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Prevalence, awareness, treatment and control of hypertension in the Brazilian population and sociodemographic associated factors: data from National Health Survey

BMC Public Health volume 25, Article number: 781 (2025) Cite this article

Abstract

Background

Hypertension is the main risk factor for cardiovascular diseases and more recent studies that estimated the prevalence of this condition considering aspects such as awareness of diagnosis, treatment, and control, revealing alarming results in the global scenario.

Objective

To estimate the prevalence and assess the factors associated with hypertension prevalence, awareness, treatment, and control.

Methods

This is a cross-sectional study based on data from the 2013 National Health Survey in Brazil. A total of 59,226 individuals of both sexes took part in this study. Exposure were defined based on blood pressure measurements, self-reported diagnosis of hypertension and use of antihypertensive medication. We estimated the prevalence of the dependent variables and the associations were subsequently tested by calculating prevalence ratios using Poisson regression.

Results

The study population was composed mostly of women (52.3%), aged 36 to 59 years (42.6%), of white race/color (47.5%), with low schooling between 0 and 8 years (49.1%), having a partner (55.7%), in the urban area of the country (86.2%), mainly in the Southeast region (43.9%) and without health insurance (69.7%). The prevalence of hypertension in the Brazilian population was 32.3%. 60.8% were aware of the diagnosis, 90.6% were taking medication treatment and, of these, 54.4% had controlled blood pressure. Female gender and older age were associated with greater awareness (PR 1,34; 95% CI 1,28 – 1,40 / PR 2,40; 95% CI 2,15 – 2,69; respectively), treatment (PR 1,10; 95% CI 1,07 – 1,12 / PR 1,25; 95% CI 1,17 – 1,35; respectively) and control (PR 1,10; 95% CI 1,02 – 1,17 / PR 0,83; 95% CI 0,73 – 0,96; respectively). Other factors such as having a partner, health insurance, living in the urban area, race/color and schooling were also associated with dependent variables.

Conclusion

This study reveals that although a high percentage of hypertensive patients are taking medication, there are still substantial gaps in awareness and control, particularly among certain sociodemographic groups. Men, those with less schooling, black and brown people, those living in rural areas and those without health insurance have lower levels of awareness and control of hypertension.

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Background

Arterial Hypertension (hypertension) is the main risk factor for cardiovascular diseases, contributing to the increase of early deaths and disabilities in the world and Brazilian population [1, 2]. In Brazil, from 1990 to 2017 there was a 53.4% increase in the number of deaths attributed to hypertension, highlighting it as the main risk factor for overall mortality [3]. Estimates of hypertension prevalence in the Brazilian population range from 18.9 to 32.3% according to age, diagnostic criteria and geographic region [3,4,5].

Despite consolidated evidence on treatment and control through changes in diet, lifestyle and low-cost medications, a large contingent of hypertensive patients persist without diagnosis and control of blood pressure levels [6]. Thus, one of the goals present in the United Nations Sustainable Development Goals to be achieved by 2030 concerns universal health coverage and access [7], such as the management of risk factors and Chronic Noncommunicable Diseases (NCDs), which has been used as an important performance measure for this achievement [8, 9]. Of a total of 1.39 billion people with hypertension worldwide, 75% live in low- and middle-income countries and only one in three have their blood pressure treated with antihypertensives and one in seven have their pressure adequately controlled [10,11,12,13,14].

A review conducted in Brazil with data published between 1995 and 2009 showed that the prevalence of awareness of hypertension ranged from 22 to 77%, treatment from 11.4% to 77.5% and control from 10.1% to 35.5% [15]. A study conducted with the Brazilian elderly population showed a prevalence of control of 34.7%, and the lowest prevalence of adequate management were in groups of low socioeconomic status, in black and brown skin color and among those without health insurance [16]. However, these results were estimated in studies restricted to specific populations, and their generalizability is limited [15,16,17].

Given the importance of hypertension as a public health concern, dimensioning awareness, treatment and control of this condition according to sociodemographic characteristics in the Brazilian context marked by social and racial inequalities becomes a challenge [18]. Using data from the Brazilian National Health Survey, the aim of this study was to estimate the prevalence of awareness, treatment and control of hypertension in the Brazilian adult population. Additionally, we examined the sociodemographic factors associated with these dependent variables.

Methods

Study population

It was a cross-sectional study using data from National Health Survey (PNS) which is a representative household survey for Brazil of the adult population (18 years and older). The first edition of this survey was conducted in August 2013 to February 2014, by the Health Surveillance Department of the Ministry of Health in partnership with Oswaldo Cruz Foundation and the Brazilian Institute of Geography and Statistics (IBGE) [19,20,21].

