Thesis (M.P.H.)--University of Alabama at Birmingham, 2009. / Title from first page of PDF file (viewed on June 11, 2009). Includes bibliographical references (p. 36-40).

Made available in DSpace on 2014-12-17T15:38:51Z (GMT). No. of bitstreams: 1 MarciaTMR.pdf: 675691 bytes, checksum: 8421c03f2a9a714352355d7c7ea5ed53 (MD5) Previous issue date: 2003-06-26 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The high blood pressure is a multifactorial chronic disease which possesses emotional and social features in the illness appearance and evolution and in the adherence to the treatment which involves a decision-making through patient so that he or she process the necessary changes on harmful living habits. Adhesion, traditionally, it is referred to the patient to answer to the doctor orientations or of other health professional, about the appearance to the appointment with a doctor, about the use of medicine or lifestyle changes and maintaining this adhesion is the main problem to be overcame. It is expected the adhesion will ever be a continual, stable and satisfactory action, disregarding the complexity of subjectivity processes which permeate the sicken. This research aimed to investigate the difficulties which the person with high blood pressure has to adhere to the treatment, from the signification processes which give sense to the actions dealing with the adhesion. The study was carried out with 48 users of assistance program to the high blood pressure patient from Hospital Universit?rio from Natal RN, between 40-65 age. The answers were submitted to a double analysis process: 1) answer systematization in categories and codes and admission in statistical program SPSS (Statistical Package of Social Science), for generation of descriptive statistics; 2) Sense and signification analysis which permeated the deepener statement and interpretatively. The greater difficulties found are present on low-salt and law-calorie diets, in the dealing with everyday feeling and stress, being these factors cited as direct motive to the high blood pressure, regardless of interviewee s sex. It is observed there is not adhesion, but adhering, as an experienced everyday process. This work contributes with its results, assessing the used strategies by program with the aim of increasing the adhesion rates / A Hipertens?o Arterial ? uma doen?a cr?nica, multifatorial, possuindo caracter?sticas emocionais e sociais implicadas no aparecimento e evolu??o da doen?a e na ader?ncia ao tratamento, que envolve uma tomada de decis?o por parte do seu portador para que sejam processadas as mudan?as necess?rias nos h?bitos de vida nocivos. Ades?o, tradicionalmente, refere-se ao paciente atender ?s orienta??es do m?dico ou de outro profissional de sa?de, no comparecimento ?s consultas marcadas, no uso do medicamento ou mudan?as de estilo de vida e manter esta ades?o ? o grande problema a ser vencido. Espera-se que a ades?o seja uma a??o cont?nua, est?vel e satisfat?ria sempre, desconsiderando a complexidade dos processos de subjetiva??o que permeiam o adoecer. A pesquisa objetivou investigar as dificuldades que a pessoa portadora de hipertens?o tem de aderir ao tratamento, a partir dos processos de significa??o que d?o sentido ?s a??es lidando com a ades?o. O estudo foi realizado com 48 usu?rios do programa de assist?ncia ao hipertenso do Hospital Universit?rio de Natal/RN, com idade entre 40 e 65 anos. As respostas foram submetidas a um duplo processo de an?lise: 1) sistematiza??o das respostas em categorias e c?digos e ingresso no programa estat?stico SPSS (Statistical Package of Social Science), para gera??o de estat?sticas descritivas; 2) an?lise dos sentidos e significados que permearam os depoimentos de forma mais aprofundada e interpretativa. As maiores dificuldades encontradas est?o presentes na dieta hiposs?dica e hipocal?rica, no lidar com sentimentos e stress da vida di?ria, sendo esses fatores citados como motivo direto para o aumento da press?o arterial, independentemente do sexo dos entrevistados. Observou-se que n?o existe ADES?O e sim ADERINDO, como um processo vivenciado diariamente. Este trabalho contribui, com os seus resultados, para avaliar as estrat?gias utilizadas pelo programa, visando um aumento dos ?ndices de ades?o

