Prevalência de hipertensão arterial sistêmica, diabetes mellitus e fatores associados em pessoas idosas longevas

• Ano de defesa: 2023
• Autor(a) principal: Silva, Andreia Matos da
• Orientador(a): Carvalho, Luiz Sérgio Fernandes de
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Católica de Brasília
• Programa de Pós-Graduação: Programa Stricto Sensu em Gerontologia
• Departamento: Escola de Saúde e Medicina
• País: Brasil
• Palavras-chave em Português: Idoso; Idoso de 80 anos ou mais; Hipertensão; Diabetes mellitus; Processo saúde-doença
• Palavras-chave em Inglês: Elderly; Elderly aged 80 or over; Hypertension; Diabetes mellitus; Health-disease process
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE
• Link de acesso: https://bdtd.ucb.br:8443/jspui/handle/tede/3303

Introduction: Chronic noncommunicable diseases (NCDs) related to aging, such as systemic arterial hypertension (SAH) and diabetes mellitus (DM), represent a relevant global public health problem, causing family, social and economic impacts. Until now, long-lived elderly people are underrepresented in epidemiological studies, and in Brazil there are few initiatives to understand the prevalence and factors associated with SAH and DM in this specific population. Objective: To identify the prevalence of SAH and DM and their associated factors in long-lived elderly people in three Brazilian regions. Methods: This is a cross-sectional observational study conducted with long-lived elderly people, that is, aged 80 years or older. This research derives from a multicenter study carried out from January 2016 to December 2018. Through face-to-face interviews, information on the diagnosis of SAH and DM, socioeconomic aspects (gender, age group, education and income), use of polypharmacy and an anthropometric assessment was performed. The latter consisted of assessing weight, height and waist circumference (WC), obtaining a nutritional status classification (Body Mass Index-BMI and WC classification). Multivariate Poisson Regression models with robust variance were performed to identify factors associated with SAH and DM. The data obtained were analyzed using Stata software, version 11.0. For all analyses, a significance value of p ≤ 0.05 was adopted. Results: 700 elderly people were evaluated, with a mean age of 85.7 ± 4.8 years and 72.9% female. The prevalence of overweight was 37.2% and 58.1% were at risk of metabolic complications according to the CC classification. The prevalence of SAH and type 2 DM was 68.2% and 25.9%, respectively. According to the multivariate model, the factors that were independently associated with SAH in the oldest old were age group, polypharmacy and BMI. The prevalence ratio of hypertension was 12% (PR: 0.88; 95% CI: 0.78-0.99; p 0.045) and 17% (PR: 0.83; 95% CI: 0.71-0 .97; p 0.020) lower among the elderly aged 85 to 89 years and aged 90 years or more when compared to those aged 80 to 84 years; it was 38% higher among those elderly people who use 5 or more medications (PR: 1.38; 95% CI: 1.23-1.55; p <0.001); and 17% higher among overweight elderly (PR: 1.17; 95% CI: 1.05-1.30; p 0.003) when compared with those with eutrophy. According to the multivariate model, the factors that were independently associated with type 2 diabetes mellitus in the oldest old were gender, age group and polypharmacy. The diabetes prevalence ratio was 24% (PR: 0.76; 95% CI: 0.590.98; p 0.041) lower among women when compared to men; was 44% (PR: 0.56; 95% CI: 0.42-0.74; p<0.001) and 57% (PR: 0.43; 95% CI: 0.29-0.65; p< 0.001) lower among elderly aged 85 to 89 years and aged 90 years or older when compared to those aged 80 to 84 years; and 2.15 times higher among elderly people who use 5 or more medications (PR: 2.15; 95% CI: 1.63-2.85; p<0.001). Conclusions: The present study revealed that age group, polypharmacy and nutritional status were factors associated with SAH and DM. In addition, gender was also identified as a factor associated with DM.