THE INFLUENCE OF SOCIAL DETERMINANTS OF HEALTH ON SYSTEMIC ARTERIAL HYPERTENSION: AN INTEGRATIVE LITERATURE REVIEW
Abstract
The Social Determinants of Health influence the ability of individuals to adopt healthy habits, access early diagnoses and maintain therapeutic adherence in cases of chronic conditions such as systemic arterial hypertension. Therefore, this research seeks to analyze how the Social Determinants of Health influence the occurrence, control and management of systemic arterial hypertension. Through an integrative literature review, data collection took place in April and May 2025, in the Virtual Health Library, Scientific Electronic Library Online, and PubMed, using search strategies with descriptors and defining inclusion and exclusion criteria for selection. The data were extracted from the articles selected with the aid of Excel and analyzed by descriptive statistics and interpretative and reflective readings. The results analyzed nine manuscripts, published between 2020 and 2025, and showed that systemic arterial hypertension is strongly associated with social determinants such as low education, insufficient income, unstable socioeconomic position, and racial inequalities. We conclude that these factors are interrelated and contribute to the increase in the prevalence of the disease, hinder access to health services, compromise adherence to treatment, and reduce the effectiveness of available therapeutic strategies.
Author Biographies
Nurse, PhD candidate in Local Development at the Catholic University Dom Bosco.
PhD in Psychology. Professor and researcher in the Master’s and Doctoral Program in Psychology and Local Development at the Catholic University Dom Bosco.
References
AKINYELURE, O. P. et al. Social Determinants of Health and Incident Apparent Treatment-Resistant Hypertension Among White and Black US Adults: The REGARDS Study. Journal of the American Heart Association, Dallas, v. 13, n. 10, p. e031695, 2024. DOI: https://doi.org/10.1161/JAHA.123.031695 DOI: https://doi.org/10.1161/JAHA.123.031695
ARTIOLI, C. A. et al. Fatores que levam o cliente hipertenso a não aderir o tratamento medicamentoso. Revista Saúde em Foco, Amparo, v. 3, n. 1, p. 1–9, 2018. DisponÃvel em: http://portal.unisepe.com.br/unifia/wp-content/uploads/sites/10001/2018/06/3saude_em_foco_Cliente-Hipertenso.pdf
BALA, C. et al. Social and Metabolic Determinants of Prevalent Hypertension in Men and Women: A Cluster Analysis from a Population-Based Study. International Journal of Environmental Research and Public Health, Basel, v. 20, n. 3, p. 1736, 18 jan. 2023. DOI: https://doi.org/10.3390/ijerph20031736 DOI: https://doi.org/10.3390/ijerph20031736
BARRADAS, S. et al. A prospective longitudinal approach to examine the association between social position in childhood, adolescence, and adulthood with the control of hypertension during adulthood. Front Public Health, Lausanne, p. 1296593–1296593, 2024. DOI: https://doi.org/10.3389/fpubh.2024.1296593 DOI: https://doi.org/10.3389/fpubh.2024.1296593
BORGES, V. M.; KIMURA, L. Panorama da hipertensão arterial nos quilombos do Brasil: uma revisão narrativa. Physis: Revista de Saúde Coletiva, Rio de Janeiro, v. 33, p. e33050, 2023. DOI: https://doi.org/10.1590/S0103-7331202333050 DOI: https://doi.org/10.1590/s0103-7331202333050.en
BRASIL. Taxa de mortalidade por hipertensão arterial atinge maior valor dos últimos dez anos. BrasÃlia: Ministério da Saúde, 2023. DisponÃvel em: https://www.gov.br/saude/pt-br/assuntos/noticias/2023/maio/taxa-de-mortalidade-por-hipertensao-arterial-atinge-maior-valor-dos-ultimos-dez-anos Acesso em: 27 maio 2025.
GANONG, L. H. Integrative Reviews Lawrence of Nursing Research. Research, Nursing e Health, Londrina, v. 10, p. 1–11, 1987. DOI: https://doi.org/10.1002/nur.4770100103
GIRÃO, A. C. et al. Análise da associação entre adesão terapêutica e letramento em saúde em hipertensos. Revista de Enfermagem do Centro-Oeste Mineiro, São João del-Rei, v. 11, 3 set. 2021. DOI: https://doi.org/10.19175/recom.v11i0.4166 DOI: https://doi.org/10.19175/recom.v11i0.4166
GLOVER, L. M. et al. Life Course Socioeconomic Status and Hypertension in African American Adults: The Jackson Heart Study. American Journal of Hypertension, New York, v. 33, n. 1, p. 84–91, 2020. DOI: https://doi.org/10.1093/ajh/hpz133 DOI: https://doi.org/10.1093/ajh/hpz133
IBE, C. A. et al. Social Determinants of Health as Potential Influencers of a Collaborative Care Intervention for Patients with Hypertension. Ethnicity & Disease, Las Vegas, v. 31, n. 1, p. 47–56, 2021. DOI: https://doi.org/10.18865/ed.31.1.47 DOI: https://doi.org/10.18865/ed.31.1.47
JBI. JBI manual for evidence synthesis. Adelaide: The Joanna Briggs Institute, 2024. DisponÃvel em: https://jbi-global-wiki.refined.site/download/attachments/355599504/JBI%20Manual%20for%20Evidence%20Synthesis%202024.pdf Acesso em: 13 nov. 2025.
