unsatisfactory, demonstrating that this problem continues to be a major challenge.

O objetivo do artigo é avaliar a prevalência de adesão ao tratamento anti-hipertensivo na população brasileira, com base nos estudos revisados por pares, que utilizaram instrumentos elaborados e/ou adaptados exclusivamente para este fim. Revisão sistemática com meta-análise, baseada nas recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A busca foi realizada nas bases BDENF, SciELO, Cuiden, PsycINFOe, CINAHL, Embase, LILACS, MEDLINE, e nos buscadores acadêmicos AgeLine, Google Scholar e ScienceDirect. O protocolo foi registrado no PROSPERO (CRD42021292689). Modelos de efeitos aleatórios foram usados para meta-análise das prevalências obtidas dos estudos individuais. Incluíram-se 104 estudos na meta-análise sobre tratamento anti-hipertensivo na população brasileira, totalizando 38.299 pacientes. O instrumento mais utilizado foi o teste de Morisky-Green de quatro itens (49,5%). A prevalência de adesão estimada pela foi de 44,4% (IC95%: 39,12%-49,94%, I2 = 91,17, p < 0,001), apresentando alta heterogeneidade. A prevalência de adesão ao tratamento anti-hipertensivo encontrada nos estudos nacionais foi insatisfatória, demonstrando que essa problemática continua sendo um grande desafio.

[Home blood pressure monitoring and control in a group of hypertensive patients]. / A monitorização residencial da pressão arterial e o controle de um grupo de hipertensos.

This qualitative study was performed with 71 hypertensive patients, with the objectives to compare outpatient and home blood pressure monitoring (HBPM), to assess blood pressure control, and characterize white-coat hypertension. A nurse performed the outpatient blood pressure measurement. The home blood pressure monitoring was carried out over seven days. White-coat hypertension was quantified as a difference between the outpatient measurement and home blood pressure monitoring in the ranges from 1 to 5, 6 to 10 and > 10 mmHg. The outpatient blood pressure measurement was significantly higher (p<0.05) than the home blood pressure measurement. Pressure control corresponded to 9.9% in the outpatient measurement and 23.9% in the home blood pressure measurement. The white-coat effect > 10 mmHg was 57.7% for systolic and 32.4% for diastolic pressure, in the range from 6 to 10 mmHg. Home blood pressure measurement provided a better assessment of hypertensive patients' control.

[Cardiovascular risk among health professionals working in pre-hospital care services]. / Risco cardiovascular em profissionais de saúde de serviços de atendimento pré-hospitalar.

The objective of this study was to assess the cardiovascular risk factors among health professionals, particularly hypertension, and stratify them according to the Framingham Risk Score (FRS). The participants were 154 professionals working in pre-hospital care in São Paulo, Brazil, and on the Br-116 highway. Values were considered significant for p<0.05. The prevalence of hypertension was 33%, 20.1% were smokers, 47% consumed alcoholic beverages, 64% were sedentary, 66% were obese/overweight and 70% had an altered abdominal circumference. In terms of laboratory values: glucose>110mg/dL- 11%, total cholesterol >200mg/dL- 36%, LDL-c>130mg/dL- 33%, HDL-c<60mg/dL- 89%, triglycerides>150mg/dL- 30% and C reactive protein>0.5mg/dL- 16%. The FRS was average in 10.3% and high in 1.3%. In logistic regression analysis, it was verified that hypertension was associated with: HDL-c (odds ratio: 0.257,) and FRS (odds ratio: 23.159). There was strong correlation between hypertension and FRS. Data are noteworthy, as this is a relatively young sample of health professionals.

[Nursing actions increases the control of hypertensive patients and reduces white-coat effect]. / Atuação da enfermeira eleva o controle de hipertensos e diminui o efeito do avental branco.

A randomized comparative study was performed to evaluate the control of hypertension with use of home blood pressure measurement (HBPM) and casual blood pressure measurement, and analyze the white coat effect. Hypertensive patients in primary health care units were randomly divided into two groups: group I, participating of the educational activities and group II that followed the routine treatment. The hypertensive patients from group I realized HBPM at the beginning and the end of the study. White-coat effect was evaluated by the difference between the casual blood pressure measurement and HBPM. The study included 290 hypertensive patients, but realized HBPM 82 hypertensive patients. There was increase in blood pressure control from the beginning to end of study in hypertensive patients from group I (p < 0.05) measured by HBP (60% to 68.3%) and casual measurement (62% to 71%) and in group II, HMBP hypertension control was higher than the casual blood pressure measurement (63% vs 50%). The white coat effect was greater in hipertensive patients from group II.

