Clinical and epidemiological profile of hypertensive patients at the primary health care level in the state of Alagoas

Study design: This was a cross-sectional, population-based and descriptive study. Study objective: To describe the clinical and epidemiological profile of hypertensive patients at the primary health care of Alagoas state. Methods: This study was carried out in the Basic Health Units of 12 cities of Alagoas, between 2014 and 2015, with hypertensive individuals between 20 and 60 years, of both gender. Socioeconomic, demographic, clinical, lifestyle, anthropometric and biochemical data were collected. Data were analyzed using descriptive statistics by Epi-Info version 7. Results: We evaluated 645 individuals. Of these, 86.2% were women, 62.3% had uncontrolled blood pressure, 41.9% had low educational level, 11.1% were smokers, 26.3% were alcohol users, 64.7% were sedentary, 48.4% were obese, 73.6% had high cardiovascular risk, according to waist circumference; 54.4% and 47.2% had elevated total cholesterol and triglycerides, respectively. Conclusion: Since hypertension is an important public health problem that has serious consequences, the knowledge of the hypertensive population profile of Alagoas will facilitate the treatment for the health of patients with this condition.Modelo do estudo: Estudo transversal, de base populacional, descritivo. Objetivo do estudo: Descrever o perfil clínico-epidemiológico dos portadores de hipertensão arterial sistêmica atendidos na atenção básica do estado de Alagoas. Metodologia: Estudo realizado nas Unidades Básicas de Saúde de 12 municípios de Alagoas, entre 2014 e 2015, com indivíduos entre 20 e 60 anos, de ambos os sexos, portadores de hipertensão arterial sistêmica. Foram coletados dados socioeconômicos, demográ- ficos, clínicos, de estilo de vida, antropométricos e bioquímicos. Os dados foram analisados segundo estatística descritiva, no Epi-Info versão 7. Resultados: Foram avaliados 645 indivíduos. Destes, 86,2% eram mulheres, 62,3% estavam com a pressão arterial não controlada, 72,8% tinham baixa escolaridade, 11,1% eram fumantes, 26,3% consumiam bebida alcoólica, 64,7% eram sedentários, 48,4% eram obesos, 73,6% apresentavam risco cardiovascular muito elevado, segundo a circunferência da cintura; 54,4% e 47,2% apesentavam colesterol total e triglicerídeos elevados, respectivamente. Conclusão: Visto que a hipertensão arterial sistêmica é um importante problema de saúde pública e que apresenta consequências graves, o conhecimento do perfil da população hipertensa de Alagoas facilitará o tratamento integral à saúde dos portadores dessa condição

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P <.01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P =.15). Secondary end points did not differ between groups after follow-up. Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death. © 2019 The Author