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Prevalence, Awareness, Treatment and Influence of Socioeconomic Variables on Control of High Blood Pressure: Results of the ELSA-Brasil Study
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High blood pressure (HBP) is the leading risk factor for years of life lost in Brazil. Factors associated with HBP awareness, treatment and control need to be understood better. Our aim is to estimate prevalence, awareness, and types of anti-hypertensive treatment and to investigate the association of HBP control with social position. Data of 15,103 (54% female) civil servants in six Brazilian state capitals collected at the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline (2008-2010) were used to estimate prevalence and cross-sectional association of HBP control with education, per capita family income and self-reported race, using multiple logistic regression. Blood pressure was measured by the oscillometric method. 35.8% were classified as presenting HBP; 76.8% of these used anti-hypertensive medication. Women were more aware than men (84.8% v. 75.8%) and more often using medication (83.1% v. 70.7%). Adjusted HBP prevalence was, in ascending order, Whites (30.3%), Browns (38.2%) and Blacks (49.3%). The therapeutic schemes most used were angiotensin-converting enzyme inhibitors, in isolation (12.4%) or combined with diuretics (13.3%). Among those in drug treatment, controlled blood pressure was more likely in the (postgraduate) higher education group than among participants with less than secondary school education (PR = 1.21; 95% CI: 1.14-1.28), and among Asian (PR = 1.21; 95% CI: 1.12-1.32) and 'Whites (PR = 1.19; 95% CI: 1.12-1.26) compared to Blacks. Socioeconomic and racial inequality-as measured by different indicators-are strongly associated with HBP control, beyond the expected influence of health services access.
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“Disparity in education and socioeconomic status has a significant impact on the prevalence and control of hypertension.”
From São Paulo call to action for the prevention and control of high blood pressure: 2020 (2019) · cites this paper as [22]
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Metadata
- Authors
- Chor, D., Pinho Ribeiro, A. L., Sá Carvalho, M., Duncan, B. B., Andrade Lotufo, P., Araújo Nobre, A., Aquino, E. M. L. L. D., Schmidt, M. I., Griep, R. H., Molina, M. D. C. B., Barreto, S. M., Passos, V. M. D. A., Benseñor, I. J. M., Matos, S. M. A., & Mill, J. G.
- Affiliations
- Escola Nacional de Saúde Pública Sergio Arouca (BR)
- Universidade Federal do Rio Grande do Sul (BR)
- Universidade Federal da Bahia (BR)
- Fundação Oswaldo Cruz (BR)
- Universidade Federal de Minas Gerais (BR)
- Universidade Federal do Espírito Santo (BR)
- Corresponding author
- Chor, Dóra
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2015-06-23
- Volume
- 10
- Issue
- 6
- Pages
- e0127382
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4478044
- OpenAlex
- W784773356
- Cited by
- 239
- References
- 66
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 3 · 2023: 25 · 2022: 26 · 2021: 34 · 2020: 39 · 2019: 32 · 2018: 24 · 2017: 20 · 2016: 23 · 2015: 2
- FWCI
- 16.73
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Americanae (AECID Library) (publishedVersion, other-oa)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-sa)
- RePEc: Research Papers in Economics (submittedVersion)
- Americanae (AECID Library) (submittedVersion, other-oa)
- Arca - Repositório Institucional da Fiocruz (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- Funders
- Conselho Nacional de Desenvolvimento Científico e Tecnológico (01060212.00BA, 01 06 0115.00, -0 and, 2013‐0, 01060071.00, 01 06 0278.00, 01060300.00, 309692/2013-0, 300694/2010-5, 01060010.00, 01 06 0212.00)
- Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (E-23557/2014)
- Financiadora de Estudos e Projetos (01060278.00, 01 06 0115.00, 01 06 0300.00, 01060212.00, 01 06 0071.00)
- Ministério da Saúde (0106 0278.00, 01 06 0300.00, 01 06 0115.00, 01 06 0212.00, 01 06 0071.00)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- hypertension, blood pressure control, hypertension awareness, antihypertensive therapy, socioeconomic disparities, racial inequality, household income, ACE inhibitors, diuretics, hypertension prevalence, ELSA-Brasil, public sector employees
- MeSH terms
- Adult, Aged, Antihypertensive Agents, Awareness, Brazil, Female, Humans, Hypertension, Longitudinal Studies, Male, Middle Aged, Socioeconomic Factors, Prevalence
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