<p>Uvod. Kardiovaskularne bolesti kao deo grupe hroničnih nezaraznih bolesti predstavljale su i predstavljaju vodeći uzrok obolevanja i umiranja u svetu. Brojni naučni dokazi potvrđuju da je arterijska hipertenzija glavni kardiovaskularni faktor rizika, a da postignute vrednosti krvnog pritiska niže od 140/90mmHg značajno smanjuju kardiovaskularni rizik, odnosno pojavu kardiovaskularnih događaja, prvenstveno infarkta miokarda i moždanog udara. Arterijska hipertenzija je najzastupljenije stanje koje se viđa u ustanovama primarne zdravstvene za&scaron;tite, a mere prevencije, rano dijagnostikovanje, lečenje i kontrola arterijske hipertenzije predstavljaju javno-zdravstveni izazov u svim zemljama sveta. Ciljevi. Ciljevi istraživanja su utvrđivanje prevalencije arterijske hipertenzije koja je pod kontrolom; utvrđivanje prevalencije i povezanosti metaboličkih faktora sa ishodom u kontroli krvnog pritiska; utvrđivanje prevalencije i povezanosti nezdravih stilova života sa ishodom u kontroli krvnog pritiska; utvrđivanje prediktora lo&scaron;e kontrole krvnog pritiska i izračunavanje 10-godi&scaron;enjeg kardivaskularnog rizika. Metode. U studiju preseka (prevalencije) uključeno je 373 ispitanika oba pola starosti od 45 do 75 godina sa dijagnozom arterijske hipertenzije u kartonu koji su u periodu od oktobra 2015. godine do februara 2016. godine dolazili kod svog izabranog lekara. Prikupljanje podataka obavljeno je merenjem krvnog pritiska, antropometrijskim merenjima, biohemijskim analizama i anketiranjem popunjavanjem upitnika. Rezultati. Uzorak ispitanika je činilo 55% žena i 45% mu&scaron;karaca prosečne starosti 59&plusmn;6,3 godine. Utvrđena je niska učestalost arterijske hipertenzije pod kontrolom od 39,1%, a visoka učestalost metaboličkih faktora (44,5% predgojaznosti, 34% gojaznosti, 29% &scaron;ećerne bolesti, 88,2% povi&scaron;enih masnoća i 41,8% metaboličkog sindroma) kao i njihova povezanost sa ishodom u kontroli krvnog pritiska jer su ispitanici sa nekontrolisanim krvnim pritiskom najče&scaron;će imali dva faktora rizika (40,5%), dok su ispitanici sa kontrolisanim krvnim pritiskom najče&scaron;će imali jedan faktor rizika (45,9%). Utvrđeno je da su prosečne vrednosti sistolnog, dijastolnog pritiska i pulsa bile značajno (p&lt;0,001) niže u grupi sa kontrolisanim pritiskom kao i da su ispitanici sa nekontrolisanim pritiskom imali značajno veći obim struka (p=0,006), metabolički sindrom (p&lt;0,001) i značajno če&scaron;će pili veći broj lekova (p&lt;0,001). Utvrđena je visoka učestalost pu&scaron;enja (26,3%) i visoka učestalost sedentarnog načina života (76,7%) kao i da znanja, stavovi i pona&scaron;anja ispitanika u vezi faktora rizika (pu&scaron;enja, konzumiranja alkohola, fizičke neaktvnosti i prekomerne upotrebe soli) nisu na zadovoljavajućem nivou. Kao nezavisni prediktori arterijske hipertenzije koja nije pod kontrolom dobijeni su obim struka, telesna masa, indeks telesne mase, starost, vrednost pulsa, broj lekova koje ispitanici piju, pasivno pu&scaron;enje, nesvesnost o postojanju arterijske hipertenzije, neznanje o &scaron;tetnosti konzumiranja prekomerne količine alkohola, nepreležan infarkt miokarda i moždani udar. Izračunato je da je u visokom i veoma visokom riziku od neželjenih kardiovaskularnih događaja u desetogodi&scaron;njem periodu 2,7% ispitanika sa arterijskom hipertenzijom bez dijabetesa i 22,2% hipertenzivnih ispitanika sa dijabetesom. Zaključak. Potrebno je sprovođenje javno-zdravstveno vaspitnih i promotivnih aktivnosti u cilju povećanja znanja, promene stavova i pona&scaron;anja kod populacije sa arterijskom hipertenzijom usled lo&scaron;e kontrole krvnog pritiska i prisustva visoke učestalosti pridruženih faktora rizika koji utiču na njegovu kontrolu.