Fatores associados à simultaneidade de excesso de peso, hipertensão e diabetes no Brasil : Vigitel 2023

Abstract

The increase in excess weight (overweight and obesity), diabetes mellitus and arterial hypertension in recent decades has been a cause for concern regarding the overload on health systems and the high impact on mortality rates. The simultaneous occurrence of these conditions produces a synergistic effect that is greater than an additive one, increasing the likelihood of cardiovascular events and other complications. The present study aimed to estimate the simultaneous prevalence of overweight, hypertension and diabetes, according to the frequency of occurrence (isolated or combined) of these conditions in the adult population, and the sociodemographic, economic and lifestyle factors associated with them. This is a descriptive and analytical cross-sectional study, with individuals of both sexes, aged 20 or over, participating in the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel) in 2023. Using the Stata statistical program - version 13, the prevalence of the simultaneous occurrence of overweight, hypertension and diabetes, and of the conditions separately, were estimated, with their respective 95% confidence intervals. Then, associations with the variables of interest were verified using the Pearson Chi-square test (Rao-Scott), with the level of statistical significance established at 5%. In a second stage, a multiple multinomial logistic regression model was constructed to identify associated factors. The simultaneous prevalence of overweight, hypertension and diabetes was 4.88%. The variables that remained associated with the outcome were: age group, education, marital status, smoking, physical activity, abusive consumption of alcoholic beverages, region of Brazil, regular consumption of beans, consumption of NCD-protective foods and ethnicity. The sex variable was maintained as an adjustment. The simultaneity of the three conditions was 44.23 times more prevalent among individuals aged 60 or over compared to those aged 20 to 39, 146% higher among individuals with a lower level of education compared to those who studied for a longer time, 61% higher among individuals with a partner compared to those without, 64% lower among smokers compared to those who never smoked, 76% higher among individuals who did not do physical activity compared to those who practiced 5 or more days a week, 71% higher among who did not consume NCDprotective foods compared to those who did and 50% higher in the Southeast Region compared to the North Region. The prevalence of two conditions was 45% higher in black/brown individuals compared to those of white ethnicity, 31% higher in ex-smokers compared to those who never smoked, 42% higher in those who abused alcoholic beverages compared to those who did not, and 23% lower in those who consumed beans regularly, compared to those who did not. The present study estimated a simultaneity of approximately 5% of excess weight, hypertension and diabetes in the Brazilian adult population, associated with sociodemographic, economic and lifestyle factors. It is necessary to broaden the perspective on chronic conditions in Brazil, also focusing on multimorbidity and not just addressing conditions in isolation.