Hipertensão sistólica isolada : epidemiologia e impacto na prática clínica
Autor(a) principal: | |
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Data de Publicação: | 2003 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10451/5696 |
Resumo: | Objective: To study the frequency, distribution and determinants of isolated systolic hypertension (ISH). Design: Cross-sectional study, in two stages. First, consecutive patients of the Portuguese national health system aged 60 or over were selected (1999). The second stage covered people aged up to 60 years (2000). Setting: Health Centers – primary care (Regional Health Administration - Lisbon). Participants: 3228 patients, 1100 male (439 aged up to 60 years and 661 aged 60 years) and 2128 female (860 aged up to 60 years and 1268 aged 60 years). Measurements: Categories of hypertension. Risk stratification. Cardiovascular morbidity. Predictors of isolated systolic hypertension. Results: The definition and staging of hypertension changed between 1988 and 1997/99 and as a consequence, there has been, in hypertensives, an increase in ISH frequency from 13 % to 44 % (2.4 times greater). This form of hypertension is far more frequent than grades 1 (mild hypertension = 22 %), 2 (moderate hypertension =15 %) or 3 (severe hypertension = 7%). The proportion of hypertensives with ISH increases from 19% in people aged up to 40, to 30 % in the fourth decade, 34 % in the fifth decade, 44 % in the sixth decade, 51 % in the seventh decade, and 57 % in those over 80 years of age. In hypertensives aged up to 50, ISH is more frequent in females. However, in those over age 50 it is predominant in males. ISH represents 60 % and 37 % respectively of untreated and treated hypertensives. Among untreated hypertensives, age was associated with ISH (p<0.001; OR=1.051 and 95 % CI 1.037-1.065). In the over-60 subgroup, the following factors were associated: age (p=0.013; OR=1.048 and 95 % CI 1.010-1.087); gender – male (p=0.004; OR=2.578 and 95 % CI 1.361- 4.881) and height (p=0.044; OR=0.966 and 95% CI 0.933-0.999). Conclusions: Isolated systolic hypertension is the most common form of hypertension and the most often untreated. The constitutional characteristics associated with isolated systolic hypertension in the elderly are age, gender (male) and body mass index (height). The extent of the problem justifies more attention to control of systolic blood pressure, both in research (efficacy) and in clinical practice (effectiveness). |
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Hipertensão sistólica isolada : epidemiologia e impacto na prática clínicaIsolated systolic hypertension : epidemiology and impact in clinical practiceEpidemiologyHypertensionCategories/grades ofIsolated systolic hypertensionObjective: To study the frequency, distribution and determinants of isolated systolic hypertension (ISH). Design: Cross-sectional study, in two stages. First, consecutive patients of the Portuguese national health system aged 60 or over were selected (1999). The second stage covered people aged up to 60 years (2000). Setting: Health Centers – primary care (Regional Health Administration - Lisbon). Participants: 3228 patients, 1100 male (439 aged up to 60 years and 661 aged 60 years) and 2128 female (860 aged up to 60 years and 1268 aged 60 years). Measurements: Categories of hypertension. Risk stratification. Cardiovascular morbidity. Predictors of isolated systolic hypertension. Results: The definition and staging of hypertension changed between 1988 and 1997/99 and as a consequence, there has been, in hypertensives, an increase in ISH frequency from 13 % to 44 % (2.4 times greater). This form of hypertension is far more frequent than grades 1 (mild hypertension = 22 %), 2 (moderate hypertension =15 %) or 3 (severe hypertension = 7%). The proportion of hypertensives with ISH increases from 19% in people aged up to 40, to 30 % in the fourth decade, 34 % in the fifth decade, 44 % in the sixth decade, 51 % in the seventh decade, and 57 % in those over 80 years of age. In hypertensives aged up to 50, ISH is more frequent in females. However, in those over age 50 it is