Key result
Two São Paulo districts report ~20% hypertension prevalence, tracking significantly below the citywide average.
Why the study?
Better surveillance of noncommunicable diseases at the country level could result in more effective policies, but detailed information on hypertension and diabetes prevalence in São Paulo districts was lacking.
Cross-Sectional (n=187,110)
Yes
Absolute Event Rate: 20.1% vs 24.7%
Routinely collected primary health care data can be used to map the prevalence of hypertension and diabetes, revealing significant sex differences and facility-level variations to guide resource allocation.
District-level hypertension prevalence lower than city estimates with facility variation; supports routine data mapping but leaves open validation before guiding allocation.
BACKGROUND: Noncommunicable diseases (NCDs) were responsible for 72.3% of global deaths in 2016, with cardiovascular diseases accounting for almost half of those deaths and low- and middle-income countries carrying the biggest burden. As a result, the prevention and control of NCDs is recognized as urgent, while better surveillance at the country level could result in more effective policies. Hence, the objective of this study was to obtain more detailed information on the distribution of the prevalence of hypertension and diabetes among the population of two large districts of the city of São Paulo in Brazil, and to compare these findings to the results of a citywide health survey. METHODS AND FINDINGS: This cross-sectional study used primary health care (PHC) routinely-collected data. The study population included 187,110 individuals 20 years of age or older registered in 13 public PHC facilities at two districts of the city of São Paulo in 2015. Data extracted from SIAB, a primary care database, was used to calculate age and sex directly standardized prevalences for diabetes and hypertension for each PHC facility. The prevalence of hypertension among women was significantly higher than the prevalence among men in the entire study population, and in every PHC facility. There was great variation among PHC facilities that was more pronounced among women. The prevalence of diabetes among women was significantly higher than the prevalence among men in the entire study population, and in every PHC facility, but there was little variation among PHC facilities. CONCLUSIONS: This study provided information that could help with policy planning and allocation of resources, and demonstrated the use of PHC routinely-collected data to generate important insights that if replicated could have a substantial impact given the broad coverage of the national public PHC program in Brazil.
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Miraglia et al. (2019) conducted a cross-sectional in Hypertension and Diabetes (n=187,110). Residence in Campo Limpo and Vila Andrade districts vs. City of São Paulo general population was evaluated on Age and sex directly standardized prevalence of hypertension (95% CI 19.9-20.3). The standardized prevalence of hypertension in two large districts of São Paulo was 20.1%, significantly lower than the citywide prevalence of 24.7%, with substantial variation among local health facilities.
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