Epidemiologia da hipertensão e diabetes em São José do Rio Preto, 2002 a 2012

Abstract

Introduction: Chronic conditions have gained a special place among the public health problems around the world, with high morbidity and mortality rates, mainly related to systemic arterial hypertension (SAH) and diabetes mellitus (DM). Objectives: To identify sociodemographic variables, risk factors and complications of the users registered in the Registration and Monitoring System of Hypertensive and Diabetic Patients (HIPERDIA) in São José do Rio Preto; to identify the main causes of hospitalizations and mortality due to SAH and DM and to analyze the morbidity and mortality tend, comparing the triennia 2002-2004 and 2010-2012. Methods: Cross-sectional and descriptive study that used secondary data from: users registered in HIPERDIA; deaths from the Mortality Information System and hospitalizations from the Datasus Hospital Information System. Univariate (tests: chi-square, t-test for independent samples, variance analysis and Tukey’s test) and multivariate (Multiple Correspondence Analysis) statistical analyses were applied. Results: 45,723 patients registered in HIPERDIA between 2002 and 2012 were studied. In this group, 31,547(69%) were hypertensive, 2,867(6.27%) diabetic and 11,309 (24.73%) hypertensive and diabetic. The majority was female, mean age 59 ± 13.8 years, unfinished primary education, white, lived with a partner and children, 59.57% presented risk factors and 16.58% complications. A statistically significant association was observed between the clinical conditions and: risk factors; smoking and sedentariness (p<0.0001) with diabetes and hypertension, with diabetes; Overweight (p<0.0001) in the three clinical conditions and family antecedents (p<0.0001) with hypertension and diabetes; with the complications: other heart diseases, stroke and kidney diseases (p < 0.01) with the three clinical conditions; and cerebrovascular accident (p<0.0001) with diabetes and diabetes and hypertension. Between 2002 and 2012, 325,439 hospitalizations took place, 14.7% due to diseases of the circulatory system (DCS) and 0.7% due to DM. The deaths corresponded to: 29,027, 31.5% DCS, 8.06% cerebrovascular diseases (CVD) and 2.75% DM. A significant association was found between the causes of hospitalization and deaths in terms of the patients’ sex and age in both triennia (p<0.001). The highest lethality in the hospitalizations was due to CVD (10%). The trend showed a drop in mortality rates and younger patients being hospitalized due to DM, advanced ages due to CVD, with higher frequencies among women. Conclusions: These study data will support the elaboration of intervention strategies to improve care for hypertensive and diabetic patients, thus preventing the complications and strengthening the course started towards the construction of Regional Care Networks, which are horizontally structured, integrated, problem-solving and coordinated at the primary care level, using clinical management tools and care line organization.