Comportamentos de saúde entre idosos com hipertensão arterial sistêmica residentes em uma zona rural

Abstract

The accelerated aging process of population is followed by the increase of chronic non-communicable diseases, such as hypertension. The presence of negative health behaviors, such as alcoholism, smoking, physical inactivity, high salt intake, in addition to overweight and increased waist circumference, contribute to the occurrence of diseases. Elderly people who lives in rural areas experience greater social isolation, socioeconomic differences and more difficult of access to health services, which may influence the health behaviors and the consequences of hypertension. This study aimed to describe socio-demographic and average morbidity between those with and without hypertension; to compare the prevalence of variables related to health behaviors (drinking, smoking, salt intake, physical activity), overweight, increased waist circumference and indicative of depression; and to compare the odds of crude and adjusted prevalence of health behaviors, waist circumference, overweight and indicative of depression among older adults with and without hypertension, living in rural areas. This is a prevalence, of a household survey type, analytical, observational and cross-sectional study, conducted with 849 elderly, 463 with and 386 without hypertension. Data were collected from June 2010 to March 2011, through the instruments: Mini-Mental State Examination, Brazilian Multidimensional Functional Assessment Questionnaire (BOMFAQ), Food Consumption Frequency Questionnaire, Geriatric Depression Scale and Demographics Questionnaire. Descriptive statistical analysis were carried out using the SPSS 17.0 software, through simple frequency distribution for categorical variables and t-Student test for independent samples. We used the prevalence rate and the chi-squared test to assess the association between categorical variables (p<0,05). Prevalence ratios and prevalence odds ratios were presented in raw form for each variable. Later, the prevalence odds ratios were adjusted applying the multiple binary logistic regression (p<0,05) for sex, age, health behaviors, overweight, waist circumference and indicative of depression. The Ethics Committee on Human Research of the Federal University of Triangulo Mineiro (UFTM), Protocol 1477, approved this study. There were greater percentage of elderly female (54%) with hypertension and male ones (60,9%) without hypertension. For both groups, most of seniors were 60├70 years old, 59,2% with and 62,4% without hypertension; 65% with and 69, 9% without hypertension were married or have been living with a partner; 36,1% of the elderly with and 37.6% of those without hypertension had 4 ├ 8 years education; 49,5% with and 46,4% without hypertension receive an income of a minimum wage; and 45,6% with and 49,0% without Hypertension live only with the spouse. The average morbidity for elderly patients with hypertension was 5,82 and 3,44 for those without the disease. Concerning the health behaviors, there was a lower proportion of elderly alcoholics (p<0,001), smokers (p<0,001) and those that add more salt to the food after it is ready (p=0,020) among elderly patients with hypertension compared to those without hypertension. The proportion of elderly overweight (p<0,001), inadequate increased waist circumference (p<0,001) and indicative of depression (p=0,002) among those with hypertension was higher than in those without morbidity. Elderly people with hypertension had less chance of prevalence for alcohol (34,6%) and smoking (45,4%) abuse compared to those without hypertension. Elderly people with hypertension were more likely to be overweighed (74,9%), to have inadequate increased waist circumference (47,3%) and to have indicative of depression (48%) compared to older ones without hypertension. Health actions directed to elderly people with and without hypertension are made necessary, through the cessation of smoking and alcohol consumption as well as weight control, reduction of increased waist circumference and indicative evaluation of depression among elderly patients with hypertension in rural areas.