Navegando por Assunto "Hypertension"

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Acesso aberto (Open Access)
Association between perceived racial discrimination and hypertension: findings from the ELSA-Brasil study
(Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, 2018-03) NOBRE, Aline Araújo; GRIEP, Rosane Härter; GUIMARÃES, Joanna Miguez Nery; PEREIRA, Alexandre; CHOR, Dóra; MENDES, Patrícia Miranda; BARRETO, Sandhi Maria; JUVANHOL, Leidjaira Lopes
“Pardos” and blacks in Brazil and blacks in the USA are at greater risk of developing arterial hypertension than whites, and the causes of this inequality are still little understood. Psychosocial and contextual factors, including racial discrimination, are indicated as conditions associated with this inequality. The aim of this study was to identify the association between perceived racial discrimination and hypertension. The study evaluated 14,012 workers from the ELSA-Brazil baseline population. Perceived discrimination was measured by the Lifetime Major Events Scale, adapted to Portuguese. Classification by race/color followed the categories proposed by Brazilian Institute of Geography and Statistics (IBGE). Hypertension was defined by standard criteria. The association between the compound variable - race/racial discrimination - and hypertension was estimated by Poisson regression with robust variance and stratified by the categories of body mass index (BMI) and sex. Choosing white women as the reference group, in the BMI < 25kg/m2 stratum, “pardo” women showed adjusted OR for arterial hypertension of 1.98 (95%CI: 1.17-3.36) and 1.3 (95%CI: 1.13-1.65), respectively, whether or not they experienced racial discrimination. For black women, ORs were 1.9 (95%CI: 1.42-2.62) and 1.72 (95%CI: 1.36-2.18), respectively, for the same categories. Among women with BMI > 25kg/m2 and men in any BMI category, no effect of racial discrimination was identified. Despite the differences in point estimates of prevalence of hypertension between “pardo” women who reported and those who did not report discrimination, our results are insufficient to assert that an association exists between racial discrimination and hypertension.
Acesso aberto (Open Access)
Avaliação da presença de metais pesados na água potável fornecida à população urbana de Altamira e o seu possível impacto epidemiológico sobre doenças crônicas renais
(Universidade Federal do Pará, 2024-04-30) STORCH, Wesley; FAIAL, Kleber R. Freitas; http://lattes.cnpq.br/0166366420811929; HTTPS://ORCID.ORG/0000-0002-8575-1262; PEREIRA, Adenilson Leão; http://lattes.cnpq.br/3184636120604556
The Xingu River is crucial for potable water supply in Altamira, but it faces risks of heavy metal pollution, especially mercury, due to illegal mining and UHBM activities. Mercury can bioaccumulate in humans and be associated with an increased risk of hypertension and kidney diseases. This study evaluated the presence of heavy metals in Altamira's drinking water and outlined the epidemiological profile of chronic kidney disease (CKD) in Altamira and the Xingu region. Concentrations of Al, As, Cr, Cd, Pb, Fe, and Hg were measured in 24 water samples collected in July 2022, using ICP/MS by the Evandro Chagas Institute, compared to Brazilian legislation and WHO limits. Mortality data from CKD, diabetes mellitus (DM), and systemic arterial hypertension (SAH) from 2000 to 2020 were analyzed using public data from DATASUS. Additionally, medical records of CKD patients treated at HRPT from 2007 to 2023 were analyzed. The concentrations of metals in the analyzed water samples were within established limits, except for aluminum (Al), which was elevated in two water samples. Mortality data obtained from DATASUS between 2000 and 2020 showed a significant increase in mortality due to SAH in Altamira (R²=0.80), while mortality from CKD (R²=0.30) and DM (R²=0.31) had a smaller impact on the mortality rate during the studied period. Considering the medical records of CKD patients treated at HRPT, it was identified that between 2007 and 2023, 174 CKD patients treated at HRPT were from Altamira, with 64.4% men and 35.6% women. Regarding age, 48.85% were over 60 years old, and 36.78% were between 41 and 60 years old. The main comorbidity associated with CKD was SAH (56.90%), followed by the association of SAH and DM (36.94%). Altamira presented an average prevalence of 8.99 cases per 100,000 inhabitants and an average incidence of 10.24 new cases per year of CKD during the analyzed period. In the Xingu region, 403 CKD cases were identified, predominantly in men (61.5%) with an average age of 60 years. The main comorbidity associated with CKD was SAH (49.88%), followed by the association of SAH and DM (37.47%). The average prevalence of CKD in the region was 6.97 cases per 100,000 inhabitants, with an average incidence of 23.70 new cases per year of CKD during the analyzed period. The levels of metals in the analyzed water samples are within the limits recommended by Brazilian legislation and WHO. The high prevalence of CKD in Altamira and the Xingu region raises concerns about public health impacts. Historical mercury contamination may be related to the high mortality from SAH and the prevalence of CKD associated with SAH. These results emphasize the need for continuous monitoring of water quality and public policies to mitigate the impacts of CKD in the region.
