Epidemiology of high blood pressure among the Kaingang people on the
               Xapecó Indigenous Land in Santa Catarina State, Brazil, 2013

Bresan, Deise; Bastos, João Luiz; Leite, Maurício Soares

doi:10.1590/0102-311X00058714

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Article • Cad. Saúde Pública 31 (2) • Feb 2015 • https://doi.org/10.1590/0102-311X00058714 copy

Epidemiology of high blood pressure among the Kaingang people on the Xapecó Indigenous Land in Santa Catarina State, Brazil, 2013

Epidemiologia da hipertensão arterial em indígenas Kaingang, Terra Indígena Xapecó, Santa Catarina, Brasil, 2013

Epidemiología de la hipertensión en los indígenas Kaingang, Tierra Indígena Xapecó, Santa Catarina, Brasil, 2013

Authorship SCIMAGO INSTITUTIONS RANKINGS

This cross-sectional study describes the prevalence of high blood pressure (HBP; measured at one setting, and suggestive of a clinical diagnosis of arterial hypertension) and mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) and their associations with socio-demographic and anthropometric variables among 355 Kaingang adults (≥ 20 years) on the Xapecó Indigenous Land in Brazil. Weight, height, waist circumference (WC), SBP, and DBP were measured and socio-demographic data were collected. Prevalence of HBP was 53.2% (95%CI: 45.3; 61.1) in men and 40.7% (95%CI: 33.8; 47.6) in women. In women, age and WC were directly associated with HBP; age was associated with SBP and schooling with DBP. In men, HBP was statistically associated with high body mass index (BMI) and tile floor in the home (as a socioeconomic proxy); BMI and WC were associated with SBP; BMI and WC were associated with DBP. The study highlights the need for measures to control risk factors for HBP, especially due to its relevance for cardiovascular diseases and their consequences.

Arterial Hypertension; South American Indians; Health of Indigenous Peoples

Variables	Men (n = 156)	Women (n = 199)	Total (N = 355)
Variables	%	%	%
Age (years)
20-39	57.7	55.3	56.3
40-59	28.2	31.1	29.9
≥ 60	14.1	13.6	13.8
Marital status
Single/Widowed	21.8	27.1	24.8
Married/Stable union	78.2	72.9	75.2
Schooling (years)
0-4	50.0	55.8	53.2
5-8	35.3	24.6	29.3
≥ 9	14.7	19.6	17.5
Flooring material in the home
Tile	23.8	27.1	25.6
Cement	7.0	8.6	7.9
Wood	66.0	61.3	63.4
Terra	3.2	3.0	3.1
Wall materials in the home
Brick	22.4	24.6	23.7
Wood	77.6	75.4	76.3
Per capita income (R$) *	301.00 (200.00-500.00)	300.00 (175.60-453.30)	300.00 (183.50-456.00)
BMI
Normal	43.8	24.4	32.9
Overweight	33.3	34.5	34.0
Obese	22.9	41.1	33.1
WC (cm) **	88.1 (±11.8)	87.1 (±11.8)	87.5 (±11.8)
HBP ***
No	46.8	59.3	53.8
Yes	53.2	40.7	46.2

