Arterial hypertension incidence and outcomes in older adults of São Paulo, Brazil: SABE cohort study

Objectives The aim of this study was to estimate the cumulative incidence of arterial hypertension (AH) over a six-year period and to identify its risk factors and associated outcomes in older adults living in São Paulo, Brazil. Methods This longitudinal study utilized data from the SABE - Health, Well-being and Aging Survey of a representative probabilistic sample of older adults in the city of São Paulo. Data collection took place in 2010 and 2016. Poisson regression models were employed to assess risk factors for hypertension incidence in 2016 and to analyze the association between hypertension categories in 2010 and health outcomes throughout the 2010-2016 period. Results The prevalence of hypertension in 2010 was 80.4% and the incidence in 2016 was 36.1% among older adults who were normotensive in 2010. Significant positive associations were identified with age ≥75 years, prehypertension, coronary heart disease, hypercholesterolemia, and diabetes. The incidence of low glomerular filtration was the most observed health outcome in 2016 among hypertensive individuals. Uncontrolled and apparent resistant hypertension were associated with the incidence of depressive symptoms and low glomerular filtration rate over the six-year period, respectively. Conclusions The incidence of hypertension was high among older adults from a megalopolis of a developing country. Uncontrolled blood pressure was associated with adverse clinical and psychological health outcomes over time. The factors observed in this study should be the focus of preventive strategies implemented by healthcare services and public policies.