Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Av. Peter Henry Rolfs, s.n. - Campus Universitário, Viçosa - MG - Brazil.
BMC Public Health. 2011 Aug 10;11:637. doi: 10.1186/1471-2458-11-637.
Poor adherence to non-pharmacological treatment of hypertension represents a serious challenge for public health policies in several countries. This study was conducted to compare two intervention strategies regarding the adherence of adult women to dietary changes recommended for the treatment of hypertension in a community covered by Primary Health Care Unit.
This study is a randomized controlled trial of a sample composed of 28 women with hypertension enrolled in the Primary Health Care Unit located in the urban area of southeastern Brazil. The participants were already undergoing treatment for hypertension but devoid of nutritional care; and were divided into two groups, each composed of 14 individuals, who received interventions that consisted of two different strategies of nutritional guidance: monthly health education workshops alone (Group 1) and combined with family orientation through home visits (Group 2). Adherence to nutritional guidelines was evaluated by dietary, anthropometric, clinical and serum biochemical parameters, measured before and after the interventions. Knowledge on control and risk of hypertension was also investigated. The study lasted five months.
Mean age was 55.6 (± 2.8) and 50.7 (± 6.5) in the groups 1 and 2, respectively. The home orientation strategy promoted greater adherence to dietary changes, leading to a statistically significant improvement in the clinical, anthropometric, biochemical and dietary parameters. The group 2 reduced the consumption of risk foods (p = 0.01), oil (p = 0.002) and sugar (p = 0.02), and decreased body mass index (-0.7 kg/m2; p = 0.01); waist circumference (-4.2 cm; p = 0.001), systolic blood pressure (-13 mm HG; p = 0.004) and glycemia (-18.9 mg/dl; p = 0. 01). In group 1 only waist circumference (-2 cm; p = 0.01) changed significantly.
Nutritional orientations at the household level were more effective with regard to the adherence of individuals to non-pharmacological treatment of hypertension, regarding the reduction of clinical and behavioral risk parameters.
在多个国家，高血压的非药物治疗依从性差是公共卫生政策面临的严峻挑战。本研究旨在比较两种干预策略对社区初级保健单位中成年女性高血压患者饮食改变的依从性，这些女性患者已经接受了高血压治疗，但未接受营养护理。
这是一项在巴西东南部城市地区初级保健单位登记的 28 名高血压女性患者组成的随机对照试验。参与者正在接受高血压治疗，但缺乏营养护理；他们被分为两组，每组 14 人，分别接受两种不同的营养指导干预策略：仅每月进行健康教育培训（第 1 组）和结合家访的家庭定向（第 2 组）。通过饮食、人体测量、临床和血清生化参数来评估对营养指南的依从性，在干预前后进行测量。还调查了对高血压控制和风险的了解。研究持续五个月。
第 1 组和第 2 组的平均年龄分别为 55.6（±2.8）和 50.7（±6.5）岁。家庭导向策略促进了对饮食改变的更大依从性，导致临床、人体测量、生化和饮食参数的统计学显著改善。第 2 组减少了风险食品的消费（p = 0.01）、油（p = 0.002）和糖（p = 0.02），并降低了体重指数（-0.7 kg/m2；p = 0.01）；腰围（-4.2 cm；p = 0.001）、收缩压（-13 mm HG；p = 0.004）和血糖（-18.9 mg/dl；p = 0.01）。第 1 组仅腰围（-2 cm；p = 0.01）显著变化。
在减少临床和行为风险参数方面，家庭层面的营养指导对个体对高血压非药物治疗的依从性更有效。
