No description available.

No description available.

Dr. J. Torline Dr. S. Sarawan Dr. H. Engelbrecht

No description available.

Background: Although the relationship between body weight and blood pressure (BP) is well established, there is a lack of data regarding the impact of obesity on the prevalence of hypertension in primary care practice. The objective of this study was to assess the prevalence of hypertension and the diagnosis, treatment status, and control rates of hypertension in obese patients as compared to patients with normal weight. Methods: A cross-sectional point prevalence study of 45,125 unselected consecutive primary care attendees was conducted in a representative nationwide sample of 1912 primary care physicians in Germany (HYDRA). Results: Blood pressure levels were consistently higher in obese patients. Overall prevalence of hypertension (blood pressure ≥140/90 mm Hg or on antihypertensive medication) in normal weight patients was 34.3%, in overweight participants 60.6%, in grade 1 obesity 72.9%, in grade 2 obesity 77.1%, and in grade 3 obesity 74.1%. The odds ratio (OR) for good BP control (<140/90 mm Hg) in diagnosed and treated patients was 0.8 (95% confidence interval [CI] 0.7– 0.9) in overweight patients, 0.6 (95% CI 0.6–0.7) in grade 1, 0.5 (95% CI 0.4–0.6) in grade 2, and 0.7 (95% CI 0.5– 0.9) in grade 3 obese patients. Conclusions: The increasing prevalence of hypertension in obese patients and the low control rates in overweight and obese patients document the challenge that hypertension control in obese patients imposes on the primary care physician. These results highlight the need for specific evidence-based guidelines for the pharmacologic management of obesity-related hypertension in primary practice.

Introdução: No âmbito da epidemiologia nos serviços de saúde, este estudo avaliou a adesão ao tratamento medicamentoso de pacientes portadores de hipertensão arterial em uma situação de pleno acesso farmacológico, verificando sua associação com aspectos sócio demográficos, comportamentais e características clínicas. Metodologia: estudo transversal com aplicação de questionário junto a usuários do Programa Remédio em Casa da Secretaria Municipal de Saúde de São Paulo. A variável dependente foi a adesão e as variáveis independentes, as características sociodemográficas, comportamentais e clínicas. Foram calculadas as razões de prevalência e a análise multivariada foi realizada por regressão de Poisson. Principais resultados: portadores de hipertensão arterial com pleno acesso aos medicamentos apresentaram alta adesão terapêutica. Os poucos participantes não aderentes não diferiram dos demais do ponto de vista das características sócio demográficas, comportamentais e clínicas. Conclusão: em situação de adequada assistência, os fatores relacionados aos aspectos individuais perdem influência na determinação da adesão, sendo superados pela oferta efetiva de atenção à saúde e pelo pleno acesso aos medicamentos / Background: This study evaluated the medication adherence of hypertensive patients who had full access to medicines and the association with sociodemographic, behavioral and clinical characteristics. Methods: Cross-sectional study using a questionnaire applied to users of Programa Remédio em Casa [Home Medicine Program], a program of distribution of medicines from the city of São Paulo-Brazil. The dependent variable was adherence and the independent variables were sociodemographic, behavioral and clinical characteristics. Prevalence ratios were calculated and multivariate analyses were performed using Poisson Regression. Results: The study population showed high adherence. The non-adherent participants did not differ from the adherent participants in sociodemographic, behavioral or clinical characteristics. Conclusions: with effective provision of health care and full access to medicine, sociodemographic, behavioral and clinical factors lose influence in the determination of adherence to medicine

Introdução: No âmbito da epidemiologia nos serviços de saúde, este estudo avaliou a adesão ao tratamento medicamentoso de pacientes portadores de hipertensão arterial em uma situação de pleno acesso farmacológico, verificando sua associação com aspectos sócio demográficos, comportamentais e características clínicas. Metodologia: estudo transversal com aplicação de questionário junto a usuários do Programa Remédio em Casa da Secretaria Municipal de Saúde de São Paulo. A variável dependente foi a adesão e as variáveis independentes, as características sociodemográficas, comportamentais e clínicas. Foram calculadas as razões de prevalência e a análise multivariada foi realizada por regressão de Poisson. Principais resultados: portadores de hipertensão arterial com pleno acesso aos medicamentos apresentaram alta adesão terapêutica. Os poucos participantes não aderentes não diferiram dos demais do ponto de vista das características sócio demográficas, comportamentais e clínicas. Conclusão: em situação de adequada assistência, os fatores relacionados aos aspectos individuais perdem influência na determinação da adesão, sendo superados pela oferta efetiva de atenção à saúde e pelo pleno acesso aos medicamentos / Background: This study evaluated the medication adherence of hypertensive patients who had full access to medicines and the association with sociodemographic, behavioral and clinical characteristics. Methods: Cross-sectional study using a questionnaire applied to users of Programa Remédio em Casa [Home Medicine Program], a program of distribution of medicines from the city of São Paulo-Brazil. The dependent variable was adherence and the independent variables were sociodemographic, behavioral and clinical characteristics. Prevalence ratios were calculated and multivariate analyses were performed using Poisson Regression. Results: The study population showed high adherence. The non-adherent participants did not differ from the adherent participants in sociodemographic, behavioral or clinical characteristics. Conclusions: with effective provision of health care and full access to medicine, sociodemographic, behavioral and clinical factors lose influence in the determination of adherence to medicine

Despite the evident improvements in the awareness of hypertension among the adult population in the United States, disparities remain in the burden of the disease, its treatment efficacy, and its control when data are compared along age, gender, and race. The purpose of this study was to determine the strength of the relationship between blood pressure control and prescription medication and lifestyle modification (smoking cessation, changes in eating habits, and weight loss). The target population were adult young Black men, and the control variables were age, low socioeconomic status (SES), and disparities in health care. A convenience sample of Black men (age 16-45 years) was obtained (N = 297) from the 2013-2014 NHANES dataset, and bivariate and multiple regressions were conducted after the assumptions were satisfied. The results indicated a statistically significant relationship between prescription medication and systolic blood pressure control (B = -4.327, p = 0.009). The findings of the study can promote social change by highlighting that medication compliance must be encouraged and adhered to by members of this high-risk group. However, further research is suggested to explore the efficacy of lifestyle modification closely to determine if this is a viable treatment option for young Black men of low SES in the United States.