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Objective: To analyze the contextual factors associated with type II diabetes mellitus in Belo Horizonte City. Methods: Cross-sectional study with 5,779 adults living in Belo Horizonte City, participating in the Risk and Protection Factors Surveillance System for Chronic Diseases through Telephone Survey (Vigitel), in 2008, 2009, and 2010. Multilevel regression models were used to test the association between contextual indicators of physical and social environments, and self-reported diagnosis of diabetes, adjusted for individual sociodemographic and lifestyle factors. Descriptive analyzes and multilevel logistic regression models were used, considering a 5% significance level. Results: The prevalence of diabetes was 6.2% (95%CI 5.54 – 6.92), and 3.1% of the variability of chance of presenting diabetes were explained by contextual characteristics. Living in areas with high density of private places for physical activity and high income was associated with a lower chance of having diabetes. The areas with high level of social vulnerability were strongly associated with the chance of presenting diabetes, adjusted for individual characteristics. Conclusion: Characteristics of physical and social environments were associated with the chance of diabetes occurrence. Urban centers with opportunities to adopt healthy behaviors can help to reduce the occurrence of diabetes and its complications. RESUMO: Objetivo: Analisar os fatores contextuais associados ao diabetes mellitus tipo II em Belo Horizonte (MG). Métodos: Estudo transversal com 5.779 adultos residentes em Belo Horizonte, participantes do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico, nos anos de 2008, 2009 e 2010. Foram utilizados modelos de regressão multinível para testar a associação entre indicadores contextuais do ambiente físico e social e diagnóstico autorreferido de diabetes, ajustados por fatores individuais sociodemográficos e de estilo de vida. Utilizaram-se análises descritivas e modelos de regressão logística multinível, considerando um nível de significância de 5%. Resultados: A prevalência de diabetes foi de 6,2% (IC95% 5,54–6,92), e 3,1% da variabilidade da chance de diabetes nas áreas de abrangência estudadas foi explicada por características contextuais. Residir em áreas com alta densidade de locais privados para prática de atividade física e com alta renda associou-se a menor chance de ter diabetes. As áreas com alto índice de vulnerabilidade social foram fortemente associadas ao diabetes, independentemente de características individuais. Conclusão: A ocorrência de diabetes está associada com as características do ambiente físico e social. Centros urbanos com oportunidades para adoção de comportamentos saudáveis podem ajudar a reduzir a ocorrência de diabetes e as suas complicações.

CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior Introdução: A Hipertensão Arterial (HA) constitui-se no principal fator de risco para as doenças cardiovasculares, contribuindo significativamente para o aumento no número de mortes e incapacidades no Brasil e em todo o mundo. Estudos mais recentes que estimaram a prevalência desse agravo considerando aspectos como conhecimento do diagnóstico, tratamento, e controle, evidenciam resultados alarmantes. No Brasil, esses estudos utilizam dados locais que se limitam a populações específicas, e não são possíveis de serem generalizados para a população brasileira. Além disso, demostram grande variabilidade e imprecisão dos achados. Objetivo: Estimar a prevalência de conhecimento sobre o diagnóstico, tratamento e controle da HA na população adulta brasileira e os fatores sociodemográficos associados a estes desfechos. Metodologia: Estudo transversal, descritivo e analítico que utilizou dados da população adulta brasileira, que responderam à Pesquisa Nacional de Saúde (PNS), em 2013. Estimou-se a prevalência total de conhecimento, tratamento e controle da HA na população adulta brasileira e de acordo com as características sociodemográficas (sexo, faixa etária, raça/cor, escolaridade, estado civil, zona de moradia e região) e de acesso (plano de saúde). Os desfechos foram definidos com base nas medidas aferidas da PA, no diagnóstico autorreferido da HA e no uso de medicação