RESEARCH ARTICLES

Socio-demographic characterization and life habits: identifying risk factors for arterial hypertension

Ana Paula Ribeiro de Almeida^I; Francisca Alexandra Araújo da Silva^II; Jênifa Cavalcante dos Santos Santiago^III; Thereza Maria Magalhães Moreira^IV; Andressa Suelly Saturnino de Oliveira^V; Ana Larissa Gomes Machado^VI

^INurse, Nursing Degree from the Federal University of Piauí. Picos, Piauí, Brazil. E-mail: anapalmeida2@hotmail.com 
^IINurse, Assistant Professor I of Bachelor Course of Nursing of the University Centre Estácio of Ceará. Master in Clinical Health Care. PhD. in Collective Health – State University of Ceará. Fortaleza, Ceará, Brazil. Email: falexandraaraujos@yahoo.com.br 
^IIINurse, Master in Nursing. PhD student of the Postgraduate Program in Nursing and Clinical Health Care of the State University of Ceará. Fortaleza, Ceará, Brazil. Email: jenifasantos@yahoo.com.br 
^IVNurse, PhD in Collective Health. Deputy of the State University of Ceará. Fortaleza, Ceará, Brazil. Email: tmmmoreira@gmail.com 
^VNurse, Master in Clinical Health Care by the State University of Ceará. Professor in the Graduation Course in Nursing at the Federal University of Piauí. Picos, Piauí, Brazil. Email: andressasuelly@hotmail.com 
^VINurse, PhD student of the Postgraduate Program in Nursing at the Federal University of Ceará. Professor at the Federal University of Piauí. Picos, Piauí, Brazil. Email: analarissa2001@yahoo.com.br 

ABSTRACT

Arterial hypertension is a disease of multi-system nature that is reaching most of the world's population, in which find adults increasingly more young. The objective was to describe the sociodemographic characteristics and academic life habits of a public University in the northeast of Brazil. Descriptive, transversal and quantitative study, conducted in 240 academic of various courses from March to April 2011. It was observed a predominance of women, aged between 18 and 29 years old, brown color, with high consumption of fried foods and salt, sedentary, with preserved sleep pattern. It was concluded that several factors contribute to change blood pressure levels of these young people, therefore, nursing should utilize sociodemographic data and life habits to intervene effectively on the young adult population, focusing their actions about the risk factors for hypertension and associated complications.

Keywords: Nursing; hypertension; risk factors; college students.

INTRODUCTION

The systemic arterial hypertension (SAH) is a multi-system nature disease that is reaching most of the world's population, in which find adults increasingly more young. It is defined as a multifactorial clinical condition characterized by high and sustained levels of blood pressure (BP). It is often associated with functional and/or structural changes of the target-organs (heart, brain, kidneys and blood vessels) and the metabolic changes, with consequent increased risk of fatal and non-fatal cardiovascular events. Thus, hypertension is an important public health problem^1-3.

Hypertension affects, approximately, 25% of the world's population, with prediction increase of 60% of the cases of the disease in 2025. In Brazil there are about 17 million hypertensive, 35% of the population of 40 years and more. These percentages are growing and its appearance is increasingly precocious and it is estimated that approximately 4% of children and adolescents are also carriers^4,5. Population inquiries in Brazilian cities over the past 20 years, showed a prevalence of hypertension above 30%. Considering PA values ≥ 140/90 mm Hg, 22 studies have found prevalence between 22.3% and 43.9% (average of 32.5%), with more than 50% of the subjects aged between 60 and 69 years and 75% above 70 years¹.

In most cases, it is unknown the cause of hypertension. However, scientists already ensure that there are several factors that may be associated with elevation of BP. Among the causes of hypertension, quote: genetic predisposition, ethnicity, age, gender, overweight/obesity, sedentarism, high sodium intake, alcohol, use of contraceptives, smoke, emotional stress, aging and diet rich in fats. The lifestyle and the socioeconomic class of individuals also have relation with hypertension, as well as the reduction or absence of skeletal muscle tone, as with people with disabilities⁶.

Changes in lifestyle and eating habits are of fundamental importance in order to avoid the risk factors determinants of hypertension. Therefore, early diagnosis of this pathology is of great interest to prevent its complications, such as: diseases of the cerebrovascular, coronary, peripheral arterial, chronic renal and heart failure.

Health strategies are, often, decisive for the early detection of risk factors for hypertension. In addition, the adoption of preventive measures contributes to the planning of conduct aimed at the control of this injury to health.

Therefore, the objective was to describe the sociodemographic characteristics and academic life habits of a public University in the northeast of Brazil, since it is a predominantly young adult population, with the aim of identifying risk factors for hypertension.

This study is relevant to the nursing care by understanding that sociodemographic characterization and description of life habits enable early detection of risk factors for hypertension, providing thus positive actions on reduction of complications arising from this pathology, in addition to providing grants for health education, with the purpose of stimulating healthy behaviors in relation to self-care that contribute to reducing the incidence of this disease, which has become a major public health problem, especially among young people.