The sampling plan used in the PNS was three-stage cluster sampling [21]. In the first stage, census tracts were randomly selected from the Primary Sampling Units defined in the IBGE master sample. In the second stage, a fixed number of private households were selected and, in the third, in each selected household, a resident aged 18 or over was chosen to answer the individual interview [21].

For the final survey sample, there was a loss rate of 20.8% and a non-response rate of 8.1% [19,20,21]. The survey visited a total of 69.994 households, resulting in 64.348 household interviews and 60.202 individual interviews with the selected residents [19,20,21]. Further details on the PNS sampling methodology are available in previous publications [19,20,21]. For this study, we excluded pregnant women (n = 800) and those uncertain of their pregnancy status at the time of the interview (n = 176). This yielded a final study sample of 59.226 individuals (Fig. 1).

Fig. 1
figure 1

Study population

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Data collection

The interview was conducted using a household questionnaire and individual questions related to socioeconomic and health status [19, 21]. In addition, weight, height, waist circumference and blood pressure measurements were performed in the randomly selected resident aged 18 years or older [20]. Three blood pressure (BP) measurements were taken using a validated oscillometric device on the right arm after a 5-min rest in a sitting position, with one-minute intervals between each measurement. The mean of the last two readings for SBP and DBP was calculated and used for analysis, following the procedures outlined in the Anthropometry Manual of the National Health Survey [22].

Study variables

Hypertension was defined as a systolic blood pressure (SBP) ≥ 140 mmHg or a diastolic blood pressure (DBP) ≥ 90 mmHg based on measured readings, or self-reported use of antihypertensive medication, assessed by the question: 'In the last two weeks, have you taken medication for hypertension (high blood pressure)? "Participants classified as hypertensive who responded positively to the question "Has a doctor ever given you a diagnosis of hypertension (high blood pressure)?" were considered to be aware of the diagnosis.

Hypertensive participants who were aware of their diagnosis and who reported using antihypertensive medication by asking the question: "In the last two weeks, have you taken medication because of hypertension (high blood pressure)?" were considered as treated. Hypertensive participants on treatment were considered to have hypertension control if their casual SBP was < 140 mmHg and casual DBP < 90 mmHg. Figure 2 shows how the prevalence of awareness, treatment and control of hypertension were calculated.

Fig. 2
figure 2

Hypertension management sequence in 2013, Brazil

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Independent variables

Sociodemographic characteristics were used, all self-reported, as follows: sex (male and female), age group (18 to 35, 36 to 59 and 60 years or older), race/color (white, brown, black and yellow/indigenous), schooling (below 8 years, 9 to 11 and 12 years or more), marital status, classified as having a partner (married) and without a partner (single, divorced, separated, widowed), area of residence (urban and rural) and region (southeast, central-west, north, northeast and south), and health insurance (yes or no).

Statistics analysis

We estimated the prevalence of hypertension awareness, treatment and control according to the sociodemographic characteristics of the individuals. For all estimates, 95% confidence intervals (95%CI) were calculated.

We used Poisson regression models to analyze the factors associated with awareness, treatment and control, obtaining estimates of prevalence ratios (PR). To facilitate the interpretation of the regression models results, we also estimated the predicted probabilities and 95%CI for each dependent variable according to the sociodemographic variables. We used Stata 14.0 software (Stata Corp., College Station, TX, USA) in the survey module to obtain population estimates. In the survey module it is possible to consider the complex structure of the sample of strata, clusters and individual weights of the PNS, in addition to the use of analytical subpopulations [23].

Ethical aspects

This study used a secondary database with public access, guaranteeing participants confidentiality and requiring prior approval by the Research Ethics Committee. PNS data were collected by IBGE and are available online (https://www.ibge.gov.br/estatisticas/sociais/saude/9160-pesquisa-nacional-de-saude.html?=&t=microdados). Even so, it is noteworthy that the PNS was approved by the National Research Ethics Committee with the respective opinion: CAAE n° 10853812.7.0000.0008 and complies with all ethical precepts, in accordance with the recommendations for research with human beings of Resolution 466/12 (No. 328159, June 26th, 2013), and all participants signed a free and informed consent at interview.

Results

The study population comprised women (52.3%; 95% CI 51,5 – 53,0), aged 36 to 59 years (42.6%, 95% CI 41,9 – 43,3), of white race/color (47.5%; 95% CI 46,7 – 48,3), with low schooling (below 8 years) (49.1%; 95% CI 48,4 – 50,0), having a partner (55.7%; 95% CI 54,9 – 56,5), residing in urban areas of the country (86.2%; 95% CI 85,8 – 86,7), concentrated in the Southeast region (43.9%; 95% CI 43,3 – 44,6), and without health insurance (69.7%; 95% CI 68,8 – 70,7) (Table 1). Table 1 also shows an estimated prevalence of hypertension of 32.3% (95% CI 31.7–33.1) in the Brazilian population and it’s sociodemographics associations.

