Recrutamento de participantes no Estudo Longitudinal de Saude do Adulto / Participants recruitment in ELSA-Brasil (Brazilian Longitudinal Study for Adult Health)

OBJETIVO: Apresentar as estratégias de comunicação e recrutamento no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) e discutir os resultados alcançados na constituição da coorte. MÉTODOS: As estratégias foram voltadas à divulgação, à institucionalização e ao recrutamento propriamente dito. As ações de comunicação pretenderam promover o fortalecimento de imagem institucional positiva para o estudo, a gestão de conhecimentos e o diálogo eficaz com seu público-alvo. Foi criado web site oficial visando dialogar com diferentes públicos, funcionar como difusor científico e contribuir para a consolidação da imagem do estudo perante a sociedade. RESULTADOS: Foram recrutados 16.435 mulheres e homens, servidores ativos e aposentados de seis instituições públicas de ensino e pesquisa para constituir a coorte de 15.105 participantes. As metas de recrutamento foram plenamente alcançadas nos seis centros, com leve predomínio de mulheres e daqueles mais jovens, e um pouco menos de servidores com menor escolarização. CONCLUSÕES: As estratégias utilizadas se mostraram adequadas e essenciais para o sucesso da captação e participação dos servidores. .

OBJECTIVE: To present the recruitment and communication strategies of the ELSA-Brasil (Estudo Longitudinal de Saúde do Adulto - Brazilian Longitudinal Study for Adult Health). METHODS: The strategies were directed at dissemination, institutionalization and recruitment. The communication actions intended to promote the strengthening of a positive institutional image for the study, knowledge management and an effective dialogue with its target audience. An official website was created in order to communicate with different audiences, to disseminate scientific knowledge, and to contribute to consolidate the image of the study within society. RESULTS: We recruited 16,435 men and women, active employees and retirees of six public institutions of education and research, to constitute the cohort of 15,105 participants. The recruitment goals were fully achieved in the six centers, with a slight predominance of women and of younger adults, and slightly fewer employees with lower level of schooling. CONCLUSIONS: The strategies used were adequate and essential to the successful inclusion and participation of the employees. .

Simultaneidade de fatores de risco cardiovascular modificáveis na população adulta de Salvador (BA), Brasil / Clustering of modifiable cardiovascular risk factors in adults living in Salvador (BA), Brazil

OBJETIVO: Estimar a freqüência da simultaneidade de fatores de risco cardiovascular modificáveis, com e sem inclusão da hipertensão arterial, em uma população miscigenada. MÉTODO: Estudo transversal realizado em 1 298 adultos com idade > 20 anos na Cidade de Salvador, Brasil, em 2000. Foram incluídos oito fatores de risco cardiovascular modificáveis, considerados em qualquer combinação: colesterol total > 240 mg/dL; colesterol das lipoproteínas de alta densidade (HDL-c) <40 mg/dL; triglicerídeos > 200 mg/dL; glicemia > 126 mg/dL + diabetes controlado; índice de massa corporal > 25 kg/m², cintura > 102 cm (homens) e > 88 cm (mulheres), tabagismo e alcoolismo. Os resultados foram estratificados de acordo com o número de fatores de risco simultâneos (de zero a cinco ou mais; e dois ou mais). Os dados foram analisados em termos de proporções estimadas e intervalo de confiança de 95 por cento (IC95 por cento), com e sem inclusão da hipertensão arterial (critério JNC-VI), razões entre proporções e qui-quadrado para proporções como medida de associação. RESULTADOS: Entre os homens (41,4 por cento dos participantes), 7,5 por cento (IC95 por cento: 2,5 a 9,7) não apresentaram fatores de risco; 68,8 por cento (IC95 por cento: 65,0 a 72,8) apresentaram dois ou mais fatores de risco, excluída a hipertensão. Quando a hipertensão foi incluída, 73,4 por cento (IC95 por cento: 69,7 a 77,1) apresentaram dois ou mais fatores de risco. Entre as mulheres, 11,6 por cento não apresentaram fatores de risco. A presença de dois ou mais fatores de risco, excluída a hipertensão, foi observada em 67,7 por cento (IC95 por cento: 64,8 a 71,4). Após inclusão da hipertensão, 71,7 por cento (IC95 por cento: 68,5 a 74,9) das mulheres apresentaram dois ou mais fatores de risco. Foram observadas diferenças significativas entre presença de dois ou mais fatores de risco para homens com até 4 anos de estudo versus homens com 5 a menos de 11 anos de estudo (P <0,05); mulheres com até 4 anos de estudo versus 5 a menos de 11 anos de estudo; mulheres com até 4 anos de estudo versus 11 ou mais anos de estudo (P <0,01); e para mulheres negras versus brancas (P <0,01). CONCLUSAO: A elevada proporção de múltiplos fatores de risco cardiovascular em Salvador, incluindo-se ou não a hipertensão, especialmente na população de baixa escolaridade e em pessoas negras, sugere a necessidade de estratégias sociais abrangentes para reduzir as desigualdades sociais, promover a saúde, e facilitar o...

