Kim Jong Koo, Jo Hye-Yeon, Malo Miguel A, Nam Eun Woo
Department of Family Medicine Department of Family Medicine Wonju College of Medicine, Yonsei University Wonju Republic of Korea Department of Family Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea.
Yonsei Global Health Center Yonsei Global Health Center Yonsei University Wonju Republic of Korea Yonsei Global Health Center, Yonsei University, Wonju, Republic of Korea.
Rev Panam Salud Publica. 2020 May 19;44:e18. doi: 10.26633/RPSP.2020.18. eCollection 2020.
To assess the effectiveness of a comprehensive blood pressure (BP) control program on improving lifestyle indicators, BP levels, and laboratory examination results among people living in low-income urban areas of Peru.
A prospective before-and-after study design was applied to 1 271 participants with hypertension or pre-hypertension. The intervention was implemented for 2 years, from May 2015 - April 2017, in three health centers in Lima (2 in Comas and 1 in Callao). The changes in participants over the study period were compared. All participants were provided with individualized consultations, group health education sessions, regular group meetings to improve self-management, and text messages providing health education. Paired t- and chi-square tests were used to determine the significance of the changes in indicators before and after the intervention.
Lifestyle behaviors, such as weight and blood pressure monitoring, reduced salt consumption, increased fruit and vegetable consumption, and stress control improved during the intervention ( < 0.001). The EuroQol-Five Dimension Scale showed improvement ( < 0.001) and body mass index, waist circumference, and systolic and diastolic BPs of the participants significantly decreased ( < 0.001). Low-density lipoprotein cholesterol (LDL-C) and triglyceride decreased ( < 0.01) and high-density lipoprotein cholesterol (HDL-C) increased. The estimated glomerular filtration rate (eGFR) increased after the program ( < 0.001).
This comprehensive BP control program was effective in improving lifestyle indicators, BP levels, and laboratory results among people living in a low-income urban area of Peru. Increasing opportunities for BP measurement, systematic management of hypertensive patients, and community-based prevention and education programs are paramount to hypertension detection, prevention, and control.
评估一项综合血压控制项目对改善秘鲁低收入城市地区居民生活方式指标、血压水平及实验室检查结果的有效性。
对1271名患有高血压或前期高血压的参与者采用前瞻性前后对照研究设计。干预措施于2015年5月至2017年4月在利马的三个健康中心实施了2年（科马斯2个，卡亚俄1个）。比较了研究期间参与者的变化情况。为所有参与者提供个性化咨询、团体健康教育课程、定期的团体会议以改善自我管理，以及提供健康教育的短信。采用配对t检验和卡方检验来确定干预前后指标变化的显著性。
在干预期间，体重和血压监测、减少盐摄入、增加水果和蔬菜摄入以及压力控制等生活方式行为得到改善（<0.001）。欧洲五维健康量表显示有所改善（<0.001），参与者的体重指数、腰围、收缩压和舒张压显著降低（<0.001）。低密度脂蛋白胆固醇（LDL-C）和甘油三酯降低（<0.01），高密度脂蛋白胆固醇（HDL-C）升高。项目实施后，估计肾小球滤过率（eGFR）增加（<0.001）。
这项综合血压控制项目在改善秘鲁低收入城市地区居民的生活方式指标、血压水平及实验室检查结果方面是有效的。增加血压测量机会、对高血压患者进行系统管理以及开展基于社区的预防和教育项目对于高血压的检测、预防和控制至关重要。
