Prevalência de hipertensão arterial e associações de fatores pessoais, ocupacionais e de risco cardiovascular com a pressão arterial alterada em bombeiros militares do estado do Espírito Santo

Abstract

Certain workers have a higher risk of cardiovascular diseases (CVD) due to their activities with inherent risks. International studies on firefighters point out that sudden cardiac death is among the leading causes of death on duty. Hypertension is the most prevalent risk factor for CVD in the world population. However, there are no studies evaluating the prevalence of hypertension in Brazilian firefighters and the association of personal, occupational, and cardiovascular risk factors with elevated blood pressure (BP) in this population. Our study assessed these aspects in the entire population of male military firefighters from the state of Espírito Santo, who participated in the Bom Estar Program (“Wellness” Program) in the year 2019 and filled up all forms. We tabulated and analyzed sociodemographic data such as age, skin color, education, health insurance, city of work, length of service, position held, smoking and alcohol consumption, as well as parameters of cardiovascular risk, such as fasting glucose, total cholesterol and triglycerides, blood pressure, cardiorespiratory fitness, and anthropometric composition. BP data was stratified according to the guidelines of the Brazilian Society of Cardiology and all firefighters in the pre-hypertension and hypertension range and/or using antihypertensive medication were considered as having BP above normal. The chi-square (X2) test was used to analyze the association between a dependent variable (outcome – above normal) and a set of independent variables (risk factors), with a significance level of p <0.05. A hierarchical binary logistic regression model was used to obtain the adjusted odds ratio (OR). 45.6% of firefighters presented pressure levels above normal. After adjusted OR analysis, a higher chance of above-normal blood pressure was observed for firefighters with complete high school (1.5; 95% CI 1.02 to 2.19) and postgraduation educational level (1.54; 95% CI 1.03 to 2.30), with black skin color (1.98; 95% CI 1.03 to 3.78), working in inner cities (2.32; 95% CI 1.14 to 4.71), with high levels of triglycerides (1.92; 95%CI 1.19 to 3.11) and blood glucose (1.5; 95% CI 1.01 to 2.22), and with central obesity (2.34; 95% CI 1.47 to 3.70). Our study demonstrated an association between the altered pressure outcome and personal, occupational, and cardiovascular risk factors. Some of these factors are modifiable and can be addressed in prevention and intervention programs in occupational health, which can prevent the progression of hypertension and CVD in this population of workers and contribute to excellence in the care provided to the population.