Association between perceived racial discrimination and hypertension: findings from the ELSA-Brasil study

Mendes, Patrícia Miranda; Nobre, Aline Araújo; Griep, Rosane Härter; Guimarães, Joanna Miguez Nery; Juvanhol, Leidjaira Lopes; Barreto, Sandhi Maria; Pereira, Alexandre C.; Chor, Dóra

doi:10.1590/0102-311x00050317

Cited by 10 publications

(10 citation statements)

References 50 publications

(67 reference statements)

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“…Existem indícios de que, desde a infância, negros tem maiores níveis de PA e aumento do risco de desenvolvimento de HAS se comparados a indivíduos de cor branca (THOMAS et al, 2018). No Brasil, entre pretos e pardos, esse risco se mantém, levando a maior taxa de mortalidade por doenças hipertensivas na população negra (MENDES et al, 2018).…”

Section: Resultsunclassified

Avaliação Da Não Adesão Ao Tratamento Farmacológico Da Hipertensão Arterial Sistêmica Em Uma População De Salvador-Ba / Evaluation of Non-Adhesion to the Pharmacological Treatment of Systemic Arterial Hypertension in a Population of Salvador-Ba

Pereira¹,

Santos

Sousa

et al. 2021

BJD

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Avaliar a não adesão ao tratamento farmacológico da Hipertensão Arterial Sistêmica (HAS), identificando sua prevalência e fatores associados, bem como comparar os níveis pressóricos de pacientes apresentando adesão e não adesão. Métodos: Trata-se de um estudo de corte transversal, observacional, realizado entre maio e agosto de 2018, com amostra composta por 71 indivíduos hipertensos tratados farmacologicamente, atendidos em um ambulatório de Atenção Primária na cidade de Salvador-BA. Avaliouse nesses pacientes a não adesão ao tratamento da HAS com o Teste Morisky-Green (TMG) e realizou-se aferições de pressão arterial (PA). Dados sociodemográficos e fatores acerca da não adesão foram avaliados através de questionários estruturados. Ademais, para o estudo quantitativo, os dados foram tabulados e utilizadas frequências absolutas e percentuais, média e mediana. Quando possível, foi aplicado o Teste Qui-Quadrado de Pearson considerando significância estatística se p<0,05. Resultados: 54,9% da população foi considerada não aderente ao tratamento pelo TMG. Não houve significância estatística entre adesão e não adesão dentro dos estratos das categorias sociodemográficas sexo, cor e renda. As médias dos níveis pressóricos de pacientes aderentes e não aderentes foram similares. Entre os pacientes sem adesão, 43,6% não relatou nenhum motivo específico para a não adesão, 30,8% disse não ter dinheiro e 28,2%, ter dificuldade de obter a medicação na Unidade Básica de Saúde (UBS). A Questão relacionada ao esquecimento foi a mais respondida no TMG, mencionada por 87,2%. Conclusões: A prevalência da não adesão foi superior à da adesão. Não houve associação entre adesão e sexo, cor ou renda. As médias dos níveis pressóricos de pacientes aderentes e não aderentes foram similares. O esquecimento do uso da medicação foi evidenciado como importante causa associada à não utilização do medicamento.

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Section: Resultsunclassified

Avaliação Da Não Adesão Ao Tratamento Farmacológico Da Hipertensão Arterial Sistêmica Em Uma População De Salvador-Ba / Evaluation of Non-Adhesion to the Pharmacological Treatment of Systemic Arterial Hypertension in a Population of Salvador-Ba

Pereira¹,

Santos

Sousa

et al. 2021

BJD

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“…Thereupon, epidemiological studies reveal higher prevalences of hypertension, diabetes and obesity in African Americans than whites [34][35][36]. In the Brazilian setting, participants of black race from the ELSA-Brasil study had poorer metrics of cardiovascular related health and lifestyle factors, along with early detection of atherosclerosis but it was not possible to establish an association between racial discrimination and hypertension [37][38][39]. Furthermore, there has been evidence of racial disparities in cardiovascular health care utilization and treatments that would lead to adverse clinical outcomes [40,41].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Incident Cardiovascular Events and Cardiac Risk Assessment in a Cohort of HIV-infected Participants in Rio de Janeiro