LITERATURE REVIEW

Arterial hypertension is a disease of slow clinical evolution, with multiplicity of factors and, when not properly treated, bring serious complications, temporary or permanent. Causes high financial cost to society, mainly by its occurrence associated with diseases such as cerebrovascular disease, coronary artery disease, chronic heart failure and renal, extremity vascular disease. In addition, by presenting in chronic and silent form, hypertension can be late diagnosed⁷.

When analyzing the cases of juvenile primary hypertension, some indicators seem to present more risk, like obesity, related to inadequate intake of food and heredity. Other authors consider, also, as determining factors for the elevation of blood pressure, in addition to those already cited, high initial values of blood pressure, age, gender, salt intake, alcoholism, smoking, sedentary lifestyle and genetic-environmental interaction⁸.

Obesity is a major risk factor for high blood pressure and reducing body mass index (BMI) causes BP levels present significant falls⁹. Another factor that affects BP levels is the age, in young individuals, hypertension is more often just the increase in diastolic pressure, while from the sixth decade the main component is the elevation of systolic pressure⁵.

Excessive use of sodium chloride in food and drinks contributes to the occurrence of hypertension, while the low consumption can reduce the blood pressure of hypertensive or even prevent the appearance of the disease¹⁰. The blood pressure can also suffer alteration through the frequent and high consumption of alcohol, since it is known that alcohol intake for prolonged periods of time can increase blood pressure and cardiovascular mortality in general¹.

The habit of smoking can cause major health disorders due to the action of nicotine on blood pressure elevation and increased deposition of cholesterol in the blood vessels¹¹. Other factors that are associated with increased blood pressure levels are high-calorie food intake, the day to day stress and sedentary lifestyle. Frequent physical activity, reduce blood pressure, and helps to reduce considerably the risk of coronary artery disease and strokes and general mortality, facilitating the control of the weight⁵.

METHODOLOGY

It is a descriptive, transversal and quantitative study, conducted during the period from August 2010 to June 2011 at a public University in the northeast of Brazil. The population consisted of 2709 academics of both sexes, aged 18 years or over, who were regularly registered in the institution, being 402 of Nursing, 364 of Nutrition, 378 of Administration, 232 of Information Systems, 211 of Mathematics, 387 of Biology, 312 of History, 209 of Letters and 214 of Pedagogy.

Calculation was performed for finite sample, totaling in 240 people, distributed proportionately among the courses, being 36 students in the course of Nursing, 32 of Nutrition, 34 of Administration, 20 of Information System, 19 of Mathematics, 34 of Biology, 28 of History, 18 of Letters and 19 of Pedagogy.

The selection of subjects was made by stratified random sampling. Data collection occurred in the months of March and April 2011, using a form on which questions were semi-structured, addressing items related to life habits of academics, moreover, was held measure blood pressure and anthropometric records.

The collected data were tabulated and arranged using the Statistical Package for Social Sciences  software (SPSS) version 17.0, and for statistical treatment of the data was performed the calculation of absolute frequency, percentage, average and standard deviation, which were presented in tables and charts. This study was submitted to the Ethics Committee of the University field of study, been approved with N° CAAE: 0413.0.045.000-10.

RESULTS

In this study, women predominated - 160 (66.7%). The age range of the participants ranged from 18 to 43 years, with predominance of the group of 18 to 29 years - 236 (98.3%). The median age reached 21.2 years, with standard deviation of ±3.2 years. Regarding religion, 194(80.3%) reported to be Catholics. We highlight that half of the students reported being dark in color, as noted in Table 1.

Of the people interviewed, 117(48.8%) reported owning a family income of 1 to 2 minimum wages and 14(5.8%) reported income of less than a salary. Regarding the marital status, almost all were single 223(92.9%).

As for the occupation that they exercised currently, 156(65%) were students and 40(16.7%), in addition to students, worked too in their own University; 44(18.3%) were students and had another profession. Among the most cited jobs were professor, administrative assistant, secretary, seller, among others.

Another variable examined was the test for total cholesterol. Of the students surveyed, 97(40.4%) had already performed this examination and 143(59.6%) never. Relative to the value of the last exam, 74(76.3%) reported present desirable value (<200mg/dl), 11(11.3%) borderline (200-239mg/dl), 1(1%) high value (>239mg/dl) and 11(11.3%) don't remember the test results, as shown in Table 2.

As for the eating pattern, were examined some factors that may increase the blood pressure values. In the study, 24(10%) students made use of salt on the table, 22(9.2%) reported add salt to foods at the time of ingestion and 126(52.5%) consume industrialized sources of salt, as noted in Table 2.

Among those interviewed, 192(80%) reported consumption of fried foods, 127(52.9%) reported consumption of coffee. As for the practice of physical activity, 158(65.8%) denied this practice and among them the most cited reason was the lack of time 98(62%). As for 82(34.2%) who practiced activities, 35(42.7%) did walk.

