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Utilização de cuidados médicos associados com a tensão arterial em doentes hipertensos : uma análise longitudinal comparando nativos e imigrantes africanos

Publication . Pinheiro, Bernardete; Fernandes, Milene; Alarcão, Violeta; Nicola, Paulo; Antunes, Marília; Rocha, Evangelista

Introduction: Ethnic and cultural diversity in Portugal has reinforced the importance of adjusting healthcare services to the health needs of different populations. This study aims to analyse longitudinally the factors associated with health care use by native Portuguese and African hypersive patients. Methods: Longitudinal study including treated hypertensive patients followed-up in primary care in the Lisbon region, between September 2010 and March 2012. For this analysis, 233 native Caucasians and 170 African immigrants were included.We applied three face-to-face questionnaires (0, 6 and 12 months) and two by telephone (3 and 9 months). The measure of service use was the number of encounters due to hypertension, in the three months preceding the interview. For the identification of the factors, a longitudinal generalised linear mixed model was estimated for each group. Results: More nativesthan immigrants consulted the GP in the last year (76.0% vs 64.7%, p=0.019), however, more immigrants used urgent health care (12.4% vs 5.2%, p=0.016).The proportion of patients with at least one medical encounter was not different between groups (46.5% vs 41.6%, p=0.387).After adjusting for all variables, the use of medical care among natives was associated with age (eβ =1.036; p=0.021), diabetes(eβ =1.898; p=0.006), hypertension control (eβ =1.036; p=0.007), uncontrolled self-assessed hypertension status (eβ =0.596; p=0.033), and follow-up time. (eβ =0.771; p=0.001). Among immigrants, the use of health services was associated with marital status (eβ =2.228; p=0.025), uncontrolled self-assessed hypertension status (eβ =0.580; p=0.013), time since diagnosis of hypertension (eβ =1.021; p=0.016) and follow-up time (eβ =0.689; p<0.001). Conclusions: There is a need to better understand the differences in the factors associated with the use of hypertension-related health care among natives and immigrants, in order to develop health promotion strategies adapted to target populations.

2018Journal article

Open access

Controlo da hipertensão arterial nos cuidados de saúde primários : uma comparação entre nativos portugueses e imigrantes dos países africanos de língua oficial portuguesa

Publication . Lopes, Elisa; Alarcão, Violeta; Simões, Rui; Fernandes, Milene; Gómez, Verónica; Souto, Diana; Nogueira, Paulo; Nicola, Paulo J.; Rocha, Evangelista

Introduction: In Portugal, the frequency of patient with treated and controlled hypertension is low. It is unknown the relation of socioeconomic determinants with hypertension control, particularly in African immigrants. Aims: To compare frequency of control in treated hypertension and to identify characteristics associated with uncontrolled and treated hypertension between Portuguese natives (Caucasian) and Portuguese Speaking African Coutries immigrants (black). Material and Methods: Cross-sectional study of patients with treated hypertension, 40-80 years old, randomized from Primary Health Care of Lisbon Region. We collected sociodemographic, clinical and health care data through structured interviews. We compared the frequency of patients with uncontrolled hypertension, and identified related factors through univariate and multivariate analysis. Results: In this study participated 786 patients with treated hypertension (participation rate: 71%): 449 natives and 337 immigrants. Of these, 46% had controlled hypertension. Diastolic blood pressure was higher in younger immigrants. Were associated with no control, in natives, male sex, low education, going to emergency and / or nursing services and not looking for the family doctor; on immigrants, being single, using the pharmacist, the number of years of illness and intentional non-adherence. Discussion: Treated hypertension control has been increasing for last years. Natives and immigrants differ, regarding blood pressure control, relatively to the frequency of family doctor consultation, and resorting to other services and health professionals. These differences didn´t reflect in statistically different control rates. Conclusions: It is needed to define strategies to control hypertension in primary health care specific for ethnic groups.

2016Journal article

Open access