BLOOD PRESSURE CONTROL IN A HIGH-COMPLEXITY OUTPATIENT SERVICE WAS LESS THAN ADHERENCE TO ANTIHYPERTENSIVE TREATMENT

Abstract

Objective: To evaluate the blood pressure control, adherence to antihypertensive treatment and associated variables. Design and method: A cross-sectional study was performed in a hypertension outpatient clinic from a Hospital in São Paulo, Brazil. Inclusion criteria were: age over 18 years old, in treatment for at least six months and also that accepted to participate signing the Informed Consent Form. Patients diagnosed with secondary hypertension, pregnant and unable to answer the interview were excluded. The sample calculation based on 60% of control rate and 5% of significance level was 253 participants. The blood pressure control was systolic blood pressure < 140 and diastolic blood pressure < 90 mmHg. The adherence to treatment was assessed by Morisky MMAS-8. Biosocial data, risk factors, habits, lifestyles, anthropometric measurements, comorbidities and psycho-emotional characteristics were evaluated. Multivariate analysis was performed by the Logistic Regression and the significance level was <0.05. Results: The blood pressure control was 69.2% and 82.2% had a high adherence to treatment. The characteristics of hypertensive patients were: 65.0 (13.3) years, 61.7% were female, 63.2% were white, 52.8% were married, 44.3% had completed high school studies, body mass index 29.5 (5.3) Kg/m2 (81.4% overweight or obesity), 47.4% had a low socio economic classification, 55.7% had never smoked, 60% hadn’t drunk alcoholic beverage currently, 84.5% hadn’t had common mental disorders, 39.9% had physical activity irregularly and 8.0 (4.0) number of drugs in use. The main comorbidities were: Dyslipidemia (71.5%), Diabetes Mellitus (40.7%), Chronic Kidney Disease (19%), Stroke (8.7%), Coronary Insufficiency (13.4%). The systolic blood pressure was 138.6 (12.1) mmHg and diastolic was 80.8 (7.2) mmHg. The most used antihypertensive drugs were: diuretics (78.3%), calcium channel blockers (68.8%), AT1 receptor blockers (61.7%), beta-blocker adrenergic inhibitors (50.2 %) and angiotensin-converting enzyme inhibitor (30.4%). The associated variables to blood pressure control were: married marital status (OR 2.3; IC95%:1.34 – 4.28), calcium channel blockers (OR 0.4; IC95%: 0.19–0.92) and number of antihypertensive drugs in use (OR 0.78; IC95%:0.66–0.92). Conclusions: The blood pressure control were more elevated than data from majority of Brazilian studies, although not coincident to the adherence to the treatment evaluated.