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O efeito dos fatores comportamentais na tensão arterial da população portuguesa sob anti-hipertensores: resultados do 1.º Inquérito Nacional de Saúde com Exame Físico
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Abstract(s)
Introdução: A hipertensão arterial é um dos principais fatores de risco para incapacidade e morte por doenças cardiovasculares. Orientações atuais preconizam medidas não farmacológicas de controlo dos valores tensionais centradas em mudanças do estilo de vida. Este estudo teve como objetivo principal estimar a associação entre fatores comportamentais de estilo de vida e a tensão arterial (TA) na população portuguesa sob anti-hipertensores. Material e Métodos: Realizou-se um estudo transversal, com análise dos dados colhidos no 1º Inquérito Nacional de Saúde com Exame Físico 2015. Foram estudados os indivíduos que referiram encontrar-se sob medicação anti-hipertensora nas duas semanas prévias à entrevista. As variáveis comportamentais (consumo adicional de sal, consumo de álcool, consumo de frutos e vegetais, prática de atividade física, hábito tabágico) foram medidas por questionário e os valores de TA sistólica (TAS) e diastólica (TAD) foram obtidos por exame físico. Foram estimadas associações entre as variáveis comportamentais e os valores médios de TA, estratificadas por sexo e ajustadas para variáveis sociodemográficas e obesidade através de um modelo de regressão linear múltipla. Resultados: O consumo de álcool (ß=6,310, IC95% 1,875;10,744) e o hábito tabágico (ß=4,724, IC95% 0,848;8,599) apresentaram-se positivamente associados à média da TAS, em homens, aumentando em média, respetivamente, em 6,3 mmHg e 4,7 mmHg os valores de TAS. O consumo adicional de sal, o consumo de frutos e vegetais e a prática de atividade física não apresentaram associação estatisticamente significativa com os valores de TA, em homens. Nas mulheres, nenhuma associação foi estatisticamente significativa para qualquer variável comportamental. Discussão: Os resultados demonstram, assim, que alterações dos estilos de vida da população portuguesa masculina sob anti-hipertensores, nomeadamente redução dos hábitos tabágicos e hábitos alcoólicos, apresentam um potencial importante em termos de controlo de valores de TAS e, consequentemente, de prevenção de eventos cardiocerebrovasculares.
Introduction: Hypertension is one of the main risk factors for disability and death from cardiovascular diseases. Current guidelines include initiatives to control blood pressure values in hypertensive patients that focus on lifestyle changes. The main objective of this study was to estimate the association between behavioural lifestyle factors and blood pressure (BP) in patients under antihypertensive medication. Materials and Methods: An analysis of the data collected in the first National Health Examination Survey 2015 was performed. Individuals who met National Health Examination Survey inclusion criteria and who referred to be under antihypertensive medication in the two weeks prior to the interview were studied. Behavioural lifestyle variables (additional salt intake, alcohol consumption, fruit and vegetables intake, practice of physical activity and smoking habits) were measured by questionnaire, and the systolic (SBP) and diastolic blood pressure (DBP) values were obtained by physical examination. Associations between behavioural variables and mean BP values, stratified by sex and adjusted to sociodemographic variables and obesity, were estimated through a multiple linear regression model. Results: Alcohol consumption (ß=6.310, IC95% 1.875;10.744) and smoking habit (ß=4.724, IC95% 0,848;8,599) were positively associated with mean SBP values in men, increasing the mean SBP values in 6.3 mmHg and 4.7 mmHg, respectively. Additional salt intake, fruit and vegetable consumption, and practice of physical activity were not statistically associated with BP values in men. In women, no association was statistically significant for any behavioural variable. Discussion: The results show that changes in the lifestyles of the male Portuguese population under antihypertensives, in particular reduction of smoking habits and alcoholic habits, represent an important potential in terms of control of SBP values and, consequently, the prevention of cardiocerebrovascular events.
Introduction: Hypertension is one of the main risk factors for disability and death from cardiovascular diseases. Current guidelines include initiatives to control blood pressure values in hypertensive patients that focus on lifestyle changes. The main objective of this study was to estimate the association between behavioural lifestyle factors and blood pressure (BP) in patients under antihypertensive medication. Materials and Methods: An analysis of the data collected in the first National Health Examination Survey 2015 was performed. Individuals who met National Health Examination Survey inclusion criteria and who referred to be under antihypertensive medication in the two weeks prior to the interview were studied. Behavioural lifestyle variables (additional salt intake, alcohol consumption, fruit and vegetables intake, practice of physical activity and smoking habits) were measured by questionnaire, and the systolic (SBP) and diastolic blood pressure (DBP) values were obtained by physical examination. Associations between behavioural variables and mean BP values, stratified by sex and adjusted to sociodemographic variables and obesity, were estimated through a multiple linear regression model. Results: Alcohol consumption (ß=6.310, IC95% 1.875;10.744) and smoking habit (ß=4.724, IC95% 0,848;8,599) were positively associated with mean SBP values in men, increasing the mean SBP values in 6.3 mmHg and 4.7 mmHg, respectively. Additional salt intake, fruit and vegetable consumption, and practice of physical activity were not statistically associated with BP values in men. In women, no association was statistically significant for any behavioural variable. Discussion: The results show that changes in the lifestyles of the male Portuguese population under antihypertensives, in particular reduction of smoking habits and alcoholic habits, represent an important potential in terms of control of SBP values and, consequently, the prevention of cardiocerebrovascular events.
Description
Dissertação de Mestrado em Saúde Pública, apresentada à Escola Nacional de Saúde Pública da Universidade Nova de Lisboa, 2019
Orientação científica de Professor Doutor Baltazar Nunes e Mestre Ana Paula Rodrigues
Orientação científica de Professor Doutor Baltazar Nunes e Mestre Ana Paula Rodrigues
Keywords
Hipertensão Arterial Alimentação Atividade Física Tabaco Álcool Estados de Saúde e de Doença Determinantes da Saúde e da Doença INSEF Inquérito Nacional de Saúde com Exame Físico Doenças Cardiovasculares Portugal Blood Pressure Diet Physical Activity Tobacco Alcohol