Monitoring the progress of health-related sustainable development goals (SDGs) in Brazilian states using the Global Burden of Disease indicators.

BACKGROUND: Measuring the Global Burden of Disease (GBD) has been the key to verifying the evolution of health indicators worldwide. We analyse subnational GBD data for Brazil in order to monitor the performance of the Brazilian states in the last 28 years on their progress towards meeting the health-related SDGs. METHODS: As part of the GBD study, we assessed the 41 health-related indicators from the SDGs in Brazil at the subnational level for all the 26 Brazilian states and the Federal District from 1990 to 2017. The GBD group has rescaled all worldwide indicators from 0 to 100, assuming that for each one of them, the worst value among all countries and overtime is 0, and the best is 100. They also estimate the overall health-related SDG index as a function of all previously estimated health indicators and the SDI index (Socio-Demographic Index) as a function of per capita income, average schooling in the population aged 15 years or over, and total fertility rate under the age of 25 (TFU25). RESULTS: From 1990 to 2017, most subnational health-related SDGs, the SDG and SDI indexes improved considerable in most Brazilian states. The observed differences in SDG indicators within Brazilian states, including HIV incidence and health worker density, increased over time. In 2017, health-related indicators that achieved good results globally included the prevalence of child wasting, NTD, household air pollution, conflict mortality, skilled birth attendance, use of modern contraceptive methods, vaccine coverage, and health worker density, but poor results were observed for child overweight and homicide rates. The high rates of overweight, alcohol consumption, and smoking prevalence found in the historically richest regions (i.e., the South and Southeast), contrast with the high rates of tuberculosis, maternal, neonatal, and under-5 mortality and WASH-related mortality found in the poorer regions (i.e., the North and Northeast). CONCLUSIONS: The majority of Brazil's health-related SDG indicators have substantially improved over the past 28 years. However, inequalities in health among the Brazilian states and regions remain noticeable negatively affecting the Brazilian population, which can contribute to Brazil not achieving the SDG 2030 targets.

Prevalence of arterial hypertension according to different diagnostic criteria, National Health Survey. / Prevalência da hipertensão arterial segundo diferentes critérios diagnósticos, Pesquisa Nacional de Saúde.

OBJECTIVE: To determine the population prevalence of arterial hypertension in adults according to different diagnostic criteria. METHODS: This is a cross-sectional study, analyzing information from the Brazilian National Health Survey in 2013, consisted of interviews, physical and laboratory measurements (n = 60,202). The prevalence of hypertension was defined according to three diagnostic criteria: self-reported; measured by instrument (blood pressure ≥ 140/90 mmHg); measured and/or using medication. Prevalence and 95% confidence interval (95%CI) were estimated by the three diagnostic criteria of hypertension. RESULTS: The high blood pressure measurements were: 21.4% (95%CI 20.8 - 22.0) using the criterion self-reported; 22.8% (95%CI 22.1 - 23.4) by measured hypertension; and 32.3% (95%CI 31.7 - 33.0) by measured hypertension and/or reported use of medication. Women presented higher prevalence for the self-reported criterion (24.2%; 95%CI 23.4 - 24.9) and men, for the measured criterion (25.8%; 95%CI 24.8 - 26.8). Hypertension increases with age and is more frequent in urban areas. Using these three criteria, the hypertension was higher in the Southeast and South regions, in relation to the average of the country and the other regions. Using these three criteria, hypertension increased with age, was more frequent in urban areas and in the Southeast and South regions, in relation to the average of the country and the other regions. CONCLUSION: These findings are important to support policies that aim to achieve the World Health Organization's goal of reducing hypertension by 25% over the next decade.