Variables	n	HBP * prevalence (%)	Crude analysis	Adjusted analysis **
Variables	n		OR (95%CI)	OR (95%CI)
Age (years)			p < 0.01 ***	p = 0.113 ***
20-39	90	43.3	1.00	1.00
40-59	44	61.4	2.07 (0.99; 4.33)	1.37 (0.58; 3.25)
≥ 60	22	77.3	4.44 (1.50; 13.26)	2.46 (0.72; 8.45)
Marital status			p = 0.255	p = 0.310
Single/Widowed	34	61.8	1.00	1.00
Married/Stable union	122	50.8	0.63 (0.29; 1.40)	0.63 (0.26; 1.51)
Schooling (years)			p = 0.048	p = 0.170
0-4	78	62.8	1.00	1.00
5-8	55	41.8	0.42 (0.21; 0.86)	0.47 (0.21; 1.05)
≥ 9	23	47.8	0.54 (0.21; 1.40)	0.51 (0.16; 1.61)
Flooring material in the home			p = 0.016	p = 0.021
Tile	37	72.9	1.00	1.00
Cement	11	45.4	0.31 (0.08; 1.24)	0.26 (0.60; 1.11)
Wood	103	45.6	0.31 (0.14; 0.71)	0.25 (0.10; 0.61)
Packed earth	5	80.0	1.48 (0.15; 14.90)	0.70 (0.05; 9.18)
Wall materials in the home			p = 0.191	p = 0.405
Brick	35	62.8	1.00	1.00
Wood	121	50.4	0.60 (0.28; 1.30)	1.75 (0.43; 7.16)
Per capita income (R$)			p = 0.146	p = 0.119 ***
1^st tertile: 50.00-227.99	51	49.0	1.00	1.00
2^nd tertile: 228.00-424.99	50	46.0	0.88 (0.40; 1.93)	1.03 (0.44; 2.41)
3^rd tertile: 425.00-1,750.00	55	63.6	1.82 (0.84; 3.96)	1.97 (0.82; 4.72)
BMI			p = 0.023 ***	p < 0.01 ***
Normal	67	46.3	1.00	1.00
Overweight	51	49.0	1.12 (0.54; 2.31)	1.21 (0.53; 2.77)
Obese	35	71.4	2.90 (1.21; 6.97)	3.47 (1.59; 11.57)
WC (cm)			p = 0.023	p = 0.015
1^st tertile: 68.0-81.9	49	51.0	1.00	1.00
2^nd tertile: 82.0-90.9	53	41.5	0.68 (0.31; 1.49)	0.66 (0.27; 1.58)
3^rd tertile: 91.0-151.9	50	66.0	2.04 (0.90; 4.61)	2.51 (1.02; 6.19)

Variables		HBP * prevalence (%)	Crude analysis	Adjusted analysis **
Variables	n		OR (95%CI)	OR (95%CI)
Age (years)			p < 0.01 ***	p < 0.01 ***
20-39	110	20.9	1.00	1.00
40-59	62	61.3	5.98 (3.01; 11.90)	4.17 (2.22; 9.98)
≥ 60	27	74.0	10.80 (4.07; 28.67)	8.18 (2.90; 23.04)
Marital status			p = 0.994	p = 0.207
Single/Widowed	54	40.7	1.00	1.00
Married/Stable union	145	40.7	1.00 (0.53; 1.88)	1.63 (0.76; 3.51)
Schooling (years)			p < 0.01 ***	p = 0.098 ***
0-4	111	55.8	1.00	1.00
5-8	49	24.6	0.31 (0.15; 0.64)	0.60 (0.26; 1.39)
≥ 9	39	19.6	0.21 (0.09; 0.52)	0.54 (0.20; 1.44)
Flooring material in the home			p = 0.466	p = 0.458
Tile	54	33.3	1.00	1.00
Cement	17	52.9	2.25 (0.74; 6.81)	1.46 (0.41; 5.12)
Wood	122	41.8	1.44 (0.73; 2.81)	0.54 (0.17; 1.66)
Packed earth	6	50.0	2.00 (0.37; 10.92)	0.33 (0.03; 2.90)
Wall materials in the home			p = 0.320	p = 0.572
Brick	49	34.7	1.00	1.00
Wood	150	42.7	1.40 (0.71; 2.74)	1.23 (0.58; 2.61)
Per capita income (R$)			p = 0.898	p = 0.315 ***
1^st tertile: 25.00-227.99	75	41.3	1.00	1.00
2^nd tertile: 228.00-424.99	61	37.7	0.86 (0.43; 1.72)	0.92 (0.41; 2.03)
3^rd tertile: 425.00-3,330.00	61	41.0	0.98 (0.50; 1.96)	0.62 (0.26; 1.49)
BMI			p = 0.223	p = 0.265 ***
Normal	48	31.2	1.00	1.00
Overweight	68	47.1	1.95 (0.90; 4.24)	1.57 (0.64; 3.84)
Obese	81	42.0	1.59 (0.75; 3.38)	1.69 (0.71; 4.02)
WC (cm)			p = 0.018 ***	p = 0.044 ***
1^st tertile: 63.0-81.9	67	29.8	1.00	1.00
2^nd tertile: 82.0-90.9	64	43.7	1.83 (0.89; 3.75)	1.65 (0.71; 3.81)
3^rd tertile: 91.0-141.9	64	50.0	2.35 (1.15; 4.81)	2.40 (1.02; 5.61)

