Essential Systemic Arterial Hypertension in Northeastern Brazil: An ecological analysis of hospitalizations using Poisson regression (2020–2024)
DOI:
https://doi.org/10.33448/rsd-v14i11.49800Keywords:
Systemic Arterial Hypertension, Hospitalizations, Poisson Regression, Time Series, Primary Care, Northeastern Brazil.Abstract
Systemic arterial hypertension (SAH) is a highly prevalent chronic condition with a substantial impact on cardiovascular and renal morbidity and mortality. In settings of population aging and social inequalities, failures in diagnosis, treatment, and control increase preventable decompensations and hospitalizations, placing pressure on health systems. This study aimed to analyze the profile and temporal trend of hospitalizations for essential arterial hypertension (ICD-10 I10) in Northeastern Brazil from 2020 to 2024, in order to support prevention strategies and chronic care organization within the Brazilian Unified Health System (SUS). Hospitalizations were described by state, sex, age group (≥20 years), and race/color (including “no information”), and annual variation was estimated using Poisson regression (IRR and 95% CI), identifying increasing, decreasing, or stable trends. A retrospective ecological time-series study was conducted using SIH/SUS data. Records were aggregated by federative unit and demographic strata, and overdispersion was assessed with sensitivity analyses when necessary. Northeastern Brazil recorded 70,816 hospitalizations in the five-year period, mostly in Maranhão and Bahia. Among adults, females predominated, with higher representation among those aged 60–79 years and relevant contribution from individuals ≥80. Mixed-race (pardo) individuals constituted most records, and missing race/color data persisted. State-specific trends formed a heterogeneous mosaic shaped by demographic and organizational characteristics. The hospital burden of hypertension remains high and unequal in the region. Strengthening primary care, ensuring continuous access to antihypertensives, improving transitional care, and qualifying race/color recording are recommended to reduce preventable hospitalizations.
References
Almeida, A. T. C. (2019). Impacts of a Brazilian pharmaceutical program on the indicators of hospitalizations and deaths for hypertension and diabetes. Revista de Saúde Pública, 53, 1–11.
Barroso, W. K. S., et al. (2021). Diretrizes brasileiras de hipertensão arterial – 2020. Arquivos Brasileiros de Cardiologia, 116(3), 516–658.
Brasil. Ministério da Saúde. (2020). Vigitel Brasil 2019: Vigilância de fatores de risco e proteção para DCNT por inquérito telefônico. Brasília: Ministério da Saúde.
Brasil. Ministério da Saúde. (2022). Vigitel Brasil 2021: Vigilância de fatores de risco e proteção para DCNT por inquérito telefônico. Brasília: Ministério da Saúde.
CONITEC. (2025). Protocolo Clínico e Diretrizes Terapêuticas – Hipertensão Arterial Sistêmica. Brasília: Ministério da Saúde.
GBD 2019 Risk Factors Collaborators. (2020). Global burden of 87 risk factors in 204 countries and territories, 1990–2019. The Lancet, 396(10258), 1223–1249.
Malta, D. C., et al. (2022). Hipertensão arterial e fatores associados na Pesquisa Nacional de Saúde 2019. Revista de Saúde Pública, 56, 1–11.
Moretin, P. A. & Toloi, C. M. C. (2006). Análise de séries temporais. Editora Blücher.
Nascimento, L. F. C., & Francisco, J. B. (2013). Particulate matter and hospitalization due to arterial hypertension in a medium-sized Brazilian city. Cadernos de Saúde Pública, 29(8), 1565–1571.
NCD Risk Factor Collaboration (NCD-RisC). (2021). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019. The Lancet, 398(10304), 957–980.
Oliveira, E. F. P., et al. (2022). Internamentos por hipertensão arterial e cobertura da Estratégia Saúde da Família no Brasil (2010–2019). Referência, 7(1), e21048.
Pan American Health Organization & WHO HEARTS Collaborators. (2022). Drivers and scorecards to improve hypertension control in primary care. The Lancet Regional Health – Americas, 5, 100123.
Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. [free ebook]. Santa Maria. Editora da UFSM.
Requia, W. J., et al. (2023). Association of high ambient temperature with daily hospitalization for cardiorespiratory diseases in Brazil. Environmental Pollution, 316, 120615.
Requia, W. J., et al. (2024). Thermal stress and hospital admissions for cardiorespiratory disease in Brazil. Environment International, 187, 107915.
Shitsuka, R. et al. (2014). Matemática fundamental para a tecnologia. (2.ed). Editora Érica.
Silva, R. A., et al. (2022). Strategic Action Plan to Combat NCDs (2011–2022): Effects on admissions and mortality in Brazil. PLOS ONE, 17(5), e0267892.
World Health Organization. (2023). Hypertension: Fact sheet. Geneva: WHO. Retrieved from https://www.who.int/news-room/fact-sheets/detail/hypertension
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Copyright (c) 2025 Érika Cristina Alcântara Lima, Mikaelly Almeida de Lima da Silva, Júlia Vittoria Ferreira Gomes, Wyctor Herysson Vitoriano Cruz, Ellen Lais Albuquerque de Deus, Isabelly Tavares Pereira Torquato, Maria Nogueira Ayres, Mariana Cardoso de Siqueira Campos, Maria Clara Pereira de Morais
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