Teleconsultation as an advanced practice nursing during the COVID-19 pandemic based on Roy and Chick-Meleis.

Teleconsultation can be classified as an advanced practice nursing that requires nurses' clinical reasoning based on a consistent theoretical framework to use in the nursing process. Our study conducted a theoretical-reflective analysis, based on Callista Roy's Adaptation Model of Nursing and Chick-Meleis' Transition Theory, about the contribution of teleconsultation as an advanced practice nursing in the care of older adults with chronic diseases during the COVID-19 pandemic. We reflect on this in two moments: "nursing theories and dealing with COVID-19" and "ways of adapting to new care models and advanced practice nursing," based on communication and information technologies. The worsening of the pandemic in Brazil changed life cycles, health/disease and organizational processes, demanding the development of an adaptive-transactional state by users and health care providers. Thus, information and communication technologies combined with advanced practice nursing can relieve social distancing and its repercussions on health care.

Adherence to antihypertensive treatment during the COVID-19 pandemic: findings from a cross-sectional study.

BACKGROUND: Nonadherence to antihypertensive treatment is one of the main causes of the lack of blood pressure (BP) control. The coronavirus disease (COVID-19) pandemic imposes substantial social restriction impairing the medical care routine, which may influence adherence to the antihypertensive treatment. To assess the rate of nonadherence to antihypertensive drug treatment during the COVID-19 pandemic. METHODS: This is a cross-sectional study evaluating hypertensive adult patients from a tertiary outpatient clinic. From March to August 2020, patients were interviewed by telephone during the social distancing period of the COVID-19 pandemic. We evaluated biosocial data, habits, attitudes, and treatment adherence using the 4-item Morisky Green Levine Scale during the social distancing. Uncontrolled BP was defined by BP ≥ 140/90 mmHg. Clinical and prescription variables for drug treatment were obtained from the electronic medical record. We performed a multivariate analysis to determine the predictors of nonadherence to BP treatment. RESULTS: We studied 281 patients (age 66 ± 14 years, 60.5% white, 62.3% women, mean education of 9.0 ± 4 years of study). We found that 41.3% of the individuals reported poor adherence to antihypertensive drug treatment and 48.4% had uncontrolled BP. Subsample data identified that adherence was worse during the pandemic than in the previous period. The variables that were independently associated with the nonadherence during the pandemic period were black skin color (odds ratio [OR], 2.62; 95% confidence interval [CI], 1.46-4.68), and intermittent lack of access to antihypertensive medication during the pandemic (OR, 2.56; 95% CI, 1.11-5.89). CONCLUSIONS: Beyond traditional variables associated with poor adherence, the lack of availability of antihypertensive medications during the study underscore the potential role of pandemic on hypertension burden.

[Development of educational hypermedia to teach an arterial blood pressure measurement procedure]. / Elaboração de uma hipermídia educacional para o ensino do procedimento de medida da pressão arterial.

Arterial blood pressure measurement is an essential conduct to evaluate the condition of the cardiovascular system. Digital teaching environment is a powerful tool for the teaching-learning process, because it adds meaning and concreteness to the content to be learned, and it can be useful to instruct this procedure. The objective of this study was to create educational hypermedia for teaching arterial blood pressure measurement, and to describe the steps of that creation process. The pedagogical framework of Robert Gagné was used; and the construction followed the model proposed by Price. The final product presents videos, photos, animations and simulations that demonstrate and teach the procedure. Although hypermedia construction has been difficult to use, it can positively enhance the teaching of nursing procedures.

[Home blood pressure monitoring: updates and the nurse's role]. / Monitorização residencial da pressão arterial: atualidades e papel do enfermeiro.

This is a review article on home blood pressure monitoring (HBPM) developed with the purpose to increase the current scientific knowledge and present the importance of this approach in the care to patients with hypertension in our setting. This technique has advantages over the causal measurement, as it provides more measurements, a better relationship with the target-organs injuries, it also quantifies the white-coat effect, has good reproducibility, good acceptability by the patients, assesses blood pressure without the influence from the observer and the environment of the appointment, reduces the number of visits to the doctor and promotes greater adherence to treatment. The importance of nursing practice in HBPM is associated with the education process, using teaching-learning strategies, implementing team-patient communication and encouraging patients towards performing self-care.

