Panorama epidemiológico da hipertensão arterial, diabetes e obesidade na Região Norte do Brasil: análise do Inquérito Telefônico VIGITEL

Abstract

Introduction: Cardiovascular diseases are part of the Group of Chronic Noncommunicable Diseases (NCDs), which constitute the largest global health problem and are responsible for thousands of deaths annually. The presence of diseases such as Hypertension, Diabetes Mellitus, Obesity and Dyslipidemias are considered cardiovascular risk factors and due to their high mortality rates have been monitored by large surveys nationwide. Objective: To estimate the prevalence and associated factors of Hypertension, Diabetes Mellitus and Obesity in the adult population of northern Brazil obtained by the VIGITEL 2019 telephone survey. Method: Cross-sectional study, with adults, residents and domiciled in the seven capitals of the northern region of Brazil, based on data from the Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey (VIGITEL), year 2019, whose sample was 3,723,439 participants. Data were collected from January to December 2019 by the Ministry of Health and subsequently disclosed and accessed from March to July 2021. The variables of interest for this study refer to: socioeconomic factors, anthropometry, eating habits, lifestyle and selfassessment of health status. The data were analyzed using the software R: The R Project for Statistical Computing, the variables were presented by absolute and relative frequencies. The bivariate analysis of the data was made with proportions for categorical variables and pearson chi-square test was applied for comparative evaluation between groups. The mean and standard deviation were used to present the distribution of continuous variables, and the use of the Student's T test. Binary Logistic Regression was used for multivariate analysis, with the variables that were associated with significance level p≤0.20 in the bivariate analysis, estimating the Prevalence Ratio (PR) and its respective Confidence Intervals of 95%. In all analyses, the sample weight was taken into account, according to the research design. To evaluate the association between SAH, DM and Obesity and the co-occurrence of risk factors, the Stereotype Model (ME) was used. The VIGITEL Survey was approved by the National Commission of Ethics in Research for Human Beings of the Ministry of Health (CAAE: 65610017.1.0000.0008). Free and informed consent was replaced by verbal consent, obtained at the time of telephone contacts with the interviewees, because it was a telephone interview. Results: In 2019, the prevalence of Systemic Arterial Hypertension in the northern region was 19.3% (n=717,013), the prevalence of Diabetes Mellitus was 5.9% (n=221,097) and Obesity was 21.4% (n=796,962). The variables associated with SAH were: height [PR= 0.96; (IC95%= 0.93 - 0.99); p=0.018], age group ≥65 years [PR= 11.29; (IC95%= 1.40 - 90.76); p=0.023], to be a widower [PR= 2.55; (95% CI = 1.01 - 6.42); p=0.046] and self-perception of very good/good health status [PR= 0.36; (IC95%= 0.19 - 0.68); p= 0.002]. The variables that were associated with DM were: age group ≥65 years [PR= 34.40; (IC95%= 14.38 - 82.31); p= <0,001], schooling with 9 to 11 years of schooling [PR= 0.68; (IC95%= 0.49 - 0.94); p= 0.022] and ≥12 years of study [PR= 0.58; (IC95%= 0.38 - 0.89); p= 0.013], the regular nonconsumption of beans [PR= 0.67; (IC95%= 0.51 - 0.87); p= 0.004], non-consumption of raw vegetables [RP= 0.64; (95% CI = 0.46 - 0.89); p= 0.008], alcohol consumption [RP= 0.66; (95% CI = 0.47 - 0.92); p= 0.017] and very good/good self-perceived health [PR= 0.50; (IC95%= 0.35 - 0.71); p= <0,001]. In the outcome Obesity only being diabetic showed an association [PR= 2.86; (CI95%= 1.07 - 7.68); p= 0.036]. Conclusions: the study provides anepidemiological overview of SAH, DM and Obesity in the capitals of the northern region, providing knowledge about these important cardiovascular risk factors, how they are distributed in this population and which risk variables were associated with the three outcomes, with a view to enabling the construction of health promotion programs to prevent these diseases, improving the quality of life of the population of northern Brazil.