Incapacidade temporária para atividades habituais: relação com a pressão arterial e o uso de terapia farmacológica antihipertensiva no Estudo Pró-Saúde

Abstract

Arterial hypertension (AH) plays a determinant role in the occurrence of severe clinical events; however, there are controversies about its impact on daily life. The temporary disability for daily activities, which is defined as a temporary restriction in an individual s usual level of functioning, is a health indicator proposed by the World Health Organization for utilization in population studies. To investigate the association between arterial hypertension and temporary disability for daily activities, we proposed the following specific objectives: A) To investigate whether elevated blood pressure (BP) determine the frequency or accumulated period of temporary disability for daily activities; 2) To investigate whether the use of anti-hypertensive drugs are associated with changes in the frequency or accumulated period of temporary disability for daily activities. We have a cross-sectional study with data obtained from 2953 participants who answered a self administered questionnaire in the Pro-Saude Study, a cohort of university employees in Rio de Janeiro state. The exposure was evaluated using the measured value of BP and the report of the use of anti-hypertensive drugs. We conducted the analysis classifying the participants in 4 groups, combining the information about measured BP (< or ³ 140/90 mmHg) and the report of the use of anti-hypertensive drugs or not. The outcome was evaluated with a composite variable with information about the report and period of disability. Multivariate analyses were conducted using multinomial logistic regression. The results are 690 (23.4 %) were classified as hypertensives, and 704 (23.8 %) reported temporary disability. The use of antihypertensive drugs, among the participants with BP < 140/90 mmHg, was directly associated with the prevalence of temporary disability for daily activities for a longer period (OR=2.25, CI 95 %: 1.31 - 3.87). The presence of BP ³ 140/90 mmHg showed an inverse relationship with the chance of temporary disability for a short period among the participants that did not use ntihypertensive drugs, not reaching statistical significance (OR=0.64; CI 95 %: 0.40 - 1.03). We found a direct association between the use of anti-hypertensive drugs and temporary disability for daily activities for a long period, which may be related to adverse effects of the drugs; the results also suggest an inverse relationship between BP values and the prevalence of temporary disability for a short period, which did not reach statistical significance, and can be related to a phenomenon known as AH-asociated hypalgesia.