Table 1 Sociodemographic characteristics of the study population (n = 59,226) and prevalence of hypertension according to sociodemographic characteristics. PNS, Brazil, 2013
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We estimated that 60.8% (95%CI 59.5—62.1) of individuals were aware of their hypertension. It was observed that males (50.5%; 95%CI 48.5—52.5), aged 18 to 35 years (28.3%; 95%CI 25.2—31.5), having a partner (56.6%; 95%CI 54.8—58.5), in the rural area of the country (54.9%; 95%CI 52.1—57.8), and without health insurance (58.9%; 95%CI 57.3—60.4) had lower prevalence of awareness (Table 2). The variables sex, age, education, marital status, area of residence and health insurance were associated with the hypertension awareness in the final adjusted model. There was a high association between the variables health insurance and schooling. For this reason, these variables were not included simultaneously in the final model.

Table 2 Prevalence of awareness, treatment and control of hypertension in the Brazilian adult population according to sociodemographic variables. PNS, Brazil, 2013
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The prevalence of individuals on medications treatment was 90.6% (95%CI 89.5–91.6) (Table 2). Males (85.9%; 95%CI 83.8–87.7) and individuals aged 18–35 years (74.4%; 95%CI 68.5–79.5) had a lower prevalence of hypertension treatment (Table 2). Sex, age group, having a partner and race/color were associated with hypertension treatment in the final adjusted model (Table 2).

Table 2 also shows the prevalence of hypertension treated patients who are under control 54.4% (95%CI 52.6–56.2). When prevalence rates were estimated by sociodemographic characteristics, individuals with low schooling (51.7%; 95%CI 49.5–53.8) and without health insurance (52.0%; 95%CI 49.9–54.2) had lower prevalence of hypertension control. Women showed significantly higher awareness of hypertension compared to men, with an adjusted PR of 1.34 (95% CI: 1.28—1.40). Awareness also increased with age: individuals aged 36–59 had an adjusted PR of 1.96 (95% CI: 1.75—2.20) compared to the 18–35 age group, those 60 and older had an adjusted PR of 2.40 (95% CI: 2.15—2.69).The prevalence of receiving treatment was also higher for women (PR = 1.10, 95% CI: 1.07—1.12) and increased with age, with those aged 60 and over showing an adjusted PR of 1.25 (95% CI: 1.17—1.35) compared to the youngest age group. Control prevalences were higher in individuals with higher education, with those who completed 12 or more years of schooling having an adjusted PR of 1.17 (95% CI: 1.06—1.28) compared to those with below 8 years of schooling. Control prevalences also varied by race/color, with black participants showing lower control (PR = 0.81, 95% CI: 0.70—0.93) compared to white participants. The predicted probabilities of awareness, treatment and control according to selected variables are shown in Fig. 3.

Fig. 3
figure 3

Predicted probabilities of awareness, treatment and control of hypertension. Brazil, 2013. Legend to Fig. 2: (2A) Awareness of hypertension diagnosis according to sex, age group, marital status, area of residence and health insurance plan, (2B) Hypertension treatment according to sex, age group, race/color and marital status and (2C) Hypertension control according to sex, age group, education, race/color and region

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Discussion

This study provides a comprehensive overview of hypertension prevalence, awareness, treatment, and control and factors associated among the Brazilian adult population, using data from National Health Survey. Among adults with hypertension, the prevalence of awareness was 60.8%. We found that awareness was significantly higher among those aged over 60, females, urban residents, and participants with health insurance in the fully adjusted models. The current use of medication to lower blood pressure showed a similar trend among females, those aged over 36, and participants without partners. Hypertensive participants identifying as brown had a significantly lower prevalence of medication use compared to white adults. Among adults with hypertension, females, those with more than nine years of schooling, and residents of the South region were more likely to have controlled hypertension. Conversely, hypertensive adults aged over 60 and participants identifying as black or brown were less likely to have controlled hypertension.

All of prevalence ratios were estimated accurately, considering the complex survey by using Poisson regression fully adjusted. In general, the health service delivery system in Brazil demonstrates limited effectiveness in managing hypertension, with significant gaps in diagnosis, awareness, and treatment adherence.

