RESUMO
BACKGROUND: Life course epidemiology is a powerful framework to unravel the role of socioeconomic position (SEP) disparities in hypertension (HTN). This study investigated whether life course SEP is associated with HTN incidence. Specifically, to test whether cumulative low SEP throughout life and unfavorable intergenerational social mobility increased HTN incidence. METHODS: Longitudinal analysis of 8,754 ELSA-Brasil participants without HTN or cardiovascular in visit 1 (2008-2010). The response variable was the incidence of HTN between visits 1 and 2 (2012-2014). The explanatory variables were childhood, youth, and adulthood SEP, cumulative low SEP, and intergenerational social mobility. Associations were estimated by incidence rate ratios (IRRs) obtained by generalized linear models, with Poisson distribution and logarithmic link function, after adjustment for sociodemographic, behavioral, and health factors. RESULTS: The incidence of HTN was 43.2/1,000 person-years, being higher in males, elderly (70-74 years), self-declared black, and low SEP individuals. After considering sociodemographic factors, low SEP in childhood, youth, and adulthood remained statistically associated with increased HTN incidence. Individuals in the third (IRR: 1.26; 95% confidence interval (CI): 1.11-1.44) and fourth top quartiles (IRR: 1.29; 95% CI: 1.11-1.49) of cumulative low SEP, vs. first, as well as those with low stable intergenerational trajectory (IRR: 1.29; 95% CI: 1.16-1.43), vs. high stable, also had increased HTN incidence rates. CONCLUSIONS: Socioeconomic disparities at all phases of the life cycle appear to raise HTN incidence rates, being the individuals with greater accumulation of exposure to low SEP and with more unfavorable intergenerational mobility at greatest risk, even in a short follow-up time.
Assuntos
Disparidades nos Níveis de Saúde , Hipertensão , Classe Social , Mobilidade Social , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Criança , Feminino , Humanos , Hipertensão/epidemiologia , Incidência , Estudos Longitudinais , Masculino , Fatores de Risco , Mobilidade Social/estatística & dados numéricosRESUMO
Pacientes hipertensos cuja pressäo sanguínea diastólica fosse igual ou superior a 130mmHg, após um período de repouso de 30 minutos e a administraçäo de 80 mg de furosemide intravenoso, foram estudados com a finalidade de verificar a eficácia de clorpromazina por via intravenosa em pequenas doses no controle de hipertensäo arterial grave. A resposta terapêutica foi considerada muito boa. Sonolência foi a queixa mais comum. Hipotensäo arterial foi detectada em 2 pacientes. Este procedimento terapêutico é uma opçäo para o contole agudo da hipertensäo arterial grave
