Table 1
Characteristics of the study population.
| VARIABLES | ALL SUBJECTS(7724) | MEN (2553) | WOMEN (5153) | P-VALUE |
|---|---|---|---|---|
| Age, mean (min-max) | 59.2 (18 – 94) | 61.1 (18 – 94) | 58.3 (19 – 92) | <0.001 |
| <50 years, % (n) | 23.3 (1801) | 18.3 (469) | 25.7 (1321) | 0.217 |
| 50–59 years, % (n) | 23.0 (1769) | 21.0 (535) | 24.0 (1235) | 0.609 |
| 60–69 years, % (n) | 32.9 (2541) | 34.7 (886) | 32.0 (1650) | 0.250 |
| ≥70 years, % (n) | 20.8 (1613) | 26.0 (663) | 18.3 (947) | 0.945 |
| Smoke | ||||
| Current smokers, % (n) | 20.7 (1596) | 21.9 (558) | 20.1 (1038) | <0.001 |
| Former smokers, % (n) | 38.7 (2987) | 48.5 (1238) | 33.9 (1749) | <0.001 |
| Hypertension, % (n) | 96.2 (7430) | 95.1 (2428) | 97.1 (5002) | 0.085 |
| Dyslipidaemia, % (n) | 70.1 (5418) | 68.6 (1751) | 71.2 (3667) | <0.001 |
| Diabetes, % (n) | 78.8 (6083) | 78.9 (2014) | 79.0 (4069) | 0.644 |
| Central obesity, % (n) | 59.8 (4617) | 37.3 (952) | 71.1 (3665) | <0.001 |
| Overweight, % (n) | 34.9 (2692) | 40.7 (1038) | 32.1 (1654) | 0.001 |
| Obesity, % (n) | 41.7 (3218) | 33.0 (842) | 46.1 (2376) | <0.001 |
| Physical inactivity defined as no physical activity, irregular or daily physical activity <30 min on average per week, % (n) | 54.3 (4188) | 50.6 (1287) | 56.2 (2901) | <0.001 |
| Moderate physical activity ≥30 min onaverage three times a week, % (n) | 13.0 (1001) | 14.1 (358) | 12.4 (643) | 0.562 |
| Daily vegetables and fruits consumption, % (n) | 48.3 (3737) | 41.6 (1064) | 51.8 (2673) | <0.001 |
| Educational levels, % (n) | 0.192 | |||
| Illiterate | 14.2 (1068) | 13.4 (329) | 14.9 (739) | |
| Incomplete elementary school | 48.7 (3593) | 49.5 (1213) | 48 (2380) | |
| Complete elementary school | 12.8 (936) | 13.3 (329) | 12.3 (607) | |
| Incomplete high school | 4.8 (353) | 4.8 (117) | 4.8 (236) | |
| Finished high school | 15.9 (1188) | 15.8 (390) | 16 (798) | |
| Finished college education | 3.6 (277) | 3.2 (79) | 4 (198) | |
| Total household income (USD = R$3.79), quartiles range | <0.001 | |||
| ≤251.7* | 41.5 (3122) | 37.3 (896) | 45.8 (2212) | |
| 251.8 to 503.4 | 38.3 (2761) | 39 (946) | 37.5 (1809) | |
| 503.5 to 1,258.5 | 17.7 (1212) | 20.6 (447) | 14.7 (706) | |
| 1,258.6 to 2,517.0 | 2.1 (143) | 2.6 (62) | 1.7 (81) | |
| >2,517.0 | 0.4 (24) | 0.3 (12) | 0.3 (12) |
[i] Central obesity: waist circumference ≥88 cm for women and ≥ 102 cm for men; Overweight was defined as body mass index >25 to <30 kg/m2; Obesity was body mass index ≥ 30 kg/m2. Age presented as mean (min-max); categorical variables presented as percentages and frequencies; * Correspondent to Brazilian Federal Minimum Wage for 2018 fiscal year.