A systematic review of with data from low- and middle-income countries (regions East Asia and Pacific, Europe and Central Asia, Latin America and the Caribbean, Middle East and North Africa, South Asia, and sub-Saharan Africa) the rate of hypertension control was 30% [10], figures lower than those presented in this study. The prevalence of control in Brazil was similar to that estimated in high-income countries, higth 50.4% [10] and 39% [13]. However, some of these a Canada, German and South Korea countries have already shown better hypertension control rates (70%) [13]. Thus, in more developed countries a Canada, the USA, South Korea, and Germany, national hypertension screening programmes use health check-ups, the implementation of regular blood pressure measurements, recording and feedback [13]. These actions probably explain the better prevalence of successful control in these countries.

The high prevalence of hypertension treament shown in this study can be explained by policy and programmatic factors. Access to treatment depends on availability, price and distance to dispensing services [24, 25]. In one of the richest states in Brazil, a study showed that there are sufficient resources and dispensing of medications, so there are no barriers to the provision of treatment and access of health service users [26]. This near universalization of access to hypertension treatment in the SUS reflects government policies prior to 2015, such as improving access to antihypertensive medication, known as the Popular Pharmacy Program of Brazil and Saúde não Tem Preço, which guarantee free antihypertensive drugs in accredited pharmacies and in Primary Health Care facilities [27,28,29,30].

Even in the context of broad access to medication, hypertension control was less than expected. Other strategies for better control should be taken into account, including adherence to treatment [10, 13, 17, 25, 31]. For instance, the linkage and accountability of both the professional and the user [26] are necessary elements to ensure the longitudinality of care. Educational actions could be a linkage strategy, but they are not highly valued and have low frequency [26]. Therefore, the establishment of non-pharmacological measures is crucial for the control of hypertension as coadjuvants interventions to medications treatment. Reducing sodium intake, regular physical activity, smoking cessation and weight control should be considered [32,33,34].

Another finding of the study was the differences between population subgroups according to sociodemographic variables. These results indicate that it is feasible to improve performance in the prevalence of awareness and control and treatment of hypertension at least from a population perspective. In this study, women showed greater awareness, treatment and control of hypertension, probably due to women's greater access to health services, reported in several studies [17, 35, 36]. In addition to the behavior of greater care for their health and, consequently, greater demand for care [25, 37], primary care assistance programs focus on the maternal and child component [9], including preventive consultations and examinations, and prenatal care. Thus, a more extensive demand for the use of health services creates opportunities for the diagnosis of chronic conditions, such as hypertension, as well as for their treatment and control.

Another aspect, the higher prevalence of treatment and control in participants who declared themselves white may reflect structural inequalities in Brazilian society [17, 38], being responsible for unequal distribution of social resources, knowledge, employment opportunities and socioeconomic status [33]. Corroborating this hypothesis, a Brazilian study showed a higher prevalence of poor access to health services [39, 40]. Similarly, in the context of social inequalities, the highest prevalence of hypertension control was observed in participants with high education, reflecting the influence of greater access to information, understanding of the health problem and adherence to treatment [13, 41]. A cohort study conducted with a population of different socioeconomic levels, professors and administrative technicians of Brazilian public universities, showed higher proportions of awareness (80.2%) and control of hypertension (69.4%) [17].

In this study, contrary to studies in the literature, participants without partners had higher prevalence of awareness of hypertension, probably explained by survival bias. A separate comment deserves the increase in age associated with a higher proportion of awareness and treatment of hypertension already consolidated in other studies [11, 13, 17, 42,43,44]. The presence of other comorbidities, mostly NCDs and their risk factors, which increases with age are strong contributors [45, 46]. However, in the elderly there is evidence of falls [13, 14, 42] associated with senescence [47,48,49], use of multiple medications [50], pharmacological interactions, adverse events and low adherence to treatment [51]. Moreover, there is a lack of consensus regarding the therapeutic goal to be achieved by the elderly, as there is for the adult population [49].

Among the limitations of this study there is the use of casual blood pressure measurement to assess the management of hypertension, which could cause classification bias, but used in similar studies [13, 17]. The absence of data on antihypertensive medication, time of use and adherence is another limitation. Another limitation of this study is the absence of data on access to healthcare services. Although our primary focus was on sociodemographic aspects, we recognize that access to healthcare plays a crucial role in the adequate control and treatment of hypertension. Furthermore, being a cross-sectional survey, it does not allow for causal inferences regarding the associations observed between sociodemographic factors and hypertension treatment outcomes. Another limitation of this study is the absence of more specific data on access to healthcare services. Although our primary focus was on sociodemographic aspects, we recognize that access to healthcare is important to the adequate control and treatment of hypertension. On the other hand, aspects of validity of the study include the use of measured BP in the population, which makes the analysis possible. It is recommended to include these measures in future editions of the PNS, since in the 2019 edition blood pressure measurement was not performed, preventing the reproducibility of this study and the monitoring of these variables of interest regarding this condition, beyond the disease prevalence itself.

