The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Background: Hypertension is highly prevalent among patients who visit primary care clinics. Various factors and lifestyle behaviors are associated with effective blood pressure control. We aimed to identify factors and lifestyle modifications associated with blood pressure control among patients prescribed antihypertensive agents.Methods: This survey was conducted at 15 hospital-based family practices in Korea from July 2008 to June 2010. We prospectively recruited and retrospectively assessed 1,453 patients prescribed candesartan. An initial evaluation of patients’ lifestyles was performed using individual questions. Follow-up questionnaires were administered at 4, 8, and 12 weeks. We defined successful blood pressure control as blood pressure <140 mm Hg systolic and <90 mm Hg diastolic.Results: Of the 1,453 patients, 1,139 patients with available data for initial and final blood pressures were included. In the univariate analysis of the change in performance index, weight gain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.52 to 3.11; P<0.001), physical inactivity (OR, 1.195; 95% CI, 1.175 to 3.387; P=0.011), and increased salt intake (OR, 1.461; 95% CI, 1.029 to 2.075; P=0.034) were related to inadequate blood pressure control. Salt in-take also showed a significant association. Multivariate ORs were calculated for age, sex, body mass index, educa-tion, income, alcohol consumption, smoking status, salt intake, comorbidity, and family history of hypertension. In the multivariate analysis, sex (OR, 3.55; 95% CI, 2.02 to 6.26; P<0.001), salt intake (OR, 0.64; 95% CI 0.43 to 0.97; P=0.034), and comorbidity (OR, 1.82; 95% CI, 1.23 to 2.69; P=0.003) were associated with successful blood pressure control.Conclusion: Weight gain, physical inactivity, and high salt intake were associated with inadequate blood pressure control.
Abstract
Background: Hypertension is highly prevalent among patients who visit primary care clinics. Various factors and lifestyle behaviors are associated with effective blood pressure control. We aimed to identify factors and lifestyle modifications associated with blood pressure control among patients prescribed antihypertensive agents.Methods: This survey was conducted at 15 hospital-based family practices in Korea from July 2008 to June 2010. We prospectively recruited and retrospectively assessed 1,453 patients prescribed candesartan. An initial evaluation of patients’ lifestyles was performed using individual questions. Follow-up questionnaires were administered at 4, 8, and 12 weeks. We defined successful blood pressure control as blood pressure <140 mm Hg systolic and <90 mm Hg diastolic.Results: Of the 1,453 patients, 1,139 patients with available data for initial and final blood pressures were included. In the univariate analysis of the change in performance index, weight gain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.52 to 3.11; P<0.001), physical inactivity (OR, 1.195; 95% CI, 1.175 to 3.387; P=0.011), and increased salt intake (OR, 1.461; 95% CI, 1.029 to 2.075; P=0.034) were related to inadequate blood pressure control. Salt in-take also showed a significant association. Multivariate ORs were calculated for age, sex, body mass index, educa-tion, income, alcohol consumption, smoking status, salt intake, comorbidity, and family history of hypertension. In the multivariate analysis, sex (OR, 3.55; 95% CI, 2.02 to 6.26; P<0.001), salt intake (OR, 0.64; 95% CI 0.43 to 0.97; P=0.034), and comorbidity (OR, 1.82; 95% CI, 1.23 to 2.69; P=0.003) were associated with successful blood pressure control.Conclusion: Weight gain, physical inactivity, and high salt intake were associated with inadequate blood pressure control.
참고문헌 (23)
- Global health risks: mortality and burden of disease attributable to selected major risks, "World Health Organization", World Health Organization, ~ (2009)
- Kim CY, "Health behaviors related to hypertension in rural population of Korea", Korean J Prev Med, 33, pp.56~68 (2000)
- Collins R, "Blood pressure, stroke, and coronary heart disease: part 2, shortterm reductions in blood pressure: overview of randomised drug trials in their epidemiological context", Lancet, 335, pp.827~838 (1990)
- Trilling JS, "The urgent need to improve hypertension care", Arch Fam Med, 9, pp.794~801 (2000)
- Bruno RM, "Association between lifestyle and systemic arterial hypertension in young adults: a national, survey-based, cross-sectional study", High Blood Press Cardiovasc Prev, 23, pp.31~40 (2016)
- Lee SY., "Health care policy and its challenges" (2015), Korea Institute for Health and Social Affairs
- Wee LE, "Hypertension management and lifestyle changes following screening for hypertension in an Asian low socioeconomic status community : a prospective study", Ann Acad Med Singapore, 42, pp.451~465 (2013)
- 이정아, "고혈압 환자에서 순응도 개선을 위한 단기간의 휴대전화 문자메시지의 효과", Korean Journal of Health Promotion, 14(1), pp.1~8 (2014), 대한임상건강증진학회
- International Physical Activity Questionnaire Research Committee, "Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ): short and long forms", International Physical Activity Questionnaire Research Committee, ~ (2005)
- Kim HJ, "Salt usage behaviors are related to urinary sodium excretion in normotensive Korean adults", Asia Pac J Clin Nutr, 16, pp.122~128 (2007)
- 정원, "고혈압·당뇨병 환자의 혈압·혈당 조절에 미치는 의원 기반 만성질환관리사업의 효과", 농촌의학.지역보건, 38(2), pp.108~115 (2013), 한국농촌의학.지역보건학회
- Hajjar I, "Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000", JAMA, 290, pp.199~206 (2003)
- Turner BJ, "Effect of unrelated comorbid conditions on hypertension management", Ann Intern Med, 148, pp.578~586 (2008)
- Bramlage P, "A global perspective on blood pressure treatment and control in a referred cohort of hypertensive patients", J Clin Hypertens (Greenwich), 12, pp.666~677 (2010)
- Goto C, "Effect of different intensities of exercise on endothelium-dependent vasodilation in humans : role of endothelium-dependent nitric oxide and oxidative stress", Circulation, 108, pp.530~535 (2003)
- Martinez DG, "Effects of long-term exercise training on autonomic control in myocardial infarction patients", Hypertension, 58, pp.1049~1056 (2011)
- Hansen AH, "Exercise training alters the balance between vasoactive compounds in skeletal muscle of individuals with essential hypertension", Hypertension, 58, pp.943~949 (2011)
- Chobanian AV, "The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure:the JNC 7 report", JAMA, 289, pp.2560~2572 (2003)
- Aburto NJ, "Effect of lower sodium intake on health : systematic review and meta-analyses", BMJ, 346, pp.1326~ (2013)
- Fregly MJ, "Estimates of sodium and potassium intake", Ann Intern Med, 98(5 Pt 2), pp.792~799 (1983)
- Graudal N, "Compared with usual sodium intake, low- and excessive-sodium diets are associated with increased mortality: a meta-analysis", Am J Hypertens, 27, pp.1129~1137 (2014)
- Stevens VJ, "Weight loss intervention in phase 1 of the Trials of Hypertension Prevention", Arch Intern Med, 153, pp.849~858 (1993)
- James PA, "2014 evidence-based guideline for the management of high blood pressure in adults : report from the panel members appointed to the Eighth Joint National Committee(JNC 8)", JAMA, 311, pp.507~520 (2014)