Effectiveness of a comprehensive blood pressure control program in primary health care in Peru
Jong-Koo Kim, Hyeyeon Jo, Miguel Á. Malo, Eun Woo Nam
Abstract
<bold>Objective.</bold> To assess the effectiveness of a comprehensive blood pressure (BP) control program on improving lifestyle indicators, BP levels, and laboratory examination results among people living in low-income urban areas of Peru. <bold>Methods.</bold> A prospective before-and-after study design was applied to 1 271 participants with hypertension or pre-hypertension. The intervention was implemented for 2 years, from May 2015 – April 2017, in three health centers in Lima (2 in Comas and 1 in Callao). The changes in participants over the study period were compared. All participants were provided with individualized consultations, group health education sessions, regular group meetings to improve self-management, and text messages providing health education. Paired t- and chi-square tests were used to determine the significance of the changes in indicators before and after the intervention. <bold>Results.</bold> Lifestyle behaviors, such as weight and blood pressure monitoring, reduced salt consumption, increased fruit and vegetable consumption, and stress control improved during the intervention (<italic>P</italic> < 0.001). The EuroQol-Five Dimension Scale showed improvement (<italic>P</italic> < 0.001) and body mass index, waist circumference, and systolic and diastolic BPs of the participants significantly decreased (<italic>P</italic> < 0.001). Low-density lipoprotein cholesterol (LDL-C) and triglyceride decreased (<italic>P</italic> < 0.01) and high-density lipoprotein cholesterol (HDL-C) increased. The estimated glomerular filtration rate (eGFR) increased after the program (<italic>P</italic> < 0.001). <bold>Conclusions.</bold> This comprehensive BP control program was effective in improving lifestyle indicators, BP levels, and laboratory results among people living in a low-income urban area of Peru. Increasing opportunities for BP measurement, systematic management of hypertensive patients, and community-based prevention and education programs are paramount to hypertension detection, prevention, and control.