Conclusion

This study reveals that although a high percentage of hypertensive patients are taking medication, there are still substantial gaps in awareness and control, particularly among certain sociodemographic groups. Men, those with less schooling, black and brown people, those living in rural areas and those without health insurance have lower levels of awareness and control of hypertension. These findings highlight the presence of socioeconomic and demographic inequalities in hypertension control, emphasizing the need for targeted health policies and interventions. Prioritizing these vulnerable groups can improve the overall management of hypertension and reduce one of the main cardiovascular risk factors, addressing disparities in health outcomes across Brazil.

Effective detection, treatment and control of arterial hypertension (hypertension are fundamental at a national level to reduce the risk of cardiovascular disease in the Brazilian population.

Data availability

The data that support the findings of this study are openly available in Brazilian Institute of Geography and Statistics (IBGE) at https://www.ibge.gov.br/estatisticas/sociais/saude/9160-pesquisa-nacional-de-saude.html?=&t=microdados.

Abbreviations

SUS:

Unified Health System

NCD:

Chronic Non-Communicable Disease

PNS:

National Health Survey

IBGE:

Brazilian Institute of Geography and Statistics

95%CI:

95% Confidence Interval

PR:

Prevalence Ratio

References

  1. GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioral, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1345–422. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/S0140-6736(17)32366-8.

  2. GBD 2016 Brazil Collaborators. Burden of disease in Brazil, 1990–2016: a systematic subnational analysis for the Global Burden of Disease Study 2016. Lancet. 2018;392(10149):760–75. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/S0140-6736(18)31221-2.

    Article  Google Scholar 

  3. Nascimento BR, Brant LCC, Yadgir S, Oliveira GMM, Roth G, Glenn SD, et al. Trends in prevalence, mortality, and morbidity associated with high systolic blood pressure in Brazil from 1990 to 2017: Estimates from the "global Burden of Disease 2017" (GBD 2017) study. Popul Health Metr. 2020;18(Suppl 1). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12963-020-00218-z.

  4. Malta DC, dos Santos NB, Perillo RD, Szwarcwald CL. Prevalence of high blood pressure measured in the Brazilian population, National Health Survey, 2013. Sao Paulo Med J. 2016;134(2):163–70.

    Article  PubMed  Google Scholar 

  5. Malta DC, Bernal RTI, Vieira Neto E, Curci KA, Pasinato MT de M, Lisbôa RM, et al. Trends in risk and protective factors for chronic noncommunicable diseases in the population with health insurance in Brazil from 2008 to 2015. Rev Bras Epidemiol. 2018;21(suppl 1):e180020. https://doiorg.publicaciones.saludcastillayleon.es/10.1590/1516-3180.2015.02090911.

    Article  PubMed  Google Scholar 

  6. O’Brien E. The Lancet Commission on hypertension: Addressing the global burden of raised blood pressure on current and future generations. J Clin Hypertens. 2017;19(6):564–8. https://doiorg.publicaciones.saludcastillayleon.es/10.1111/jch.12998.

    Article  Google Scholar 

  7. United Nations. Transforming our world: the 2030 agenda for sustainable development. New York: United Nations; 2015.

    Google Scholar 

  8. Chow CK, Gupta R. Blood pressure control: a challenge to global health systems. Lancet. 2019;394(10199):613–5. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/S0140-6736(19)31293-0.

    Article  PubMed  Google Scholar 

  9. Geldsetzer P, Manne-Goehler J, Marcus ME, Ebert C, Zhumadilov Z, Wesseh CS, et al. The state of hypertension care in 44 low-income and middle-income countries: a cross-sectional study of nationally representative individual-level data from 1–1 million adults. Lancet. 2019;394(10199):652–62. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/S0140-6736(19)30955-9.

    Article  PubMed  Google Scholar 

  10. Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies From 90 Countries. Circulation. 2016;134(6):441–50. https://doiorg.publicaciones.saludcastillayleon.es/10.1161/CIRCULATIONAHA.115.018912.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Lu J, Lu Y, Wang X, Li X, Linderman GC, Wu C, et al. Prevalence, awareness, treatment, and control of hypertension in China: data from 1–7 million adults in a population-based screening study (China PEACE Million Persons Project). Lancet. 2017;390(10112):2549–58. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/S0140-6736(17)32478-9.

    Article  PubMed  Google Scholar 

  12. Lu Y, Wang P, Zhou T, Lu J, Spatz ES, Nasir K, et al. Comparison of Prevalence, Awareness, Treatment, and Control of Cardiovascular Risk Factors in China and the United States. J Am Heart Assoc. 2018;7(3): e007462. https://doiorg.publicaciones.saludcastillayleon.es/10.1161/JAHA.117.007462.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. NCD Risk Factor Collaboration. Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: an analysis of 123 nationally representative surveys. Lancet. 2019;394(10199):639–51. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/S0140-6736(19)31145-6.

