Purpose:Epidemiologic studies suggest that the transgender population has a higher burden of cardiovascular (CV) disease. We aimed to assess CV risk and investigate the relationship between estradiol (E2) or ethinylestradiol (EE) use and carotid intima media thickness (cIMT) in transgender women. Methods:This is a cross-sectional analysis nested into a transgender-specific cohort in Rio de Janeiro, Brazil, from August 2015 to February 2018. Increased cIMT was defined as a measurement above the 75th percentile. We tested the association of E2, EE, or both with cIMT. We calculated odds ratios (ORs) using adjusted logistic regression models to assess the association of current use (use in the last 30 days) and long-term use (using for at least 365 consecutive days) of the hormone categories with cIMT. Results:We included 298 transgender women with a median age of 31 years (interquartile range [IQR]=25-38), 54.2% had human immunodeficiency virus (HIV) infection. Among transgender women currently on hormone therapy (44.9%), most were on estradiol (27.2%), a combination of E2/EE (12.7%), or EE alone (5.1%). Median cIMT was 0.57 mm (IQR=0.52-0.64). In the final adjusted models, current (OR=0.37; 95% confidence interval [95% CI]=0.14 to 0.93) and long-term (OR=0.20; 95% CI=0.04 to 0.7) E2 use was negatively associated with increased cIMT. Conclusions:Both current- and long-term E2 use had a negative association with increased cIMT in a young population of transgender women. Follow-up studies are needed to confirm its safety and support hormone recommendations for transgender women.

Abstract Background The occurrence of multimorbidity and its impacts have differentially affected population subgroups. Evidence on its incidence has mainly come from high-income regions, with limited exploration of racial disparities. This study investigated the association between racial groups and the development of multimorbidity and chronic conditions in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods Data from self-reported white, brown (pardos or mixed-race), and black participants at baseline of ELSA-Brasil (2008–2010) who were at risk for multimorbidity were analysed. The development of chronic conditions was assessed through in-person visits and self-reported diagnosis via telephone until the third follow-up visit (2017–2019). Multimorbidity was defined when, at the follow-up visit, the participant had two or more morbidities. Cumulative incidences, incidence rates, and adjusted incidence rate ratios (IRRs) were estimated using Poisson models. Results Over an 8.3-year follow-up, compared to white participants: browns had a 27% greater incidence of hypertension and obesity; and blacks had a 62% and 45% greater incidence, respectively. Blacks also had 58% more diabetes. The cancer incidence was greater among whites. Multimorbidity affected 41% of the participants, with a crude incidence rate of 57.5 cases per 1000 person-years (ranging from 56.3 for whites to 63.9 for blacks). Adjusted estimates showed a 20% higher incidence of multimorbidity in black participants compared to white participants (IRR: 1.20; 95% CI: 1.05–1.38). Conclusions Significant racial disparities in the risk of chronic conditions and multimorbidity were observed. Many associations revealed a gradient increase in illness risk according to darker skin tones. Addressing fundamental causes such as racism and racial discrimination, alongside considering social determinants of health, is vital for comprehensive multimorbidity care. Intersectoral, equitable policies are essential for ensuring health rights for historically marginalized groups.

Background To identify multimorbidity patterns, by sex, according to sociodemographic and lifestyle in ELSA-Brasil. Methods Cross-sectional study with 14,516 participants from ELSA-Brasil (2008–2010). Fuzzy c-means was used to identify multimorbidity patterns of 2+ chronic morbidities, where the consequent morbidity had to occur in at least 5% of all cases. Association rule (O/E≥1.5) was used to identify co-occurrence of morbidities, in each cluster, by sociodemographic and lifestyle factors. Results The prevalence of multimorbidity was higher in women (73.7%) compared to men (65.3%). Among women, cluster 1 was characterized by hypertension/diabetes (13.2%); cluster 2 had no overrepresented morbidity; and cluster 3 all participants had kidney disease. Among men, cluster 1 was characterized by cirrhosis/hepatitis/obesity; cluster 2, most combinations included kidney disease/migraine (6.6%); cluster 3, no pattern reached association ratio; cluster 4 predominated co-occurrence of hypertension/rheumatic fever, and hypertension/dyslipidemia; cluster 5 predominated diabetes and obesity, and combinations with hypertension (8.8%); and cluster 6 presented combinations of diabetes/hypertension/heart attack/angina/heart failure. Clusters were characterized by higher prevalence of adults, married and participants with university degrees. Conclusion Hypertension/diabetes/obesity were highly co-occurred, in both sexes. Yet, for men, morbidities like cirrhosis/hepatitis were commonly clustered with obesity and diabetes; and kidney disease was commonly clustered with migraine and common mental disorders. The study advances in understanding multimorbidity patterns, benefiting simultaneously or gradually prevention of diseases and multidisciplinary care responses.