About the consumption of alcohol, 130(54.2%) reported not ingest, on the other hand, 109(45.4%) reported their consumption and one person had abandoned the habit of drinking. As for smoking, 5(2.1%) were smokers and 1(0.4%) was an ex-smoker.

As regards to sleep, the study showed that 67(27.9%) had their sleep interrupted, according to the Table 2. Regarding the duration of sleep, 102(42.5%) reported sleeping less than 8 hours per night. It was noted also that 5(2.1%) participants used some medication to sleep. The medications used for this purpose, the most cited were the anti-anxiety drugs and benzodiazepines.

DISCUSSION

The female predominance corroborated other studies with young adults^12-14. The survey showed that half of the students surveyed reported being dark in color. The predominant age group was between 18 to 29 years, the larger share of household income was 1 to 2 minimum wages and almost all were unmarried students.

It was observed a predominance of dark race, diverging from another study with University students, which found predominance of the white race (75.8%)12 . This research showed similarity with another in which the predominant age group of academics interviewed was between 18 to 29 years (61.3%)¹⁰.

The primary dyslipidemias are caused by genetic factors, some of which only manifest themselves due to environmental influence, such as inadequate food intake and sedentarism. In contrast, the secondary dyslipidemias occur in function of diseases, medicines or improper living habits. Some clinical studies have shown that lowering LDL decreases significantly the risks for cardiovascular diseases. Studies indicate that for every 1% reduction in LDL levels, the relative risk of coronary events also have their rates reduced by approximately 1%^15,16.

Studies have shown a direct relation of the salt consumption with increased blood pressure. A survey of academics found that 25.8% had the habit of eating foods prepared with excess salt¹². Another study with students detected that 60.6% of them indicated a preference for salty foods or prepared with too much salt¹⁰. Therefore, such studies corroborate the results of this investigation, which found more than half of respondents stating food consumption with elevator salt content. In other research, it was evidenced that normotensive individuals with high sensitivity to salt intake  showed five times higher incidence of HAS, in 15 years, than those with low sensitivity¹.

The use of caffeine may influence on changes of blood pressure, especially if in association with other factors. In this study, more than half reported consumption of coffee, agreeing with the data found in another study¹⁷.

The practice of physical activities, in addition to provide a mental and physical wellbeing, has significant importance in the genesis of hypertension by preventing its occurrence or favoring their control. It is known that the physical activity recommendation is based on parameters of frequency, duration, intensity and realization mode⁴. In this study it was found minority practicing any physical activity.

As for the consumption of alcoholic beverages, in this study, approximately half of the students mentioned do not ingest any kind of alcoholic beverage. The literature shows that there is relationship between the consumption of drink and the elevation of blood pressure. The reduction in the consumption of alcohol can reduce BP in normotensive and hypertensive men who ingest large amounts of alcohol⁴.

In the present study was also carried out an investigation into the habit of smoking and found that only 5(2.1%) of the sample students were smokers and 1(0.4%) was an ex-smoker. It is known that the nicotine present in tobacco is evil to the organism because it increases the release of catecholamines that are responsible for the increase in heart rate, blood pressure and levels of peripheral resistance. Moreover, it also increases the ability of organic form clots and decreases its function to destroy them¹⁷.

In the present study, another factor analyzed was stress, which has become a big problem of the modern world, as it is often associated with increased blood pressure values. It was noted that nearly half of respondents reported ease in developing stress. As for sleep, most academics reported that had no interruption of the same. It is known that the human body requires alternating periods of sleep and vigil to keep their physiological balance, so when extending the period of vigil, damage may occur to the proper mental functioning¹⁸.

CONCLUSION

This study described the sociodemographic characteristics and living habits of north easterners academics, turning to the risk factors for hypertension, a disease that has been taking high proportions and in increasingly young age groups, and relates directly with cardiovascular complications.

The findings showed the predominance of female students, aged between 18 and 29 years, and dark color with preserved sleep pattern. It were identified factors that contribute to change blood pressure levels among young people, such as salt intake and fried foods combined with the high consumption of alcoholic beverages and sedentary lifestyle. It should be noted that the smoking habit was not significant, representing a reduction of its harm to health.

It was noted then, that the risk factors for hypertension are intertwined with the young audience, this highlights the need to assess thoroughly this growing phenomenon and its serious consequences for the lives of the students.

Nursing has key role in promoting measures aimed at, especially in young adults, the adoption of healthier living habits and to stimulate the knowledge for the early detection of risk factors, which can lead to serious health consequences. Therefore, the nurse, as a member of the health team, has the responsibility to evaluate and develop strategies to control or even a reduction of this disease.

One limitation of the present study was not having assessed students ' knowledge about the risk factors for hypertension. The findings, however, have relevance for providing knowledge about the risk factors present in young investigated, which can be modified from educational measures that enable to self-care.

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Recebido em: 01.02.2012
Aprovado em: 18.05.2013