Moreira¹,

Miranda²,

Müller³

et al. 2021

IJIDT

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Background: Cardiovascular events (CVEs) have emerged as an important cause of morbimortality in people living with HIV/AIDS (PLHA). We aimed to investigate factors associated with incident CVE and compare the observed incidence with the predicted CVE risk by three different equations. Methods: Among the 649 active participants of the INI-ELSA cohort, we analysed data of 644 individuals free of CVE at baseline examinations. We used Cox regression models to study factors associated with CVE and to assess the equation's performance we compared the observed incidence with the overall 5-year predicted risks. Results: Over a median follow-up of 6.26-years (interquartile range [IQR] 6.01-6.47), there were 18 CVE, four deaths. Overall, 57.92% were male, median age was 43.4 years (35.82-50.73), most were on cART (88.65%). Participants who had CVE were older, had poorer renal function, higher proportion of dyslipidemia and higher levels of systolic blood pressure and triglycerides. The observed CVE rate was 2.90% (1.60-4.90%) whereas their overall cardiovascular disease (CVD) risk differed depending on which score was used: 0.91 (0.42-20), 1.16 (0.38-2.78) and 1.68 (0.60-3.87), according to Framingham, ASCVD and DAD, respectively. In the multivariable Cox analysis black race, smoking 10+ packs years, dyslipidemia, current CD4 cell count x10 1 , cumulative viral load and time on NNRTI were independent predictors of CVE. Conclusion: Both traditional and HIV-related factors were associated with incident CVE. Risk scores were inconsistent in classifying patients who had CVE as high risk, indicating that validation studies are required to improve risk assessment of PLHA in Brazil.

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“…37,38 For race/color, it is known that ABPM shows that blacks have a greater BP average and variability and blunted dipping than whites. 5,10,19,20 Particularly in Brazil, studies have already explained differences in the prevalence of hypertension among "pardos" and blacks 39,40 but there is still lack of studies on the impact of the race/ color on the ABPM parameters. Abbreviations: ABPM, ambulatory blood pressure monitoring; ARV, average real variability; BP, blood pressure; SD, standard deviation.…”

Section: Re Sultsmentioning

confidence: 99%

Identifying patterns of diurnal blood pressure variation among ELSA‐Brasil participants

Paula

Lopes²,

Mill

et al. 2020

J of Clinical Hypertension

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Noncommunicable diseases are the leading cause of death in the world, and the majority of these deaths occur due to cardiovascular diseases. 1,2 Ambulatory blood pressure monitoring (ABPM) is recommended as the gold standard method for the diagnosis of hypertension. Moreover, ABPM gives a more accurate assessment of cardiovascular risk than blood pressure (BP) levels obtained by the traditional office measurements. 3,4 Daytime, nighttime, and 24-h average are among the most important ABPM parameters in clinical practice, related to the diagnosis of hypertension. 5-8 The fall in nighttime BP average, compared to the daytime average, defined as nocturnal dipping, is an established predictor of cardiovascular events. 5,7-11 In particular, the nondipping

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Association between perceived racial discrimination and hypertension: findings from the ELSA-Brasil study

Abstract: Abstract" Pardos" and blacks in Brazil and blacks

Cited by 10 publications

References 50 publications

Avaliação Da Não Adesão Ao Tratamento Farmacológico Da Hipertensão Arterial Sistêmica Em Uma População De Salvador-Ba / Evaluation of Non-Adhesion to the Pharmacological Treatment of Systemic Arterial Hypertension in a Population of Salvador-Ba

Avaliação Da Não Adesão Ao Tratamento Farmacológico Da Hipertensão Arterial Sistêmica Em Uma População De Salvador-Ba / Evaluation of Non-Adhesion to the Pharmacological Treatment of Systemic Arterial Hypertension in a Population of Salvador-Ba

Factors Associated with Incident Cardiovascular Events and Cardiac Risk Assessment in a Cohort of HIV-infected Participants in Rio de Janeiro

Identifying patterns of diurnal blood pressure variation among ELSA‐Brasil participants

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