The mechanisms underlying racial inequities in uncontrolled hypertension have been limited to individual factors. We investigated racial inequities in uncontrolled hypertension and the explanatory role of economic segregation in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). All 3897 baseline participants with hypertension (2008–2010) were included. Uncontrolled hypertension (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg), self-reported race (White/Brown/Black people), and neighborhood economic segregation (low/medium/high) were analyzed cross-sectionally. We used decomposition analysis, which describes how much a disparity would change (disparity reduction; explained portion) and remain (disparity residual; unexplained portion) upon removing racial differences in economic segregation (i.e., if Black people had the distribution of segregation of White people, how much we would expect uncontrolled hypertension to decrease among Black people). Age- and gender-adjusted prevalence of uncontrolled hypertension (39.0

Introduction: Platelet volume indices (PVI) are obtained using haematology analysers at a low cost. Studies have suggested that these indices might be good markers of platelet function in women using oral contraceptives (OC) or hormone therapy (HT). This study aims to investigate the association of PVI with both OC and HT use (current or past) in women. Methods: Cross-sectional study carried out with 609 women of childbearing age and 640 going through menopause from the baseline of ELSA-Brasil. We used analysis of variance and the Bonferroni post-test to compare the PVI means according to the use of OC and HT, considering p<0.05 as statistically significant. Results: The mean (SD) age of participants of childbearing age was 45.1 (5.0) years, and of those going through menopause 58.3 (6.5) years. No significant differences were observed in the mean values of PVI between non-users, ex-users, and current users of OC and HT. Conclusion: PVI were not associated with the current or past use of OC and HT in women over 35 years of age.

We evaluated data from 14,156 baseline participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) collected from 2008 to 2010, to analyze the effect modification of occupational social class on the association between sex and prevalence of type 2 diabetes. The crude and age-adjusted prevalence, according to sex and occupational social class, were estimated using generalized linear models with binomial distribution and logarithmic link function. This model was also used to estimate prevalence ratios (PR), adjusting for age group, race/skin color, and maternal education. The effect modification was measured in the multiplicative and additive scales. Males had higher crude and age-adjusted prevalence in all occupational social class strata. As occupational social class increases, the prevalence among males and females decreases. The PR of males to females decreased according to occupational class: 66% (PR = 1.66; 95%CI: 1.44; 1.90), 39% (PR = 1.39; 95%CI: 1.02; 1.89), and 28% (PR = 1.28; 95%CI: 0.94; 1.75) in the high, middle, and low occupational social classes, respectively. We found an inverse effect of the occupational social class on the association between sex and type 2 diabetes on the multiplicative scale, suggesting that it acts as an effect modifier.

Insulin resistance (IR) is defined as the subnormal response to insulin action on its target tissues. Studies suggest that IR may increase the risk of hypertension, but the results are inconsistent and it is not known whether such an effect is independent of overweight/obesity. We aimed to evaluate the association between IR and the incidence of prehypertension and hypertension in the Brazilian population and whether this association is independent of overweight/obesity. In 4717 participants of the Brazilian Longitudinal Study of Adult’s Health (ELSA-Brasil), free of diabetes and cardiovascular disease at baseline (2008–2010), we investigated the incidence of prehypertension and hypertension after a mean follow-up of 3.8 ± 0.5 years. Insulin resistance at baseline was assessed by the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index, defined if above the 75th percentile. The risk of IR-associated prehypertension/hypertension was estimated by multinomial logistic regression after adjustment for confounding factors. Secondary analysis were stratified by body mass index. The mean (SD) age of participants was 48 (8) years, 67% were women. The 75th percentile of HOMA-IR at baseline was 2.85. The presence of IR increased the chance of developing prehypertension by 51% (95% CI 1.28–1.79) and hypertension by 150% (95% CI 1.48–4.23). In individuals with BMI < 25 kg/m 2 , the presence of IR remained associated with the incidence of prehypertension (OR 1.41; 95% CI 1.01–1.98) and hypertension (OR 3.15; 95% CI 1.27–7.81). In conclusion, our results suggest that IR is a risk factor for hypertension, regardless of the presence of overweight or obesity.