anti-hipertensiva. Utilizou-se Regressão de Poisson para estimar a razão de prevalência entre as variáveis explicativas e os desfechos. Foram calculados os intervalos de 95% de confiança das estimativas. Para obter estimativas populacionais, considerou-se o desenho amostral complexo da PNS. Resultados: A prevalência de hipertensão na população brasileira foi de 32,3% (IC95%: 31,7 - 33,1), sendo que, aproximadamente 60,8% (IC95% 59,5 - 62,1) têm conhecimento do seu diagnóstico, 90,6% (IC95% 89,5 - 91,6) realizam tratamento medicamentoso e desses, 54,4% (IC95%52,6 - 56,2) apresentaram controle da HA. As prevalências desses desfechos foram menores nos homens, nos indivíduos que vivem na zona rural do país, com companheiro e sem plano de saúde. O sexo feminino se associou positivamente a todos os desfechos analisados. O aumento da idade associou-se no sentido de aumentar a prevalência de conhecimento e tratamento, porém no sentido diminuir com a prevalência de controle. Ser autodeclarado preto esteve associado no sentido de diminuir a prevalência de controle, enquanto ser autodeclarado pardo esteve associado no sentido de diminuir a prevalência de tratamento e controle. Conclusões: Foram observadas maiores prevalências de conhecimento, tratamento e controle da HA em subgrupos populacionais com antecedentes de melhor acesso a saúde tais como mulheres, posse de plano de saúde, maior escolaridade e residentes em áreas urbanas; e menores prevalências de tratamento e controle foram observadas em grupos com condições sociodemográficas desfavoráveis tais como raça/cor negra e parda e idade avançada. Background: Arterial Hypertension (AH) is the main risk factor for cardiovascular diseases, contributing significantly to the increase in the number of deaths and disabilities in Brazil and worldwide. Previous studies have distinguished the prevalence of awareness, treatment and control of hypertension, and the results are worrisome. In Brazil, similar studies were conducted in local and specific populations, hindering the possibility to generalized their results to the Brazilian population. In addition, they show great variability and inaccuracy of the data. Objectives: To estimate the prevalence of arterial hypertension awareness, treatment and control in the Brazilian adult population and the sociodemographic factors associated with these outcomes. Methodology: Cross-sectional, descriptive and analytical study that used data from the Brazilian adult population, which responded to the National Health Survey (PNS), in 2013. The total prevalence of awareness, treatment and control of hypertension in the Brazilian adult population was estimated and according to sociodemographic characteristics (sex, age group, race / color, education, marital status, area of residence and region) and access, using the variable health insurance. The 95% confidence intervals (95%CI) of the estimates were calculated. Poisson regression was used to estimate the prevalence ratios. To obtain population estimates, the PNS complex sample design was considered. Results: The prevalence of hypertension in the Brazilian population was 32.3% (95% CI: 31.7 - 33.1), with approximately 60.8% (95% CI 59.5 - 62.1) of awareness, 90.6% (95% CI 89.5 - 91.6) of these used anti-hypertensive medications and considering those in treatment, 54.4% (95% CI 52.6 - 56.2) showed controlled of AH. Prevalence of these outcomes was lower in men, in those who live in rural areas of the country, living with a partner and without health insurance. Female gender was positively associated with all outcomes. Older individuals were associated with higher prevalence of awareness and treatment, but the prevalence of control did decrease. Individuals who self-declared as black were associated with lower prevalence of control, while those who self-declared as brown were associated with lower prevalence of treatment and control. Conclusions: Higher prevalence of awareness, treatment and control of AH were observed in population subgroups with a history of better access to health such as women, health insurance, higher education and residents in urban areas; lower prevalence of treatment and control was observed in groups with unfavorable sociodemographic conditions such as race / black and brown and older individuals.