Table 2
Medications use for treatment of patients with hypertension, diabetes mellitus and dyslipidemia.
| ALL SUBJECTS | MEN | WOMEN | P-VALUE* | |
|---|---|---|---|---|
| Patients using BP-lowering medication, % (n) | ||||
| ACEi | 26.9 (1998) | 30.3 (735) | 25.2 (1263) | 0.607 |
| ARBs | 37.7 (2803) | 37.3 (906) | 37.9 (1897) | 0.481 |
| Diuretics | 44.3 (3290) | 39.6 (962) | 46.5 (2328) | 0.206 |
| Beta-blockers | 19.7 (1461) | 17.2 (417) | 20.9 (1044) | 0.173 |
| Calcium-channel blockers | 9.5 (706) | 9.4 (228) | 9.6 (478) | 0.666 |
| Other drugs | 2.1 (157) | 1.9 (46) | 2.3 (113) | 0.939 |
| Number of BP lowering drugs, % (n) | ||||
| 1 BP lowering drugs | 37.2 (2756) | 38.5 (936) | 36.0 (1820) | 0.086 |
| 2 BP lowering drugs | 32.5 (2418) | 30.7 (747) | 33.4 (1671) | 0.288 |
| 3 BP lowering drugs | 10.3 (769) | 9.1 (222) | 11.0 (547) | 0.136 |
| ≥4 BP lowering drugs | 1.7(128) | 1.9 (48) | 1.6 (80) | 0.132 |
| Patients using glucose-lowering medication, % (n) | ||||
| Metformin | 34.5 (2106) | 34.0 (684) | 34.9 (1422) | 0.274 |
| Insulin | 8.9 (544) | 8.7 (175) | 9.0 (369) | 0.459 |
| Other oral antidiabetic drugs | 17.7 (1076) | 18.4 (371) | 17.3 (705) | 0.355 |
| Patients using lipid-lowering medications, % (n) | ||||
| Statins | 31.1 (1686) | 29.9 (489) | 32.6 (1197) | 0.296 |
[i] ACEi: Angiotensin converting enzyme inhibitors; ARBs: Angiotensin receptor blockers; BP: Blood pressure. % related to sexes groups. * P-value is related to sexes groups comparations.
Figure 1
The prevalence of one or more outcomes for the study population.
Table 3
Control CVD risk factors according to patient characteristics.
| ALL SUBJECTS | SEX | AGE | |||||
|---|---|---|---|---|---|---|---|
| %, n | MEN(2553) | WOMEN(5153) | P-VALUE | <60 YEARS(3570) | ≥60 YEARS(4154) | P-VALUE | |
| %, n | %, n | %, n | %, n | ||||
| Systolic/diastolic blood pressure <130/80 mmHg | 34.9 (2596) | 31.9 (776) | 36.4 (1820) | <0.001 | 35.8 (1283) | 24.3 (1257) | 0.133 |
| Systolic/diastolic blood pressure <140/90 mmHg | 55.5 (4125) | 53.8 (1301) | 56.4 (2824) | <0.001 | 54.5 (1946) | 50.0 (2080) | 0.094 |
| Patients with hypertension using BP lowering and BP <130/80 mmHg | 33.5 (2493) | 30.3 (737) | 35.1 (1756) | 0.001 | 32.8 (1173) | 24.3 (1257) | 0.082 |
| LDL-c <100 mg/dL | 31.8 (844) | 35.6 (309) | 29.0 (535) | <0.001 | 30.6 (374) | 30.3 (456) | 0.719 |
| LDL-c <70 mg/dL | 10.1 (276) | 12.7 (110) | 8.9 (166) | 0.003 | 10.0 (122) | 9.9 (149) | 0.846 |
| Patients with dyslipidemia using lipids lowering drugs and LDL-c <100 mg/dL | 13.9 (132) | 15.3 (42) | 13.3 (90) | 0.019 | 11.5(44) | 15.5 (88) | 0.008 |
| Patients with dyslipidemia using lipids lowering drugs and LDL-c <70 mg/dL | 5.2 (50) | 8.4 (23) | 4.0 (27) | <0.001 | 4.1 (16) | 5.9 (34) | 0.282 |
| Fasting glucose < 115 mg/dL | 64.0 (2136) | 61.8 (670) | 65.4 (1466) | 0.044 | 67.6 (1028) | 61.2 (1071) | <0.001 |
Figure 2
The control of LDL-c is presented for two different targets (LDL-c < 100 mg/dL; < 70 mg/dL) for patients presenting three CVD risk factors (hypertension, dyslipidemia, and diabetes). For all patients, the blood glucose adopted was <115 mg/dL. A. Grey: Systolic Blood pressure <140 mm Hg and diastolic blood pressure <90 mmHg. B. Dark grey: Systolic Blood pressure <130 mm Hg and diastolic blood pressure <80 mmHg.