OBJETIVO: Determinar a prevalência populacional de hipertensão arterial em adultos, segundo diferentes critérios diagnósticos. MÉTODOS: Trata-se de um estudo transversal, que analisa informações da Pesquisa Nacional de Saúde de 2013, que consistiu em entrevistas, medidas físicas e laboratoriais da população brasileira (n = 60.202). A prevalência de hipertensão arterial foi definida segundo três critérios diagnósticos: hipertensão autorreferida; medida por instrumento (pressão arterial ≥ 140/90 mmHg); medida e/ou em uso de medicamentos anti-hipertensivos. Foram estimadas as prevalências de hipertensão arterial segundo os três critérios diagnósticos e seus respectivos intervalos de confiança de 95% (IC95%). RESULTADOS: As prevalências de hipertensão arterial encontradas foram: 21,4% (IC95% 20,8 - 22,0) utilizando-se o critério autorreferido, 22,8% (IC95% 22,1 - 23,4) para hipertensão arterial medida e 32,3% (IC95% 31,7 - 33,0) para hipertensão arterial medida e/ou relato de uso de medicação. As mulheres apresentaram prevalências de hipertensão mais elevadas no critério autorreferido (24,2%; IC95% 23,4 - 24,9). Entre os homens, a prevalência foi maior no critério hipertensão arterial medida (25,8%; IC95% 24,8 - 26,7). Utilizando os três critérios, a hipertensão arterial aumentou com a idade, foi mais frequente na região urbana e maior nas regiões sudeste e sul, em relação à média do país e às demais regiões. CONCLUSÃO: Estes resultados são importantes para apoiar políticas que visem atingir a meta da Organização Mundial de Saúde de redução da hipertensão em 25% na próxima década.

Prevalência da hipertensão arterial segundo diferentes critérios diagnósticos, Pesquisa Nacional de Saúde / Prevalence of arterial hypertension according to different diagnostic criteria, National Health Survey

RESUMO: Objetivo: Determinar a prevalência populacional de hipertensão arterial em adultos, segundo diferentes critérios diagnósticos. Métodos: Trata-se de um estudo transversal, que analisa informações da Pesquisa Nacional de Saúde de 2013, que consistiu em entrevistas, medidas físicas e laboratoriais da população brasileira (n = 60.202). A prevalência de hipertensão arterial foi definida segundo três critérios diagnósticos: hipertensão autorreferida; medida por instrumento (pressão arterial ≥ 140/90 mmHg); medida e/ou em uso de medicamentos anti-hipertensivos. Foram estimadas as prevalências de hipertensão arterial segundo os três critérios diagnósticos e seus respectivos intervalos de confiança de 95% (IC95%). Resultados: As prevalências de hipertensão arterial encontradas foram: 21,4% (IC95% 20,8 - 22,0) utilizando-se o critério autorreferido, 22,8% (IC95% 22,1 - 23,4) para hipertensão arterial medida e 32,3% (IC95% 31,7 - 33,0) para hipertensão arterial medida e/ou relato de uso de medicação. As mulheres apresentaram prevalências de hipertensão mais elevadas no critério autorreferido (24,2%; IC95% 23,4 - 24,9). Entre os homens, a prevalência foi maior no critério hipertensão arterial medida (25,8%; IC95% 24,8 - 26,7). Utilizando os três critérios, a hipertensão arterial aumentou com a idade, foi mais frequente na região urbana e maior nas regiões sudeste e sul, em relação à média do país e às demais regiões. Conclusão: Estes resultados são importantes para apoiar políticas que visem atingir a meta da Organização Mundial de Saúde de redução da hipertensão em 25% na próxima década.

ABSTRACT: Objective: To determine the population prevalence of arterial hypertension in adults according to different diagnostic criteria. Methods: This is a cross-sectional study, analyzing information from the Brazilian National Health Survey in 2013, consisted of interviews, physical and laboratory measurements (n = 60,202). The prevalence of hypertension was defined according to three diagnostic criteria: self-reported; measured by instrument (blood pressure ≥ 140/90 mmHg); measured and/or using medication. Prevalence and 95% confidence interval (95%CI) were estimated by the three diagnostic criteria of hypertension. Results: The high blood pressure measurements were: 21.4% (95%CI 20.8 - 22.0) using the criterion self-reported; 22.8% (95%CI 22.1 - 23.4) by measured hypertension; and 32.3% (95%CI 31.7 - 33.0) by measured hypertension and/or reported use of medication. Women presented higher prevalence for the self-reported criterion (24.2%; 95%CI 23.4 - 24.9) and men, for the measured criterion (25.8%; 95%CI 24.8 - 26.8). Hypertension increases with age and is more frequent in urban areas. Using these three criteria, the hypertension was higher in the Southeast and South regions, in relation to the average of the country and the other regions. Using these three criteria, hypertension increased with age, was more frequent in urban areas and in the Southeast and South regions, in relation to the average of the country and the other regions. Conclusion: These findings are important to support policies that aim to achieve the World Health Organization's goal of reducing hypertension by 25% over the next decade.