Objective. To estimate the frequency of modifiable cardiovascular risk factors, with and without inclusion of arterial hypertension, occurring simultaneously in a raciallymixed population. Method. A cross-sectional study was carried out with 1 298 adults aged ≥ 20 years in the city of Salvador, Brazil, in 2000. Eight modifiable cardiovascular risk factors were assessed, in any combination: total cholesterol ≥ 240 mg/dL; high density-lipoprotein cholesterol (HDL-c) < 40 mg/dL; triglycerides ≥ 200 mg/dL; glycemia ≥ 126 mg/dL + wellcontrolled diabetes; body mass index ≥ 25 kg/m2, waist ≥ 102 cm for males and ≥ 88 cm for females, smoking and alcoholism. The results were stratified according to the number of simultaneous risk factors (zero to five or more and two or more risk factors). The data were analyzed in terms of estimated proportions and 95% confidence intervals (95%CI), with and without the inclusion of arterial hypertension (VI Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure [JNC-VI], United States of America), ratio of proportions and chi-square for proportions as a measure of association. Results. Among men (41.4% of participants), 7.5% (95%CI: 2.5 to 9.7) did not present risk factors; 68.8% (95%CI: 65.0 to 72.8) presented two or more risk factors, not including hypertension. After inclusion of hypertension, 73.4% (95%CI: 69.7 to 77.1) presented two or more risk factors. Among women, 11.6% did not present risk factors. The presence of two or more risk factors, not including hypertension, was observed in 67.7% (95%CI: 64.8 to 71.4). After inclusion of hypertension, 71.7% (95%CI: 68.5 to 74.9) of the women presented two or more risk factors. Significant differences were observed for the presence of two or more risk factors in men with not more than 4 years of schooling vs. 5 to less than 11 years of schooling (P < 0.05); in women with not more than 4 years of schooling vs. 5 to less than 11 years of schooling; in women with not more than 4 years of schooling vs. 11 or more years of schooling (P < 0.01); and in black vs. white women (P < 0.01). Conclusions. The high proportion of clustering cardiovascular risk factors in Salvador, with or without hypertension, especially in the population with little schooling and in black individuals, suggests the need for broad social strategies to reduce social inequality, promote health, and facilitate the treatment of cardiovascular risk factors

Alcohol drinking patterns by gender, ethnicity, and social class in Bahia, Brazil

OBJECTIVE: To study patterns of alcohol consumption and prevalence of high-risk drinking. METHODS: A household survey was carried out in a sample of 2,302 adults in Salvador, Brazil. Cases of High-Risk Drinking (HRD) were defined as those subjects who referred daily or weekly binge drinking plus episodes of drunkenness and those who reported any use of alcoholic beverages but with frequent drunkenness (at least once a week). RESULTS: Fifty-six per cent of the sample acknowledged drinking alcoholic beverages. Overall consumption was significantly related with gender (male), marital status (single), migration (non-migrant), better educated (college level), and social class (upper). No significant differences were found regarding ethnicity, except for cachaça (Brazilian sugarcane liquor) and other distilled beverages. Overall 12-month prevalence of high-risk drinking was 7 percent, six times more prevalent among males than females (almost 13 percent compared to 2.4 percent). A positive association of HRD prevalence with education and social class was found. No overall relationship was found between ethnicity and HRD. Male gender and higher socioeconomic status were associated with increased odds of HRD. Two-way stratified analyses yielded consistent gender effects throughout all strata of independent variables. CONCLUSIONS: The findings suggest that social and cultural elements determine local patterns of alcohol-drinking behavior. Additional research on long-term and differential effects of gender, ethnicity, and social class on alcohol use and misuse is needed in order to explain their role as sources of social health inequities.

Hipertensäo arterial em trabalhadoras de enfermagem: padräo de ocorrência, diagnóstico e tratamento / Hypertension in a female nursing staff: pattern of occurrence, diagnosis, and treatment

OBJECTIVE: To report the pattern of occurrence, diagnosis, and treatment of hypertension in a female nursing staff of an emergency hospital. METHODS: We carried out a cross-sectional study that included interviews and blood pressure measurements of 494 nursing professionals at an emergency hospital in the city of Salvador, in the state of Bahia, Brazil. We considered hypertensive all individual with blood pressure > or = 140/90 mmHg or normal pressure if on regular treatment. RESULTS: We found a prevalence of hypertension of 36.4 percent. Only 18.3 percent of the individuals ignored their hypertensive condition, and 64.2 percent admitted not being having regular treatment. Of those individuals who were having treatment, 69.4 percent had elevated blood pressure on examination. The major reasons for not being on treatment was the occasional elevation of blood pressure (22.2 percent) and medical counseling (20.0 percent). CONCLUSION: The results point to the need to introduce hypertension control measures in this occupational group, because of the magnitude of the disease and the potential impact on diffusion of knowledge and measures to control hypertension