CARDIOMETABOLIC MULTIMORBIDITY AND ASSOCIATED FACTORS: THE FIRST BRAZILIAN REGISTRY OF PATIENTS WITH HYPERTENSION

Abstract

Objective: Cardiometabolic multimorbidity (CM-MM) is defined by the occurrence of at least two of morbidities (diabetes mellitus, stroke, acute myocardial infarction). The purpose of this study was to analyze the occurrence of CM-MM and associated factors among Brazilian patients with hypertension. Design and method: Cross-sectional study with participants of The First Brazilian Registry of Patients with Hypertension (BRH) from 45 sites in all regions of Brazil (n = 2,646). For this study we select the individuals with 65 and more years (n = 1,033) and CM-MM was defined with the presence of 2 or more of the following: diabetes mellitus, stroke, acute myocardial infarction evaluated by self related. CM-MM was analyzed according to sex, age, race, presence of others morbidities (dyslipidemia, myocardial revascularization, heart failure and chronic kidney disease), control of blood pressure, obesity, physical activity, actual smoking and alcohol consumption. The numerical variables were presented by median and interquartile range, the categorical variables by absolute and relative frequency. To verify the variables associated with the outcome, simple logistic regression was performed. Results: CM-MM was present in 8.9% of participants. The median age was 71.6 (IQ: 67.9–76.8), female (59.7%), 65–70 years of age (39.6%), and 59.8% were white. Obesity was present in 55.8% and 48.4% of individuals have no blood pressure controlled. The occurrence of diabetes mellitus, stroke, and acute myocardial infarction was, respectively, 32.7%, 14.7% and 6.7%. A higher occurrence of CM-MM was observed in males, aged between 70 and 75 years old and with 75 years old or more, the presence of dyslipidemia; myocardial revascularization (MR); heart failure (HF) and kidney disease. The intersection size among diseases is represented in Figure 1. After multiple analysis, the following variables were associated with the presence of cardiovascular multimorbidity: male gender; age equal to or greater than 75 years and report of dyslipidemia, MR and HF. Conclusions: The prevalence of CM-MM was high and an approach based on the clusters of cardiometabolic diseases can be a potent care strategy.