MARQUES, A. P. et al. Fatores associados à hipertensão arterial: uma revisão sistemática. Ciência & Saúde Coletiva, São Paulo, v. 25, p. 2271–2282, 3 jun. 2020. DOI: https://doi.org/10.1590/1413-81232020256.26972018 DOI: https://doi.org/10.1590/1413-81232020256.26972018
MENDES, K. D. S.; SILVEIRA, R. C. D. C. P.; GALVÃO, C. M. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & Contexto - Enfermagem, Florianópolis, v. 17, n. 4, p. 758–764, dez. 2008. DOI: https://doi.org/10.1590/S0104-07072008000400018 DOI: https://doi.org/10.1590/S0104-07072008000400018
NISHIDA, W. et al. Mobilidade educacional intergeracional, discriminação e hipertensão arterial em adultos do Sul do Brasil. Cadernos de Saúde Pública, Rio de Janeiro, v. 36, p. e00026419, 8 maio 2020. DOI: https://doi.org/10.1590/0102-311X00026419 DOI: https://doi.org/10.1590/0102-311x00026419
NOBRE, A. L. C. S. D. et al. Hipertensos assistidos em serviço de atenção secundária: risco cardiovascular e determinantes sociais de saúde. Cadernos Saúde Coletiva, São Paulo, v. 28, p. 334–344, 2020. DOI: https://doi.org/10.1590/1414-462X202028030386 DOI: https://doi.org/10.1590/1414-462x202028030386
ODUTAYO, A. et al. Income Disparities in Absolute Cardiovascular Risk and Cardiovascular Risk Factors in the United States, 1999-2014. JAMA Cardiology, Illinois, v. 2, n. 7, p. 782–790, 2017. DOI: https://doi.org/10.1001/jamacardio.2017.1658 DOI: https://doi.org/10.1001/jamacardio.2017.1658
OLIVEIRA, F. E. G. et al. Racial inequalities in the development of multimorbidity of chronic conditions: results from a Brazilian prospective cohort. Int J Equity Health, Amsterdam, p. 120–120, 2024. DisponÃvel em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11170781 Acesso em: 22 maio 2025.
PAULI, S. et al. Prevalência autorreferida de hipertensão e fatores associados em comunidades quilombolas do Rio Grande do Sul, Brasil. Ciência & Saúde Coletiva, São Paulo, v. 24, p. 3293–3303, 2019. DOI: https://doi.org/10.1590/1413-81232018249.28002017 DOI: https://doi.org/10.1590/1413-81232018249.28002017
PEIXOTO, A. C. dos S. L.; JÚNIOR, H. S. de F. Fatores contribuintes a não adesão medicamentosa no tratamento da hipertensão arterial sistêmica em idosos. Revista Ibero-Americana de Humanidades, Ciências e Educação, São Paulo, v. 10, n. 3, p. 226–237, 2024. DOI: https://doi.org/10.51891/rease.v10i3.13117 DOI: https://doi.org/10.51891/rease.v10i3.13117
QIN, Z. et al. Association of socioeconomic status with hypertension prevalence and control in Nanjing: a cross-sectional study. BMC public health, Oxford, v. 22, n. 1, p. 423, 2022. DOI: https://doi.org/10.1186/s12889-022-12799-5 DOI: https://doi.org/10.1186/s12889-022-12799-5
RUTLEDGE, R. I. et al. Medicaid accountable care organizations in four states: implementation and early impacts. The Milbank Quarterly, Nova York, v. 97, n. 2, p. 583–619, 2019. DOI: https://doi.org/10.1111/1468-0009.12386 DOI: https://doi.org/10.1111/1468-0009.12386
SALVADOR, A. D. Métodos e técnicas de pesquisa bibliográfica. Porto Alegre: Sulina, 1986. 254 p.
SBN, S. B. de N. CapÃtulo 6 – Populações especiais. In: III Consenso Brasileiro de Hipertensão Arterial na Doença Renal Crônica. São Paulo: Sociedade Brasileira de Nefrologia, 2020. DisponÃvel em: https://www.bjnephrology.org/iii-consenso-brasileiro-de-hipertensao-arterial-capitulo-6/
SHAO, Y. et al. Health literacy interventions among patients with chronic diseases: A meta-analysis of randomized controlled trials. Patient Education and Counseling, Cham, v. 114, p. 107829, 2023. DOI: https://doi.org/10.1016/j.pec.2023.107829 DOI: https://doi.org/10.1016/j.pec.2023.107829
SILVA, I. C. da et al. Letramento em saúde e adesão ao tratamento farmacológico de pessoas com hipertensão arterial. Revista Brasileira de Enfermagem, BrasÃlia, v. 75, p. e20220008, 2022. DOI: https://doi.org/10.1590/0034-7167-2022-0008pt DOI: https://doi.org/10.1590/0034-7167-2022-0008pt
SILVA, M. F. F. da et al. Percepção de pacientes hipertensos sobre a doença e motivação para mudança de hábitos. Interação em Psicologia, Curitiba, v. 25, n. 2, 2021. DOI: https://doi.org/10.5380/riep.v25i2.71800 DOI: https://doi.org/10.5380/riep.v25i2.71800
SONNENBLICK, R. et al. Social Determinants of Health and Hypertension Control in Adults with Medicaid. Journal of Primary Care & Community Health, Thousand Oaks, v. 13, p. 21501319221142426, 2022. Thousand Oaks. DOI: https://doi.org/10.1177/21501319221142426 DOI: https://doi.org/10.1177/21501319221142426
WHITTEMORE, R.; KNAFL, K. The integrative review: updated methodology. Journal of Advanced Nursing, Hoboken, v. 52, n. 5, p. 546–553, 2005. DOI: https://doi.org/10.1111/j.1365-2648.2005.03621.x DOI: https://doi.org/10.1111/j.1365-2648.2005.03621.x
