Prevalence of Systemic Arterial Hypertension and Associated Factors Among Adults from the Semi-Arid Region of Pernambuco, Brazil / Prevalência e Fatores Associados à Hipertensão Arterial Sistêmica em Adultos do Sertão de Pernambuco, Brasil

Abstract Background: Systemic arterial hypertension is a substantial public health problem responsible for millions of deaths per year worldwide. However, little is known about the epidemiology of this disease in areas distant from large urban centers in Brazil. Such information is necessary to plan health promotion strategies. Objective: To estimate the prevalence of hypertension and determine its associated factors in adults residing in the semi-arid region of the state of Pernambuco, Northeastern Brazil. Method: This is a cross-sectional study conducted with a random sample of male and female adults. Individuals with systolic blood pressure ≥ 140 mm/Hg and/or diastolic blood pressure ≥ 90 mm/Hg and those who reported being under treatment with antihypertensive drugs were considered hypertensive. We collected data on demographic, socioeconomic, behavioral, and anthropometric characteristics, as well as health and nutrition. The statistical analysis used Pearson's chi-square test, the chi-square test for trend, and multivariate Poisson regression analysis. A p-value < 0.05 in the final model was considered indicative of statistical significance. Results: The sample consisted of 416 individuals, and the prevalence of hypertension was 27.4% (95%CI 23.2 - 32.0). In the final model, the independent predictors of hypertension were age of 40 years or older (p = 0.000), low economic class (p = 0.007), smoking (p = 0.023), overweight determined by the body mass index (p = 0.003), and reduced glucose tolerance/diabetes mellitus (p = 0.012). Conclusion: The prevalence of hypertension was high and related to important risk factors. Thus, prevention and control strategies are recommended.

Resumo Fundamento: A hipertensão arterial sistêmica (HAS) constitui grande problema de saúde pública, responsável por milhões de mortes por ano no mundo. Apesar disso e frente à necessidade de informações para o delineamento de estratégias de promoção da saúde, pouco se conhece sobre a epidemiologia da doença em regiões distantes dos grandes centros urbanos brasileiros. Objetivo: Estimar a prevalência e verificar os aspectos associados à HAS em adultos do sertão de Pernambuco, Brasil. Métodos: Estudo de delineamento transversal, com uma amostra aleatória de adultos de ambos os sexos. Foram considerados hipertensos aqueles que apresentaram pressão arterial sistólica ≥ 140 mmHg e/ou diastólica ≥ 90 mmHg, além daqueles que relataram estar em tratamento com anti-hipertensivos. Informações demográficas, socioeconômicas, comportamentais, antropométricas e de saúde e nutrição foram coletadas. Foram aplicados os testes do 2 de Pearson, c2 para tendência e a regressão multivariada de Poisson. No modelo final, foi considerada significância estatística quando p < 0,05. Resultados: A amostra foi composta por 416 indivíduos e a prevalência de HAS foi de 27,4% (IC95% 23,2 - 32,0). No modelo final, foram identificados como preditores independentes da HAS a faixa etária a partir dos 40 anos (p = 0,000), classe econômica baixa (p = 0,007), tabagismo (p = 0,023), excesso de peso pelo índice de massa corporal (p = 0,003) e adultos com tolerância à glicose diminuída/diabetes mellitus (p = 0,012). Conclusão: A prevalência de HAS é elevada e se relaciona com fatores de risco importantes, logo, são recomendáveis ações de prevenção e controle.

Cross-cultural adaptation of Hypertension Knowledge Test into European Portuguese

ABSTRACT We aim to validate a European-Portuguese version of the Hypertension Knowledge Test (HKT) questionnaire and examine its factorial structure with a confirmatory factor analysis (CFA). A process of translation and back-translation was performed. A cross-sectional study was developed in which all adult patients taking at least one antihypertensive drug were invited to participate. Data on personal and family history were collected, and the HKT, Strelec, and the Batalla questionnaires were administered. We enrolled 304 patients with a mean age of 68.12±10.83 years. The mean score of HKT was 15.33±2.79. CFA indicated that the construct being tested was unidimensional, and Cronbach's alpha (α=0.65) showed that the instrument had an acceptable internal consistency. When evaluating concurrent validity, HKT was significantly correlated with the Batalla and Strelec scores. Thus, the Portuguese version of HKT (HKT-pt-PT) can be used either in research or in clinical practice. With this version, a potential standard exists to evaluate knowledge about hypertension, which could avoid the practice of using non-validated questionnaires in Portugal and allow the cross-sectional and longitudinal comparability of studies.