Prevalence of Hypertension Among Elderly Persons in Urban Brazil: A Systematic Review With Meta-Analysis

BACKGROUND The prevalence of hypertension among elderly persons has been assessed in several circumscribed studies scattered across Brazil, and no representative data about this exist for the whole country. In this meta-analysis with a systematic review of the literature, we provide a summary estimate of hypertension among elderly persons in Brazil and present the trend in prevalence of the condition from 1980 to 2010. METHODS Population-based prevalence studies carried out between 1980 and 2010 were identified by two independent reviewers, without language restrictions, in electronic databases. For PubMed searches we used the following Mesh Terms: "Aged"[Majr] AND "Hypertension" AND "Prevalence" AND "Brazil." Elderly individuals were defined as being ≥ 60 or ≥ 65 years of age, depending on the cutoff age of the relevant study. Hypertension was defined as the use of antihypertensive medication or as a seated blood pressure ≥ 140/90mm Hg, in accord with the criteria of the Joint National Committee (JNC) on the Prevention, Detection, Evaluation and Treatment of High Blood Pressure of the U.S. National Heart, Lung and Blood Institute. The prevalence of self-reported hypertension, assessed by household surveys and through telephone inquiries, was also evaluated. Prevalence estimates were calculated with a random-effects model. RESULTS On the basis of the screening process, we selected 16 studies for meta-analysis, comprising 13,978 individuals. The prevalence of hypertension for the period from 1980 to 2010, according to the JNC criteria, was 68.0% (95% CI, 65.1%-69.4%). In the 2000s, the prevalence of hypertension according to the same criteria was 68.9% (95% CI, 64.1%-73.3%), whereas the self-reported prevalence based on household surveys was 49.0% (95% CI, 46.8%-51.2%) and the prevalence based on telephone surveys was 53.8% (95% CI, 44.8%-62.6%). CONCLUSIONS The prevalence of hypertension is high among elderly persons in Brazil, and there is considerable underestimation of the prevalence of the disease through self-reported estimates.