Abstract
This study aimed to measure the contribution of selected health behaviors to the prevalence of hypertension control in Brazilian adults 50 years or older, based on data from the ELSI-Brasil study. The study included 4,318 individuals 50 years or older who reported having received a medical diagnosis of hypertension and were taking antihypertensive medication. The selected health behaviors were: physical activity, healthy diet, not consuming excessive alcohol, and never having smoked. The contribution of each health behavior to prevalence of hypertension control was estimated by the attribution method, via adjustment of the binomial additive hazards model, stratified by sex. Prevalence of hypertension control was 50.7% (95%CI: 48.2; 53.1). Overall, health behaviors made a larger contribution to hypertension control in women (66.3%) than in men (36.2%). Moderate alcohol consumption made the largest contribution in both sexes, but particularly in women (52.7% in women versus 19% in men). Physical activity contributed 12.6% in women and 10.7% in men. The other behaviors were more relevant in men: never having smoked (3.4%) and regular consumption of vegetables, legumes, and fruits (3.1%). These results underline the need for measures to promote the adoption of healthy behaviors by hypertensive individuals to reduce blood pressure levels, improve the effectiveness of antihypertensive medication, and decrease their cardiovascular risk.
Highlights
Hypertension is still a public health problem worldwide due to its high prevalence and difficult control [1,2,3]
Among 4,451 participants of the ELSI study that reported having received a medical diagnosis of hypertension and using antihypertensive medication, 4,318 (97%) had information for all the variables and were included in the study
Regular physical activity was similar in women and men (62.5% and 61.7%, respectively)
Summary
Hypertension is still a public health problem worldwide due to its high prevalence and difficult control [1,2,3]. Prevalence of hypertension is high in the general population (about 30%) and increases sharply with age, reaching some 65% of the elderly [1,4,5,6,7]. Even with the development of modern pharmaceutical technologies, blood pressure control is still low, posing a major global public health challenge [2,3,10]. Various studies in different populations have focused on assessing the prevalence of blood pressure control in hypertensive individuals. A study in China consisting of 1,738,886 adults 35 to 75 years of age showed that fewer than 30% of the study population had their blood pressure controlled 12.
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