Objective: Evaluating the evidence of hypertension prevalence among indigenous populations in Brazil through a systematic review and meta-analysis. Methods: A search was performed by two reviewers, with no restriction of date or language in the databases of PubMed, LILACS, SciELO, Virtual Health Library and Capes Journal Portal. Also, a meta-regression model was designed in which the last collection year of each study was used as a moderating variable. Results: 23 articles were included in the review. No hypertension was found in indigenous populations in 10 studies, and its prevalence was increasing and varied, reaching levels of up to 29.7%. Combined hypertension prevalence in Indigenous from the period of 1970 to 2014 was 6.2% (95% CI, 3.1% -10.3%). In the regression, the value of the odds ratio was 1.12 (95% CI, 1.07 -1.18; p <0.0001), indicating a 12% increase every year in the probability of an indigenous person presenting hypertension. Conclusion: There has been a constant increase in prevalence despite the absence of hypertension in about half of the studies, probably due to changes in cultural, economic and lifestyle habits, resulting from indigenous interaction with non-indigenous society. DESCRIPTORSHypertension; Indigenous Population; Prevalence; Review.Hypertension prevalence among indigenous populations in Brazil: a systematic review with meta-analysis Prevalência de hipertensão arterial em indígenas do Brasil: uma revisão sistemática com meta-análise Prevalencia de hipertensión arterial en indígenas de Brasil: una revisión sistemática con meta-análisis

BackgroundThe Brazilian indigenous population is currently undergoing a process of epidemiological transition regarding the occurrence of communicable diseases, malnutrition and non-communicable chronic diseases. Chronic non-infectious diseases are the most common causes of death worldwide, and hypertension is one of the main cardiovascular risk factors. Thus, the main objective of this paper was to evaluate the prevalence of cardiovascular risk factors, with an emphasis on hypertension, in the Mura Indians living in the municipality of Autazes in the northern Brazilian state of Amazonas.MethodsThis cross-sectional study was conducted among 455 natives (57.8% women, 42.2 ± 16.7 years) selected by simple random sampling. Sociodemographic variables, habits and lifestyles, anthropometric data, fasting glycaemia and lipid profiles were evaluated. Blood pressure was measured with a validated automatic device. Values of p ≤ 0.05 were considered significant.ResultsThe prevalence of hypertension was 26.6%. The other cardiovascular risk factors were as follows: increased waist-hip ratio (85.1%); increased neck circumference (60.2%); increased waist circumference (48.6%); overweight (57.1%); physical inactivity (52.7%); use of alcoholic beverages (40.2%); high total cholesterol (27.5%); increased triglycerides (23.5%); smoking (20.4%); and diabetes mellitus (3.0%). In relation to non-hypertensive individuals, indigenous hypertensive individuals were (p ≤ 0.05) older and had a higher proportion of individuals living with partners and individuals who were retired, as well as a lower level of schooling and higher family income. The indigenous people living in urban areas had a higher prevalence of hypertension than did those living in rural areas. In relation to habits and lifestyles, hypertensive Indians had a lower prevalence of smoking, higher frequency of the use of animal fat during meal preparation, lower frequency of vegetable oil use and lower frequency of salt addition to already-prepared meals. An assessment of anthropometric variables and laboratory markers showed that the hypertensive indigenous individuals had higher values of body mass index, neck circumference, waist circumference, visceral fat, Conicity Index, and body fat than did the non-hypertensive individuals.ConclusionThe prevalence of hypertension and other important cardiovascular risk factors in the Mura Indians was high. This finding is probably due to the adoption of inappropriate habits and lifestyles.

