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Hypertension – a public health problem

Author(s): Zélia Maria de Sousa Araújo Santos

Journal: Revista Brasileira em Promoção da Saúde
ISSN 1806-1222

Volume: 24;
Issue: 4;
Start page: 287;
Date: 2011;
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Hypertension is considered an important public health problem in Brazil,which is aggravated by its high prevalence and late detection. In addition, it is oneof the major risk factor for cardiovascular and cerebrovascular diseases.Hypertension, considered a “silent murder”, is the largest social problem indeveloped countries and in a large number of developing countries. Despite of knownefficacy and affectivity of various preventive and control measures, including thepharmacological ones, hypertension will continue, for decades, representing oneof the largest health challenges and high cost disease for individuals and society. Ifcontrol of existed cases, as well as control and prevention of risks factors for thisdisease are not implemented, this problematic will affect a large proportion of thepopulation in our country, which, in 2020, will have had increase significantly over60 years of age.Hypertension is a multifactor, multisystem syndrome. It can be cause bymultiple causes, being related to inadequate life style, constitutional factors, suchas: sex, age, race/color and family history; as well as environmental issues, suchas: sedentary lifestyle, stress, smoking, alcoholism, inadequate diet and obesity.Due to its silent course, a person can be surprised by its complications, beingnecessary learn to live with its chronic nature on an every day basis. Nevertheless,this type of problem is influenced by a series of determinants, including personalitycharacteristics, forms to face the disease, self-concept, self-image, experience withthe disease and health care professionals attitudes.One of the difficulties found in the treatment of persons with hypertensionis the lack of adhesion to the treatment, as 50% of the known patients withhypertension don’t treat themselves, and among those who do, few have controlledblood pressure. Between 30 and 50% of persons with hypertension stop treatmentwithin the first year of treatment, and 75% after five years(1).The problem related to treatment adhesion is complex. A series of factorsinfluence this process: biological characteristics (sex, age, race/color and familyhistory), social and cultural issues (civil status, years of schooling, income,profession, origin and religion); as well as the experience of the person with thedisease and its treatment; relationship with health care professionals; family support;and access to health care systems linked to updated public health policies(2).The lack of adhesion to treatment is an important challenge for theimplementation of policies for this population, possibly being responsible for theincrease in social costs with work absence, license for health treatment, and earlyretirement. On the other hand, the adhesion to treatment means the decrease oftreatment cost, and the possibility to integrate or reintegrate those in treatmentinto society. In addition, it reduces the morbimortality taxes by cardiovascular andcerebrovascular diseases related to hypertension.The population, mainly the most vulnerable to hypertension, needs to increaseits knowledge regarding hypertension risk factors in order to adhere to treatment andcontrol measures. The intermediation of this process should mainly be done troughhealth education, due its ability to capacitate and transform individuals, turningthem independent, based on informed knowledge regarding their health, in taking their own decisions regarding their body, and undertaking,or not, healthier behaviors.Education is the main action implemented by theprimary care, as it allows health promotion. Like this, it canbe admitted that the follow-up of a person with hypertension,together with family care, and implementation of educationalactions, will allow adhesion to therapeutic conducts in orderto control hypertension, as well as others conducts, whichwill promote health to individuals and families.The idea of health promotion relates itself tothe surrounding reality, as updated healthy policies,collaboration among various sectors, and sustainabledevelopment. If one brings the perspective relating healthto life conditions, multiple elements, such as physical,psychological and social will emerge as linked to ahealthy life. Nevertheless, an importance should be givento the development of community participation regardingpopulational abilities.Finally, the problems related to hypertension needsolutions through prevention and/or control of risk factorssince childhood, as well as adhesion to therapeuticalconducts aiming control, in the diagnosed cases, on allfields of human activity – home, work and other socialenvironments.REFERENCES1. Andrade JP, Vilas-Boas F, Chagas HA. Aspectosepidemiológicos da aderência ao tratamento dahipertensão arterial sistêmica. Arqui Bras Cardiol.2009; 79(2):375-89.2. Santos ZMSA, Frota MA, Cruz DM, Holanda SDO.Adesão do cliente hipertenso ao tratamento: análisecom abordagem interdisciplinar. Texto Contex Enferm.2005; 14(3):87-99.
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