Self-reported medical diagnosis of heart disease and associated risk factors: National Health Survey

Gonçalves, Renata Patrícia Fonseca; Haikal, Desirré Sant’Ana; Freitas, Maria Imaculada de Fátima; Machado, Ísis Eloah; Malta, Deborah Carvalho

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Brasil

Revista Brasileira de Epidemiologia

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Brasil

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Sumário

ORIGINAL ARTICLE • Rev. bras. epidemiol. 22 (Suppl 02) • 2019 • https://doi.org/10.1590/1980-549720190016.supl.2 copy

Self-reported medical diagnosis of heart disease and associated risk factors: National Health Survey

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT:

Objective:

To analyze the risk factors associated with the self-reported medical diagnosis of heart disease in Brazil.

Methods:

This is a cross-sectional study, analyzing information from 60,202 adult participants of the Brazilian National Health Survey in 2013. Heart disease was defined by self-reported medical diagnosis of heart disease. We analyzed associations between the occurrence of disease and sociodemographic characteristics, health conditions and lifestyle. A hierarchical binary logistic regression model was used.

Results:

The prevalence of self-reported diagnosis of heart disease in Brazil was 4.2% (confidence interval of 95% [95%CI] 4.0 ‒ 4.3) and was associated with females (odds ratio [OR] = 1.1; 95%CI 1.1 ‒ 1.1), people 65 years old or older (OR = 4.7; 95%CI 3.3 ‒ 5.6), poor or very poor health conditions (OR = 4.1; 95%CI 3.5 ‒ 4.6) and fair health conditions (OR = 2.4; 95%CI 2.2 ‒ 2.7), hypertensive individuals (OR = 2.4; 95%CI 2.2 ‒ 2.7), those with increased cholesterol (OR = 1.6; 95%CI 1.5 ‒ 1.8), overweight individuals (OR = 1.5; 95%CI 1.4 ‒ 1.8) and obese individuals (OR = 2.0; 95%CI 1.7 ‒ 2.2), sedentary behavior (OR = 1.5; 95%CI 1.02 ‒ 2.1), former smokers (OR = 1.4; 95%CI 1.3 ‒ 1.6) or current smokers (OR = 1.2; 95%CI 1.03 ‒ 1.3) and the consumption of fruits and vegetables 5 or more days each week (OR = 1.5; 95%CI 1.1 ‒ 1.5).

Conclusion:

The importance of knowledge on the prevalence of heart disease and associated risk factors in the present Brazilian epidemiological context must be emphasized because it guides actions to control and prevent cardiovascular diseases, the leading cause of death in Brazil and worldwide.

Keywords:
Cardiovascular diseases; Self-report; Risk factors; Health surveys; Chronic disease.

