Risk factor control in hypertensive and diabetic subjects attended by the Family Health Strategy in the State of Pernambuco, Brazil: the SERVIDIAH study

Abstract

The SERVIDIAH study (Evaluation of Health Services for Diabetic and Hypertensive Subjects) was conducted in 2010 in the State of Pernambuco, Brazil. A multi-stage random sample of 785 hypertensive and 823 diabetic patients was drawn from 208 Family Health Strategy (FHS) units selected throughout 35 municipalities. Patients underwent a structured interview and weight, height, blood pressure and HbA1c levels (for diabetic patients) were measured. Mean age was approximately 60 years, and women were overrepresented in the sample (70%). 43.7% of hypertensive subjects and 25.8% of diabetic subjects achieved adequate blood pressure control and 30.5% of diabetic subjects had HbA1c levels below 7%. Despite 70% of the patients being overweight or obese, few had adhered to a weight-loss diet. The study of this representative sample of hypertensive and diabetic patients attended by the FHS in the State of Pernambuco shows that improvements in the management of hypertension and diabetes are needed in order to prevent the occurrence of serious and costly complications, especially given the context of increasing incidence of these two conditions.

Tratamentos anti-hipertensivos usados na Estratégia de Saúde da Família dos municípios polos das macrorregiões de saúde de Pernambuco: um estudo transversal

“…A amostra aleatória de hipertensos acompanhados pela ESF aqui estudada tem características condizentes aos achados de outros estudos realizados, no Brasil, em usuários com hipertensão, vinculados à ESF (Barreto et al, 2015;Fontbonne et al, 2013;Lefort et al, 2018;Monteiro et al, 2019;Silva et al, 2022). A idade média dos entrevistados foi superior a 50 anos, fato atribuído a uma maior tendência da hipertensão com o aumento da idade, conforme demonstrado por Monteiro et al (2019).…”

Direct cost of systemic arterial hypertension and its complications in the circulatory system from the perspective of the Brazilian public health system in 2019

“…It will be difficult to reach the goal of a 25% reduction in the prevalence of SAH by 2025 [ 11 ], established by the WHO [ 16 ], in projections for Brazil [ 83 ]. The control of SAH still needs to be improved in many regions of the country [ 84 – 87 ], as well as in other LMICs [ 19 ]. Despite efforts to improve the follow-up of hypertensive patients in primary care [ 88 ], the weak link between them and primary care professionals [ 89 ] and nonattendance at medical consultations [ 90 ] are still problems observed in Brazil, compromising the effectiveness of SAH management.…”

Relações entre os atributos de qualidade de atenção aos usuários hipertensos e diabéticos na Estratégia Saúde da Família e o controle dos fatores prognósticos de complicações

“…Conclusion: Good quality of care may have a positive impact on the practice of physical activity by hypertensive or diabetic subjects. Mais detalhes sobre a metodologia do estudo SERVIDIAH podem ser encontrados em Fontbonne et al 6 .…”

“…No entanto, verifica-se na prática dos serviços que o controle da HAS e do DM continua insatisfatório. Em um artigo anterior baseado no estudo SERVIDIAH, que incluiu uma amostra representativa de hipertensos e diabéticos cadastrados nas ESF de Pernambuco, observou-se que menos da metade dos hipertensos tinha pressão arterial controlada e que somente 30% dos diabéticos apresentavam hemoglobina glicada (indicadora do controle glicêmico) abaixo do nível recomendado de 7%; ademais, apesar de cerca de 75% dos entrevistados apresentarem excesso de peso, somente 16% dos hipertensos e 14% dos diabéticos disseram seguir uma dieta para perder peso, enquanto 70% afirmaram não praticar nenhuma atividade física 6 .…”