Le Minh Huu, Nguyen Trung Kien, Pham Thi Tam, Pham Trung Tin, Tran Van De
Department of Epidemiology, Can Tho University of Medicine and Pharmacy, Can Tho 900000, Vietnam.
Department of Physiology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho 900000, Vietnam.
Healthcare (Basel). 2023 Aug 4;11(15):2208. doi: 10.3390/healthcare11152208.
Hypertension, a major health concern, is associated with significant mortality and disease burden worldwide, including Vietnam. Comprehensive interventions targeting medication, lifestyle modifications, dyslipidemia (DLP), and microalbuminuria (MAU) are vital for effective hypertension management and reducing the risk of cardiovascular disease complications (CDV). While medication interventions have proven efficacy, the evidence regarding the effectiveness of community-based health education interventions in managing DLP and MAU is limited. Therefore, this study aims to evaluate the effectiveness of community health education interventions in reducing hypertension risk factors and achieving hypertension management objectives, as well as managing DLP and MAU among hypertension patients.
A quasi-experimental study was conducted on 330 hypertensive patients with dyslipidemia (DLP) and/or microalbuminuria (MAU) who were divided into a control group (n = 164) and an intervention group (n = 166). The control group received standard national hypertension management, while the intervention group received additional intensive health education provided by trained volunteers. The effectiveness of the intervention was assessed by comparing outcomes such as lifestyle factors, BMI control, treatment adherence, hypertension control, and DLP and MAU status between the two groups before and after a two-year intervention period.
The health education intervention resulted in significant reductions in dietary risk factors, specifically in fruit and vegetable consumption ( < 0.001). There was a lower prevalence of high salt intake in the intervention group compared to the control group ( = 0.002), while no significant differences were observed in other dietary factors. Smoking habits and low physical activity significantly decreased in the intervention group, with a notable disparity in physical activity proportions ( < 0.001). Both groups showed significant improvements in achieving hypertension management targets, with the intervention group demonstrating superior outcomes. The intervention was effective in reducing the prevalence of risk factors, particularly treatment non-adherence, blood pressure control, and low physical activity. Additionally, the intervention group had a higher likelihood of achieving DLP and MAU control compared to the control group.
This study underscored the additional positive impact of incorporating health education by non-professional educators in achieving favorable outcomes, including better control of BMI, blood pressure, medication adherence, and management of dyslipidemia (DLP) and microalbuminuria (MAU). Further research is warranted to fully explore the potential of health education in primary healthcare settings and maximize its effectiveness.
高血压是一个主要的健康问题，在全球范围内，包括越南，都与显著的死亡率和疾病负担相关。针对药物治疗、生活方式改变、血脂异常（DLP）和微量白蛋白尿（MAU）的综合干预对于有效管理高血压和降低心血管疾病并发症（CDV）的风险至关重要。虽然药物干预已被证明有效，但关于基于社区的健康教育干预在管理DLP和MAU方面有效性的证据有限。因此，本研究旨在评估社区健康教育干预在降低高血压危险因素、实现高血压管理目标以及管理高血压患者的DLP和MAU方面的有效性。
对330例患有血脂异常（DLP）和/或微量白蛋白尿（MAU）的高血压患者进行了一项准实验研究，这些患者被分为对照组（n = 164）和干预组（n = 166）。对照组接受标准的国家高血压管理，而干预组接受由经过培训的志愿者提供的额外强化健康教育。通过比较两组在两年干预期前后的生活方式因素、BMI控制、治疗依从性、高血压控制以及DLP和MAU状况等结果来评估干预的有效性。
健康教育干预导致饮食危险因素显著降低，特别是水果和蔬菜的摄入量（< 0.001）。与对照组相比，干预组高盐摄入的患病率较低（ = 0.002），而在其他饮食因素方面未观察到显著差异。干预组的吸烟习惯和低体力活动显著减少，体力活动比例存在显著差异（< 0.001）。两组在实现高血压管理目标方面均有显著改善，干预组表现出更好的结果。该干预在降低危险因素的患病率方面有效，特别是治疗不依从、血压控制和低体力活动。此外，与对照组相比，干预组实现DLP和MAU控制的可能性更高。
本研究强调了非专业教育工作者纳入健康教育在实现良好结果方面的额外积极影响，包括更好地控制BMI、血压、药物依从性以及管理血脂异常（DLP）和微量白蛋白尿（MAU）。有必要进行进一步研究，以充分探索初级卫生保健环境中健康教育的潜力并使其有效性最大化。