Work-related violences and associated variables in oncology nursing professionals. / Violências relacionadas ao trabalho e variáveis associadas em profissionais de enfermagem que atuam em oncologia.

Occupational violence is a problem that health professionals are exposed to daily. This cross-sectional study aimed at identifying the prevalence of violence at work (verbal/physical) and the variables related to it in nursing professionals working in oncology. Physical or verbal aggression was assessed through self-report. The relationship between sociodemographic, psycho-emotional and work-related violence (verbal/physical) variables was analyzed using the Chi-Square, Fisher's Exact, Student T and Mann-Whitney tests. The study sample consisted of 231 nursing professionals. The prevalence of physical or verbal aggression reported in the last year was 61.5%. A higher prevalence of aggression was evidenced in professionals who stated that they were tired at the end of the shift and presented reduced concentration during the shift. It is noteworthy that workers who suffered violence presented high levels of burnout in all subscales, a higher Mean score on the work stress scale and a lower Mean with regards to sleep quality. The findings of this study point to the need for institutional measures to prevent and control occupational violence.

A violência ocupacional é um agravo ao qual os profissionais de saúde estão cotidianamente expostos. O objetivo deste artigo é identificar a prevalência de violência no trabalho (verbal/física) e as variáveis relacionadas em profissionais de enfermagem atuantes em oncologia. Estudo transversal, em que a agressão física ou verbal foi avaliada por meio do autorrelato. Analisou-se a relação entre as variáveis sociodemográficas, psicoemocionais e relacionadas ao trabalho violência (verbal/física) por meio dos testes Qui-Quadrado, exato de Fisher, Test T Student e Mann-Whitney. A amostra do estudo foi composta por 231 profissionais de enfermagem. A prevalência de agressão física ou verbal referida no último ano foi de 61,5%. Maior prevalência de agressão foi evidenciada nos profissionais que afirmaram apresentar-se cansados ao final do plantão e com concentração diminuída durante este turno. Destaca-se que os trabalhadores que sofreram violência apresentaram Burnout em alto nível em todas as subescalas, maior escore médio na escala de estresse no trabalho e pior qualidade do sono. Os achados do presente estudo apontam para necessidade de medidas institucionais para prevenção e controle da violência ocupacional.

Blood Pressure Control and Adherence to Drug Treatment in Patients with Hypertension Treated at a Specialized Outpatient Clinic: A Cross-Sectional Study.

OBJECTIVE: To evaluate and identify variables associated with the control of hypertension and adherence to antihypertensive drug treatment in a group of patients with hypertension monitored in a specialized, highly complex outpatient service. METHODS: A prospective, cross-sectional study was carried out in the hypertension unit of a tertiary teaching hospital. Patients diagnosed with hypertensive aged 18 years and over and accompanied for at least six months were included in the study. Patients with secondary hypertension and pregnant women were excluded. The sample consisted of 253 patients. Adherence/concordance to antihypertensive treatment was assessed using the Morisky Green Levine Scale. Blood pressure control was set for values less than 140/90 mmHg. Variables with p≤0.20 in univariate analysis were included in multiple logistic regression. The level of significance adopted was p ≤0.05. RESULTS: Most of patients were white, married and women, with a mean age of 65 (13.3) years old, low income, and education levels. Blood pressure control and adherence were observed in 69.2% and 90.1% of the patients, respectively. Variables that were independently associated with blood pressure control were (OR, odds ratio; CI, 95% confidence interval): married marital status (OR 2.3; CI 1.34-4.28), use of calcium channel blockers (OR 0.4; CI 0.19-0.92) and number of prescribed antihypertensive drugs (OR 0.78; CI 0.66-0.92). Adherence was not associated with any of the variables studied. CONCLUSION: There was a high frequency of patients with satisfactory adherence to antihypertensive drug treatment. Blood pressure control was less frequent and was associated with social and treatment-related factors.

Blood pressure control of hypertensive patients followed in a high complexity clinic and associated variables.

