Alarcão, V.

Cardoso, I.

Fernandes, M.

Guerra, F.

Guiomar, S.

Nicola, P.

Pinto, A.

Rocha, E.

Simões, R.

Repositório Científico do Instituto Nacional de Saúde

   Data from 497 subjects were analyzed: 59.8% natives and 40.2% migrants, with a mean±SD age of 64.0±9.1 and 57.0±10.2 years (p<0.01), respectively.        Table 2: Characteristics of the study sample.                      *p-value for Chi-square (categorical variables) and Mann-Whitney U (continuous variables) tests. As shown in table 2, a higher proportion of overweight/obesity was observed among migrants (p=0.04), who also reported more frequently to know vegetables NR (p<0.01). A higher proportion of natives reported to comply with NR for fruit and fish (p<0.01 for both).   Multiple linear regression models were used (p<0.10) to explore predictors for MAP in both ethnic groups. Table 3 presents male and female natives, and migrants (no sex differences were found in this group) predictors.      Table 3: Multiple linear regression results.        Results European Congress of Epidemiology  5-8 September 2012 – Porto, Portugal Are Diet-related Factors Associated with Differences in Mean Arterial Pressure Among Portuguese Natives and African Migrants?  A Study with Medicated Hypertensive Patients followed at Lisbon Primary Health Care Centres Cardoso I (isa.msc@gmail.com), Alarcão V, Simões R, Guerra F, Pinto A, Nicola P, Fernandes M, Guiomar S, Rocha E Epidemiology Unit, Institute of Preventive Medicine, Faculty of Medicine, University of Lisbon, PORTUGAL    Introduction Discussion and Conclusions References: 1 Satia JA. Diet-related disparities: understanding the problem and accelerating solutions. J Am Diet Assoc. 2009;109(4):610-5. 2 Appel LJ,et al. Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension. 2006;47(2):296-308.  3 Halberg DL, et al. Pulse and Mean Arterial Pressure as Predictors of Stroke in the REGARDS Study. Stroke. 2012; 43:A2593. 4 Zheng L, et al. Pulse Pressure and Mean Arterial Pressure in Relation to Ischemic Stroke Among Patients With Uncontrolled Hypertension in Rural Areas of China. Stroke. 2008;39:1932-1937. Acknowledgements  Health Centers participants in theDIMATCH-HTA  Study (PTDC/SAU-ESA/103511/2008).   Financial grant:                                                                                 Scientific support:      Design and Participants Population-based cross-sectional study, integrated in the DIMATCH-HTA project that evaluated BP control and its determinants among hypertensive medicated patients, aged between 40-80 years, from two cohorts (African migrants and Portuguese natives). Both cohorts were randomly selected from Primary Health Care Centers of Lisbon’s Region.   Data Collection and Variables Participants were interviewed between September 2010 and March 2011. Table 1 presents the conceptual model1 and the relevant variables that were collected.  Table 1: Collected variables              Dependent Variable  From three BP measurements taken at baseline interview, we estimated MAP, using the following formula:  MAP = DBP + 1/3 (SBP – DBP).    Methods Aims To explore if MAP is associated with diet-related factors such as knowledge of and compliance with the nutritional recommendations (NR) of fruit, vegetables and fish, in Portuguese natives and African migrants medicated hypertensive patients. Characteristics All (n=497) Natives (n=297) Migrants (n=200) p* Age (yrs), mean±SD 61.2±10.4 64.0±9.1 57.0±11.0 <0.01 Male, % (n) 45.1% (224) 54.2% (161) 31.5% (63) <0.01 MAP, mean±SD 105.2±14.5 104.2±13.5 106.8±15.9 0.18 Anthropometric data, % (n) Overweight/obesity (BMI >= 25.0 Kg/m2) 82.1% (408) 88.4% (240) 85.4% (168) 0.04 Compliance with NR (number of times), % (n)  Daily fruit intake (3-5) 29.2% (145) 35.0% (104) 20.5% (41) <0.01  Daily vegetables intake (3-5) 7.4% (37) 6.7% (20) 8.5% (17) 0.46  Weekly fish intake (at least 2) 77.7% (386) 83.2% (247) 69.5% (139) <0.01 Knowledge about NR (number of times), % (n)  Daily fruit intake (3-5) 55.7% (277) 55.9% (166) 55.5% (111) 0.93  Daily vegetables intake (3-5) 24.9% (124) 19.5% (58) 33.0% (66) <0.01  Weekly fish intake (at least 2) 94.6% (470) 95.6% (284) 93.0% (186) 0.21 Diet-related disparities: differences in diet, as well as in the incidence, prevalence, mortality, and burden of disease between and within specific population subgroups – normally experienced by racial and ethnic minority groups1.  What is known  Nutrition and diet have been presented as key factors in the control of chronic diseases such as hypertension (HTN)2, and also as a source of disparities between different ethnic groups1.    It is well known that the major dietary modifications that lower BP are: reduced salt intake, weight loss, moderation of alcohol intake, a diet rich in fruits and vegetables2.    African migrants, when compared with the other ethnic groups, have higher blood pressure  (BP) and are at greater risk of BP-related complications2.    An increasing attention has been given to mean arterial pressure (MAP)3, which is a well-established marker of cardiovascular risk in different clinical settings4. In agreement with the results previously stated, ours indicate that MAP levels seem to be related with nutrition and diet (higher MAP levels seem to be related to lower fruit consumption and overweight in male and female natives, respectively, and to lower vegetables consumption in migrants). Therefore they support intervention strategies towards priority groups, in order to improve eating habits while reducing CV risk.  What this study adds • BP control is affected by: - Nutritional knowledge and dietary patterns, and - Comorbidities and sociodemographic conditions, which vary by ethnicity. • MAP can be a useful measure to explore HTN disparities.  Demographic characteristics Social inequality factors Psychosocial factors Disease-related factors Biomedical factors Age Ethnicity Knowledge of NR BP values Diabetes Sex Age Beliefs about diet Years of disease Cholesterol Education Sex Need for information about diet Number of medicines for HTN Obesity Employment Language and literacy Social support Income Immigrant status / acculturation Ethnicity Model Variable CI p Male Natives Age ]-0.6:-0.1[ <0.01 Meet the NR for fruit? ]-0.6:8.5[ 0.09 Female Natives BMI  ]-0.1:1.1[ 0.10 Diabetes ]-0.5:-13.3[ 0.07 Migrants Male ]-0.4:10.2[ 0.07 Meet the NR for vegetables? ]0.5:16.7[ 0.04 Level of Education ]-1.2:0.1[ 0.08 Adherence to antihypertensive medication ]-11.4:-1.9[ 0.01 

Are Diet-related Factors Associated with Differences in Mean Arterial Pressure Among Portuguese Natives and African Migrants? A Study with Medicated Hypertensive Patients followed at Lisbon Primary Health Care Centres

Are Diet-related Factors Associated with Differences in Mean Arterial Pressure Among Portuguese Natives and African Migrants? A Study with Medicated Hypertensive Patients followed at Lisbon Primary Health Care Centres

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