Background Job strain has been reported as a trigger for binge eating, yet the underlying mechanisms have been unclear. The aim of this study was to evaluate whether work-family conflict is a pathway in the association between job strain and binge eating, considering the possible effect-modifying influence of body mass index (BMI). Methods This cross-sectional analysis included 12,084 active civil servants from the multicenter Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Job strain was assessed using the Demand-Control-Support Questionnaire. Work-family conflict was considered as a latent variable comprising three items. Binge eating was defined as eating a large amount of food in less than 2 h at least twice a week in the last six months with a sense of lack of control over what and how much was eaten. Structural equation modelling was used to test the role of work-family conflict in the association between job strain and binge eating, stratifying for BMI. Results For individuals of normal weight, positive associations were found between skill discretion and binge eating (standardized coefficient [ SC] = 0.209, 95%CI = 0.022–0.396), and between psychological job demands and work-family conflict (SC = 0.571, 95%CI = 0.520–0.622), but no statistically significant indirect effect was found. In overweight individuals, psychological job demands, skill discretion, and work-family conflict were positively associated with binge eating (SC = 0.099, 95%CI = 0.005–0.193; SC = 0.175, 95%CI = 0.062–0.288; and SC = 0.141, 95%CI = 0.077–0.206, respectively). Also, work-family conflict was observed to be a pathway on the associations of psychological job demands and decision authority with binge eating (SC = 0.084, 95%CI = 0.045–0.122; and SC = − 0.008, 95%CI = − 0.015– − 0.001, respectively). Conclusions Work-family conflict partly explains effects of high levels of psychological job demands and low levels of decision authority on binge eating among overweight individuals. Moreover, skill discretion is positively associated with binge eating, regardless of BMI category.

We investigated whether racial dis-crimination accelerates the weight and Body Mass Index (BMI) gain in Blacks and Browns participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) in four years of follow-up. We compared body weight and BMI between the 1st (2008-2010) and 2nd visit (2012-2014) of 5,983 Blacks and Browns participants. Exposure to racial discrimination and covari-ates (age, sex, education, and research center) were obtained at the 1st visit. Linear mixed ef-fects models stratified by race/skin color were used. Report of racial discrimination was more frequent among Blacks (32.1%) than Browns (6.3%). During the follow-up period, Blacks and Browns gained an average of 1.4kg and 1.2kg, re-spectively. This increase was greater among those who reported discrimination when compared to those who did not, both in Blacks (2.1kg vs.1.0kg, p < 0.001) and Browns (1.9kg vs. 1.1kg, p < 0.05). The results of the interaction between racial dis-crimination and time showed that Blacks, but not Browns, who reported racial discrimination had greater weight and BMI gains between visits. Our results suggest that reducing racial discrimination would contribute to prevent and/or control obesi-ty increase in the country.

Abstract Background Evidence of multimorbidity has come mainly from high-income regions, while disparities among racial groups have been less explored. This study examined racial differences in multimorbidity in the multiracial cohort of the Longitudinal Study of Adult Health (Estudo Longitudinal de Saúde do Adulto), ELSA-Brasil. Methods The study examined baseline (2008–2010) data for 14 099 ELSA-Brasil participants who self-reported being white, mixed-race, or black. A list of 16 morbidities was used to evaluate multimorbidity, operationalised by simple count into ≥ 2, ≥ 3, ≥ 4, ≥ 5 and ≥ 6 morbidities, in addition to evaluating the number of coexisting conditions. Prevalence ratios (PR) were estimated from logistic models and a quantile model was used to examine racial differences graphically in the distribution quantiles for the number of morbidities. Results Overall prevalence of multimorbidity (≥ 2 morbidities) was 70% and, after controlling for age and sex, was greater among mixed-race and black participants – by 6% (PR: 1.06; 95% CI: 1.03–1.08) and 9% (PR: 1.09; 95% CI: 1.06–1.12), respectively – than among white participants. As the cutoff value for defining multimorbidity was raised, so the strength of the association increased, especially among blacks: if set at ≥ 6 morbidities, the prevalence was 27% greater for those of mixed-race (PR: 1.27; 95% CI: 1.07–1.50) and 47% greater for blacks (PR: 1.47; 95% CI: 1.22–1.76) than for whites. The disparities were smaller in the lower morbidity distribution quantiles and larger in the upper quantiles, indicating a heavier burden of disease, particularly on blacks. Conclusions Multimorbidity was common among adults and older adults in a Brazilian cohort, but important racial inequalities were found. Raising the cutoff point for defining multimorbidity revealed stronger associations between race/skin colour and multimorbidity, indicating a higher prevalence of multimorbidity among mixed-race and black individuals than among whites and that the former groups coexisted more often with more complex health situations (with more coexisting morbidities). Interventions to prevent and manage the condition of multimorbidity that consider the social determinants of health and historically discriminated populations in low- and middle-income regions are necessary.