    Article  Google Scholar 

  14. Muli S, Meisinger C, Heier M, Thorand B, Peters A, Amann U. Prevalence, awareness, treatment, and control of hypertension in older people: Results from the population-based KORA-age 1 study. BMC Public Health. 2020;20(1):1049. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12889-020-09165-8.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Scala LC, Magalhães LB, Machado A. Epidemiology of systemic arterial hypertension. In: Moreira SM, Paola AV, organizers. Textbook of the Brazilian Society of Cardiology. 2° ed São Paulo: Manole; 2015. p. 780–5.

  16. Santimaria MR, Borim FSA, Leme DE da C, Neri AL, Fattori A. Failure in the diagnosis and drug treatment of hypertension in older Brazilians - FIBRA Study. Cien Saude Colet. 2019;24(10):3733–42. https://doiorg.publicaciones.saludcastillayleon.es/10.1590/1413-812320182410.32442017.

    Article  PubMed  Google Scholar 

  17. Chor D, Pinho Ribeiro AL, Sá Carvalho M, Duncan BB, Andrade Lotufo P, Araújo Nobre A, 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. https://doiorg.publicaciones.saludcastillayleon.es/10.1371/journal.pone.0127382.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Paim J, Travassos C, Almeida C, Bahia L, MacInko J. The Brazilian health system: history, advances, and challenges. Lancet. 2011;377(9779):1778–97. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/S0140-6736(11)60054-8.

    Article  PubMed  Google Scholar 

  19. Szwarcwald CL, Malta DC, Pereira CA, Vieira MLFP, Conde WL, de Souza Júnior PRB, et al. National Health Survey in Brazil: conception and application methodology. Cien Saude Colet. 2014;19(2):333–42. https://doiorg.publicaciones.saludcastillayleon.es/10.1590/1413-81232014192.14072012.

    Article  PubMed  Google Scholar 

  20. Damacena GN, Szwarcwald CL, Malta DC, Souza-Júnior PRB de, Vieira MLFP, Pereira CA, et al. The development process of the National Health Survey in Brazil, 2013. Epidemiol Serv Saúde. 24(2):197–206. https://doiorg.publicaciones.saludcastillayleon.es/10.5123/S1679-49742015000200002.

  21. Souza-Júnior PRB, de Freitas MPS, Antonaci GA, Szwarcwald CL. Sample design of the National Health Survey 2013. Epidemiol e Serviços Saúde. 2015;24(2):207–16. https://doiorg.publicaciones.saludcastillayleon.es/10.5123/S1679-49742015000200003.

    Article  Google Scholar 

  22. Brazilian Institute of Geography and Statistics. National Health Survey 2013: Anthropometry Manual. Rio de Janeiro: IBGE; 2013.

    Google Scholar 

  23. West BT, Berglund P, Heeringa SG. A closer examination of subpopulation analysis of complex-sample survey data. Stata J. 2008;8(4):520–31.

    Article  Google Scholar 

  24. Attaei MW, Khatib R, McKee M, Lear S, Dagenais G, Igumbor EU, et al. Availability and affordability of blood pressure-lowering medicines and the effect on blood pressure control in high-income, middle-income, and low-income countries: an analysis of the PURE study data. Lancet Public Heal. 2017;2(9):e411–9. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/S2468-2667(17)30141-X.

    Article  Google Scholar 

  25. Rauniyar SK, Rahman MM, Rahman MS, Abe SK, Nomura S, Shibuya K. Inequalities and risk factors analysis in prevalence and management of hypertension in India and Nepal: A national and subnational study. BMC Public Health. 2020;20(1):1–11. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12889-020-09450-6.

    Article  Google Scholar 

  26. Venancio SI, Rosa TE da C, Bersusa AAS. Comprehensive care for hypertension and diabetes mellitus: implementation of the Line of Care in a Health Region of the state of São Paulo. Brazil Physis. 2016;26(1):113–35. https://doiorg.publicaciones.saludcastillayleon.es/10.1590/S0103-73312016000100008.

    Article  Google Scholar 

  27. Malta DC, Stopa SR, Andrade SSC de A, Szwarcwald CL, Júnior JBS, dos Reis AAC. Health care in adults with self-reported hypertension in Brazil according to data from the National Health Survey, 2013. Rev Bras Epidemiol. 2015;18(Suppl 2):109–22. https://doiorg.publicaciones.saludcastillayleon.es/10.1590/1980-5497201500060010.

