LAUSR

Objective: To evaluate the prevalence and awareness of hypertension diagnosed by clinic blood pressure (BP) and home blood pressure monitoring (HBPM) in a young adult population assisted by a Family Health Program unit in Rio de Janeiro – LapARC cohort study Design and method: This is a cross-sectional population study enrolling young adult between 20–50 years. The eligible population consisted of all 1,795 residents in Rio de Janeiro downtown, previously registered in Family Health Program unit. This pilot project intends to evaluate 15% of the total population at this first moment. Sociodemographic characteristics, traditional cardiovascular (CV) risk factors, and anthropometric measurements (height, weight, and abdominal circumference) were registered. BP was measured twice in supine position, using a digital oscillometric BP monitor with a suitably sized cuff. BP considered was the mean between the two readings. All participants were submitted to 7-day HBPM taking duplicate morning and evening measurements, using a validated oscillometric BP device. Subjects with uncontrolled clinic BP (> = 140/90mmHg) were classified as sustained hypertension (home BP > = 135/85mmHg) or white-coat hypertension (home BP <135/85mmHg), and those with controlled clinic BP were classified as masked hypertension (home BP > = 135/85mmHg) or normotension (home BP <135/85mmHg). Results: A total of 270 subjects [34.2% males, mean (SD) age: 38(9) years] were evaluated and the prevalence of hypertension was 28.5%. Mean (SD) clinic BP was 121(15)/76(10) mmHg and home BP was 120(14)/75(10)mmHg. The awareness, treatment, control, and control among treated patients were 65.5, 54.5, 40, and 56.7%, respectively. Older age, male gender, obesity, and increased waist circumference were identified as risk factors for hypertension. Elderly men with family history of hypertension and premature CV diseases had better awareness and treatment. Based on clinic and home BP, normotension, sustained hypertension, white-coat and masked hypertension was presented in 73, 8.5, 8.5 and 10%, respectively. Conclusions: The levels of awareness, treatment, and control needs more aggressive strategies should thus be adopted. A HBPM is an important tool to refine the diagnosis of hypertension, as home BP changed the diagnosis of hypertension in 18.5% of the subjects evaluated.