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Eficacia de una intervencion educativa grupal sobre cambios en los estilos de vida en hipertensos en atencion primaria: un ensayo clinico aleatorio (Efficacy of an educational intervention group on changes in lifestyles in hypertensive patients in primary care: a randomized clinical trial) [Spanish]
Martin CR, Sanchez CS, Ortiz LG, Rodriguez JIR, Sanchez YC, Marcos MAG
Revista Espanola de Salud Publica 2009 May-Jun;83(3):441-452
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Healthy lifestyles are associated with less risk of cardiovascular disease. The aim of this study is to evaluate the effectiveness of a group educational strategy in lifestyle changes, as well as the control of risk factors and cardiovascular risk in hypertensive patients. METHODS: Randomized clinical trial carried out in Primary Care. 101 hypertensive patients were selected by random sampling, aged 35 to 74; 51 patients were randomized to the intervention group (IG) (aged 64.5 +/- 9.7, 56% women) and other 50 to the control group (CG) (aged 65.4 +/- 8.4, 68% women). We performed a basal evaluation and an educational intervention on lifestyles, six sessions during one year, and final-point evaluation. Effect of intervention was evaluated through of cardiovascular risk (Framingham), blood pressure, lipid profile, waist circumference, body mass index (BMI), nutrient consumption, physical exercise (7-PAR day) and quality of life(SF-36). RESULTS: Basal blood pressure was 136.8/82.7 mmHg IG and 139.3/79.3 CG, cardiovascular risk was 11.1% y 12.3% respectively. Systolic blood pressure decreased 5.6 +/- 19.6 (p = 0.07) IG and 7.1 +/- 16.3 mmHg (p = 0.004) GC, and diastolic decreased 3.9 +/- 10.8 (p = 0.02) and 2.7 +/- 11.5 mmHg (p = 0.10) respectively. BMI decreased 0.3 +/- 1.6 points IG (p = 0.17) and increased 0.1 +/- 1.5 CG (p = 0.81). Coronary risk decreased 0.8 +/- 6.5 points IG and increased 0.2 +/- 6.8 CG; effect of intervention was a reduction in 1 point (CI95% -3.9/1.9) (p = 0.48). Calories ingestion decreased 42.8 +/- 1,141.2 Kcal/day p = 0.14) IG and 278.9 +/- 1,115.9 (p = 0.62) CG. Physical exercise increased in both groups: 3.6 +/- 19 IG (p = 0.20) and 3.9 +/- 14.9 mets/hour/week CG (p = 0.07). CONCLUSIONS: There was a higher decline of cardiovascular risk in the intervention group than control group, we did not find statistically significant differences between both groups in parameters evaluated.

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