Variables	Self-reported heart disease
	%	95%CI		OR	95%CI		p-value
	%	Lower	Upper	OR	Lower	Upper	p-value
Total	4.18	4.03	4.34
Block 1: Sociodemographic characteristics
Gender
Male	3.93	3.64	4.25	1.00
Female	4.40	4.18	4.63	1.13	1.04	1.22	0.004
Age group (years)
18 to 24	0.83	0.66	1.05	1.00
25 to 34	1.18	1.00	1.40	1.43	1.09	1.87	0.011
35 to 44	2.51	2.20	2.86	3.07	2.39	3.93	< 0.001
45 to 54	3.77	3.36	4.24	4.67	3.66	5.94	< 0.001
55 to 64	8.21	7.45	9.04	10.64	8.42	13.45	< 0.001
65 and older	12.58	11.84	13.35	17.12	13.60	21.57	< 0.001
Education
No education and incomplete elementary school	6.30	5.56	7.14	1.00
Completed elementary and high school	3.06	2.59	3.61	0.47	0.41	0.53	0.002
Completed high school, incomplete higher education	2.47	2.13	2.86	0.38	0.34	0.42	< 0.001
Completed higher education	3.48	3.09	3.91	0.54	0.47	0.61	< 0.001
Race/color
White	4.89	4.51	5.31	1.00
Dark-skinned black	3.49	2.99	4.07	0.70	0.60	0.82	< 0.001
Light-skinned black	3.52	3.30	3.75	0.71	0.65	0.77	< 0.001
Block 2: Health conditions
Health status evaluation
Good/Very good	1.99	1.77	2.24	1.00
Fair	7.63	6.88	8.45	4.06	3.71	4.44	< 0.001
Poor/very poor	14.14	13.01	15.34	8.09	7.19	9.11	< 0.001
Hypertension
No	2.07	1.91	2.24	1.00
Yes	11.93	11.39	12.50	6.42	5.91	6.97	< 0.001
Diabetes
No	3.61	3.26	4.00	1.00
Yes	12.72	11.69	13.82	3.89	3.50	4.32	< 0.001
High cholesterol
No	3.59	3.30	3.91	1.00
Yes	11.03	10.34	11.76	3.33	3.05	3.63	< 0.001
Body mass index classification
Eutrophic	3.28	2.92	3.69	1.00
Overweight	4.69	4.19	5.26	1.45	1.30	1.62	< 0.001
Obese	6.09	5.58	6.64	1.91	1.69	2.16	< 0.001
Block 3: Lifestyle
Smoking
Non-smoker	3.33	2.96	3.75	1.00
Ex-smoker	7.81	6.91	8.81	2.46	2.25	2.69	<0.001
Smoker	3.76	3.38	4.18	1.13	1.00	1.28	0.044
Recommended consumption of fruits and vegetables
No	3.79	3.50	4.09	1.00
Yes	4.84	4.57	5.13	1.29	1.19	1.40	0.016
Consumption of fatty red meat
No	4.22	3.87	4.59	1.00
Yes	3.54	3.31	3.79	0.83	0.76	0.91	< 0.001
Alcohol abuse
No	4.32	3.43	5.43	1.00
Yes	1.94	1.54	2.45	0.44	0.35	0.56	< 0.001
High salt intake
No	4.31	3.82	4.86	1.00
Yes	3.37	3.01	3.78	0.78	0.68	0.88	< 0.001
Insufficiently active in all four areas^∞
No	3.32	3.07	3.59	1.00
Yes	5.19	4.94	5.46	1.59	1.47	1.73	< 0.001

Variables	Self-reported heart disease
	OR*	95%CI		p-value**
	OR*	Lower	Upper	p-value**
Gender
Masculine	1.00
Feminine	1.09	1.06	1.13	0.002
Age group (years)
18 to 24	1.00
25 to 34	1.08	0.80	1.45	0.630
35 to 44	1.87	1.34	2.32	0.015
45 to 54	1.91	1.45	2.50	< 0.001
55 to 64	3.18	2.43	4.15	< 0.001
65 and older	4.66	3.31	5.64	< 0.001
Race/color
White	1.00
Dark-skinned black	0.82	0.58	0.81	< 0.001
Light-skinned black	0.79	0.69	0.83	< 0.001
Health status evaluation
Good/very good	1.00
Fair	2.44	2.20	2.71	< 0.001
Poor/very poor	4.07	3.46	4.56	< 0.001
Hypertension
No	1.00
Yes	2.45	2.22	2.70	< 0.001
High cholesterol
No	1.00
Yes	1.62	1.48	1.79	< 0.001
Body mass index classification
Eutrophic	1.00
Overweight	1.53	1.42	1.78	0.010
Obese	2.01	1.69	2.16	< 0.001
Smoking
Non-smoker	1.00
Ex-smoker	1.40	1.30	1.59	< 0.001
Smoker	1.19	1.03	1.34	< 0.001
Recommended consumption of fruits and vegetables
No	1.00
Yes	1.50	1.14	1.53	0.048
Insufficiently active in the four areas^∞
No	1.00
Yes	1.52	1.02	2.07	< 0.001

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[1] Corresponding author: Renata Patrícia Fonseca Gonçalves. Avenida Peter Henry Rolfs, s/n, Campus Universitário, CEP: 36570-900, Viçosa, MG, Brazil. Email: renatapfonseca@yahoo.com.br