Objective: To investigate the association between diabetes mellitus (DM) and incidence of depressive episodes among men and women. Methods: Data were used from 12,730 participants (5866 men and 6864 women) at baseline (2008–2010) and follow-up 1 (2012–2014) of the Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort of Brazilian civil servants. Participants were classified for diabetes using self-reported and clinical information, and evaluated for presence of depressive episodes by the Clinical Interview Schedule–Revised (CIS-R). Associations were estimated by means of logistic regression models (crude and adjusted for socio-demographic variables). Results: Women classified as with DM prior to the baseline were at 48% greater risk (95% confidence interval (CI) = 1.03–2.07) of depressive episodes in the crude model and 54% greater risk (95% CI = 1.06–2.19) in the final adjusted model compared to women classified as non-DM . No significant associations were observed for men. The regression models for duration of DM and incidence of depressive episodes ( n = 2143 participants; 1160 men and 983 women) returned no significant associations. Conclusion: In women classified as with prior DM, the greater risk of depressive episodes suggests that more frequent screening for depression may be beneficial as part of a multi-factorial approach to care for DM.

Background It seems that the worst response to some classes of antihypertensive drugs, especially angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, on the part of the Black population, would at least partially explain the worse control of hypertension among these individuals. However, most of the evidence comes from American studies. Objectives This study aims to investigate the association between self-reported race/skin color and BP control in participants of the Longitudinal Study of Adult Health (ELSA-Brasil), using different classes of antihypertensive drugs in monotherapy. Methods The study involved a cross-sectional analysis, carried out with participants from the baseline of ELSA-Brasil. Blood pressure control was the response variable, participants with BP values ≥140/90 mmHg were considered out of control in relation to blood pressure levels. Race/skin color was self-reported (White, Brown, Black). All participants were asked about the continuous use of medication. Association between BP control and race/skin color was estimated through logistic regression. The level of significance adopted in this study was of 5%. Results Of the total of 1,795 users of antihypertensive drugs in monotherapy at baseline, 55.5% declared themselves White, 27.9% Brown, and 16.7% Black. Even after adjusting for confounding variables, Blacks using angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blocker (ARB), thiazide diuretics (thiazide DIU), and beta-blockers (BB) in monotherapy had worse blood pressure control compared to Whites. Conclusions Our results suggest that in this sample of Brazilian adults using antihypertensive drugs in monotherapy, the differences in blood pressure control between different racial groups are not explained by the possible lower effectiveness of ACEIs and ARBs in Black individuals.

Objective To investigate the mediation effect of socioeconomic position and racial discrimination in the association between race/color and incidence of hypertension in 4-years follow up. Methods We included 8,370 participants of the Longitudinal Study of Adult Health (ELSA-Brasil). A latent variable was constructed to represent socioeconomic position (SEP). The perception of discrimination was measured through an adaptation of the Lifetime Major Events Scale; and hypertension was defined using standard criteria. We investigated Body Mass Index (BMI) due to its role in proximal risk for hypertension. To investigate the mediating role of SEP and racial discrimination, we used structural equation modeling. Results SEP had a direct and negative effect on HT incidence (HT incidence increased in worse SEP categories), while the effect of BMI on HT was direct and positive. We did not find significant direct effects of race/color and racial discrimination on HT. As for indirect effects, we observed associations between race/color and HT only through SEP mediation. Conclusion According to our results, race/color is indirectly related to HT incidence, mediated by SEP. Racial discrimination was not a mediator in the relationship between race/color and HT in the follow-up period.