Variables	n	SBP (mmHg)		DBP (mmHg)
		Crude analysis	Adjusted analysis *	Crude analysis	Adjusted analysis *
		Mean (SD)	β	Mean (SD)	β
Age (years)		p = 0.063 **	p = 0.323 **	p = 0.140 **	p = 0.361
20-39	84	131.1 (±18.1)	0.0	84.7 (±11.6)	0.0
40-59	36	135.9 (±18.9)	3.3	88.7 (±12.3)	3.8
≥ 60	10	140.9 (±24.5)	5.4	90.4 (±18.6)	3.7
Marital status		p = 0.279	p = 0.413	p = 0.732	p = 0.905
Single/Widowed	28	136.7 (±16.4)	0.0	87.0 (±11.6)	0.0
Married/Stable union	102	132.3 (±19.6)	-3.5	86.1 (±12.8)	-0.3
Schooling (years)		p = 0.320	p = 0.502	p = 0.723	p = 0.936
0-4	60	127.8 (±18.9)	0.0	87.2 (±14.4)	0.0
5-8	49	122.1 (±15.0)	-4.6	85.4 (±11.3)	-0.9
≥ 9	21	118.5 (±14.6)	-3.8	85.5 (±9.3)	-0.6
Flooring material in the home		p = 0.254	p = 0.411	p = 0.109	p = 0.239
Tile	28	138.4 (±19.8)	0.0	89.6 (±11.9)	0.0
Cement	10	128.5 (±12.5)	-9.9	84.9 (±10.2)	-4.9
Wood	90	131.9 (±18.8)	-7.3	85.1 (±12.3)	-4.4
Packed earth	2	146.2 (±38.5)	3.2	102.0 (±33.2)	11.3
Wall materials in the home		p = 0.616	p = 0.883	p = 0.385	p = 0.905
Brick	26	134.9 (±18.7)	0.0	88.2 (±12.4)	0.0
Wood	104	132.8 (±19.1)	0.9	85.8 (±12.6)	0.5
Per capita income (R$)		p = 0.361	p = 0.506	p = 0.584	p = 0.755
1st tertile: 50.00-227.99	44	135.6 (±22.6)	0.0	87.2 (±13.8)	0.0
2nd tertile: 228.00-424.99	47	130.1 (±16.1)	-4.6	84.8 (±10.9)	-1.7
3rd tertile: 425.00-1,750.00	39	134.2 (±17.7)	-1.4	87.0 (±13.0)	0.0
BMI		p = 0.046 **	p = 0.046 **	p = 0.027 **	p = 0.027 **
Normal	54	129.2 (±18.2)	0.0	83.5 (±10.3)	0.0
Overweight	46	135.5 (±21.4)	6.3	87.8 (±14.6)	4.2
Obese	28	137.3 (±15.5)	8.1	89.5 (±11.9)	6.0
WC (cm)		p < 0.01 **	p < 0.01 **	p < 0.01 **	p < 0.01**
1st tertile: 68.0-81.9	39	127.8 (±13.6)	0.0	82.9 (±9.1)	0.0
2nd tertile: 82.0-90.9	47	131.4 (±19.8)	3.6	84.7 (±11.9)	1.9
3rd tertile: 91.0-151.9	41	140.7 (±20.9)	13.0	91.5 (±14.5)	8.7