ObjectiveTo identify the consumption of alcoholic beverage and the relation with hypertension, their prevalence and associated factors, in indigenous Mura, Brazil.MethodsA cross-sectional population-based study was conducted with 455 adult indigenous aged 18 years or more of Mura ethnics in Amazonia, Brazil. Interview was conducted and the alcohol intake was assessed by the Alcohol Use Disorders Identification Test. Blood pressure was measured in three measurements and the mean of the last two measurements was used. Physical examination included the following data: weight, height, waist and neck circumference, bioimpedance, and capillary measurement of glucose, triglycerides and cholesterol. Through multivariate Logistic regression in stepwise, the odds ratios for alcohol consumption and associated factors were identified.ResultsThe prevalence of alcoholic beverage was 40.2%, with no significant difference for hypertension in those who drink (23.0%) and those who did not drink (29.0%). Referred hypertension in indigenous was associated to less use of alcoholic beverages (14.2% vs 24.3%, P = 0.009). After an adjusted analysis (Odds Ratio, 95% CI), there was a positive association between alcoholic drink intake and male sex (10.27, CI: 5.76–18.30), smoking (4.72, CI: 2.35–9.46) and live in rural areas (9.77, CI: 5.08–18.79). On the other hand, age (0.95, IC: 0.94–0.97), and absence of dyslipidemia (0.41, CI: 0.19–0.89) were associated to lower alcohol consumption.ConclusionThe prevalence of alcoholic beverage was high and associated with referred hypertension, but this association was not maintained after adjusted analysis. Changes to habits and inappropriate lifestyles in indigenous populations and living in urban areas may contribute to increase risk for cardiovascular diseases. Therefore, health policies should be implemented to meet the uniqueness of indigenous people.

ObjectiveIdentify and analyze the factors associated to length of hospital stay among HIV positive and HIV negative patients with tuberculosis in Manaus city, state of Amazonas, Brazil, in 2010.MethodsEpidemiological study with primary data obtained from monitoring of hospitalized patients with tuberculosis in Manaus. Data were collected by interviewing patients and analyzing medical records, according to the following study variables age, sex, co-morbidities, education, race, income, lifestyle, history of previous treatment or hospitalization due to tuberculosis, treatment regimen, adverse reactions, smear test, clinical form, type of discharge, and length of hospital stay. The associated factors were identified through chi-square or t-Student test at a 5% significance level.ResultsIncome from 1 to 3 minimum wages (P = 0.028), pulmonary tuberculosis form (P = 0.011), negative smear test or no information in this regard (P = 0.014), initial 6-month treatment scheme (P = 0.029), and adverse drug reactions (P = 0.021) were associated to prolonged hospital stay in HIV positive patients.ConclusionWe found out that although there were no significant differences in the length of hospital stay in HIV positive patients, all factors significantly associated to prolonged hospital stay occurred in this group of patients. This finding corroborates other studies indicating the severity of tuberculosis in HIV patients, which may also contribute to lengthen their hospital stay.

ResumoObjetivo: identificar o conhecimento dos idosos, participantes do parque municipal do idoso (Manaus -Brasil), sobre os sinais e sintomas da depressão. Métodos: estudo descritivo, de abordagem quantitativa, realizado em 2015, com 306 idosos participantes ativos das atividades do parque, para a coleta de dados foi desenvolvido um questionário composto de duas partes: a primeira de dados sociodemográficos e a segunda constituída de sentenças baseadas na escala de Yesavage, alternadas com frases não relacionadas à depressão, onde o idoso, com base em seu julgamento, circulava as alternativas relacionadas à doença. Resultados: A amostra foi composta, em sua maioria, pelo gênero feminino, aposentados, grande parte com até um salário mínimo, ensino fundamental até a quinta série, cristãos, procedentes da região norte do país. Do total dos 306 participantes, 245 idosos nunca receberam o diagnóstico de depressão, 203 conheceram alguém acometido pela doença e 130 idosos apresentaram conhecimento intermediário em relação à depressão, caracterizando o maior grupo. Apesar da pontuação, os idosos lançam mão do conhecimento empírico, o que não contribui com sua verdadeira autonomia e envelhecimento ativo. Conclusão: É necessário que o enfermeiro e a equipe de saúde utilizem a educação em saúde na construção de conhecimento e auxílio aos idosos na promoção da qualidade de vida.