Compliance to Multidisciplinary Lifestyle Intervention Decreases Blood Pressure in Patients with Resistant Hypertension: A Cross-Sectional Pilot Study
| Autor: | Espinel Garuz, Eugenia, Azancot, María A, Gomez-Garrido, Alba, Beneria, Anna, Caraben, Anna, Andurell, Laura, Delgado Martínez, María Pilar, Castañé, Helena, Joven, Jorge, Seron, Daniel, Universitat Autònoma de Barcelona |
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| Přispěvatelé: | Institut Català de la Salut, [Espinel E, Azancot MA, Caraben A, Seron D] Servei de Nefrologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Gomez A] Servei de Medicina Física i Rehabilitació, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Beneria A] Servei de Psiquiatria, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Andurell L] Servei d’Endocrinologia i Nutrició, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Delgado P] Servei de Neurologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Castañé H, Joven J] Unitat de Recerca Biomèdica, Hospital Universitari de Sant Joan, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain, Vall d'Hebron Barcelona Hospital Campus |
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: |
Estils de vida
conducta y mecanismos de la conducta::psicología social::estilo de vida [PSIQUIATRÍA Y PSICOLOGÍA] General Medicine Therapeutics Cardiovascular Diseases::Vascular Diseases::Hypertension [DISEASES] Other subheadings::/therapy [Other subheadings] Pressió sanguínia Circulatory and Respiratory Physiological Phenomena::Cardiovascular Physiological Phenomena::Hemodynamics::Blood Pressure::Arterial Pressure [PHENOMENA AND PROCESSES] Weight management Hipertensió - Tractament Hypertension hypertension therapeutics weight management fenómenos fisiológicos respiratorios y circulatorios::fenómenos fisiológicos cardiovasculares::hemodinámica::presión sanguínea::presión arterial [FENÓMENOS Y PROCESOS] Behavior and Behavior Mechanisms::Psychology Social::Life Style [PSYCHIATRY AND PSYCHOLOGY] enfermedades cardiovasculares::enfermedades vasculares::hipertensión [ENFERMEDADES] Otros calificadores::/terapia [Otros calificadores] |
| Zdroj: | Scientia Journal of Clinical Medicine; Volume 12; Issue 2; Pages: 679 |
| Popis: | Hypertension; Therapeutics; Weight management Hipertensió; Terapèutica; Gestió del pes Hipertensión; Terapéutica; Control de peso Hypertension is a common chronic medical condition. Treatment is not satisfactory in a significant proportion of patients with primary hypertension, despite the concurrent use of three or more medications with different mechanisms of action. Such treatment-resistant hypertension is a clinical challenge associated with poor prognosis and needs further investigation. The efficacy of lifestyle changes has not been established yet in patients with resistant hypertension, and educational efforts appear clinically irrelevant in patients who must achieve behavioral changes without supervision. A 6-month multidisciplinary pilot intervention enrolled 50 patients with established resistant hypertension. The aims were: (1) to examine whether intensive and supervised lifestyle changes contribute to decreasing blood pressure in this condition, and (2) to identify which components affect compliance and feasibility. The program provided intensive changes in nutrition, physical exercise, and control of sleep disturbances supervised by nutritionists, physiotherapists, and psychologists. Nurses and pharmacists followed up on adherence to the antihypertensive medication. The primary outcome was 24 h blood pressure control. Data in patients with full compliance (n = 30) indicate that lifestyle modifications in resistant hypertension significantly reduced 24 h both systolic and diastolic blood pressure (p < 0.01), body mass index (p < 0.01), medication burden (p = 0.04), improving physical fitness, and cardiovascular risk markers such as heart rate (p = 0.01) and augmentation index (p = 0.02). The adherence to the intervention was moderate, with an attrition rate of 12%. A modified version reducing visits and explorations will likely improve compliance and can be used to assess the long-term maintenance of these benefits in managing resistant hypertension by diverse healthcare providers. The program against Resistant Hypertension was supported, in part, by the Hospital Vall d’Hebron, the Menarini Foundation, and the Instituto de Salud Carlos III grant (PI21/00510) co-funded by the Fondo Europeo de Desarrollo Regional. H.C. is a recipient of a fellowship of the Department of Health of Catalonia (Government of Catalonia) “Pla Estratègic de Recerca i Innovació en Salut” (PERIS-SLT017/3501/2020). |
| Databáze: | OpenAIRE |
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