Factors associated with cardiovascular disease in the Brazilian adult population: National Health Survey, 2019

Gomes, Crizian Saar; Gonçalves, Renata Patrícia Fonseca; Silva, Alanna Gomes da; Sá, Ana Carolina Micheletti Gomide Nogueira de; Alves, Francielle Thalita Almeida; Ribeiro, Antonio Luiz Pinho; Malta, Deborah Carvalho

doi:10.1590/1980-549720210013.supl.2

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Revista Brasileira de Epidemiologia

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ORIGINAL ARTICLE • Rev. bras. Epidemiol. 24 (suppl 2) • 2021 • https://doi.org/10.1590/1980-549720210013.supl.2 copy

Factors associated with cardiovascular disease in the Brazilian adult population: National Health Survey, 2019

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to estimate the prevalence and investigate the sociodemographic, health, and lifestyle factors associated with the self-reported diagnosis of Cardiovascular Disease (CVD) in the adult Brazilian population.

Methods:

Data from the National Health Survey (PNS 2019) were analyzed. The presence of CVD was self-reported through the question: “Has any doctor ever given you a diagnosis of heart disease?”. Sociodemographic factors, health conditions, and lifestyle were evaluated. For data analysis, Poisson Regression with robust variance was used.

Results:

5.3% (95%CI 5.04–5.57) of Brazilian adults reported CVD, of which, 29.08% (95%CI 27.04–31.21) underwent coronary artery bypass surgery or angioplasty and 8.26% (95%CI 7.09–9.6) reported severe limitation in usual activities due to CVD. The factors associated with CVD were advanced age; being male; white race/color; complete middle school and incomplete high school education; have health insurance; self-assessing health as regular or bad/very bad; self-reported hypertension, high cholesterol, and diabetes; being a former smoker; consuming fruits and vegetables as recommended; not consuming alcohol in excess; and not practicing leisure-time physical activity.

Conclusions:

CVD is associated with sociodemographic, health, and lifestyle factors. It is important to support public policies, programs, and goals for the reduction of cardiovascular diseases in Brazil, especially in the most vulnerable groups.

