Short Editorial: Hypertension in Special Populations: An Epidemiological Challenge

Rui Póvoa About the author

Keywords
Hypertension/epidemiology; Hypertension/prevention & control; African Continental Ancestry Group/genetics; Risk Factors; Tobacco Use Disorder; Alcoholism

Arterial hypertension (AH) is the most prevalent chronic disease worldwide and the main risk factor for most cardio-cerebrovascular diseases.11 Picon RV, Fuchs FD, Moreira LB, Riegel G, Fuchs SC. Trends in prevalence of hypertension in Brazil: a systematic review with meta-analysis. PLOS One. 2012;7(10):e48255. The true prevalence in Brazil is still unknown, and the available data are from the Vigitel Study, where the information is obtained by telephone contact. The prevalence of hypertension in Brazil is estimated at around 31% in adult individuals.22 Chor D, Ribeiro AL, Carvalho MS, Duncan BB, Lotufo PA, Nobre AA, et al. Prevalence, awareness, treatment and influence of socioeconomic variables on control of high blood pressure: results of the ELSA-Brasil Study. PLOS One. 2015;10(6):e0127382. In recent data from the Vigitel Study, the prevalence was 25.7% of the adult Brazilian population.33 Brasil.Ministério da Saúde.Vigitel Brasil 2016. Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico. [Internet]. [Acesso em 2019 abr 23]. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/vigitel_brasil_2016_fatores_risco.pdf
http://bvsms.saude.gov.br/bvs/publicacoe...
Knowledge of the real prevalence and geographic distribution is not only important for prevention and treatment measures, but also contribute to the knowledge of the genesis of the disease.

In some populations, particularly individuals of African descent, AH has its own characteristics, including prevalence, therapeutic response and severity.44 Kimura L, Angeli CB, Auricchio MT, Fernandes GR, Pereira AC, Vicente JP, et al. Multilocus family-based association analysis of seven candidate polymorphisms with essential hypertension in an African-derived semi-isolated Brazilian population. Int J Hypertens. 2012;2012:859219.,55 Musemwa N, Gadegbeku CA. Hypertension in African Americans. Curr Cardiol Rep. 2017; 19(12):129. The multifactorial aspect of AH is only understood when assessing special populations considering their own habitats and habits, as in the case of quilombolas, where individuals with African ancestry still retain some genetic and cultural characteristics of the African origin.66 Santos DMS, Prado BS, Oliveira CCC, Almeida-Santos MA. Prevalência da Hipertensão Arterial Sistêmica em Comunidades Quilombolas do Estado de Sergipe, Brasil. Arq Bras Cardiol. 2019; 113(3):383-390. The analysis in this context is important, since we can detect aspects inherent to factors related to AH development.

In this study,66 Santos DMS, Prado BS, Oliveira CCC, Almeida-Santos MA. Prevalência da Hipertensão Arterial Sistêmica em Comunidades Quilombolas do Estado de Sergipe, Brasil. Arq Bras Cardiol. 2019; 113(3):383-390. the prevalence of hypertension in the quilombola communities of Sergipe was 26%, with the authors reporting that the mean value in the state is much lower (20.4%).77 Instituto Brasileiro de Geografia Estatística (IBGE). [Internet]. Censo demográfico: características da população e dos domicílios. 2010. [Citado em 2013 jan 12]. Disponível em: https://sidra.ibge.gov.br/pesquisa/censo-demografico/demografico-2010/universo-caracteristicas-da-populacao-e-dos-domicilios
https://sidra.ibge.gov.br/pesquisa/censo...
However, the values are very similar to those found in the Vigitel Study, which attempts to represent the Brazilian population. Regarding the risk factors for AH, in this population with a certain degree of vulnerability, the study disclosed inadequate lifestyle habits, especially physical inactivity, smoking and alcohol consumption. The quantification of salt in the diet was not accurate, as more complex tests are needed to determine the values, and the authors justify the fact by the study's own limitation.88 Jacobson MF, Campbell NRC. Shaking out the truth about salt. J Clin Hypertens (Greenwich). 2019;21(7):1018-9.

Knowledge of these risk factors for both hypertension and cardiovascular events is important for the planning of health actions in these at-risk populations. This study66 Santos DMS, Prado BS, Oliveira CCC, Almeida-Santos MA. Prevalência da Hipertensão Arterial Sistêmica em Comunidades Quilombolas do Estado de Sergipe, Brasil. Arq Bras Cardiol. 2019; 113(3):383-390. has a very significant epidemiological value, as it allows social considerations and extrapolation to other quilombola communities, so that health team interventions can achieve a better cardiovascular prevention.

  • Short Editorial related to the article: Prevalence of Systemic Arterial Hypertension in Quilombola Communities, State of Sergipe, Brazil

References

  • 1
    Picon RV, Fuchs FD, Moreira LB, Riegel G, Fuchs SC. Trends in prevalence of hypertension in Brazil: a systematic review with meta-analysis. PLOS One. 2012;7(10):e48255.
  • 2
    Chor D, Ribeiro AL, Carvalho MS, Duncan BB, Lotufo PA, Nobre AA, et al. Prevalence, awareness, treatment and influence of socioeconomic variables on control of high blood pressure: results of the ELSA-Brasil Study. PLOS One. 2015;10(6):e0127382.
  • 3
    Brasil.Ministério da Saúde.Vigitel Brasil 2016. Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico. [Internet]. [Acesso em 2019 abr 23]. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/vigitel_brasil_2016_fatores_risco.pdf
    » http://bvsms.saude.gov.br/bvs/publicacoes/vigitel_brasil_2016_fatores_risco.pdf
  • 4
    Kimura L, Angeli CB, Auricchio MT, Fernandes GR, Pereira AC, Vicente JP, et al. Multilocus family-based association analysis of seven candidate polymorphisms with essential hypertension in an African-derived semi-isolated Brazilian population. Int J Hypertens. 2012;2012:859219.
  • 5
    Musemwa N, Gadegbeku CA. Hypertension in African Americans. Curr Cardiol Rep. 2017; 19(12):129.
  • 6
    Santos DMS, Prado BS, Oliveira CCC, Almeida-Santos MA. Prevalência da Hipertensão Arterial Sistêmica em Comunidades Quilombolas do Estado de Sergipe, Brasil. Arq Bras Cardiol. 2019; 113(3):383-390.
  • 7
    Instituto Brasileiro de Geografia Estatística (IBGE). [Internet]. Censo demográfico: características da população e dos domicílios. 2010. [Citado em 2013 jan 12]. Disponível em: https://sidra.ibge.gov.br/pesquisa/censo-demografico/demografico-2010/universo-caracteristicas-da-populacao-e-dos-domicilios
    » https://sidra.ibge.gov.br/pesquisa/censo-demografico/demografico-2010/universo-caracteristicas-da-populacao-e-dos-domicilios
  • 8
    Jacobson MF, Campbell NRC. Shaking out the truth about salt. J Clin Hypertens (Greenwich). 2019;21(7):1018-9.

Publication Dates

  • Publication in this collection
    10 Oct 2019
  • Date of issue
    Sept 2019
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