Awareness Of Disease: A Comparison Between Glaucoma, Systemic Arterial Hypertension, And Diabetes In A Population-based Study From South Of Brazil

Abstract

 

Purpose:

 

Systemic arterial hypertension (SAH), diabetes and glaucoma represent chronic diseases that may lead to several complications if left untreated. Public health measurements have been implemented in most countries in order to diagnose and treat SAH and diabetes, and thus, prevent complications and reduce costs to the healthcare system. The purpose of this study is to compare the awareness of glaucoma with SAH and diabetes diagnosis.

 

Methods:

 

This cross-sectional population-based study included 1636 subjects over 40 years of age from the South Region of Brazil(76.5% participation rate).Subjects underwent a screening examination which included medical interview, blood pressure (BP) and capillary glucose measurements, slit-lamp exam, Goldmann tonometry, and fundoscopy. Glaucoma suspects underwent a complete ophthalmologic examination. Glaucoma was diagnosed based on the presence of structural/functional damage, as proposed by the ISGEO classification. SAH was diagnosed in subjects with previous diagnosis in treatment for BP control, and new cases were diagnosed in subjects with a mean systolic BP >140mmHg and/or mean diastolic BP >90mmHg. Diabetes was diagnosed in subjects with previous diagnosis in treatment for glycemia control, and new cases were diagnosed in subjects with capillary glycemia levels >200mg/dl.

 

Results:

 

Primary glaucoma was found in 56 subjects (3.4%; 95%CI, 2.5-4.3), SAH was diagnosed in 960 subjects (58.7%; 95%CI 56.2-61.1), and DM was diagnosed in 178 subjects (10.9%; 95%CI 9.4-12.4). Six (10.7%) glaucoma cases were already aware of their diagnosis, while 700 (72.9%) SAH cases and 161 (90.4%) diabetes cases were already aware of their diseases (p<.001, chi-square test).

 

Conclusions:

 

The awareness of glaucoma disease was considerably lower than SAH and diabetes. The low level of previous glaucoma diagnosis represents a public health problem that must be tackled in order to reduce the burden of glaucoma blindness particularly in developing countries.  

 

Keywords: clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • clinical (human) or epidemiologic studies: health care delivery/economics/manpower • optic disc