</p> / <p>Introduction. Cardiovascular diseases, as part of a group of chronic noncommunicable diseases, have been and still are the leading cause of morbidity and mortality in the world. Numerous scientific proofs confirm that arterial hypertension is a major cardiovascular risk factor and that the achieved blood pressure values lower than 140/90mmHg significantly reduce cardio-vascular risk, or the appearance of cardio-vascular events, mainly myocardial infarction and stroke. Arterial hypertension is the most common condition that is seen in primary health care institutions and preventive measures, early diagnosis, treatment and control of arterial hypertension are a public health challenge in all countries of the world. Objectives. The objectives of the research were to determine the prevalence of arterial hypertension which is controlled; to determine the prevalence and correlation of the metabolic factors with the outcome in blood pressure control; to determine the prevalence and correlation of unhealthy lifestyles with the outcome in blood pressure control; to determine the predictors of poor blood pressure control and calculate a 10-year cardiovascular risk. Methods. The cross-sectional study (of prevalence) included 373 respondents of both sexes aged 45 to 75 years diagnosed with arterial hypertension who in the period from October 2015 to February 2016 visited their chosen doctor. Data collection was performed by measuring blood pressure, anthropometric measurements, biochemical analyses and surveying by filling out a questionnaire. Results. The sample consisted of 55% women and 45% men, of mean age of 59&plusmn;6.3 years. The results showed low incidence of arterial hypertension under control of 39.1%, and high incidence of metabolic factors (44.5% of overweight, 34% of obesity, 29% of diabetes mellitus, 88.2% of elevated fat and 41.8% of the metabolic syndrome) as well as their association with the outcome in blood pressure control as the respondents with uncontrolled blood pressure usually had two risk factors (40.5%), while the group with controlled blood pressure usually had one risk factor (45.9%). It was found that the average values of systolic, diastolic blood pressure and heart rate were significantly (p&lt;0.001) lower in the group with controlled blood pressure, as well as that the respondents with uncontrolled pressure had a significantly greater waist circumference (p=0.006), the metabolic syndrome (p&lt;0.001) and more often drunk greater number of medicines (p&lt;0.001). There was a high prevalence of smoking (26.3%) and a high incidence of sedentary lifestyle (76.7%) and it was found that knowledge, attitudes, and behaviors of the respondents related to risk factors (smoking, alcohol consumption, physical inactivity and excessive use of salt) were not satisfactory. As independent predictors of arterial hypertension which was not under the control, the study obtained waist circumference, body weight, body mass index, age, heart rate value, the number of medicines that the respondents drunk, second-hand smoking, unawareness of the existence of arterial hypertension, inexperience on the harmful effects of excessive amounts of alcohol, not overcome myocardial infarction and stroke. It was calculated that 22.2% of hypertensive respondents with diabetes and 2.7% of respondents with arterial hypertension without diabetes were in the high and very high risk of adverse&nbsp; Conclusion. It is necessary to implement public-health educational and promotional activities in order to increase the knowledge, changes in the attitudes and behavior of the population with arterial hypertension due to the poor control of blood pressure and the presence of the high incidence of associated risk factors affecting its control.</p>

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