Cellular phone and Internet-based individual intervention on blood pressure and obesity in obese patients with hypertension

https://www.internationaljournalofcardiology.com/article/S0167-5273(08)00520-2/pdf

Meta-analysis of interventions to increase physical activity among cardiac subjects.

Evaluation of mobile phone and Internet intervention on waist circumference and blood pressure in post-menopausal women with abdominal obesity.

The prevalence of hypertension continues to rise across the world, and most patients who receive medical intervention are not adequately treated to goal. A Working Group including representatives of nine international health-care organizations was convened to review the barriers to more effective blood pressure control and propose actions to address them. The group concluded that tackling the global challenge of hypertension will require partnerships among multiple constituencies, including patients, health-care professionals, industry, media, health-care educators, health planners and governments. Additionally, health-care professionals will need to act locally with renewed impetus to improve blood pressure goal rates. The Working Group identified five core actions, which should be rigorously implemented by practitioners and targeted by health systems throughout the world: (1) detect and prevent high blood pressure; (2) assess total cardiovascular risk; (3) form an active partnership with the patient; (4) treat hypertension to goal and (5) create a supportive environment. These actions should be pursued with vigour in accordance with current clinical guidelines, with the details of implementation adapted to the economic and cultural setting.

Achieving blood pressure goals globally: five core actions for health-care professionals. A worldwide call to action.

La investigacion tuvo como objetivo determinar la efectividad de un programa de intervencion biopsicosocial para reducir niveles de presion arterial y mejorar la adherencia al tratamiento de personas con diagnostico de hipertension arterial. El estudio fue cuasi-experimental, diseno intra e intergrupo, pre-post intervencion. La muestra estuvo conformada por 44 participantes, con ausencia de otra enfermedad cronica y/o de trastorno psiquiatrico diagnosticado, atendidos en una Institucion de Salud de la ciudad de Cali, Colombia. Los niveles de presion arterial sistolica y diastolica fueron medidos pre-post intervencion por el personal de salud. Se encontro una disminucion estadisticamente significativa en la PAS, la PAD no presento cambios pero se mantuvo en niveles controlados. En adherencia al tratamiento los cambios post-intervencion fueron estadisticamente significativos (p = 0,000; n.c. 95%), el 86,6% termino en nivel alto de adherencia y el 11,4% finalizo en nivel medio.

/pdf/adherencia-al-tratamiento-de-hipertension-arterial-54adhv96zd.pdf

Adherencia al tratamiento de hipertensión arterial: efectividad de un programa de intervención biopsicosocial

The burden of insufficiently treated arterial hypertension is still underestimated. In addition to pharmacological therapy, patient training is a valuable therapeutic option. During 1998-1999, the Institute for Preventive Medicine conducted an intensive training programme in cooperation with regional practitioners. The goal of this programme was to educate patients about their disease and motivate them to comply with the therapy. To evaluate the effectivity of this programme, 126 patients with arterial hypertension were trained. They received eight training sessions of 90 min each. In 90 patients blood pressure measurements before and 6 months after training were available. In addition, data concerning health status and lifestyle risk factors were analysed with standardised questionnaires. There was a marked reduction in blood pressure after 6 months (152+/-6/89+/-10 vs. 145+/-12/85+/-8 mmHg, P<0.001). In parallel, mean body weight declined by 0.9 +/- 2.9 kg (P<0.001) and body mass index (BMI) by 0.33+/-1.04 kg/m2 (P<0.001). Further analysis revealed that weight loss was more marked in obese patients (P< 0.01) than in lean subjects. Similarly, the decline of blood pressure was also greater in obese patients, but did not reach statistical significance. The activity score for physical exercise increased overall from 2.1+/-0.4 to 2.8+/-3.1 h/week (P<0.01). Moreover, knowledge about hypertension increased as well (P<0.01). Of all the quality life measurements, the vitality index improved from 53+/-19 to 59+/-19 (P<0.05) according to the patients' self-estimation. In conclusion, training of hypertensive patients has a profound effect on blood pressure control. It motivates patients to change lifestyle risk factors, namely to lose weight, and increases the patients' physical activity level, thereby decreasing the patients' blood pressure. Thus, intensive training programmes are effective and should be used on a widespread basis.

Intensive training of patients with hypertension is effective in modifying lifestyle risk factors.

BACKGROUND AND OBJECTIVE The burden of insufficiently treated arterial hypertension is still underestimated. During 1998 to 1999 we conducted an intensive training program in cooperation with regional practitioners. The aim of this program was to educate the patients about their disease and motivate them to comply with therapy. The effectivity of this program yet needs to be evaluated. PATIENTS AND METHODS 146 patients (mean age 62 years; 57 male, 89 female) with arterial hypertension were trained. They received 8 training units of 90 min each. Before training and 6 months after training data concerning health status and life style risk factors were assessed with questionnaires. RESULTS There was a marked reduction in blood pressure after 6 months (152/89 mmHg vs 145/85 mmHg, p < 0.001). The mean body weight also declined on the average by 0.9 kg (p < 0.001). Physical exercise spent per week increased from mean 2.0 to 2.8 hours (p < 0.01). Moreover, knowledge about hypertension increased (p < 0.001). The established questionnaire SF-36 revealed a better score for vitality (p < 0.05) six months after therapy than before. CONCLUSION Our intensive training program of patients with arterial hypertension has profound effects on their systolic and diastolic blood pressure. It also motivates patients to change life style. Our data suggest that intensive training programs should be developed on a widespread basis.

K Gallert

Papers

Intensive training of patients with hypertension is effective in modifying lifestyle risk factors.

Results of an intensive training program for hypertension at the Institute for Preventive Medicine

H001: Evaluation of an education program for hypertensive patients

[Nürnberg Prevention Survey. "Prevention yes--but only when no effort is required"].