INTRODUCTION: Arterial hypertension is a disease that has a high impact on cardiovascular mortality and morbidity; however, it is still insufficiently controlled. OBJECTIVES: To assess hypertension control in patients seen at a specialized clinic and to identify associated variables. METHOD: Cross-sectional study involving the analysis of medical records from 782 patients treated in a highly complex outpatient clinic. Inclusion criteria: age ≥18 years, diagnosed with hypertension, in treatment ≥6 months. Patients with secondary hypertension (104) and incomplete data (64) were excluded. The main outcome was blood pressure control (systolic <140 and diastolic <90 mmHg). The independent variables studied were: sociodemographic and clinical characteristics (use of drugs, comorbidities and laboratory tests). Pearson's χ2 tests, Fisher's test, Student's t and Wilcoxon-Mann-Whitney tests were performed in the bivariate analysis and logistic regression in the multiple analyses, adopting p≤0.05. RESULTS: The prevalence of hypertensive control was 51.1%. It was associated with a lack of control: body mass index (OR = 1.038; 95% CI = 1.008 - 1.071), history of stroke (OR = 0.453; 95% CI = 0.245 - 0.821), left ventricular hypertrophy (OR = 1.765; 95% CI = 1.052 - 3.011), and number of medications (OR = 1.082; 95% CI = 1.033 - 1.136). CONCLUSION: About half of the hypertensive patients had their blood pressure controlled; clinical variables and target organ damage were associated with the control.

[The effect of educational interventions on nursing team knowledge about arterial hypertension]. / O efeito de intervenções educativas no conhecimento da equipe de enfermagem sobre hipertensão arterial.

Hypertension is one of the main risk factors for cardiovascular diseases. Nursing carries a large responsibility in care delivery to hypertensive individuals. Thus, the goal was to assess a nursing team's knowledge on hypertension and its treatment before and after educational interventions. A questionnaire was used, addressing theoretical aspects of hypertension knowledge among nurses (5), technicians (2), auxiliaries (11) and community agents (37) at two Basic Health Units in São Paulo City, Brazil. For statistical analysis, Student's T test was used, as well as variance analysis and p < 0.05. A knowledge increase was verified after the educational interventions for the group constituted by nurses, technicians and nursing auxiliaries (84.6 +/- 12.0% vs. 92.7 +/- 15.0%, p < 0.05), while no significant change occurred for community health agents (80.8 +/- 12.2% vs. 83.5 +/- 24.0%). Thus, it was concluded that the educational actions were effective and must be put in practice in the nursing team, which they can influence the improvement of care delivery for hypertensive patients.

Hypertensive crisis: clinical characteristics of patients with hypertensive urgency, emergency and pseudocrisis at a public emergency department.

OBJECTIVE: To assess patients with hypertensive crisis, classified as urgency, emergency or pseudocrisis, and identify the associated variables. METHODS: We evaluated a total of 508 patients (57% women; 56.3±13.8 years old) with hypertensive crisis (diastolic blood pressure of 120mmHg), aged 18 years or over, seen at the emergency department of a public general hospital. RESULTS: The prevalence of hypertensive crises was 6/1,000; in that, 71.7% presented hypertensive urgency, 19.1% hypertensive emergency, and 9.2% hypertensive pseudocrisis. In the multinominal logistic regression, pseudocrisis and urgency conditions were compared to hypertensive emergency. Therefore, the presence of pain (OR: 55.58; 95%CI: 10.55-292.74) except chest pain and headache, and emotional problems (OR: 17.13; 95%CI: 2.80-104.87) increased the likelihood of hypertensive pseudocrisis. Age >60 years (OR: 0,32; 95%CI: 0.10-0.96) and neurologic problems (OR: 1.5.10-8; 95%CI: 1.5.10-8-1.5.10-8) protected against hypertensive pseudocrisis. The comparison of hypertensive urgency with hypertensive emergency showed that age >60 years (OR: 0.50; 95%CI: 0.27-0.92), neurologic (OR: 0.09; 95%CI: 0.04-0.18) and emotional problems (OR: 0.06; 95%CI: 4.7.10-3-0.79) protected against hypertensive urgency. Moreover, only headache (OR: 14.28; 95%CI: 3.32-61.47) increased the likelihood of hypertensive urgency. CONCLUSION: Advanced age and neurological problems were associated to hypertensive emergency. Headache was associated with hypertensive urgency. Pain and emotional problems were associated with hypertensive pseudocrisis. Our results can contribute to identifying patients with hypertensive crisis who seek emergency services.