Table 4
Association of clinical and social-economics parameters with cardiovascular risk factors on target in univariate and multivariate analyses.
| ODDS RATIO (95% CI) | ||
|---|---|---|
| UNIVARIATE ANALYSIS | MULTIVARIATE ANALYSIS | |
| Blood Pressure < 130 /80 mmHg | ||
| Sex | 0.86 (0.78 – 0.96) | 0.64 (0.47–0.88) |
| Age ≥ 60 y | 0.76 (0.69 – 0.84) | |
| Hypertension | 0.31 (0.26–0.37) | 0.29 (0.20–0.41) |
| Diabetes | 0.93 (0.83–1.05) | |
| Hypercholesterolemia | 1.10 (0.98–1.24) | |
| Obesity | 0.70 (0.36–0.77) | 0.48 (0.36–0.66) |
| Smoke | 1.05 (0.83–1.33) | |
| Total household income | 1.07 (1.04–1.10) | |
| Educational levels | 1.02 (0.96–1.09) | 1.10 (1.00–1.21) |
| Blood Pressure < 140 /90 mmHg | ||
| Sex | 0.81 (0.73 –0.90) | 0.67 (0.49–0.91) |
| Age ≥ 60 y | 0.79 (0.71–0.87) | |
| Hypertension | 0.30 (0.24–0.37) | 0.17 (0.10–0.29) |
| Diabetes | 0.88 (0.79–0.99) | 0.67 (0.49–0.93) |
| Hypercholesterolemia | 1.20 (1.06–1.35) | |
| Obesity | 0.71 (0.64–079) | 0.62 (0.46–0.83) |
| Smoke | 0.84 (0.66–1.06) | |
| Total household income | 1.03 (0.97–1.09) | |
| Educational levels | 1.09 (1.09–1.12) | |
| Glucose < 115 mg/dL | ||
| Sex | 0.85 (0.73–0.99) | |
| Age ≥ 60 y | 0.70 (0.60–0.81) | |
| Hypertension | 1.14 (0.90–1.44) | 0.51 (0.29–0.91) |
| Diabetes | 0.04 (0.04–0.06) | 0.04 (0.02–0.07) |
| Hypercholesterolemia | 0.77 (0.65–0.92) | |
| Obesity | 0.84 (0.73–0.97) | |
| Smoke | 0.57 (0.42–0.77) | 0.61 (0.38–0.97) |
| Total household income | 1.04 (0.96–1.13) | |
| Educational levels | 1.04 (1.00–1.10) | |
| LDL-C < 100 mg/dL | ||
| Sex | 1.13 (1.14–1.61) | |
| Age ≥ 60 y | 1.04 (0.88–1.22) | |
| Hypertension | 1.16 (0.89–1.52) | |
| Diabetes | 1.67 (1.39–2.00) | 2.09 (1.38–3.16) |
| Hypercholesterolemia | 0.64 (0.53–0.57) | 0.48 (0.32–0.73) |
| Obesity | 1.16 (0.98–1.37) | |
| Smoke | 1.39 (0.90–1.94) | |
| Total household income | 0.97 (0.89–1.07) | |
| Educational levels | 1.00 (0.96–1.05) | |
[i] Abbreviations: 95% CI, Confidence interval; *Model with variable selection, considering all significant variables (P < 0.10) in the univariate analysis with at least 90 of information completed. Forward logistic regressions were used to find the significant predictors. Forward logistic regressions were used to find the significant predictors. Sex the male was reference. Obesity was body mass index ≥ 30 kg/m2. Familiar monthly income was used ≤ U$ 251.7 as reference. Educational level was used Illiterate as reference.