Blood pressure control in hypertensive patients within Family Health Program versus at Primary Healthcare Units
analytical cross-sectional study
Keywords:
Hypertension, Health plan implementation, Public health, Population control, Health educationAbstract
CONTEXT AND OBJECTIVE: Hypertension is a public health problem due to its high prevalence and longterm cardiovascular complications. In Brazil in 2005, cardiovascular diseases were responsible for 28% of all deaths. Efforts are being made within primary care to achieve adequate hypertension control. The Family Health Program (FHP) has the aims of promoting quality of life and intervening in factors that put this at risk. The objective of this study was to evaluate the rate of blood pressure control among patients followed up at FHP units compared with those at primary healthcare units (PHUs). DESIGN AND SETTING: Analytical cross-sectional study in the municipality of Petrópolis, Rio de Janeiro, from January to December 2005. METHODS: Five hundred patients with a diagnosis of hypertension were included: 250 were being followed up at two FHP units and 250 at two PHUs. The diagnosis of hypertension was based on the Fourth Brazilian Hypertension Consensus, and the patients needed to have been under follow-up at the units for at least 12 months. Patients’ blood pressure was considered to be under control if it was less than 140/90 mmHg at the last consultation. RESULTS: Blood pressure was under control in 29.2% (n = 73) at FHP units and 39.23% (n = 98) at PHUs (odds ratio = 0.64; confidence interval = 0.44-0.93; P = 0.024). CONCLUSION: Blood pressure control was better among patients followed up at PHUs than among those followed up at FHP units.
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References
Kearney PM, Whelton M, Reynolds K, et al. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365(9455):217-23.
Brasil. Ministério da Saúde. Informações de Saúde. Mortalidade — Brasil. Available from: http://tabnet.datasus.gov.br/cgi/deftohtm.exe?sim/cnv/obt10uf.def. Accessed in 2011 (Oct 7).
Ramos ACMF, Seixas TC, Rocha CRM, Monteiro GTR, Farias AMRO. Avaliação transversal do controle da hipertensão em programa de larga escala [Cross-sectional evaluation of arterial hypertension in a massive program control]. J Bras Med. 2001;81(3):63-70.
Gus I, Harzheim E, Zaslavsky C, Medina C, Gus M. Prevalência, reconhecimento e controle da hipertensão arterial sistêmica no estado do Rio Grande do Sul [Prevalence, awareness, and control of systemic arterial hypertension in the state of Rio Grande do Sul]. Arq Bras Cardiol. 2004;83(5):424-3.
Matos AC, Ladeia AM. Avaliação de fatores de risco cardiovascular em uma comunidade rural da Bahia [Assessment of cardiovascular risk factors in a rural community in the Brazilian state of Bahia]. Arq Bras Cardiol. 2003;81(3):291-302.
Brasil. Ministério da Saúde. Portaria no 1.886, de 18 de dezembro de 1997. Aprova as normas e diretrizes do programa de agentes comunitários de saúde e do programa de saúde da família. Available from: http://dtr2004.saude.gov.br/susdeaz/legislacao/arquivo/21_Portaria_1886_de_18_12_1997.pdf. Accessed in 2011 (Aug 31).
Brasil. Ministério da Saúde. Secretaria de Políticas de Saúde. Departamento de Ações Programáticas Estatégicas. Plano de reorganização da atenção à hipertensão arterial e ao diabetes mellitus: hipertensão arterial e diabetes mellitus. Brasília: Ministério da Saúde; 2001. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/miolo2002.pdf. Accessed in 2011 (Aug 31).
Sociedade Brasileira de Hipertensão, Sociedade Brasileira de Cardiologia, Sociedade Brasileira de Nefrologia. IV Diretrizes Brasileiras de Hipertensão Arterial [IV Brazilian Guidelines on Hypertension]. Arq Bras Cardiol. 2004;82(supl. 4):7-22.
Vassar stats: website for statistical computation. Available from: http://faculty.vassar.edu/lowry/VassarStats.html. Accessed in 2010 (May 13).
Davis DA, Taylor-Vaisey A. Translating guidelines into practice. A systematic review of theoretic concepts, practical experience and research evidence in the adoption of clinical practice guidelines. CMAJ. 1997;157(4):408-16.
Schneider CA, Hagemeister J, Pfaff H, Mager G, Höpp HW. [Guideline- adequate knowledge in internists and general practitioners about the diagnosis and treatment of arterial hypertension]. Z Arztl Fortbild Qualitatssich. 2001;95(5):339-44.
Whitworth JA; World Health Organization, International Society of Hypertension Writing Group. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens. 2003;21(11):1983-93.
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Avaliação normativa do Programa Saúde da Família no Brasil: monitoramento da implantação e funcionamento das equipes de Saúde da Família - 2001/2002 [Normative Evaluation of the Health Family Program in Brazil: monitorment of the implementation of the teams of family health - 2001/2002]. Brasília: Ministério da Saúde; 2004.
Haynes RB, McDonald H, Garg AX, Montague P. Interventions for helping patients to follow prescriptions for medications. Cochrane Database Syst Rev. 2002;(2):CD000011.
Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008;(2):CD000011.
Haynes RB, McDonald HP, Garg AX. Helping patients follow prescribed treatment: clinical applications. JAMA. 2002;288(22):2880-3.
Schroeder K, FaheyT, Ebrahim S. Interventionsforimprovingadherence to treatment in patients with high blood pressure in ambulatory settings. Cochrane Database Syst Rev. 2004;(2):CD004804.
Ministério da Saúde. Resultado do Programa HiperDia. TabNet. Informações Estatísticas. Available from: http://hiperdia.datasus.gov.br/. Accessed in 2011(Oct 11).
