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Evaluation of the awareness, control and cost-effectiveness of hypertension treatment in a Brazilian city: populational study

Moreira, Gisela C; Cipullo, José P; Martin, José F Vilela; Ciorlia, Luiz AS; Godoy, Maria RP; Cesarino, Claudia B; Cordeiro, José A; Lupino, Plínio L; Ciorlia, Gustavo; Burdmann, Emmanuel A

doi: 10.1097/HJH.0b013e32832dd10f
Original papers: Therapeutic aspects

Objectives Hypertension is a highly prevalent disease worldwide, constituting one of the main risk factors for cardiovascular morbidity and mortality. The aims of this study were to evaluate the level of awareness and control of hypertension comparing sex, socioeconomic and educational level, BMI and drug therapy in over 40-year-old patients. The cost-effectiveness of the main pharmacologic classes of antihypertensives, as monotherapy and combination therapy, was also assessed.

Methods In this randomized and cross-sectional populational study, a sample of 738 hypertensive adults with ages at least 40 years were evaluated. Of these, 345 (46.7%) were men and 393 (53.3%) were women.

Results A total of 72.9% of the hypertensives knew about their disease. Women in the 40–49 and 50–59 age groups and obese individuals had a higher rate of awareness of their hypertensive status. The rates of awareness were similar in different social classes and educational levels, however, blood pressure control varied. β-Blockers were the most effective drugs to control blood pressure with no differences being observed between monotherapy and combinations. Diuretics were the most cost-effective.

Conclusion Approximately half of the participants received monotherapy. The best percentage of control with monotherapy was obtained with β-blockers but the diuretics treatment was the most cost-effective. The levels of awareness and control were high compared with developed countries, most evident in the higher social classes and higher education levels.

Internal Medicine Department, State Medical School of São José Rio Preto, São Paulo, Brazil

Received 15 January, 2009

Revised 17 April, 2009

Accepted 5 May, 2009

Correspondence to Gisela Cipullo Moreira, Rua Afonso Guimarães Junior, 555, 15070-620 São José do Rio Preto, São Paulo, Brazil Tel/fax: +55 17 32272409; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.