Effycacy of an Educational Intervention Group on Changes in Lifestyles in Hypertensive Patients in Primary Care: A Randomized Clinical Trial

Abstract

Background: Healthy lifestyles are associated with less risk of cardiovascular disease. The aim of this study is to evaluate the effectiveness of a group educational strategy in lifestyle changes, as well as the control of risk factors and cardiovascular risk in hypertensive patients. Methods: Randomized clinical trial carried out in Primary Care. 101 hypertensive patients were selected by random sampling, aged 35-74; 51 patients were randomized to the intervention group (IG) (aged: 64,5±9,7, 56% women) and other 50 to the control group(CG)(aged: 65,4±8,4, 68% women). We performed a basal evaluation and an educational intervention on lifestyles, six sessions during one year, and final-point evaluation. Effect of intervention was evaluated through of cardiovascular risk (Framingham), blood pressure, lipid profile, waist circumference, body mass index (BMI), nutrient consumption, physical exercise (7-PAR day) and quality of life(SF-36). Results: Basal blood pressure was 136,8/82,7 mmHg IG and 139,3/79,3 CG, cardiovascular risk was 11,1% y 12,3% respectively. Systolic blood pressure decreased 5,6±19,6 (p=0,07) IG and 7,1±16,3 mmHg (p=0,004) GC, and diastolic decreased 3,9±10,8 (p=0,02) and 2,7±11,5 mmHg (p=0,10) respectively. BMI decreased 0,3±1,6 points IG (p=0,17) and increased 0,1±1,5 CG (p=0,81). Coronary risk decreased 0,8±6,5 points IG and increased 0,2± 6,8 CG; effect of intervention was a reduction in 1 point (CI95%-3,9÷1,9)(p=0,48). Calories ingestion decreased 42,8±1141,2 Kcal/day p=0,14) IG and 278,9±1115,9(p=0,62) CG. Physical exercise increased in both groups: 3,6±19 IG (p=0,20) and 3,9±14,9 mets/hour/week CG (p=0,07). Conclusions: There was a higher decline of cardiovascular risk in the intervention group than control group, we did not find statistically significant differences between both groups in parameters evaluated.