Prevalência da hipertensão arterial na população brasileira, acesso e utilização dos serviços de saúde: Pesquisa Nacional de Saúde 2019

Abstract

Introduction: Among the Chronic Noncommunicable Diseases (CNCDs), hypertension stands out, a complex health condition influenced by multiple factors, including genetics, environment, lifestyle, and socioeconomic aspects. Objectives: To identify the prevalence of individuals with systemic arterial hypertension (SAH) and the access to and use of health services based on the 2019 National Health Survey (PNS). Study design: This is a cross-sectional study, with a quantitative approach, using data from the 2019 (PNS). For the analyses, only interviews with residents over 15 years of age were considered, totaling 21,315 individuals. It is worth noting that the percentages of hypertensive individuals were in relation to the total number of individuals according to the groups analyzed within the sociodemographic data of each variable, including only those who declared having hypertension. Variables from the general characteristics module of residents were used for sociodemographic data, and variables from the chronic diseases module (hypertension) and health insurance coverage to verify the prevalence of hypertension and the access to and use of health services. The outcome studied was hypertension obtained by the question: “Has a doctor ever diagnosed you with hypertension?”. The prevalence of hypertension in each group of the chosen variables was calculated together with their respective confidence intervals (95%). All analyses were performed in the statistical program with the aid of the PNSIBGE packages and analyzed in the survey package. Regarding the sociodemographic data of the study participants, there was a predominance of hypertension in female individuals (25.15%), elderly (54.99%), black (24.58%), widowed (55.30%), with a low level of education (32.38%), living in urban areas (22.83%), southeast region (24.64%) followed by the south region (23.33%), with an income between 1 and 3 minimum wages (24.78%) during the research period and unemployed individuals (29.97%). The results describe that access to and use of health services by people with hypertension occurs as follows: 59.47% regularly visit a doctor or health services. Among those who do not seek regular care, 38.69% claimed that their blood pressure was under control and 38.58% did not find it necessary. 95.27% of the interviewees received a prescription for hypertension medication; 59.15% did not obtain the medications through the public service and 54.29% paid for them out of their own pocket. Regarding the place of care, 45.80% were seen at the basic health units (BHU) and 28.78% at a private practice. In addition, 85.25% did not pay for the care, which was provided by the Brazilian Unified Health System (SUS) for 65.64% of them. Finally, 51.90% were seen by the same doctor as their previous consultation. Regarding the use of health insurance, it was found that 23.46% have a private health insurance plan, either from a company or a public agency. Another 32.45% stated that their main health insurance plan is from an institution that assists public servants (municipal, state or military). When asked about the quality of the health insurance plan, 29.77% rated it as poor. Conclusion: The results revealed that SAH has a significant prevalence among certain groups of the Brazilian population. Regarding access to and use of health services, there was a clear increase in demand for care at the BHU.