Antihypertensive treatments in the Family Health Strategy teams in poles of the health macro-regions of Pernambuco: a cross-sectional study
DOI:
https://doi.org/10.33448/rsd-v11i13.35182Keywords:
Arterial Hypertension; Health Care; Drug Therapy; Antihypertensive agents.Abstract
To characterize the antihypertensive therapeutic regimens and their associations, in use by hypertensive patients registered in the Family Health Strategy (FHS) of the pole cities of the macro-regions of the state of in the Pernambuco. This is a descriptive and analytical cross-sectional study carried out on a random sample of hypertensive patients. Of the 334 hypertensive participants in the study, 144 had diabetes. Most (62.27%) lived in Recife and were female (68.56%). The interviewees’ average age was 64.1 ± 13.0 years. More than 50% reported the use of diuretics, with the predominant use of hydrochlorothiazide. This class was the most present in polytherapy, while angiotensin receptor blockers, represented by losartan (34.45%) and angiotensin converting enzyme inhibitors (30.25%) were more used in monotherapy; in Recife a greater use of the latter was observed, while in the interior poles the first was privileged. Polytherapy with two antihypertensive drugs predominated and most associations were consistent with national and international guidelines. Some inappropriate associations were identified, such as an angiotensin-converting enzyme inhibitor with an angiotensin receptor blocker. The study expanded the knowledge of antihypertensive treatment regimens used in primary care in a representative sample of a population with socioeconomic vulnerabilities, in an area where information and observations are still scarce. The confrontation between actual practice and recommendations aims to favor the appropriate choice of pharmacotherapy, knowing that blood pressure control is essential to avoid the occurrence of complications.
References
Barreto, M. N. S. C., Cesse, E. A. P., Lima, R. F., Marinho, M. G. S., Specht, Y. S., Carvalho, E. M. F., & Fontbonne, A. (2015). Análise do acesso ao tratamento medicamentoso para hipertensão e diabetes na Estratégia Saúde da Família no Estado de Pernambuco, Brasil. Revista Brasileira de Epidemiologia, 18(2), 413-424. https://doi.org/10.1590/1980-5497201500020010
Barroso, W. K. S., Rodrigues, C. I. S., Bortolotto, L. A., Mota-Gomes, M. A., Brandão, A. A., Feitosa, A. D. ... Nadruz, W. (2021). Diretrizes brasileiras de hipertensão. Arquivos Brasileiros de Cardiologia, 116(3), 516-658. https://doi.org/10.36660/abc.20201238
Burnier, M., Bakric, G., & Williams, B. (2019). Redefining diuretics use in hypertension: why select a thiazide-like diuretic? Journal of Hypertension, 37(8), 1574-1586. https://doi.org/10.1097/HJH.0000000000002088
Carvalho, S. S., & Oliveira, B. R. (2020). Hábitos e hipertensão: estudo realizado em hipertensos dos serviços públicos de saúde em Feira de Santana-BA. Revista de Atenção à Saúde, 18(64), 22-31. https://doi.org/10.13037/ras.vol18n64.6369
Chaves, D. F. L., Jesus, J. H., Geron, V. L. M. G., Nunes, J. S., & Lima, R. R. O. (2017). A substituição do captopril pelo enalapril no tratamento de hipertensão arterial no âmbito do Sistema Único de Saúde. Saber Científico, 6(2), 111-124. https://doi.org/10.22614/resc-v6-n2-797
Costa, C. M. F. N., Silveira, M. R., Acurcio, F. A., Guerra Junior, A. A., Guibu, I. A., Costa, K. S. ... Álvares, J. (2017). Utilização de medicamento pelos usuários da atenção primária do Sistema Único de Saúde. Revista de Saúde Pública, 51(supl. 2), 18s. https://doi.org/10.11606/S1518-8787.2017051007144
Costa, J. M. B. S., Barreto, M. N. S. C., Gomes, M. F., Fontbonne, A., & Cesse, E. A. P. (2020). Avaliação da estrutura das farmácias das Unidades de Saúde da Família para o atendimento aos portadores de hipertensão arterial sistêmica e diabetes mellitus em Pernambuco. Cadernos de Saúde Coletiva, 28(4), 609-618. https://doi.org/10.1590/1414-462X202028040243
Cuspidi, C., Tadic, M., Grasso, G., & Mancia, G. (2018). Treatment of hypertension: The ESH/ESC guidelines recommendation. Pharmacological research, 128, 315-321. https://doi.org/10.1016/j.phrs.2017.10.003
Fontbonne, A., Cesse, E. A. P., Sousa, I. M. C., Souza, W. V., Chaves, V. L. V., Bezerra, A. F. B., & Carvalho, E. F. (2013). Risk factor control in hypertensive and diabetic subjects attended by the Family Health Strategy in the State of Pernambuco, Brazil: the SERVIDIAH study. Cadernos de Saúde Pública, 29(6), 1195–1204. https://doi.org/10.1590/S0102-311X2013000600016
Garjón, J., Saiz, L. C., Azparren, A., Elizondo, J. J., Gaminde, I., Ariz, M. J., & Erviti, J. (2020). First-line combination therapy versus first-line monotherapy for primary hypertension. The Cochrane database of systematic reviews, 2(2), CD010316. https://doi.org/10.1002/14651858.CD010316.pub3