    Article  PubMed  Google Scholar 

  28. Brazil, National Health Council. Resolution n. 338, of 2004, of May 6, 2004. Approves the National Policy of Pharmaceutical Assistance and establishes its general principles and strategic axes. Brasília: Diário Oficial da União, 2004.

  29. Brazil, Ministry of Health. Decree no 5.090, of May 20, 2004. Regulates Law no 10.858, of April 13, 2004, and institutes the "Farmácia Popular do Brasil" program, and makes other provisions. Brasília: Official Gazette of the Union, 2004.

  30. Brazil. Ministry of Health. Popular Pharmacy Program of Brazil. Health has no price, 2013.

  31. Hussain MA, Al Mamun A, Reid C, Huxley RR. Prevalence, Awareness, Treatment and Control of Hypertension in Indonesian Adults Aged ≥40 Years: Findings from the Indonesia Family Life Survey (IFLS). PLoS ONE. 2016;11(8): e0160922. https://doiorg.publicaciones.saludcastillayleon.es/10.1371/journal.pone.0160922.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Whelton PK, He J, Appel LJ, Cutler JA, Havas S, Kotchen TA, et al. Primary Prevention of Hypertension: Clinical and Public Health Advisory From the National High Blood Pressure Education Program. JAMA. 2002;288(15):1882–8. https://doiorg.publicaciones.saludcastillayleon.es/10.1001/jama.288.15.1882.

    Article  PubMed  Google Scholar 

  33. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for themanagement of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J. 2018;39(33):3021–104. https://doiorg.publicaciones.saludcastillayleon.es/10.1097/HJH.0000000000001940.

    Article  CAS  PubMed  Google Scholar 

  34. Ribeiro ALP, Duncan BB, Brant LCC, Lotufo PA, Mill JG, Barreto SM. Cardiovascular Health in Brazil: Trends and Perspectives. Circulation. 2016;133(4):422–33. https://doiorg.publicaciones.saludcastillayleon.es/10.1161/CIRCULATIONAHA.114.008727.

    Article  PubMed  Google Scholar 

  35. Malta DC, Bernal RTI, Lima MG, de Araújo SSC, da Silva MMA, Freitas MI de F, et al. Noncommunicable diseases and the use of health services: analysis of the National Health Survey in Brazil. Rev Saude Publica. 2017;51(Suppl 1):4s. https://doiorg.publicaciones.saludcastillayleon.es/10.1590/S1518-8787.2017051000090.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Guibu IA, de Moraes JC, Junior AAG, Costa EA, Acurcio F de A, Costa KS, et al. Main characteristics of patients of primary health care services in Brazil. Rev Saude Publica. 2017;51(Suppl 2):17s. https://doiorg.publicaciones.saludcastillayleon.es/10.11606/S1518-8787.2017051007070.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Levorato CD, de Mello LM, da Silva AS, Nunes AA. Factors associated with the demand for health services from a gender relational perspective. Cien Saude Colet. 2014;19(4):1263–74. https://doiorg.publicaciones.saludcastillayleon.es/10.1590/1413-81232014194.01242013.

    Article  PubMed  Google Scholar 

  38. Mendes PM, Nobre AA, Griep RH, Guimarães JMN, Juvanhol LL, Barreto SM, et al. Association between perceived racial discrimination and hypertension: findings from the ELSA-Brasil study. Cad Saude Publica. 2018;34(2): e00050317. https://doiorg.publicaciones.saludcastillayleon.es/10.1590/0102-311X00050317.

    Article  PubMed  Google Scholar 

  39. Faro A, Pereira ME. Race, racism and health: the social inequality of stress distribution. Estud Psicol. 2011;16(3):271–8. https://doiorg.publicaciones.saludcastillayleon.es/10.1590/S1413-294X2011000300009.

    Article  Google Scholar 

  40. Dantas MNP, de Souza DLB, de Souza AMG, Aiquoc KM, de Souza TA, Barbosa IR. Factors associated with poor access to health services in Brazil. Rev Bras Epidemiol. 2020;24: e210004. https://doiorg.publicaciones.saludcastillayleon.es/10.1590/1980-549720210004.

    Article  PubMed  Google Scholar 

  41. Lima DB da S, Moreira TMM, Borges JWP, Rodrigues MTP. Association between treatment compliance and different types of cardiovascular complications in arterial hypertension patients. Texto Context - Enferm. 2016;25(3):e0560015. https://doiorg.publicaciones.saludcastillayleon.es/10.1590/0104-07072016000560015.

    Article  Google Scholar 

  42. Mirzaei M, Mirzaei M, Bagheri B, Dehghani A. Awareness, treatment, and control of hypertension and related factors in adult Iranian population. BMC Public Health. 2020;20(1):1–10. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12889-020-08831-1.

