Abstract
The prevalence of hypertension in Brazil and worldwide has been increasing in recent decades, and drug therapy is one of the strategies used to control this condition. The objective of this study was to estimate the prevalence of use and identify the sources for obtaining antihypertensive drugs in Brazil, according to sociodemographic variables, comparing three periods: 2011, 2014 and 2017. Data from individuals aged ≥20 years who reported a medical diagnosis of hypertension, interviewed by Vigitel in 2011, 2014 and 2017 were used. Frequency and prevalence of drug use in addition to the sources for obtaining medication were estimated by sociodemographic variables, with 95% confidence intervals. The differences between proportions were verified by Pearson's chi-square test (Rao-Scott), with a significance level of 5%. The prevalence of antihypertensive drug use remained stable (80%). Regarding the sources for obtaining these medicines, there was variation in the period, indicating a decrease in usage through the Brazilian Unified Health System (SUS) (44.2% in 2011; 30.5% in 2017). This decrease was accompanied with increase in PFPB (16.1% in 2011; 29.9% in 2017). The prevalence of other sources for obtaining medicine (private pharmacies/drugstores) showed stability in the period. The prevalence of medication use remained high and there was a change in the pattern of use according to sources, demonstrating migration between SUS pharmacies to the PFPB, and suggesting a reduction in the availability of medicines from public pharmacies universally, and for free.
Highlights
Chronic non-communicable diseases (NCDs) were responsible for 71% of a total of 57 million deaths worldwide in 20161,2
According to data from the National Health Survey (Pesquisa Nacional de Saúde - PNS) of 2013, the prevalence of hypertension reported by the adult Brazilian population was 21.4%6, results similar to those obtained by the Vigitel survey, which pointed to a prevalence of 22.7% in 2011, and reaching 24.3% in 2017
The results of this study showed a high prevalence of medication use for the treatment of arterial hypertension in the three years considered
Summary
Chronic non-communicable diseases (NCDs) were responsible for 71% of a total of 57 million deaths worldwide in 20161,2. Data from 2014 indicate that approximately 75% of deaths from NCDs occur in low- and middle-income countries, and 40% of them are considered premature deaths (before the age of 70)[3]. Arterial hypertension is the main risk factor for cardiovascular diseases and has an important impact on NCD mortality[4]. In Brazil, in 2016, more than 975 thousand deaths were attributed to NCDs, which represents 74% of the total deaths that year, 28% due to cardiovascular diseases[5]. The global prevalence of arterial hypertension in adults (≥ 18 years old) was around 22% in 2014, ranging from 30% in the African continent to 18% in the Americas[3]. This study considered 27 cities[7,8,9] and indicated, that approximately one in four adults in Brazil is hypertensive
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