This study sought to analyze the effect of work-to-family conflict (demands from work that affect one's family/personal life), family-to-work conflict (demands from family/personal life that affect work), and lack of time for self-care and leisure due to professional and domestic demands on the incidence of weight gain and increase in waist circumference by gender in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Our study included 9,159 ELSA-Brasil participants (4,413 men and 4,746 women) who attended baseline (2008-2010) and the first follow-up visit (2012-2014). Weight gain and increase in waist circumference were defined as an annual increase ≥ 75th percentile, i.e., ≥ 1.21kg/year and ≥ 1.75cm/year, respectively for women; and ≥ 0.96kg/year and ≥ 1.41cm/year respectively for men. Associations were estimated by Poisson regression applying robust variance with the R software. Analyses were stratified by gender and adjusted for socioeconomic variables. Adjusted models showed a higher risk of weight gain among women who reported family-to-work conflict frequently and sometimes (relative risk - RR = 1.37 and RR = 1.15, respectively) and among those who reported frequent lack of time for self-care and leisure (RR = 1.13). Among men, time-based work-to-family conflict (RR = 1.17) and strain-based work-to-family conflict (RR = 1.24) were associated with weight gain. No associations were observed between work-family conflict domains and increase in waist circumference. These findings suggest that occupational and social health promotion programs are essential to help workers balance work and family life to reduce weight gain.

Blacks and Browns have major health disadvantages, are less likely to rise in the social hierarchy throughout the course of life, and pertain to lower socioeconomic levels than Whites as a result of structural racism. However, little is known about the mediating role of intergenerational mobility in the association between race/skin color and health. The aim of the present study was to investigate the association between racism and self-rated health and to verify to what extent intergenerational social mobility mediates this association. This was a cross-sectional study conducted with data from 14,386 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline (2008-2010). Maternal education, education of the participant, socio-occupational class of the head of household, and socio-occupational class of the participant were used in the indicators of intergenerational social mobility (educational and socio-occupational). Logistic regression models were used. The prevalence of poor self-rated health was 15%, 24%, and 28% among Whites, Browns, and Blacks, respectively. After adjustments for age, sex, and research center, greater chances of poor self-rated health were found among Blacks (OR = 2.15; 95%CI: 1.92-2.41) and Browns (OR = 1.82; 95%CI: 1.64-2.01) when compared to Whites. Intergenerational educational and socio-occupational mobility mediated, respectively, 66% and 53% of the association between race/color and poor self-rated health in Blacks, and 61% and 51% in Browns, respectively. Results confirm racial iniquity in self-rated health and point out that unfavorable intergenerational social mobility is an important mechanism to explain this iniquity.

OBJETIVO: Descrever o processo de adaptação transcultural para o uso no Brasil das escalas de discriminação no dia a dia (EDD) e vigilância intensificada (EVI), aplicadas no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). MÉTODOS: Foram realizadas análises das equivalências conceitual, de itens e semântica conduzidas por um grupo de quatro epidemiologistas; avaliação da equivalência de mensuração (análise fatorial das estruturas configural, métrica e escalares, segundo características sociodemográficas) e a confiabilidade. Responderam à escala de escala de discriminação 11.987 participantes e uma subamostra de 260 pessoas participaram do estudo teste-reteste. No caso da EVI, 8.916 pessoas responderam e 149 indivíduos no estudo teste-reteste. RESULTADOS: As escalas apresentaram equivalências conceitual, de itens e semântica pertinentes no contexto brasileiro, além de adequada correspondência de significado referencial/denotativa de termos e também da geral/conotativa dos itens. A análise fatorial confirmatória da EDD revelou estrutura unidimensional, com correlações residuais entre dois pares de itens, apresentando invariância configural e métrica entre os quatro subgrupos avaliados. Identificou-se invariância escalar segundo sexo e faixa etária, mas não foi observada para recortes de raça/cor e escolaridade. A vigilância intensificada apresentou cargas baixas e resíduos altos, com indicadores de ajuste inadequados. Para os itens da escala de discriminação o coeficiente de concordância kappa ponderado (Kp) variou de 0,44 a 0,78, e o Coeficiente de Correlação Intraclasse (CCI) foi 0,87. Para os itens da EVI, o Kp variou de 0,47 a 0,59 e o CCI foi 0,83. CONCLUSÕES: Embora haja itens correlacionados, concluiu-se que a EDD é uma escala promissora para avaliar experiências de discriminação percebidas no cotidiano brasileiro. Entretanto, a escala de vigilância intensificada não apresentou equivalência de mensuração no formato atual.