    Article  Google Scholar 

  43. Li D, Lv J, Liu F, Liu P, Yang X, Feng Y, et al. Hypertension burden and control in mainland China: Analysis of nationwide data 2003–2012. Int J Cardiol. 2015;184:637–44. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.ijcard.2015.03.045.

    Article  PubMed  Google Scholar 

  44. Yang L, Yan J, Tang X, Xu X, Yu W, Wu H. Prevalence, Awareness, Treatment, Control and Risk Factors Associated with Hypertension among Adults in Southern China, 2013. PLoS ONE. 2016;11(1): e0146181. https://doiorg.publicaciones.saludcastillayleon.es/10.1371/journal.pone.0146181.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Yarnall AJ, Sayer AA, Clegg A, Rockwood K, Parker S, Hindle JV. New horizons in multimorbidity in older adults. Ageing. 2017;46(6):882–8. https://doiorg.publicaciones.saludcastillayleon.es/10.1093/ageing/afx150.

    Article  Google Scholar 

  46. Abbafati C, Abbas KM, Abbasi-Kangevari M, Abd-Allah F, Abdelalim A, Abdollahi M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204–22. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/S0140-6736(20)30925-9.

    Article  Google Scholar 

  47. Franklin SS, Gustin W IV, Wong ND, Larson MG, Weber MA, Kannel WB, et al. Hemodynamic Patterns of Age-Related Changes in Blood Pressure. Circulation. 1997;96(1):308–15. https://doiorg.publicaciones.saludcastillayleon.es/10.1161/01.cir.96.1.308.

    Article  CAS  PubMed  Google Scholar 

  48. Pearson JD, Morrell CH, Brant LJ, Landis PK, Fleg JL. Age-associated changes in blood pressure in a longitudinal study of healthy men and women. J Gerontol Ser A. 1997;52(3):M177-83. https://doiorg.publicaciones.saludcastillayleon.es/10.1093/gerona/52a.3.m177.

    Article  CAS  Google Scholar 

  49. Barroso WKS, Rodrigues CIS, Bortolotto LA, Mota-Gomes MA, Brandão AA, Feitosa AD de M, et al. Brazilian Guidelines for Hypertension - 2020. Arq Bras Cardiol. 2021;116(3):516–658.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Flores LM, Mengue SS. Use of medicines by the elderly in a region of southern Brazil. Rev Saude Publica. 2005;39(6):924–9. https://doiorg.publicaciones.saludcastillayleon.es/10.1590/S0034-89102005000600009.

    Article  PubMed  Google Scholar 

  51. Fulton MM, Allen ER. Polypharmacy in the elderly: A literature review. J Am Acad Nurse Pract. 2005;17(4):123–32. https://doiorg.publicaciones.saludcastillayleon.es/10.1111/j.1041-2972.2005.0020.x.

    Article  PubMed  Google Scholar 

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Acknowledgements

Not applicable.

Funding

We thank the National Council for Scientific and Technological Development (CNPq), for the Research Productivity grant received by GVM and DCM and the Minas Gerais State Research Support Foundation (FAPEMIG), for the Scientific Initiation grant received by MJSS and for the funding for research Edital Universal 2021 FAPEMIG/APQ-02591–21.

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Authors and Affiliations

  1. Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, 30190 000, Brazil

    Maria Alice Souza Vieira, Luís Antônio Batista Tonaco, Maria José Silva Souza, Deborah Carvalho Malta, Mariana Santos Felisbino-Mendes & Gustavo Velasquez-Melendez

  2. School of Social Work, University of Illinois at Urbana-Champaign, Champaign, USA

    Flávia Cristina Drumond Andrade

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  1. Maria Alice Souza Vieira
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Contributions

Study design and planning—MASV; MSFM; GVM. Analysis and interpretation of data—MASV; MSFM; GVM. Drafting or revising the manuscript: MASV; MSFM; GVM; LABT; MJSS; FCDA; DCM. All authors have reviewed and approved the final version of the manuscript and agree to be responsible for the content of the article.

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Correspondence to Mariana Santos Felisbino-Mendes.

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The PNS was approved by the National Research Ethics Committee with its opinion: CAAE n° 10853812.7.0000.0008 and complies with all ethical precepts, in accordance with the recommendations for research with human beings of Resolution 466/12.

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Vieira, M.A.S., Tonaco, L.A.B., Souza, M.J.S. et al. Prevalence, awareness, treatment and control of hypertension in the Brazilian population and sociodemographic associated factors: data from National Health Survey. BMC Public Health 25, 781 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12889-025-22008-8

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