predominant in males. ISH represents 60 % and 37 % respectively of untreated and treated hypertensives. Among untreated hypertensives, age was associated with ISH (p<0.001; OR=1.051 and 95 % CI 1.037-1.065). In the over-60 subgroup, the following factors were associated: age (p=0.013; OR=1.048 and 95 % CI 1.010-1.087); gender – male (p=0.004; OR=2.578 and 95 % CI 1.361- 4.881) and height (p=0.044; OR=0.966 and 95% CI 0.933-0.999). Conclusions: Isolated systolic hypertension is the most common form of hypertension and the most often untreated. The constitutional characteristics associated with isolated systolic hypertension in the elderly are age, gender (male) and body mass index (height). The extent of the problem justifies more attention to control of systolic blood pressure, both in research (efficacy) and in clinical practice (effectiveness).Objectivo: Caracterizar a frequência, a distribuição e os factores associados à hipertensão sistólica isolada (HSI). Desenho do estudo: Transversal, realizado em duas fases. Na primeira, foram seleccionados e observados utentes do SNS com idade 60 anos (Ano 1999). A segunda fase destinou-se aos grupos etários com idade <60 anos (Ano 2000). Atendimento: Centros de Saúde (ARS de Lisboa) – cuidados de sáude primários. Participantes: Inquiridos 3228 indivíduos, 1100 do sexo masculino (439 com <60 anos e 661 com idade 60 anos) e 2128 do sexo feminino (860 com <60 anos e 1268 com idade 60 anos). Medições: Categorias/graus de hipertensão. Estratificação de risco. Morbilidade cardiovascular. Factores discriminantes da hipertensão sistólica isolada. Resultados: A mudança dos critérios de definição e classificação da hipertensão arterial, entre 1988 e 1997/99, correspondeu, nos hipertensos, a um aumento na frequência da HSI de 13 % para 44 %. Neste estudo de base populacional, a HSI foi predominante em relação à hipertensão ligeira (22 %), moderada (15%) e grave (7 %). A proporção de hipertensos com HSI aumentou de 19 %, abaixo dos 40 anos, para 30 % na 4.ª década, 34 % na 5.ª década, 44 % na 6.ª década, 51 % na 7.ª década e 57 % a partir da 8.ª década. Até à 5.ª década de vida foi predominante no sexo feminino, mas acima dessa idade foi mais frequente no sexo masculino. No grupo de hipertensos não medicados, a maioria (60%) tinha HSI enquanto no grupo sob terapêutica anti-hipertensiva a sua proporção foi de 37 %. As variáveis que demonstraram uma associação positiva com a HSI, no grupo de hipertensos não medicados, foram a idade (p<0,001; OR=1,051 e IC 95 % 1,037-1,065). No grupo de idade 60 anos, os factores relacionados de modo significativo com HSI foram a idade (p=0,013; OR=1,048 e IC 95 %=1,010-1,087), o sexo masculino (p=0,004; OR= 2,578 e IC 95 %=1,361-4,881) e a altura (p=0,044; OR=0,966 e IC 95 %=0,933-0,999). Conclusões: A hipertensão sistólica isolada é a forma de hipertensão mais frequente na população e menos vezes tratada. As características constitucionais que se associam à hipertensão sistólica isolada são a idade, o sexo e a altura (índice de massa corporal). A dimensão do problema justifica que seja dada mais atenção ao controlo da pressão arterial sistólica, quer na investigação (eficácia e eficiência), quer na prática clínica (efectividade).A investigação teve o patrocínio da Pentafarma, Sociedade Técnico-Medicinal.Sociedade Portuguesa de CardiologiaRepositório da Universidade de LisboaRocha, EvangelistaSilva, Alberto Mello eOliveira, A. GouveiaNogueira, PauloGrupo de Investigação da ARS de Lisboa2012-03-22T12:08:43Z20032003-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10451/5696porRev Port Cardiol 2003;22(1):7-230870-2551info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-08T15:47:34Zoai:repositorio.ul.pt:10451/5696Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:30:57.595818Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Hipertensão sistólica isolada : epidemiologia e impacto na prática clínica Isolated systolic hypertension : epidemiology and impact in clinical practice |
title |
Hipertensão sistólica isolada : epidemiologia e impacto na prática clínica |
spellingShingle |