Purpose: The association between racial discrimination and subclinical cardiovascular markers remains under-examined. We aimed to investigate the association of race/skin color and racial discrimination with pulse wave velocity (PWV) and carotid intima-media thickness (c-IMT) in the Brazilian context. Methods: We used data from 13,284 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline with information of PWV and 9850 for c-IMT. Self-reported race/skin color and perceived racial discrimination were the exposures. PWV and c-IMT were used continuously and categorizing according to cutoff that indicates increased cardiovascular risk. Linear and logistic regression models were used. Results: Experience of racial discrimination was reported by 7% of total participants, but this prevalence was much higher among Blacks than Browns (PWV sample: 31,9% vs. 6,1%; c-IMT sample: 33,7% vs. 6,8%). After adjustments for age, sex, and research center, Blacks and Browns presented higher means of PWV and c-IMT and had greater chances of PWV > 10 m/s and c-IMT >= 75th percentile than Whites. The magnitude of all these associations were higher among Blacks and Browns with racial discrimination. In final models adjusted for education this pattern of association remained the same, although an attenuation in the magnitude of the association has been observed. Conclusions: Blacks and Browns presented worse profiles of subclinical cardiovascular markers compared to Whites and those exposed to racial discrimination seem to have an additional cardiovascular risk. (C) 2022 Elsevier Inc. All rights reserved.

Resumo Fundamento Aparentemente, a pior resposta a algumas classes de anti-hipertensivos, especialmente inibidores da enzima conversora da angiotensina e bloqueadores de receptor de angiotensina, pela população negra, explicaria, pelo menos parcialmente, o pior controle da hipertensão entre esses indivíduos. Entretanto, a maioria das evidências vêm de estudos norte-americanos. Objetivos Este estudo tem o objetivo de investigar a associação entre raça/cor da pele autorrelatadas e controle de PA em participantes do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) utilizando várias classes de anti-hipertensivos em monoterapia. Métodos O estudo envolveu uma análise transversal, realizada com participantes da linha de base do ELSA-Brasil. O controle de pressão arterial foi a variável de resposta, participantes com valores de PA ≥140/90 mmHg foram considerados descontrolados em relação aos níveis de pressão arterial. A raça/cor da pele foi autorrelatada (branco, pardo, negro). Todos os participantes tiveram que responder perguntas sobre uso contínuo de medicamentos. A associação entre o controle de PA e raça/cor da pele foi estimada por regressão logística. O nível de significância adotado nesse estudo foi de 5%. Resultados Do total de 1.795 usuários de anti-hipertensivos em monoterapia na linha de base, 55,5% se declararam brancos, 27,9%, pardos e 16,7%, negros. Mesmo depois de padronizar em relação a variáveis de confusão, negros em uso de inibidores da enzima conversora de angiotensina (IECA), bloqueadores de receptor de angiotensina (BRA), diuréticos tiazídicos (DIU tiazídicos) e betabloqueadores (BB) in monoterapia tinham controle de pressão arterial pior em comparação a brancos. Conclusões Os resultados deste estudo sugerem que, nesta amostra de brasileiros adultos utilizando anti-hipertensivos em monoterapia, as diferenças de controle de pressão arterial entre os vários grupos raciais não são explicadas pela possível eficácia mais baixa dos IECA e BRA em indivíduos negros.

OBJECTIVE: To describe the process of cross-cultural adaptation for the use in Brazil of the everyday discrimination scale (EDS) and the heightened vigilance scale (HVS) applied in the Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: Conceptual, item and semantic equivalence analyses were conducted by a group of four epidemiologists; evaluation of measurement equivalence (factorial analysis of configural, metric and scalar structures, according to sociodemographic characteristics) and reliability. A total of 11,987 participants responded to the discrimination scale, and a subsample of 260 people participated in the test-retest study. In the case of HVS, 8,916 people responded, while 149 individuals did so in the test-retest study. RESULTS: The scales presented conceptual, item and semantic equivalence pertinent in the Brazilian context, in addition to adequate correspondence of referential/denotative meaning of terms and also of the general/connotative of the items. The confirmatory factor analysis of EDS revealed a unidimensional structure, with residual correlations between two pairs of items, presenting configural and metric invariance among the four subgroups evaluated. Scalar invariance was identified according to sex and age group, but it was not observed for race/color and education. Heightened vigilance showed low loads and high residuals, with inadequate adjustment indicators. For the items of the discrimination scale the weighted kappa coefficient (Kp) ranged from 0.44 to 0.78, and the intraclass correlation coefficient (ICC) was 0.87. For HVS items, the Kp ranged from 0.47 to 0.59 and the ICC was 0.83. CONCLUSIONS: Although there are correlated items, it was concluded that the EDS is a promising scale to evaluate experiences of perceived discrimination in Brazilian daily life. However, the heightened vigilance scale did not present equivalence of measurement in the current format.