Blood Pressure Control in Public and Private Brazilian Healthcare Services

Abstract

Objective: To compare office and home blood pressure (BP) measurements of treated hypertensive patients followed in public and private healthcare in a Brazilian multicenter study. Design and method: A cross-sectional study. The datas were exported from TeleMRPA plataform to an excel file containing the variables to be analyzed. Public and private healthcare units were coordinated by same cardiologists and followed same guidelines concerning BP treatment. Descriptive statistics were used through the measure of central tendency (mean), measure of dispersion (standard deviation) and measure of frequency (percentage). For inferential statistics, the unpaired t-student test was used. A 95% confidence interval and a significance level of p<0.05 were considered. Results: The sample consisted of 3.043 study patients: 1.842 (60.5%) of them at private and 1,201 (39.5%) at public healthcare services with a mean age of 58± 12.2 years [public = 59±11.3; private = 58±12.8, p = 0.18], BMI of 28.9±5.2 Kg/m2 [public = 29.4±5.7; private = 28.6±4.8, p<0.001]. Concerning office BP values, Systolic BP [public = 144±25.5mmHg; private = 130±17.2mmHg, p<0.001] and Diastolic BP [public = 87±14.4mmHg; private = 81±10.2mmHg, p<0.001] and at home BP the average Systolic BP[public = 134±20.8mmHg and private = 123±13.6mmHg, p<0.001] and Diastolic BP [public = 82±13mmHg; private = 76±8.9mmHg, p<0.001]. Conclusions: Hypertensive patients followed at public healthcare services have greater BMI and higher level of BP than private services. Better care is suggested and necessary for public health care, including actions to reviewing the classes of anti-hypertensive drugs and their fixed or non-fixed combinations in order to reduce cardiovascular outcomes.