Variables	n	SBP (mmHg)		DBP (mmHg)
		Crude analysis	Adjusted analysis *	Crude analysis	Adjusted analysis *
		Mean	β	Mean	β
Age (years)		p < 0.01	p = 0.021	p = 0.084	p = 0.345
20-39	106	120.5 (±14.4)	0.0	79.3 (±11.2)	0.0
40-59	44	131.2 (±20.9)	9.2	83.9 (±13.5)	3.4
≥ 60	11	129.9 (±18.3)	5.9	82.6 (±11.4)	2.1
Marital status		p = 0.426	p = 0.218	p = 0.581	p = 0.391
Single/Widowed	42	122.2 (±18.0)	0.0	79.9 (±13.4)	0.0
Married/Stable union	119	124.7 (±17.1)	4.0	86.1 (±11.5)	1.8
Schooling (years)		p < 0.01 **	p = 0.205 **	p = 0.010 **	p = 0.023 **
0-4	80	127.8 (±18.9)	0.0	82.7 (±12.2)	0.0
5-8	44	122.1 (±15.0)	-2.2	81.3 (±10.7)	-2.0
≥ 9	37	118.5 (±14.6)	-4.9	76.3 (±12.0)	-5.6
Flooring material in the home		p = 0.815	p = 0.948	p = 0.969	p = 0.074 **
Tile	48	122.6 (±15.7)	0.0	81.3 (±10.9)	0.0
Cement	13	122.7 (±17.6)	-2.5	81.6 (±13.1)	-1.0
Wood	96	124.8 (±18.3)	-2.3	80.4 (±12.6)	-5.3
Packed earth	4	129.4 (±13.5)	-1.23	80.4 (±6.7)	-7.6
Wall materials in the home		p = 0.411	p = 0.368	p = 0.618	p = 0.131
Brick	41	122.1 (±14.1)	0.0	80.0 (±10.6)	0.0
Wood	120	124.7 (±18.3)	4.3	81.1 (±12.4)	4.8
Per capita income (R$)		p = 0.316	p = 0.347	p = 0.058 **	p = 0.175
1^st tertile: 25.00-227.99	64	125.1 (±17.7)	0.0	83.1 (±12.5)	0.0
2^nd tertile: 228.00-424.99	52	121.0 (±19.1)	-2.9	79.2 (±12.6)	-3.8
3^rd tertile: 425.00-3,330.00	44	125.8 (±14.3)	2.3	78.9 (±9.7)	-3.3
BMI		p = 0.284 **	p = 0.479	p = 0.114 **	p = 0.235 **
Normal	42	122.2 (±18.3)	0.0	78.2 (±11.9)	0.0
Overweight	53	123.6 (±17.5)	-0.5	81.4 (±12.2)	2.6
Obese	64	125.8 (±16.8)	3.0	82.1 (±11.9)	3.0
WC (cm)		p = 0.041 **	p = 0.090 **	p = 0.023 **	p = 0.155 **
1^st tertile: 63.0-81.9	59	121.3 (±18.1)	0.0	78.1 (±12.7)	0.0
2^nd tertile: 82.0-90.9	51	123.2 (±17.2)	0.2	81.6 (±11.0)	2.3
3^rd tertile: 91.0-141.9	48	128.3 (±16.4)	4.7	83.3 (±12.0)	3.3

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[1] Correspondence D. Bresan Departamento de Nutrição, Centro de Ciências Biológicas e da Saúde, Universidade Federal de Mato Grosso do Sul. Cidade Universitária, Campo Grande, MS 79070-900, Brasil. deisebresan@yahoo.com.br