Acesso aberto (Open Access)
Desafios do Programa HIPERDIA e implicações para a enfermagem
(Universidade Federal do Pará, 2014-06-27) FERNANDEZ, Darla Lusia Ropelato; POLARO, Sandra Helena Isse; http://lattes.cnpq.br/7875594038005793; GONÇALVES, Lucia Hisako Takase; http://lattes.cnpq.br/6191152585879205; https://orcid.org/0000-0001-5172-7814
INTRODUCTION: The HIPERDIA Program was established in 2001 in primary care because of the severity of epidemiological Hypertension (HBP) and Diabetes Mellitus (DM), conditions that can lead to serious complications instilling limitations and suffering in the lives of their patients and their families. In this context, it is worth mentioning the importance of primary prevention of these diseases and their complications. Past more than a decade of implementation, it is worth to reflect on the impact on health conditions that the program has generated among its users. OBJECTIVES: To elucidate the principles, philosophy and the guiding policy of HIPERDIA Program of the Ministry of Health (MH); describe how the patient care works, by a health team of HIPERDIA Program; explore the life and health behaviors demonstrated by users of HIPERDIA after its insertion into the program. METHODOLOGY DESCRIPTION: This is a Case Study second Yin (2010) whose object of study was a HIPERDIA Program executed in a Basic Health Unit outskirts of Belém. Data were obtained through interviews with users, staff and managers of the program, in addition to direct field observation, consultation records and official documentation of MS. The data analysis was performed by the analytical strategy "Relying on Theoretical Propositions" and the analytical technique "Standard Combination". RESULTS: The deterioration of the HIPERDIA program management illustrated by deficiencies in infrastructure, supplies, medicines and weaknesses in the reference and counter reference network, excessive spontaneous demand that overloads the health team allocated insufficient in number and the context of poverty and urban violence in users living contribute to poor adherence to treatment regimen and limit the team in its interdisciplinary and integral action. Furthermore, the current model of care is grounded in traditional, based on consultations and prescriptions and that has not proved sufficient to fully meet the needs of care to people with chronic condition requiring long-term care by adopting lifestyles more consistent and healthy. FINAL THOUGHTS: Big challenges are drawn against the data emerged from this study and it involves governmental and intersectoral actions that promote improvements in the living conditions of the population which requires political will to investing the necessary resources. Notwithstanding this, the nurse can make a contribution by promoting cultural care and self-care actions, customizing the plan of action and bringing the responsibility of the user and their families in improving their health condition.
Acesso aberto (Open Access)
A Implicação do apoio social no viver de pessoas com hipertensão arterial
(Universidade Federal do Rio Grande do Sul. Escola de Enfermagem, 2013-09) TAVARES, Roseneide dos Santos; SILVA, Denise Maria Guerreiro Vieira da
This study aimed to know the types of support offered by the network of social support and implications on hypertensive life. Qualitative study whose methodology was based on Grounded Theory. 35 people were interviewed between October 2008 and August 2010, 22 hypertensive compulsorily enrolled in HIPERDIA at a Health Unit in Belém / PA, 5 family members, 5 health professionals and 3 representatives of community institutions, referenced by hypertensive patients, as members of the network support. Data were subjected to coding procedures: analysis, comparison and categorization. The category "Identifying the types of social support offered to people in their living with hypertension" was the Intervening Condition of the Theory. The types of emotional, informational and instrumental support originated mainly from family relationships and may mean alternative treatments, featuring a care focused on people with hypertension and their network of relationships which requires attention from healthcare professionals, including nurses.
Acesso aberto (Open Access)
Protocolo de diagnóstico e tratamento da hipertensão arterial sistêmica no Diabetes Mellitus
(Universidade Federal do Pará, 2024-02-23) OLIVEIRA, Cássio Antônio Bezerra de; QUEIROZ, Natércia Neves Marques de; http://lattes.cnpq.br/5359261920325026; FELÍCIO, João Soares; http://lattes.cnpq.br/8482132737976863
Hypertension is a chronic disease that often accompanies diabetes mellitus and the relationship between the two is complex. Like diabetes, it is an important cardiovascular risk factor and microvascular complications, such as nephropathy and retinopathy, and has higher health costs than diabetes itself. The treatment of hypertension in diabetes has been widely debated and there is still a need to reach a consensus on treatment goals and strategies. The objective of the present study was to develop a clinical protocol on the diagnosis and treatment of hypertension in diabetes mellitus whose main foundation was its applicability in the Brazilian public health system, focusing on medical adherence to recommendations, the impact of applying the evidence in primary and secondary care, and the evolution of health quality in these scenarios. To this end, an integrative literature review was carried out, selecting health articles based on the quality of evidence located in the PUBMED database and published in the last 20 years (2004-2024). Five researchers were responsible for selecting those with the best quality of evidence. National and international guidelines and works published by the UFPA diabetes clinical research group were also used. In the end, 106 articles were selected as theoretical references for preparing the protocol. The results were synthesized in the form of a clinical protocol containing concise texts and teaching resources (27 tables, 3 flowcharts and 1 figure) that will guarantee safety in clinical decision-making in primary and secondary health care settings, configuring a practical guide on the topic in question.