Keywords:
Cardiovascular diseases; Risk factors; Health surveys; Brazil

Characteristics	Self-reported CVD
Characteristics	%	95%CI	PR	95%CI	p-value
Total	5.3	5.0–5.6
Gender
Male	4.9	4.6–5.3	1.00
Female	5.6	5.3–6.0	1.13	1.3–1.3	0.010
Age range years
18 to 24	1.4	0.9–2.2	1.00
25 to 39	1.9	1.6–2.3	1.40	0.9–2.2	0.160
40 to 59	4.8	4.4–5.2	3.40	2.2–5.3	<0.001
60 or more	13.1	12.4–13.9	9.40	6.1–14.6	<0.001
Education
Illiterate and incomplete elementary/middle school	7.8	7.4–8.3	1.00
Complete Middle school and incomplete high school	4.8	4.2–5.5	0.60	0.5–0.7	<0.001
Complete high school and incomplete higher degree	3.5	3.1–3.9	0.40	0.4–0.5	<0.001
Complete Higher degree	4.3	3.7–4.8	0.50	0.5–0.6	<0.001
Race/color
White	6.1	5.7–6.6	1.00
Black	4.8	4.2–5.5	0.80	0.7–0.9	<0.001
Brown	4.6	4.3–5.0	0.80	0.7–0.8	0.002
Others, yellow/indigenous	5.2	3.2–8.3	0.90	0.5–1.4	0.500
Income
Up to 1 minimum wage	4.9	4.6–5.1	1.00
1 to 3 minimum wages	5.6	5.2–6.0	1.10	1.0–1.3	0.020
3 to 5 minimum wages	6.1	5.1–7.3	1.20	1.0–1.5	0.040
5 or more minimum wages	5.8	4.9–6.8	1.30	1.0–1.4	0.080
Region
North	3.3	2.8–3.8	1.00
Northeast	4.1	3.8–4.4	1.20	1.0–1.5	0.015
Southeast	6.0	5.5–6.6	1.80	1.5–2.2	<0.001
South	6.8	6.2–7.4	2.10	1.7–2.5	<0.001
Midwest	4.8	4.2–5.4	1.40	1.2–1.8	<0.001
Health insurance
No	4.9	4.7–5.4	1.00
Yes	6.2	5.7–6.8	1.30	1.1–1.4	<0.001
Health status
Good/very good	2.8	2.6–3.0	1.00
Regular	8.8	8.2–9.4	3.20	2.9–3.5	<0.001
Bad/very bad	17.1	15.6–18.8	6.10	5.4–6.9	<0.001
Hypertension
No	2.7	2.5–2.9	1.00
Yes	13.6	12.8–14.4	5.00	4.6–5.5	<0.001
Diabetes
No	4.5	4.2–4.7	1.00
Yes	15.4	14.1–16.9	3.50	3.1–3.9	<0.001
High cholesterol
No	3.9	3.7–4.2	1.00
Yes	13.4	12.4–14.5	3.40	3.1–3.8	<0.001
Nutritional status
Eutrophic	4.6	4.2–5.0	1.00
Overweight	5.3	4.9–5.7	1.20	1.0–1.3	0.020
Obesity	7.0	6.4–7.8	1.50	1.4–1.8	<0.001
Smoking
Non-smoker	4.3	4.0–4.6	1.00
Former smoker	7.9	7.4–8.5	1.85	1.7–2.0	<0.001
Smoker	4.6	4.0–5.3	1.07	0.9–1.3	0.410
Recommended fruits and vegetables intake
No	5.0	4.7–5.3	1.00
Yes	7.2	6.5–8.1	1.40	1.3–1.6	<0.001
Ultra-processed foods intake
No	5.2	4.9–5.5	1.00
Yes	5.7	5.2–6.2	1.1	1.0–1.2	0.110
Excessive alcohol intake
No	5.9	5.6–6.2	1.00
Yes	2.5	2.1–3.0	0.4	0.4–0.5	<0.001
High salt intake
No	5.4	5.1–5.7	1.00
Yes	4.5	3.9–5.2	0.8	0.7–1.0	0.020
Physically active during leisure time
No	6.1	5.8–6.5	1.00
Yes	3.4	3.1–3.8	0.6	0.5–0.6	<0.001

Characteristics	PR	95%CI	p-value
Gender
Male	1.00
Female	0.80	0.7–0.9	<0.001
Age range years
18 to 24	1.00
25 to 39	1.20	0.7–1.9	0.500
40 to 59	1.70	1.1–2.6	0.020
60 years or more	2.80	1.8–4.4	<0.001
Race/color
White	1.00
Brown	0.80	0.7–0.9	<0.001
Black	0.80	0.7–0.9	0.010
Education
Illiterate and incomplete elementary/middle school	1.00
Complete middle school and incomplete high school	1.20	1.0–1.4	0.045
Complete high school and incomplete higher degree	1.00	0.9–1.2	0.758
Complete higher degree	1.10	0.9–1.3	0.512
Health insurance
No	1.00
Yes	1.40	1.2–1.6	<0.001
Health status
Good/very good	1.00
Regular	2.00	1.8–2.3	<0.001
Bad/very bad	3.10	2.7–3.6	<0.001
Hypertension
No	1.00
Yes	2.30	2.0–2.5	<0.001
High cholesterol
No	1.00
Yes	1.70	1.5–1.9	<0.001
Diabetes
No	1.00
Yes	1.20	1.1–1.3	0.010
Smoking
Non-smoker	1.00
Former smoker	1.20	1.1–1.3	<0.001
Smoker	1.00	0.9–1.2	0.770
Recommended fruits and vegetables intake
No	1.00
Yes	1.20	1.1–1.4	0.002
Alcohol intake
No	1.00
Yes	0.70	0.6–0.9	<0.001
Leisure physical activity
No	1.00
Yes	0.80	0.7–0.9	<0.001

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[1] Corresponding author: Crizian Saar Gomes. Avenida Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte (MG) Brasil. E-mail: criziansaar@gmail.com