avaliação da efetividade do controle da hipertensão arterial em unidade básica de saúde evaluation of the effectiveness of arterial hypertension control in a primary health unit
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1996
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Abstract
Como parte integrante da avaliação de desempenho do Programa de Atenção à Saúde no Envelhecimento, desenvolvido em uma unidade básica de saúde, foi mensurada a efetividade da hipertensão arterial, segundo a redução dos níveis de pressão arterial em indivíduos hipertensos submetidos a ações programáticas para controle da doença, procurando identificar condições associadas com tal redução. Dos 396 pacientes portadores de hipertensão arterial sistêmica inscritos no Programa, no período de 01/01/92 a 30/06/93, foram considerados para esta avaliação 250 casos que apresentavam, além de níveis pressóricos elevados (PA ³ 160/95 mmHg) em atendimentos iniciais no serviço (anteriores à inscrição no programa), pelo menos duas consultas médicas no seguimento programático. As diferenças de níveis pressóricos entre as medidas realizadas nas consultas anteriores ao início do atendimento programático, e as realizadas a partir do início destes atendimentos foram analisadas segundo o nível pressórico inicial, idade, sexo, diagnósticos na inscrição e faltas ao agendamento programático. Obteve-se redução na pressão arterial diastólica (PAD) de 5 mmHg ou mais, e/ou redução de 10 mmHg ou mais na pressão arterial sistólica (PAS) em l97 (78,8%) pacientes. A média da redução da PAD foi 8,8 mmHg (d.p. = 11,4), e da PAS foi 17,7 mmHg (d.p. = 18,6). Resultados de diversos estudos epidemiológicos permitem inferir redução do risco de mortalidade por doença cardiovascular em proporção considerável de indivíduos inscritos no Programa. Em 111 (44,4%) indivíduos ocorreu normalização da pressão aos níveis preconizados pelo Programa. A análise por meio de regressão linear múltipla demonstrou que, entre as variáveis estudadas, a pressão inicial e a percentagem de faltas no seguimento programático estiveram associadas de modo independente com a redução da PAS e da PAD. A idade esteve associada independentemente apenas com a redução da PAS. A participação da idade e da percentagem de faltas no seguimento programático revelam que o resultado final do trabalho programático não é insensível aos diferentes modos com que as pessoas assumem o cuidado com a própria saúde.
The present study is part of a performance evaluation of the Aging Health Care Program carried out at a Primary Health Care Clinic. Activities for Arterial Hypertension (AH), control oriented accorging to a risk assessment, in conformity with Ministry of Health norms, are included in the Program mentioned. The effectiveness of the reduction of blood pressure (BP) levels in hypertensive individuals subjected to programmatic activities for disease control, in an attempt to identify conditions associated with that reduction, is evaluated. Of the 396 patients with AH registered under the Program between 01/01/92 and 06/30/93, 250 cases were included for this evaluation. These patients had, in addition to high blood pressure levels (BP ³ 160/95 mm Hg) on the first attendances at the health center (before registration in the programme), at least two medical consultations during program follow-up. The differences in blood pressure levels between measurements taken during consultations before the beginning of attendance at the program and those taken on the first attendances to the programme were analysed according to initial blood pressure level, age, sex, registering diagnosis and absences during the program follow-up. Reductions of ³ 5 mm Hg in diastolic blood pressure (DBP) and/or ³ 10 mm Hg in systolic blood pressure (SBP) were obtained in 197 (78.8%) patients. The mean reduction was 8.8 mm Hg (sd = 11.4) for DBP and 17.7 mm Hg (sd = 18.6) for SBP. Results of several epidemiological studies allow the inference that a decrease in the mortality risk from Cardiovascular Disease can be achieved in a significant proportion of the individuals registered in the program. Blood pressure normalization according to program norms occurred in 111 (44.4%) individuals. Multiple linear regression analysis demonstrated that initial blood pressure and percentages of absenteeism during the follow-up were independently associated with the reductions in SBP and DBP. Age was independently associated only with the reductions in SBP. Participation of age and percentage of absenteeism during follow-up thus reveal that the final result of the programmed work is also a result of the different ways people take care of their own health.
The present study is part of a performance evaluation of the Aging Health Care Program carried out at a Primary Health Care Clinic. Activities for Arterial Hypertension (AH), control oriented accorging to a risk assessment, in conformity with Ministry of Health norms, are included in the Program mentioned. The effectiveness of the reduction of blood pressure (BP) levels in hypertensive individuals subjected to programmatic activities for disease control, in an attempt to identify conditions associated with that reduction, is evaluated. Of the 396 patients with AH registered under the Program between 01/01/92 and 06/30/93, 250 cases were included for this evaluation. These patients had, in addition to high blood pressure levels (BP ³ 160/95 mm Hg) on the first attendances at the health center (before registration in the programme), at least two medical consultations during program follow-up. The differences in blood pressure levels between measurements taken during consultations before the beginning of attendance at the program and those taken on the first attendances to the programme were analysed according to initial blood pressure level, age, sex, registering diagnosis and absences during the program follow-up. Reductions of ³ 5 mm Hg in diastolic blood pressure (DBP) and/or ³ 10 mm Hg in systolic blood pressure (SBP) were obtained in 197 (78.8%) patients. The mean reduction was 8.8 mm Hg (sd = 11.4) for DBP and 17.7 mm Hg (sd = 18.6) for SBP. Results of several epidemiological studies allow the inference that a decrease in the mortality risk from Cardiovascular Disease can be achieved in a significant proportion of the individuals registered in the program. Blood pressure normalization according to program norms occurred in 111 (44.4%) individuals. Multiple linear regression analysis demonstrated that initial blood pressure and percentages of absenteeism during the follow-up were independently associated with the reductions in SBP and DBP. Age was independently associated only with the reductions in SBP. Participation of age and percentage of absenteeism during follow-up thus reveal that the final result of the programmed work is also a result of the different ways people take care of their own health.
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sala1996revistaavaliao
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| Authors | ;Arnaldo Sala;Alexandre Nemes Filho;José Eluf-Neto |
| Journal | proceedings - 2016 3rd international conference on information technology, computer, and electrical engineering, icitacee 2016 |
| Year | 1996 |
| DOI |
10.1590/S0034-89101996000200008
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