Klafke, A., Vaghetti, L. A. P., & Costa, A. D. (2017). Efeito do vínculo com um médico de família no controle da pressão arterial em hipertensos. Revista Brasileira de Medicina de Família e Comunidade, 12(39), 1-7. http://dx.doi.org/10.5712/rbmfc12(39)1444
Lefort, M., Neufcourt, L., Pannier, B., Vaisse, B., Bayat, S., Grimaud, O., & Girerd, X. (2018). Sex differences in adherence to antihypertensive treatment in patients aged above 55: The French League Against Hypertension Survey (FLAHS). Journal of Clinical Hypertension, 20(10), 1496-1503. https://doi.org/10.1111/jch.13387
Luiza, V. L., Mendes, L. V. P., Tavares, N. U. L., Bertoldi, A. D., Fontanella, A. T., Oliveira, M. A., Campos, M. R., & PNAUM Group. (2019). Inappropriate use of medicines and associated factors in Brazil: an approach from a national household survey. Health Policy and Planning, 34(suppl. 3), 27-35. https://doi.org/10.1093/heapol/czz038
Meiners, M. M. M. A., Tavares, N. U. L., Guimarães, L. S. P., Bertoldi, A. D., Dal Pizzol, T. S., Luiza, V. L. … Merchan-Hamann, E. (2017). Acesso e adesão a medicamentos entre pessoas com diabetes no Brasil: evidências da PNAUM. Revista Brasileira de Epidemiologia, 20(3), 445-459. https://doi.org/10.1590/1980-5497201700030008
Monteiro, C. N., Lima, M. G., Szwarcwald, C. L., Bastos, T. F., & Barros, M. B. A. (2019). Utilização de anti-hipertensivos e antidiabéticos no Brasil: análise das diferenças socioeconômicas. Pesquisa Nacional de Saúde 2013. Revista Brasileira de Epidemiologia, 22(2), 1-12. https://doi.org/10.1590/1980-549720190014.supl.2
National Institute for Health and Clinical Excellence. (2019). Hypertension in adults: diagnosis and management. NICE Guideline. https://www.nice.org.uk/guidance/ng136/resources/hypertension-in-adults-diagnosis-and-management-pdf-66141722710213
Pinto, I. C., & Martins, D. (2017). Prevalence and risk factors of arterial hypertension: a literature review. Journal of Cardiovascular Medicine and Therapeutics, 1(2), 1-7. http://hdl.handle.net/10198/16934
Póvoa, R., Barroso, W. S., Brandão, A. A., Jardim, P. C. V., Barroso, O., Passarelli Jr., O. ... Sanjuliani, A. F. (2014). I Posicionamento Brasileiro sobre Combinação de Fármacos Anti-Hipertensivos. Arquivos Brasileiros de Cardiologia, 102(3), 203-210. https://doi.org/10.5935/abc.20140023
Qaseem, A., Wilt, T. J., Rich, R., Humphrey, L. L., Frost, J., & Forciea, M. A. (2017). Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the 15 American College of Physicians and the American Academy of Family Physicians. Annals of Internal Medicine, 166(6). https://doi.org/10.7326/M16-1785
Queiroz, E. J., Alves, H. H. S., Oliveira, C. P. A., Santos, S. L. F., Silveira, J. E. S., & Bandeira Filho, D. M. (2018). Perfil de pacientes geriátricos com hipertensão arterial: uma abordagem no cuidado farmacêutico. Revista Saúde (Santa Maria), 44(3), 1-12. https://doi.org/10.5902/2236583431454
Rouquayrol, M. Z., & Gurgel, M. (2018). Epidemiologia & Saúde (8a ed.). Rio de Janeiro: Medbook.
Silva, M. A. E., Pereira, T. L. B., Pimenta, C. J. L., Carmo, B. C. M., Carvalho, R. R., & Santos, S. C. (2022). Perfil farmacológico da prescrição de anti-hipertensivos e adequabilidade à diretriz brasileira de hipertensão. Research, Society and Development, 11(1), e24411124735. http://dx.doi.org/10.33448/rsd-v11i1.24735
Sociedade Brasileira de Diabetes. (2019). Diretrizes da Sociedade Brasileira de Diabetes 2019-2020. São Paulo: Clannad.
Tavares, N. U. L., Luiza, V. L., Oliveira, M. A., Costa, K. S., Mengue, S. S., Arrais, P. S. D. ... Bertoldi, A. D. (2016). Acesso gratuito a medicamentos para tratamento de doenças crônicas no Brasil. Revista de Saúde Pública, 50(suppl. 2), 1-10. https://doi.org/10.1590/s1518-8787.2016050006118
Wei, J., Galaviz, K. I., Kowalski, A. J., Magee, M. J., Haw, J. S., Narayan, K. M. V., & Ali, M. K. (2020). Comparison of cardiovascular events among users of different classes of antihypertension medications a systematic review and network meta-analysis. JAMA Network Open, 3(2), e1921618. https://doi.org/10.1001/jamanetworkopen.2019.21618
Williams, B., Mancia, G., Spiering, W., Rosei, E. A., Azizi, M., Burnier, M. ... Desormais, I. (2018). The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). European Heart Journal, 39, 3021-3104. https://doi.org/10.1093/eurheartj/ehy339
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Copyright (c) 2022 Maria Nelly Sobreira de Carvalho Barreto; Rodrigo Fonseca Lima; Nathália Paula de Souza; Silvia Pereira da Silva de Carvalho Melo; Heloisa de Melo Rodrigues; Annick Fontbonne; Eduarda Ângela Pessoa Cesse
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