Hipertensão sistólica isolada : epidemiologia e impacto na prática clínica Rocha, Evangelista Epidemiology Hypertension Categories/grades of Isolated systolic hypertension |
title_short |
Hipertensão sistólica isolada : epidemiologia e impacto na prática clínica |
title_full |
Hipertensão sistólica isolada : epidemiologia e impacto na prática clínica |
title_fullStr |
Hipertensão sistólica isolada : epidemiologia e impacto na prática clínica |
title_full_unstemmed |
Hipertensão sistólica isolada : epidemiologia e impacto na prática clínica |
title_sort |
Hipertensão sistólica isolada : epidemiologia e impacto na prática clínica |
author |
Rocha, Evangelista |
author_facet |
Rocha, Evangelista Silva, Alberto Mello e Oliveira, A. Gouveia Nogueira, Paulo Grupo de Investigação da ARS de Lisboa |
author_role |
author |
author2 |
Silva, Alberto Mello e Oliveira, A. Gouveia Nogueira, Paulo Grupo de Investigação da ARS de Lisboa |
author2_role |
author author author author |
dc.contributor.none.fl_str_mv |
Repositório da Universidade de Lisboa |
dc.contributor.author.fl_str_mv |
Rocha, Evangelista Silva, Alberto Mello e Oliveira, A. Gouveia Nogueira, Paulo Grupo de Investigação da ARS de Lisboa |
dc.subject.por.fl_str_mv |
Epidemiology Hypertension Categories/grades of Isolated systolic hypertension |
topic |
Epidemiology Hypertension Categories/grades of Isolated systolic hypertension |
description |
Objective: To study the frequency, distribution and determinants of isolated systolic hypertension (ISH). Design: Cross-sectional study, in two stages. First, consecutive patients of the Portuguese national health system aged 60 or over were selected (1999). The second stage covered people aged up to 60 years (2000). Setting: Health Centers – primary care (Regional Health Administration - Lisbon). Participants: 3228 patients, 1100 male (439 aged up to 60 years and 661 aged 60 years) and 2128 female (860 aged up to 60 years and 1268 aged 60 years). Measurements: Categories of hypertension. Risk stratification. Cardiovascular morbidity. Predictors of isolated systolic hypertension. Results: The definition and staging of hypertension changed between 1988 and 1997/99 and as a consequence, there has been, in hypertensives, an increase in ISH frequency from 13 % to 44 % (2.4 times greater). This form of hypertension is far more frequent than grades 1 (mild hypertension = 22 %), 2 (moderate hypertension =15 %) or 3 (severe hypertension = 7%). The proportion of hypertensives with ISH increases from 19% in people aged up to 40, to 30 % in the fourth decade, 34 % in the fifth decade, 44 % in the sixth decade, 51 % in the seventh decade, and 57 % in those over 80 years of age. In hypertensives aged up to 50, ISH is more frequent in females. However, in those over age 50 it is predominant in males. ISH represents 60 % and 37 % respectively of untreated and treated hypertensives. Among untreated hypertensives, age was associated with ISH (p<0.001; OR=1.051 and 95 % CI 1.037-1.065). In the over-60 subgroup, the following factors were associated: age (p=0.013; OR=1.048 and 95 % CI 1.010-1.087); gender – male (p=0.004; OR=2.578 and 95 % CI 1.361- 4.881) and height (p=0.044; OR=0.966 and 95% CI 0.933-0.999). Conclusions: Isolated systolic hypertension is the most common form of hypertension and the most often untreated. The constitutional characteristics associated with isolated systolic hypertension in the elderly are age, gender (male) and body mass index (height). The extent of the problem justifies more attention to control of systolic blood pressure, both in research (efficacy) and in clinical practice (effectiveness). |
publishDate |
2003 |
dc.date.none.fl_str_mv |
2003 2003-01-01T00:00:00Z 2012-03-22T12:08:43Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10451/5696 |
url |
http://hdl.handle.net/10451/5696 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
Rev Port Cardiol 2003;22(1):7-23 0870-2551 |
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info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Cardiologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Cardiologia |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799134198542368768 |