Background Given that sleep disturbances seem to be increasing in Brazil, this may have serious implications on Cardiovascular Health and mortality. Objective To examine the predicted probabilities of attained Lifés Simple 7 factors (LS7) in the presence of sleep problems among Brazilian adults. Methods We used data from the 2013 Brazilian National Health Survey (PNS), a nationally representative cross-sectional household survey of adults in Brazil. Cardiovascular Health was assessed by the sum of Lifés Simple 7 factors (LS7), which includes four behaviors (smoking, physical activity, body mass index and diet) and three biological factors (hypercholesterolemia, hypertension and diabetes). We analyzed self-reported data from 36,480 Brazilian adults aged 18 and over, including the sleep problems. We estimated predicted probabilities after multivariate Poisson regression. Results Mean CVH scores was higher among those who did not report sleep disturbances [4.2 (95% CI: 4.1; 4.2)], than those with sleep disturbances [3.8 (95% CI: 3.7; 3.8)]. Predicted probabilities of attained LS7 and CVH score was lower in the presence of sleep complaints, with a dose response for blood pressure, glucose, smoking and CVH score in both unadjusted and adjusted analyses, for age, sex, schooling, depression and night work shift. Conclusions Brazilian adults with sleep disturbances are less likely to achieve LS7 and consequently ideal cardiovascular health. Given that sleep disturbances seem to be increasingly more common in Brazil, recent gains in CVH mortality may be affected. Key messages Sleep disturbances may potentially affect metabolic outcomes and modifiable lifestyles behaviors as decreased physical activity and smoking. Sleep disturbances is novel risk factor for metabolic diseases.

Background Hypertension is the main risk factor for cardiovascular diseases, contributing significantly to the increase in the number of deaths and disabilities worldwide. Moreover, hypertension control is a major action for NCDs prevention. Although pharmacological treatment has been shown effective, high rates of uncontrolled hypertension remain. The objective is to estimate the prevalence of uncontrolled arterial hypertension and the factors associated to this outcome in a representative adult Brazilian population under a pharmacological treatment. Methods This is a cross-sectional study conducted with 10,016 Brazilian adults over 18 years old who participated in the National Health Survey in Brazil carried-out in 2013. The sample comprised of residents from all Federative Units, Poisson multivariate regression was used to calculate the prevalence ratio (PR) and 95% confidence interval. Results 45% (95% CI: 44; 48) of hypertensive adults under drug treatment have uncontrolled blood pressure levels. Female gender [PR = 0.92; CI: 0.85; 0.99] and not having previous hospitalizations due to complications from hypertension or other causes [PR = 0.86; CI: 0.78; 0.94] were associated to low the prevalence of uncontrolled blood pressure. Participants aged 60 years old or more [PR = 1.31; CI:1.04; 1.64], who self-declared as black [PR = 1.19; CI: 1.04; 1.36], without health insurance [PR = 1.15; CI: 1.05; 1.27] and not attending the health service because of arterial hypertension [PR = 1.10; CI:1.01; 1.20)] presented higher prevalence of uncontrolled blood pressure. Conclusions The prevalence of uncontrolled hypertension among Brazilian adults was high among the male gender, black people, elderly, without previous hospitalizations, without health insurance and not regularly attending the health service. These results may alert the need for a reassessment of the assistance provided, in addition to raising awareness of a possible change in public policies in these groups. Key messages Evidence the magnitude of people who are at risk of hypertension even under pharmacological treatment. Highlight inequities related to the uncontrol of hypertension.

Objective: To describe the profile and evolution of the mortality rate due to motorcycle accidents in Belo Horizonte and its Metropolitan Region, from 2000 to 2012. Methods: A time series study with data extracted from the Mortality Information System (Sistema de Informacoes sobre Mortalidade, SIM) and from the IBGE. A linear regression model was used, with a 5% significance level. Results: From 2000 to 2012 there was a 278% increase in the number of deaths. The population most affected was that of male individuals, aged 20 to 29 years old, of black/brown skin, without partners, and with 8 to 11 years of schooling. The mortality rate increased from 1.7 to 3.58 deaths/100,000 inhabitants, with an increasing trend (β=0.25 per year; p